Tag: pubmed

Prev Chronic Dis. 2024 Nov 21;21:E92. doi: 10.5888/pcd21.240136.

ABSTRACT

INTRODUCTION: We conducted a retrospective cohort study to evaluate changes in metabolic biomarkers among participants in Bridging the [Health Equity] Gap (BTG), a free program run by Clínica Esperanza/Hope Clinic (CEHC) for Spanish-speaking immigrants without health insurance in Rhode Island.

METHODS: From July 2019 through June 2021, 471 people volunteered to participate in the BTG program. Participants enrolled in lifestyle change classes and visited quarterly with health care providers. We reviewed medical records to collect data on blood glucose, total cholesterol, hemoglobin A_1c (HbA_1c), and systolic and diastolic blood pressure at baseline and at 6, 12, 18, and 21 months after enrollment. We used paired t tests to identify changes in measurements and conducted a regression analysis to analyze trends in longitudinal patient outcomes.

RESULTS: From baseline to 6-month follow-up, we observed significant decreases in all participants’ mean HbA_1c (-0.71%), systolic (-5 mm Hg), and diastolic blood pressure (-2 mm Hg). At 12 months, significant decreases in mean HbA_1c persisted among participants with diabetes and prediabetes (-1.07%). At 12 months, participants with mean systolic blood pressure >120 mm Hg also had significant decreases in mean systolic blood pressure (-9 mm Hg), and patients with diastolic blood pressure >80 mm Hg had significant decreases in mean diastolic blood pressure (-9 mm Hg). Local population-level surges in COVID-19 due to Delta and Omicron variants were associated with increases in HbA_1c and blood glucose measurements above trendlines.

CONCLUSION: The BTG program demonstrated resilience in supporting improvement in the metabolic biomarkers of participants, despite disruptions caused by the COVID-19 pandemic, the continued engagement of participants in self-care despite limited health care access, and underscores the positive role of free clinics among low-income, Spanish-speaking immigrants.

PMID:39571088 | DOI:10.5888/pcd21.240136

Ethn Health. 2024 Nov 21:1-24. doi: 10.1080/13557858.2024.2430296. Online ahead of print.

ABSTRACT

OBJECTIVES: The present study sheds novel light on the so-called ‘racial paradox in mental health,’ i.e., the phenomenon that Blacks, despite their relative socioeconomic disadvantages are mentally healthier than their more privileged White counterparts in the US. Evidence from prior research has been largely based on non-probability or regional surveys fielded during ‘ordinary’ times. In contrast, we analyze probability data on American adults collected during the extraordinary period of the COVID-19 pandemic across the country.

DESIGN: Data came from the Census Household Pulse Survey (CHPS). The CHPS sampled community-dwelling U.S. adults across 50 States and the District of Columbia using the Master Address File (MAF). Data collection began on April 23 2020 and was carried out on a biweekly basis. We used three phases of data covering 21 weeks in total (with the week ending on February 1, 2021). Mixed-effects (multilevel) modeling was employed to analyze the data.

RESULTS: Statistical results show that compared to their Black counterparts Whites fared worse mentally during the pandemic. We also found that the magnitude of the focal association is stronger with greater vulnerability operationalized at the individual level, i.e., in the context of lower income, job insecurity, and food shortage. Additionally, significant cross-level interactions emerged: the effect of race was more pronounced in geographic regions with higher coronavirus infection, greater ethnic heterogeneity, and higher structural disadvantage.

CONCLUSION: Our research supports existing studies that Blacks vis-à-vis Whites are psychologically more resilient. We add to the literature by shedding novel light on the mental health paradox during the extraordinary times brought about by the COVID-19-induced public health crisis. Ironically, there is a mental cost involved with the ‘White privilege’ in the US.

PMID:39571067 | DOI:10.1080/13557858.2024.2430296

Nurs Open. 2024 Nov;11(11):e70094. doi: 10.1002/nop2.70094.

ABSTRACT

OBJECTIVES: Academic self-efficacy (ASE), as well as self (SA) and peer assessment (PA), is associated with the subjective judgements of the individual. The correlation among these concepts merits further research. This study aims to examine the correlation between nursing students’ attitudes towards ASE and SA and PA.

DESIGN: This is a correlational cross-sectional study.

METHODS: The sample consisted of 1401 nursing students from five universities in Istanbul, Turkey. The study employed the proportional quota sampling method. The data were collected using a Personal Information Form, View Scale for Peer and Self-Assessment and ASE Scale. Descriptive statistics and multiple linear regression model (stepwise) tests were used to analyse the data.

