Tag: nevin manimala

Am Nat. 2022 Jul;200(1):168-180. doi: 10.1086/720152. Epub 2022 Jun 2.

ABSTRACT

AbstractThis essay explores shifting scientific understandings of fish and the evolution of fisheries science, and it grapples with colonialism as a system of power. We trace the rise of fisheries science to a time when Western nation-states were industrializing fishing fleets and competing for access to distant fishing grounds. A theory of fishing called “maximum sustainable yield” (MSY) that understands fish species in aggregate was espoused. Although alternatives to MSY have been developed, decision-making continues to be informed by statistical models developed within fisheries science. A challenge for structured management systems now rests in attending to different systems of knowledge and addressing local objectives, values, and circumstances. To deepen and illustrate key points, we examine Pacific herring (Clupea pallasii) and the expansion of commercial herring fisheries and state-led management in British Columbia, Canada. A feedback between colonialism and fisheries science is evident: colonialism generated the initial conditions for expansion and has been reinforced through the implementation of approaches and tools from fisheries science that define and quantify conservation in particular ways. Some features may be unique to the herring illustration, but important aspects of the feedback are more broadly generalizable. We propose three interconnected goals: (a) transform the siloed institutions and practices of Western science, (b) reimagine and rebuild pathways between information (including diverse values and perspectives) and decision-making, and (c) devolve governance authority and broaden governance processes such that multiple ways of knowing share equal footing.

PMID:35737985 | DOI:10.1086/720152

Eur J Cardiovasc Nurs. 2022 Jun 23:zvac051. doi: 10.1093/eurjcn/zvac051. Online ahead of print.

ABSTRACT

AIMS: The symptom burden of patients with chronic heart failure (CHF), together with social determinants and psychosocial factors, results in limitations to maintain adequate social life and roles, participate in social events and maintain relationships. This situation’s impact on health outcomes makes it of utmost importance to develop meaningful social networks for these patients. The primary objective aimed to identify randomized controlled trials that impact the social dimension of people with CHF. The secondary objectives were to analyze the methodological quality of these interventions, establish their components, and synthesize their results.

METHODS AND RESULTS: A systematic review following PRISMA guidelines was conducted in Pubmed, Scopus, Cochrane CENTRAL, PsychINFO, and CINAHL databases between 2010 and February 2022. The Revised Cochrane risk-of-bias tool for randomized trials was used. The protocol was registered in PROSPERO. Eight randomized controlled trials were identified, among which two were at ‘high risk of bias.’ Interventions were synthesized according to the following categories: delivery format, providers and recipients, and the intervention content domains. Half of the studies showed statistical superiority in improving the intervention group’s social support in people with CHF.

CONCLUSION: This review has highlighted the scarcity of interventions targeting the social dimension of people with CHF. Interventions have been heterogeneous, which limits the statistical combination of studies. Based on narrative review and vote counting, such interventions could potentially improve social support and self-care, which are important patient reported outcomes, thus warrant further research. Future studies should be co-created with patients and families to be adequately targeted.

REGISTRATION: PROSPERO CRD42021256199.

PMID:35737922 | DOI:10.1093/eurjcn/zvac051

JCO Precis Oncol. 2022 Jun;6:e2100427. doi: 10.1200/PO.21.00427.

ABSTRACT

PURPOSE: Comprehensive tumor biomarker testing is a fundamental step in the selection of highly effective molecularly driven therapies for a variety of solid tumors. The primary objective of this study was to examine racial differences in biomarker testing and clinical trial participation in the United States using a real-world database.

METHODS: Patients in a real-world deidentified database diagnosed with advanced/metastatic non-small-cell lung cancer (NSCLC), metastatic colorectal cancer (CRC), or metastatic breast cancer were eligible. Biomarker testing and clinical trial participation was compared between Black and White racial groups using chi-squared test and stepwise logistic regression controlling for baseline covariates.

RESULTS: A total of 23,488 patients met eligibility criteria. Next-generation sequencing (NGS) testing rates differed significantly between White versus Black race before first-line therapy (36.6% v 29.7%, P < .0001) and at any given time (54.7% v 43.8%, P < .0001) in the nonsquamous NSCLC cohort. Similar disparities in NGS testing rates at any time during the study were observed among patients with CRC (White 51.6%; Black 41.8%, P < .0001). No differences were observed in the breast cancer cohort. Patients of Black race were less likely to be treated in a clinical trial in the overall NSCLC cohort when compared with White counterparts (3.9% v 2.1%, P = .0002). A statistically significant relationship between biomarker/NGS testing and clinical trial enrollment was observed in all cohorts (P < .003) after adjusting for covariates.

