Tag: pubmed

Ther Apher Dial. 2024 Jun 3. doi: 10.1111/1744-9987.14164. Online ahead of print.

ABSTRACT

INTRODUCTION: The aim of this study was to determine the level of frailty in older hemodialysis patients and to examine the relationship between their functional capacity, depression, and laboratory variables.

METHOD: This was a cross-sectional study, and the data were collected 243 dialysis patients aged 65 and over between May 2021 and May 2022.

RESULTS: The frailty rate was 49%. A statistically significant positive correlation was found between the frailty and age, hemodialysis vintage, and the number of hospitalizations. The frailty was negatively correlated with body mass index, Kt/V, Albumin, and parathyroid hormone. There was a statistically significant positive correlation between frailty and depression and a negative correlation between functional capacity.

CONCLUSION: A relationship was found between frailty and depression, functional capacity, and laboratory variables. In addition, the variables affecting the level of frailty in geriatric dialysis patients included dialysis vintage, dialysis adequacy, number of hospitalizations, albumin level, and patient weight.

PMID:38828537 | DOI:10.1111/1744-9987.14164

Reprod Domest Anim. 2024 Jun;59(6):e14621. doi: 10.1111/rda.14621.

ABSTRACT

Estimating the parturition date in dogs is challenging due to their reproductive peculiarities that. Ultrasonographic examination serves as a tool for studying embryo/foetal biometry and estimating the time of parturition by measuring foetal and extra-foetal structures. However, due to reproductive differences among various dog breeds, such estimates may have a non-significant pattern, representing inaccuracies in the estimated date of birth. This study aimed to monitor pregnant Toy Poodle bitches and establish relationships between ultrasonographically measured foetal and extra-foetal dimensions and the remaining time until parturition. Eighteen pregnant Toy Poodle bitches were subjected to weekly ultrasonographic evaluations and measurements of the inner chorionic cavity diameter, craniocaudal length (CCL), biparietal diameter (BPD), diameter of the deep portion of diencephalo-telencephalic vesicle (DPTV), abdominal diameter, thorax diameter (TXD), placental thickness and the renal diameter (REND). These parameters were retrospectively correlated with the date of parturition and linear regressions were established between gestational measurements and days before parturition (DBP). All analyses were conducted using the Statistical Package for Social Sciences (IBM® SPSS®) program at a 5% significance level. The foetal measurements that showed a high correlation (r) and reliability (R²) with DBP were BPD [(DBP = [15.538 × BPD] – 39.756), r = .97 and R² = .93], TXD [(DBP = [8.933 × TXD] – 32.487), r = .94 and R² = .89], DPTV [(DBP = [34.580 × DPTV] – 39.403), r = .93 and R² = .86] and REND [(DBP = [13.735 × REND] – 28.937), r = .91 and R² = .82]. This statistically validates the application of these specific formulas to estimate the parturition date in Toy Poodle bitches.

PMID:38828534 | DOI:10.1111/rda.14621

Soc Sci Med. 2024 Jun;351 Suppl 1:116863. doi: 10.1016/j.socscimed.2024.116863. Epub 2024 May 31.

ABSTRACT

United States’ federal policy and infrastructure fail to explicitly consider the health of men, particularly the poor health of marginalized men. This inattention to men’s health hinders the nation’s ability to improve population health, to achieve gender health equity, and to achieve health equity more broadly. Expanding efforts to consider gender in federal policy and infrastructure to include men, naming men as a population whose poor health warrants policy attention, creating offices of men’s health in federal agencies, and utilizing an intersectional lens to develop and analyze policies that affect health would likely yield critical improvements in population health and health equity in the United States. Using data from the Centers for Disease Control and Prevention, I illustrate the persistence of sex differences in mortality and leading causes of death, and how these patterns mask gender gaps in health that are driven largely by marginalized men. Given the common practice of presenting data by sex and race separately, it is difficult to recognize when the health of specific groups of men warrants attention. I utilize the case of Black men to illustrate the importance of an intersectional approach, and why men’s health is critical to achieving gender and racial equity in health. While a gender mainstreaming approach has enhanced the nation’s ability to consider and address the health of women and girls, it has not expanded to be inclusive of boys and men. Consequently, I argue that if our goal is to achieve health equity, it is critical to employ an intersectional approach that simultaneously considers the full range of factors that influence individual and population health and well-being. An intersectional approach would facilitate efforts to simultaneously explore strategies to achieve racial, ethnic, and gender health equity, which are driven by structural determinants beyond sex and gender related factors.

PMID:38825381 | DOI:10.1016/j.socscimed.2024.116863

Soc Sci Med. 2024 Jun;351 Suppl 1:116804. doi: 10.1016/j.socscimed.2024.116804. Epub 2024 May 31.