RESULTS: Descriptive statistics revealed that 82.2% of the participants were female and their Academic Grade Point Average was 3.00 ± 0.48. As a result of the regression analysis, it was determined that students’ age, gender, perception of academic achievement, status of receiving PA training and attitudes towards doing PA and self-assessment significantly predicted their ASE score.

CONCLUSIONS: Students’ ASE was found to be medium-level, their attitudes towards peer and self-assessment were high and SA and PA attitudes was associated with ASE.

PATIENT OR PUBLIC CONTRIBUTION: A total of 1401 undergraduate nursing students from five undergraduate universities participated in the study and responded to questions on ASE, peer assessment, self assessment, etc.

PMID:39571065 | DOI:10.1002/nop2.70094

Nurs Open. 2024 Nov;11(11):e70101. doi: 10.1002/nop2.70101.

ABSTRACT

AIM: To investigate concurrent changes in short shift intervals (< 11 h) and workload among hospital employees.

DESIGN AND DATA SOURCES: This cohort study of 1904 employees in one hospital district in Finland utilised data on employees’ working hours for short shift intervals and workload based on the patient classifications aggregated to a 3-week period level across 2 years, 2018-2019. The data was analysed by group-based trajectory modelling and multinominal regression models.

RESULTS: The seven trajectories model had the best fit to the data-Group 1: very few short shift intervals that are decreasing and low workload (15.0%); Group 2: a low amount of short shift intervals that are decreasing and stable low workload (14.2%); Group 3: moderate amount of short shift intervals that are slightly increasing and low workload (25.1%); Group 4: a low amount of short shift intervals that are slightly decreasing and stable low workload that is slightly increasing (12.1%): Group 5: a moderate amount of both short shift intervals and workload (19.8%): Group 6: short shift intervals that are clearly decreasing, with higher than the average workload decreasing (5.6%); Group 7: moderate amount of short shift intervals and very high workload (8.3%).

CONCLUSIONS: Only a minority of hospital employees were found to have both high workloads and insufficient recovery possibilities, but the time-related increases in objective workload were not compensated by better recovery possibilities in working hours. For shift scheduling, it is noteworthy that older employees might seek to work at units in which the workload is lower, which could be considered to support workability.

REPORTING METHOD: Record.

PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution.

PMID:39571045 | DOI:10.1002/nop2.70101

Science. 2024 Nov 22;386(6724):853-856. doi: 10.1126/science.adr0787. Epub 2024 Nov 21.

ABSTRACT

Gender gaps in engineering and computer science narrow at math-selective schools and widen in others.

PMID:39571023 | DOI:10.1126/science.adr0787

PLoS Biol. 2024 Nov 21;22(11):e3002913. doi: 10.1371/journal.pbio.3002913. Online ahead of print.

ABSTRACT

How can we figure out how the different microbes interact within microbiomes? To combine theoretical models and experimental data, we often fit a deterministic model for the mean dynamics of a system to averaged data. However, in the averaging procedure a lot of information from the data is lost-and a deterministic model may be a poor representation of a stochastic reality. Here, we develop an inference method for microbiomes based on the idea that both the experiment and the model are stochastic. Starting from a stochastic model, we derive dynamical equations not only for the average, but also for higher statistical moments of the microbial abundances. We use these equations to infer distributions of the interaction parameters that best describe the biological experimental data-improving identifiability and precision. The inferred distributions allow us to make predictions but also to distinguish between fairly certain parameters and those for which the available experimental data does not give sufficient information. Compared to related approaches, we derive expressions that also work for the relative abundance of microbes, enabling us to use conventional metagenome data, and account for cases where not a single host, but only replicate hosts, can be tracked over time.

PMID:39571000 | DOI:10.1371/journal.pbio.3002913

PLoS Med. 2024 Nov 21;21(11):e1004435. doi: 10.1371/journal.pmed.1004435. eCollection 2024 Nov.

ABSTRACT

BACKGROUND: Findings from Kronos Early Estrogen Prevention Study (KEEPS)-Cog trial suggested no cognitive benefit or harm after 48 months of menopausal hormone therapy (mHT) initiated within 3 years of final menstrual period. To clarify the long-term effects of mHT initiated in early postmenopause, the observational KEEPS Continuation Study reevaluated cognition, mood, and neuroimaging effects in participants enrolled in the KEEPS-Cog and its parent study the KEEPS approximately 10 years after trial completion. We hypothesized that women randomized to transdermal estradiol (tE2) during early postmenopause would show cognitive benefits, while oral conjugated equine estrogens (oCEE) would show no effect, compared to placebo over the 10 years following randomization in the KEEPS trial.