CONCLUSION: In a real-world database, significant disparities in NGS-based testing rates were observed between Black and White races in NSCLC and CRC. NGS and any biomarker testing were both associated with trial enrollment in all cohorts. There is a need for interventions to promote access to comprehensive testing for patients with advanced/metastatic tumors.

PMID:35737912 | DOI:10.1200/PO.21.00427

JMIR Form Res. 2022 Jun 8. doi: 10.2196/36206. Online ahead of print.

ABSTRACT

BACKGROUND: The COVID-19 pandemic has wreaked havoc on healthcare systems and governments worldwide. Although eHealth literacy is acknowledged as a critical component of public health, it was overlooked during the pandemic. To assist patients and their families, health professionals should be knowledgeable about online health information resources and capable of evaluating relevant online information. In a resource-constrained situation, the level of eHealth literacy among health professionals is not well documented.

OBJECTIVE: This study aimed to assess eHealth literacy level and its associated factors among health professionals working in Amhara regional state teaching hospitals, Ethiopia.

METHODS: A self-administered questionnaire was used in an institutional-based cross-sectional study design. Descriptive statistics were done to describe eHealth literacy statements and key variables using SPSS v.24. Bi-variable and multivariate logistic regression was fitted to identify factors related to eHealth literacy. Variables having a p-value < 0.05 were declared statistically significant predictors.

RESULTS: A total of 383 study participants completed and returned the questionnaire with a response rate of 90.5%. Health professionals have a moderate level of eHealth literacy (mean =29.21). Most of them were aware of the available health resources located on the Internet, and know how to search, and locate these resources. However, they lack to distinguish high-quality health resources from low-quality resources. Factors that are associated with eHealth literacy were computer access, computer knowledge, perceived ease of use, and perceived usefulness of electronic health information resources.

CONCLUSIONS: It is crucial to provide training and support to healthcare workers on how to find, interpret, and, most importantly, evaluate the quality of health information found on the Internet in order to improve their eHealth literacy level. Further study is needed to explore the role of eHealth literacy in mitigating pandemics in developing countries.

PMID:35737897 | DOI:10.2196/36206

Environ Sci Technol. 2022 Jun 23. doi: 10.1021/acs.est.2c01912. Online ahead of print.

ABSTRACT

We assessed mortality risks associated with source-specific fine particles (PM_2.5) in a pooled European cohort of 323,782 participants. Cox proportional hazard models were applied to estimate mortality hazard ratios (HRs) for source-specific PM_2.5 identified through a source apportionment analysis. Exposure to 2010 annual average concentrations of source-specific PM_2.5 components was assessed at baseline residential addresses. The source apportionment resulted in the identification of five sources: traffic, residual oil combustion, soil, biomass and agriculture, and industry. In single-source analysis, all identified sources were significantly positively associated with increased natural mortality risks. In multisource analysis, associations with all sources attenuated but remained statistically significant with traffic, oil, and biomass and agriculture. The highest association per interquartile increase was observed for the traffic component (HR: 1.06; 95% CI: 1.04 and 1.08 per 2.86 μg/m³ increase) across five identified sources. On a 1 μg/m³ basis, the residual oil-related PM_2.5 had the strongest association (HR: 1.13; 95% CI: 1.05 and 1.22), which was substantially higher than that for generic PM_2.5 mass, suggesting that past estimates using the generic PM_2.5 exposure response function have underestimated the potential clean air health benefits of reducing fossil-fuel combustion. Source-specific associations with cause-specific mortality were in general consistent with findings of natural mortality.

PMID:35737879 | DOI:10.1021/acs.est.2c01912

J Manag Care Spec Pharm. 2022 Jul;28(7):721-731. doi: 10.18553/jmcp.2022.28.7.721.