ABSTRACT

Accumulating evidence links structural sexism to gendered health inequities, yet methodological challenges have precluded comprehensive examinations into life-course and/or intersectional effects. To help address this gap, we introduce an analytic framework that uses sequential conditional mean models (SCMMs) to jointly account for longitudinal exposure trajectories and moderation by multiple dimensions of social identity/position, which we then apply to study how early life-course exposure to U.S. state-level structural sexism shapes mental health outcomes within and between gender groups. Data came from the Growing Up Today Study, a cohort of 16,875 children aged 9-14 years in 1996 who we followed through 2016. Using a composite index of relevant public policies and societal conditions (e.g., abortion bans, wage gaps), we assigned each U.S. state a year-specific structural sexism score and calculated participants’ cumulative exposure by averaging the scores associated with states they had lived in during the study period, weighted according to duration of time spent in each. We then fit a series of SCMMs to estimate overall and group-specific associations between cumulative exposure from baseline through a given study wave and subsequent depressive symptomology; we also fit models using simplified (i.e., non-cumulative) exposure variables for comparison purposes. Analyses revealed that cumulative exposure to structural sexism: (1) was associated with significantly increased odds of experiencing depressive symptoms by the subsequent wave; (2) disproportionately impacted multiply marginalized groups (e.g., sexual minority girls/women); and (3) was more strongly associated with depressive symptomology compared to static or point-in-time exposure operationalizations (e.g., exposure in a single year). Substantively, these findings suggest that long-term exposure to structural sexism may contribute to the inequitable social patterning of mental distress among young people living in the U.S. More broadly, the proposed analytic framework represents a promising approach to examining the complex links between structural sexism and health across the life course and for diverse social groups.

PMID:38825380 | DOI:10.1016/j.socscimed.2024.116804

Soc Sci Med. 2024 Jun;351 Suppl 1:116556. doi: 10.1016/j.socscimed.2023.116556. Epub 2024 May 31.

ABSTRACT

Historically, the physician professional identity and the organizational structure of Western medicine have been defined by masculine norms such as authority and assertiveness. The past five decades have seen a rapid shift in the demographics of attendees as medical schools, with equal numbers of women and men matriculants for nearly twenty years. Gender as a social, cultural, and structural variable continues to influence the physician workforce. The entry of women into medicine, has had far reaching effects on the expectations of patients, the interactions of physicians with other members of the healthcare team, and the delivery of care. Redefining the culture of medicine to accommodate the diversity of the modern workforce may benefit all physician and improve the delivery of healthcare.

PMID:38825379 | DOI:10.1016/j.socscimed.2023.116556

Soc Sci Med. 2024 Jun;351 Suppl 1:116455. doi: 10.1016/j.socscimed.2023.116455. Epub 2024 May 31.

ABSTRACT

RATIONALE: Marianismo beliefs, or traditional female gender role beliefs among Latinas, have been found to serve as risk or protective factors linked with health risk behaviors in prior studies, including alcohol and drug misuse. However, limited research has examined potential factors that may contribute to or explain these associations. Sexist discrimination, which can serve as a significant stressor that may contribute to substance misuse, is one potential factor that may link marianismo beliefs and substance misuse among Latina young adult women.

OBJECTIVE: This study examined sexism as a potential mediator of hypothesized negative associations between five marianismo beliefs (Family Pillar, Virtuous and Chaste, Subordinate to Others, Silencing Self to Maintain Harmony, and Spiritual Pillar) and alcohol and drug misuse using structural equation modeling.

METHOD: Participants included 611 cisgender Latina full-time college student young adult women in the U.S. ages 18-26 who participated in an online cross-sectional survey about their health and behaviors.

RESULTS: Results delineated experiences of sexism as a significant risk factor for alcohol and drug misuse and as a potential explanatory factor that may partly explain associations between certain marianismo beliefs (i.e., Virtuous and Chaste beliefs) and substance misuse. Specifically, experiences of sexism partially accounted for the negative association between endorsement of the Virtuous and Chaste belief and increased alcohol and drug misuse among Latina young adults.

CONCLUSIONS: Prevention and intervention efforts should take a culturally responsive, gender-informed approach to address substance misuse among Latina young adults and address the negative influence of sexism on health.

PMID:38825377 | DOI:10.1016/j.socscimed.2023.116455

Soc Sci Med. 2024 Jun;351 Suppl 1:116434. doi: 10.1016/j.socscimed.2023.116434. Epub 2024 May 31.

ABSTRACT

The United States has some of the poorest maternal health outcomes of any developed nation. Existing research on maternal cardiovascular morbidities has focused predominantly on individual- and clinic-level drivers, but we know little about community- and structural-level factors that shape these outcomes. We use a composite measure of “structural heteropatriarchy” which includes measures of structural sexism and structural LGB-stigma to examine the relationship between structural heteropatriarchy and three cardiovascular-related maternal morbidities using the National Longitudinal Study of Adolescent to Adult Health (n = 3928). Results using multivariate regressions show that structural heteropatriarchy is associated with increased risk of reporting maternal morbidities. Our findings provide further evidence that sexuality- and gender-based stigma operate together to shape health disparities, including maternal health.

PMID:38825374 | DOI:10.1016/j.socscimed.2023.116434

Soc Sci Med. 2024 Jun;351 Suppl 1:116396. doi: 10.1016/j.socscimed.2023.116396. Epub 2024 May 31.