METHODS AND FINDINGS: The KEEPS-Cog (2005-2008) was an ancillary study to the KEEPS (NCT00154180), in which participants were randomized into 3 groups: oCEE (Premarin, 0.45 mg/d), tE2 (Climara, 50 μg/d) both with micronized progesterone (Prometrium, 200 mg/d for 12 d/mo) or placebo pills and patch for 48 months. KEEPS Continuation (2017-2022), an observational, longitudinal cohort study of KEEPS clinical trial, involved recontacting KEEPS participants approximately 10 years after the completion of the 4-year clinical trial to attend in-person research visits. Seven of the original 9 sites participated in the KEEPS Continuation, resulting in 622 women of original 727 being invited to return for a visit, with 299 enrolling across the 7 sites. KEEPS Continuation participants repeated the original KEEPS-Cog test battery which was analyzed using 4 cognitive factor scores and a global cognitive score. Cognitive data from both KEEPS and KEEPS Continuation were available for 275 participants. Latent growth models (LGMs) assessed whether baseline cognition and cognitive changes during KEEPS predicted cognitive performance at follow-up, and whether mHT randomization modified these relationships, adjusting for covariates. Similar health characteristics were observed at KEEPS randomization for KEEPS Continuation participants and nonparticipants (i.e., women not returning for the KEEPS Continuation). The LGM revealed significant associations between intercepts and slopes for cognitive performance across almost all domains, indicating that cognitive factor scores changed over time. Tests assessing the effects of mHT allocation on cognitive slopes during the KEEPS and across all years of follow-up including the KEEPS Continuation visit were all statistically nonsignificant. The KEEPS Continuation study found no long-term cognitive effects of mHT, with baseline cognition and changes during KEEPS being the strongest predictors of later performance. Cross-sectional comparisons confirmed that participants assigned to mHT in KEEPS (oCEE and tE2 groups) performed similarly on cognitive measures to those randomized to placebo, approximately 10 years after completion of the randomized treatments. These findings suggest that mHT poses no long-term cognitive harm; conversely, it provides no cognitive benefit or protective effects against cognitive decline.

CONCLUSIONS: In these KEEPS Continuation analyses, there were no long-term cognitive effects of short-term exposure to mHT started in early menopause versus placebo. These data provide reassurance about the long-term neurocognitive safety of mHT for symptom management in healthy, recently postmenopausal women, while also suggesting that mHT does not improve or preserve cognitive function in this population.

PMID:39570992 | DOI:10.1371/journal.pmed.1004435

Libyan J Med. 2024 Dec 31;19(1):2421625. doi: 10.1080/19932820.2024.2421625. Epub 2024 Nov 21.

ABSTRACT

Electronic Health Records (EHR) have been adopted to improve the quality of care. Despite the growing use of health information technology, nursing documentation remains a challenge. In Tunisia, the implementation of the Electronic Medical Record (EMR) system is gaining momentum as part of national initiatives to modernize healthcare. However, nursing documentation is still largely paper-based, and no studies in Tunisia have adressed this topic. This research aims to assess the effect of the Electronic Nursing Record (ENR) on the quality and safety of care indicators (QSCI). This is an interventional study structured in four phases: development, pre-implementation, implementation, and evaluation, integrating the principles of the ‘Standards for Reporting Implementation Studies’ (StaRI). A list of QSCI was defined and validated through a literature review and Delphi consensus. The impact of the ENR on these indicators was evaluated in a Tunisian university hospital through a quasi-experimental study. Indicators were measured before ENR, one month after, and six months after. Data analyses was conducted using SPSS with statistical tests. Initially, the study led to the identification and validation of seventeen QSCI. Subsequently, a quasi-experimental study was conducted to evaluate the impact of ENR implementation on these indicators. The results revealed a significant improvement in the intervention group (using ENR), particularly in the traceability of vital signs (p < 10⁻³) and infusion administration (p = 0.027). Conversely, the control group (using paper-based documentation) performed better in terms of traceability of inter-team handovers (95.1% compared to 71.9% for the intervention group). The electronic documentation system is seen as a major transformation in healthcare in many hospitals worldwide. Moreover, electronic nursing documentation is crucial for patient safety. Its implementation in our hospital revealed a positive impact of the ENR on certain aspects of care quality while highlighting gaps in inter-team handovers.