ABSTRACT

BACKGROUND: Cystic fibrosis (CF) is a rare, life-threatening disease that results in severe respiratory, digestive, and metabolic problems. Elexacaftor/tezacaftor/ivacaftor is an oral drug that was approved by the US Food and Drug Administration (FDA) on October 21, 2019, after demonstrating clinical improvements compared with previous CF transmembrane conductance regulator modulators. Use of CF transmembrane conductance regulator modulators has improved CF care, but their high costs exceed commonly used cost-effectiveness thresholds. The Institute for Clinical and Economic Review issued an access and affordability alert warning that these high costs could threaten sustainable access to high-value care. There exists little real-world evidence on the uptake of elexacaftor/tezacaftor/ivacaftor and the impact on total cost of care and other health care resource utilization. This exploratory study analyzed the uptake and total cost-of-care impact of elexacaftor/tezacaftor/ivacaftor using pharmacy and medical claims data in a commercially insured patient population. OBJECTIVE: To analyze the uptake of elexacaftor/tezacaftor/ivacaftor by members who qualified for treatment and to evaluate the differences in total cost of care and health care resource utilization in members who started treatment with elexacaftor/tezacaftor/ivacaftor. METHODS: Uptake and per-member per-month information was obtained from Prime Therapeutics databases using cystic fibrosis transmembrane conductance regulator (CFTR) modulator claims. The total cost-of-care and resource utilization analysis used pharmacy and medical claims from Prime Therapeutics and Blue Cross NC across approximately 1.34 million commercially insured members over 20 months. Members with CF were identified by 2 or more International Classification of Diseases, Tenth Revision codes (E84.xx) in any field at least 30 days apart or by a CFTR modulator claim. Only continuously enrolled members with CF with an elexacaftor/tezacaftor/ivacaftor pharmacy claim were included. The date of the first claim served as the index date. RESULTS: At 12 months after FDA approval, 77 (68%) Blue Cross NC members with CF were using elexacaftor/tezacaftor/ivacaftor. Of these, 33 had switched from a different CFTR modulator and 44 were naive to CFTR modulator therapy. Pharmacy and medical claims for 51 continuously enrolled members that initiated elexacaftor/tezacaftor/ivacaftor were analyzed. The average total cost of care increased by 52% (P < 0.00001). Hospitalizations decreased from an average of 7.7 (± 7.2) to 3.9 (± 5.5) (P < 0.00001). The sum and average number of Pseudomonas aeruginosa infections were numerically lower, but the results did not meet statistical significance. Use of other supportive medications was numerically lower, but no statistically significant differences were observed. CONCLUSIONS: The uptake of elexacaftor/tezacaftor/ivacaftor was rapid, and the total cost of care increased despite reductions in hospitalizations and nonpharmacy costs. Differences in use of other CF-related medications appeared to be minimally affected. DISCLOSURES: Dr Smith and Dr Borchardt have no financial conflicts of interest to report. Both authors are employed at BCBSNC at the time of writing. The project had no outside funding or sponsorship. The majority of the work and data analysis was completed as part of the requirements of the PGY1 Managed Care Pharmacy Residency program at BCBSNC during the 2020-2021 cycle year. This research does not meet the definition of human subject research as defined by the US Department of Health and Human Services at 45 C.F.R. § 46.102(f). According to definitions in section (e)(1), our research did not require either (i) information or biospecimens through intervention or interaction with any individuals or (ii) obtained, used, studied, analyzed, or generated private information or identifiable biospecimens. Therefore, institutional review board approval or a valid exemption is not required.

PMID:35737861 | DOI:10.18553/jmcp.2022.28.7.721

J Psychiatr Ment Health Nurs. 2022 Jun 23. doi: 10.1111/jpm.12853. Online ahead of print.

ABSTRACT

INTRODUCTION: The shift in mind-set within mental health care has led to the adoption of peer-delivered self-management interventions in promoting recovery among individuals with severe and enduring mental health challenges. However, no reviews have hitherto examined their effectiveness.

AIM: To determine the effectiveness of peer-delivered self-management interventions in improving symptom severity, self-perceived recovery, hopefulness, and empowerment.

METHOD: A search was performed in nine English databases for published studies and grey literature from inception to the 5 January 2021. The methodological quality of the studies was graded with the Joanna Briggs Institute’s critical appraisal tools. The overall effects were pooled through a meta-analysis with heterogeneity evaluated via the Chi-square test and I-square statistics. This review was guided by the PRISMA 2020 statement on transparent reporting of systematic review and meta-analyses.

RESULTS: 17 publications involving 3189 participants were included in this review, ten were included for the meta-analysis and accounted for 2725 participants. The meta-analysis demonstrated significant small to medium effects favoring such interventions on symptom severity, self-perceived recovery, hopefulness, and empowerment.

DISCUSSION: Peer-delivered self-management interventions should be implemented as it is effective in promoting recovery among individuals with severe and enduring mental health challenges.

PMID:35737863 | DOI:10.1111/jpm.12853

Proc Natl Acad Sci U S A. 2022 Jun 28;119(26):e2118283119. doi: 10.1073/pnas.2118283119. Epub 2022 Jun 23.