ABSTRACT

RATIONALE: Immigrants represent a rapidly growing proportion of the population, yet the many ways in which structural inequities, including racism, xenophobia, and sexism, influence their health remains largely understudied. Perspectives from immigrant women can highlight intersectional dimensions of structural gendered racism and the ways in which racial and gender-based systems of structural oppression interact.

OBJECTIVE: This study aims to show the multilevel manifestations of structural gendered racism in the health experiences of immigrant women living in New York City.

METHOD: Semi-structured, in-depth interviews were conducted in 2020 and 2021 with 44 cisgender immigrant women from different national origins in New York City to explore how immigrant women experienced structural gendered racism and its pathways to their health. Interviews were thematically analyzed using a constant comparative approach.

RESULTS: Participants expressed intersectional dimensions of structural gendered racism and the anti-immigrant climate through restrictive immigration policy and issues related to citizenship status, disproportionate immigration enforcement and criminalization, economic exploitation, and gendered interpersonal racism experienced across a range of systems and contexts. Participants weighed their concerns for safety and facing racism as part of their life course and health decisions for themselves and their families.

CONCLUSIONS: The perspectives and experiences of immigrant women are key to identifying multilevel solutions for the burdens of structural gendered racism, particularly among individuals and communities of non-U.S. national origin. Understanding how racism, sexism, xenophobia, and intersecting systems of oppression impact immigrant women is critical for advancing health equity.

PMID:38825373 | DOI:10.1016/j.socscimed.2023.116396

J Rheumatol. 2024 Jun 1:jrheum.2023-1073. doi: 10.3899/jrheum.2023-1073. Online ahead of print.

ABSTRACT

OBJECTIVE: No prior studies in rheumatology have evaluated the quality or timeliness of patient reported outcome (PRO) measure reporting.

METHODS: Clinical trials that informed new Food and Drug Administration (FDA) approvals for the first rheumatological indication between 1995-2021 were identified. Whether collected PROs were published, met minimal clinically important (MCID) difference or statistical significance (p < 0.05) thresholds, or were consistent with CONSORT-PRO reporting standards was recorded. Hazard ratios and the Kaplan-Meier estimate were used to assess the time from FDA approval to PRO publication.

RESULTS: Thirty one FDA approvals corresponded with 110 pivotal trials and 262 reported patient reported outcome measures (PROs). One of the included studies (1.1%) met all five recommended items, 10/90 (11.1%) met 4 items, 17/90 (18.9%) met 3 items, 21/90 (23.3%) met 2 items, 26/90 (28.9%) met 1 item, and 15/90 (16.7%) met none of the reporting standards. Most PROs met MCID thresholds (149/262, 56.9%) and were statistically significant (223/262, 85.1%). Of our subset analysis, one third of PROs were not published upfront (70/212, 33.0%) and one of nine (22/212, 10.4%) remained unpublished four or more years after initial trial reporting. Publication rates were highest for HAQ-DI (97.4%) and lowest for SF-36 (81.8%). Less than half of these published PROs met MCID and statistical significance thresholds (94/212, 44.3%).

CONCLUSION: One in nine PROs remained unpublished for more than 4 years after initial trial reporting, and compliance with CONSORT PRO reporting guideline was poor. Efforts should be made to ensure PROs are adequately reported and expeditiously published.

PMID:38825357 | DOI:10.3899/jrheum.2023-1073

J Rheumatol. 2024 Jun 1:jrheum.2023-1246. doi: 10.3899/jrheum.2023-1246. Online ahead of print.

ABSTRACT

OBJECTIVE: There are limited data on the reproductive health of women with vasculitis. This study utilized a prospective, international vasculitis pregnancy registry to survey women during and after pregnancy.

METHODS: The Vasculitis Pregnancy Registry (VPREG) is imbedded within the Vasculitis Patient-Powered Research Network (VPPRN), an international online research infrastructure. Any pregnant woman with a diagnosis of vasculitis can self-enroll. After enrollment, women are invited to complete online surveys at study entry, once per trimester, and postpartum. Descriptive statistics are reported here.

RESULTS: Between 2015-2022, 147 women with 149 pregnancies enrolled in VPREG from 16 countries. Data on 78 pregnancies with known outcomes were included in this analysis. During pregnancy, women on average experienced low levels of pain related to vasculitis (scale 0-10, median 2 (IQR 1-5)) and preserved feelings of wellness (scale 0-10, median 3 (IQR 1-5)). Thirty-six percent of women reported their vasculitis was active during pregnancy. Of the 14 women requiring hospitalization during pregnancy outside of delivery, four cited active vasculitis as the indication. Most women (54/73, 74%) were prescribed medications for vasculitis during pregnancy. Seventy-six (97%) pregnancies resulted in live births with 64% delivering vaginally and 21% experiencing a preterm delivery.

CONCLUSION: These results demonstrate that most women with vasculitis can experience pregnancies that result in live births delivered at term. During pregnancy, a minority of women reported flares of vasculitis or the need for hospitalization due to vasculitis. These data are useful to rheumatologists and patients to inform and facilitate discussions about reproductive health and vasculitis.

PMID:38825354 | DOI:10.3899/jrheum.2023-1246