PMID:39570988 | DOI:10.1080/19932820.2024.2421625

PLoS One. 2024 Nov 21;19(11):e0311113. doi: 10.1371/journal.pone.0311113. eCollection 2024.

ABSTRACT

OBJECTIVES: This study examined differences in young adults’ mood states during immersive virtual reality (VR), non-immersive VR, and traditional exercise biking sessions.

DESIGN: Repeated-measure study design.

METHODS: Forty-nine college students (34 females; Mage = 23.6 years) completed three separate 20-minute exercise biking sessions: (1) immersive VR biking using the PlayStation 4 + VirZoom VR bike; (2) non-immersive VR biking using the Gamercize bike + Xbox 360; and (3) traditional stationary biking using the Spirit Fitness XBU55. Participants’ mood states (anger, confusion, depression, fatigue, tension, and vigor) were assessed by using the Brunel Mood Scale after each session.

RESULTS: Statistically significant differences were observed between biking sessions for all components of mood [F (2, 96) = 3.84-278.56, p < 0.05, η2 = 0.07-0.85], except for tension (p > 0.05). Results indicated non-immersive VR biking yielded significantly higher anger compared to immersive VR biking; non-immersive VR biking yielded significantly higher confusion compared to immersive VR biking and traditional biking, respectively; immersive VR biking yielded significantly lower depression compared to traditional biking; both immersive VR biking and non-immersive VR biking yielded significantly lower fatigue compared to traditional biking; and immersive VR biking yielded significantly higher vigor compared to non-immersive VR biking) and traditional biking, respectively.

CONCLUSION: Findings suggested the immersive VR-based biking exercise may facilitate in reducing the negative feelings, such as anger, fatigue, depression, and improving positive feeling, such as vigor, among college students. The immersive VR-based exercise appeared to be a feasible approach for motivating college students participating in physical activity and improving overall mood states.

PMID:39570986 | DOI:10.1371/journal.pone.0311113

PLoS Negl Trop Dis. 2024 Nov 21;18(11):e0012675. doi: 10.1371/journal.pntd.0012675. Online ahead of print.

ABSTRACT

BACKGROUND: Leishmaniasis has emerged as an escalating public health problem in Sri Lanka, with reported cases increasing nearly three folds over past decade, from 1,367 in 2014 to 3714 cases in 2023. Phlebotominae sand flies are the vectors of leishmaniasis. Their density is known to be influenced by context-specific climatic and land use patterns. Thus, we aimed to investigate how these factors drive sand fly density across Sri Lanka.

METHODOLOGY/PRINCIPAL FINDINGS: We analysed monthly collections of sand flies (n = 38,594) and weather data from ten sentinel sites representing three main geo-climatic zones across Sri Lanka, over 24 months. Site-specific land use data was also recorded. The influence of climate and land use patterns on sand fly density across the sentinel sites were estimated using distributed lag non-linear models and machine learning. We found that climate played a major role on sand fly density compared to land use structure. Increase in rainfall and relative humidity at real time, and ambient temperature and soil temperature with a 2-month lag were associated with a statistically significant increase in sand fly density. The maximum relative risk (RR) observed was 3.76 (95% CI: 1.58-8.96) for rainfall at 120 mm/month, 2.14 (95% CI: 1.04-4.38) for relative humidity at 82% (both at real time). The maximum RR was 2.81 (95% CI: 1.09-7.35) for ambient temperature at 34.5°C, and 11.6 (95% CI, 4.38-30.76) for soil temperature (both at a 2-month lag). The real-time increase in ambient temperature, sunshine hours, and evaporation rate, however, reduced sand fly density homogeneously in all study settings. The high density of chena and coconut plantations, together with low density of dense forests, homesteads, and low human footprint values, positively influenced sand fly density.

CONCLUSIONS/SIGNIFICANCE: The findings improve our understanding of the dynamic influence of environment on sand fly densities and spread of leishmaniasis. This knowledge lays a foundation for forecasting of sand fly densities and designing targeted interventions for mitigating the growing burden of leishmaniasis among the most vulnerable populations, particularly in an era of changing climate.

PMID:39570981 | DOI:10.1371/journal.pntd.0012675