ABSTRACT

Over half the world’s population is at risk for viruses transmitted by Aedes mosquitoes, such as dengue and Zika. The primary vector, Aedes aegypti, thrives in urban environments. Despite decades of effort, cases and geographic range of Aedes-borne viruses (ABVs) continue to expand. Rigorously proven vector control interventions that measure protective efficacy against ABV diseases are limited to Wolbachia in a single trial in Indonesia and do not include any chemical intervention. Spatial repellents, a new option for efficient deployment, are designed to decrease human exposure to ABVs by releasing active ingredients into the air that disrupt mosquito-human contact. A parallel, cluster-randomized controlled trial was conducted in Iquitos, Peru, to quantify the impact of a transfluthrin-based spatial repellent on human ABV infection. From 2,907 households across 26 clusters (13 per arm), 1,578 participants were assessed for seroconversion (primary endpoint) by survival analysis. Incidence of acute disease was calculated among 16,683 participants (secondary endpoint). Adult mosquito collections were conducted to compare Ae. aegypti abundance, blood-fed rate, and parity status through mixed-effect difference-in-difference analyses. The spatial repellent significantly reduced ABV infection by 34.1% (one-sided 95% CI lower limit, 6.9%; one-sided P value = 0.0236, z = 1.98). Aedes aegypti abundance and blood-fed rates were significantly reduced by 28.6 (95% CI 24.1%, ∞); z = -9.11) and 12.4% (95% CI 4.2%, ∞); z = -2.43), respectively. Our trial provides conclusive statistical evidence from an appropriately powered, preplanned cluster-randomized controlled clinical trial of the impact of a chemical intervention, in this case a spatial repellent, to reduce the risk of ABV transmission compared to a placebo.

PMID:35737833 | DOI:10.1073/pnas.2118283119

Science. 2022 Jun 24;376(6600):1491-1495. doi: 10.1126/science.abk3126. Epub 2022 Jun 23.

ABSTRACT

Changes in woody biomass over centuries to millennia are poorly known, leaving unclear the magnitude of terrestrial carbon fluxes before industrial-era disturbance. Here, we statistically reconstructed changes in woody biomass across the upper Midwestern region of the United States over the past 10,000 years using a Bayesian model calibrated to preindustrial forest biomass estimates and fossil pollen records. After an initial postglacial decline, woody biomass nearly doubled during the past 8000 years, sequestering 1800 teragrams. This steady accumulation of carbon was driven by two separate ecological responses to regionally changing climate: the spread of forested biomes and the population expansion of high-biomass tree species within forests. What took millennia to accumulate took less than two centuries to remove: Industrial-era logging and agriculture have erased this carbon accumulation.

PMID:35737803 | DOI:10.1126/science.abk3126

PLoS One. 2022 Jun 23;17(6):e0270122. doi: 10.1371/journal.pone.0270122. eCollection 2022.

ABSTRACT

No published studies have evaluated the accuracy of volumetric measurement of solid nodules and ground-glass nodules on low-dose or ultra-low-dose chest computed tomography, reconstructed using deep learning-based algorithms. This is an important issue in lung cancer screening. Our study aimed to investigate the accuracy of semiautomatic volume measurement of solid nodules and ground-glass nodules, using two deep learning-based image reconstruction algorithms (Truefidelity and ClariCT.AI), compared with iterative reconstruction (ASiR-V) in low-dose and ultra-low-dose settings. We performed computed tomography scans of solid nodules and ground-glass nodules of different diameters placed in a phantom at four radiation doses (120 kVp/220 mA, 120 kVp/90 mA, 120 kVp/40 mA, and 80 kVp/40 mA). Each scan was reconstructed using Truefidelity, ClariCT.AI, and ASiR-V. The solid nodule and ground-glass nodule volumes were measured semiautomatically. The gold-standard volumes could be calculated using the diameter since all nodule phantoms are perfectly spherical. Subsequently, absolute percentage measurement errors of the measured volumes were calculated. Image noise was also calculated. Across all nodules at all dose settings, the absolute percentage measurement errors of Truefidelity and ClariCT.AI were less than 11%; they were significantly lower with Truefidelity or ClariCT.AI than with ASiR-V (all P<0.05). The absolute percentage measurement errors for the smallest solid nodule (3 mm) reconstructed by Truefidelity or ClariCT.AI at all dose settings were significantly lower than those of this nodule reconstructed by ASiR-V (all P<0.05). Furthermore, the lowest absolute percentage measurement errors for ground-glass nodules were observed with Truefidelity or ClariCT.AI at all dose settings. The absolute percentage measurement errors for ground-glass nodules reconstructed with Truefidelity at ultra-low-dose settings were significantly lower than those of all sizes of ground-glass nodules reconstructed with ASiR-V (all P<0.05). Image noise was lowest with Truefidelity (all P<0.05). In conclusion, the deep learning-based algorithms were more accurate for volume measurements of both solid nodules and ground-glass nodules than ASiR-V at both low-dose and ultra-low-dose settings.

PMID:35737734 | DOI:10.1371/journal.pone.0270122