Tag: pubmed

J Appl Gerontol. 2023 May 8:7334648231172673. doi: 10.1177/07334648231172673. Online ahead of print.

ABSTRACT

Chronic diseases (CDs) are increasingly common among the aging population. Some evidence suggests that older Hispanic women ages 50 years and older (OHW) are at an increased risk for CDs and poorer outcomes than other groups. This study investigated the preliminary efficacy of ActuaYa, a culturally tailored CD prevention and health promotion intervention for OHW. A prospective, single-group, repeated measures study (n = 50) was conducted in Florida. Clinical measures and surveys were collected at baseline and post-intervention at 3- and 6-month follow-up. Descriptive statistics, paired-sample t-tests, and McNemar tests were used for analysis. At baseline, more than half of the participants had a CD. Post-intervention results showed a significant decrease in participants’ MAP, BMI, and A1C, and a significant increase in self-efficacy for exercise and HIV knowledge compared to baseline measures. The results of this study support the preliminary efficacy of ActuaYa in preventing CDs and increasing health promotion among OHW.

PMID:37157793 | DOI:10.1177/07334648231172673

BMJ Open. 2023 May 8;13(5):e069982. doi: 10.1136/bmjopen-2022-069982.

ABSTRACT

OBJECTIVES: Type 2 diabetes (T2D) is a growing concern in South Africa, where many find self-management challenging. Behaviour-change health interventions are enhanced by involving partners of patients. We aimed to develop a couples-focused intervention to improve self-management of T2D among adults in South Africa.

DESIGN: We used the person-based approach (PBA): synthesising evidence from existing interventions; background research; theory; and primary qualitative interviews with 10 couples to ascertain barriers and facilitators to self-management. This evidence was used to formulate guiding principles that directed the intervention design. We then prototyped the intervention workshop material, shared it with our public and patient involvement group and ran iterative co-discovery think-aloud sessions with nine couples. Feedback was rapidly analysed and changes formulated to improve the intervention, optimising its acceptability and maximising its potential efficacy.

SETTING: We recruited couples using public-sector health services in the area of Cape Town, South Africa, during 2020-2021.

PARTICIPANTS: The 38 participants were couples where one person had T2D.

INTERVENTION: We developed the ‘Diabetes Together’ intervention to support self-management of T2D among couples in South Africa, focussing on: improved communication and shared appraisal of T2D; identifying opportunities for better self-management; and support from partners. Diabetes Together combined eight informational and two skills-building sections over two workshops.

RESULTS: Our guiding principles included: providing equal information on T2D to partners; improving couples’ communication; shared goal-setting; discussion of diabetes fears; discussing couples’ roles in diabetes self-management; and supporting couples’ autonomy to identify and prioritise diabetes self-management strategies.Participants viewing Diabetes Together valued the couples-focus of the intervention, especially communication. Feedback resulted in several improvements throughout the intervention, for example, addressing health concerns and tailoring to the setting.

CONCLUSIONS: Using the PBA, our intervention was developed and tailored to our target audience. Our next step is to pilot the workshops’ feasibility and acceptability.

PMID:37156595 | DOI:10.1136/bmjopen-2022-069982

BMJ Open. 2023 May 8;13(5):e066189. doi: 10.1136/bmjopen-2022-066189.

ABSTRACT

INTRODUCTION: The 2021 Action Plan for Pain from the Canadian Pain Task Force advocates for patient-centred pain care at all levels of healthcare across provinces. Shared decision-making is the crux of patient-centred care. Implementing the action plan will require innovative shared decision-making interventions, specifically following the disruption of chronic pain care during the COVID-19 pandemic. The first step in this endeavour is to assess current decisional needs (ie, decisions most important to them) of Canadians with chronic pain across their care pathways.

METHODS AND ANALYSIS: DesignGrounded in patient-oriented research approaches, we will perform an online population-based survey across the ten Canadian provinces. We will report methods and data following the CROSS reporting guidelines.SamplingThe Léger Marketing company will administer the online population-based survey to its representative panel of 500 000 Canadians to recruit 1646 adults (age ≥18 years old) with chronic pain according to the definition by the International Association for the Study of Pain (eg, pain ≥12 weeks). ContentBased on the Ottawa Decision Support Framework, the self-administered survey has been codesigned with patients and contain six core domains: (1) healthcare services, consultation and postpandemic needs, (2) difficult decisions experienced, (3) decisional conflict, (4) decisional regret, (5) decisional needs and (6) sociodemographic characteristics. We will use several strategies such as random sampling to improve survey quality. AnalysisWe will perform descriptive statistical analysis. We will identify factors associated with clinically significant decisional conflict and decision regret using multivariate analyses.

ETHICS AND DISSEMINATION: Ethics was approved by the Research Ethics Board at the Research Centre of the Centre Hospitalier Universitaire de Sherbrooke (project #2022-4645). We will codesign knowledge mobilisation products with research patient partners (eg, graphical summaries and videos). Results will be disseminated via peer-reviewed journals and national and international conferences to inform the development of innovative shared decision-making interventions for Canadians with chronic pain.

PMID:37156591 | DOI:10.1136/bmjopen-2022-066189

BMJ Open. 2023 May 8;13(5):e069212. doi: 10.1136/bmjopen-2022-069212.

ABSTRACT

OBJECTIVE: The objective of this systematic review was to examine how the record linkage process is reported in multimorbidity research.

METHODS: A systematic search was conducted in Medline, Web of Science and Embase using predefined search terms, and inclusion and exclusion criteria. Published studies from 2010 to 2020 using linked routinely collected data for multimorbidity research were included. Information was extracted on how the linkage process was reported, which conditions were studied together, which data sources were used, as well as challenges encountered during the linkage process or with the linked dataset.

RESULTS: Twenty studies were included. Fourteen studies received the linked dataset from a trusted third party. Eight studies reported variables used for the data linkage, while only two studies reported conducting prelinkage checks. The quality of the linkage was only reported by three studies, where two reported linkage rate and one raw linkage figures. Only one study checked for bias by comparing patient characteristics of linked and non-linked records.

CONCLUSIONS: The linkage process was poorly reported in multimorbidity research, even though this might introduce bias and potentially lead to inaccurate inferences drawn from the results. There is therefore a need for increased awareness of linkage bias and transparency of the linkage processes, which could be achieved through better adherence to reporting guidelines.

PROSPERO REGISTRATION NUMBER: CRD42021243188.

PMID:37156590 | DOI:10.1136/bmjopen-2022-069212

BMJ Open. 2023 May 8;13(5):e066783. doi: 10.1136/bmjopen-2022-066783.

ABSTRACT

INTRODUCTION: Sexual health is essential for general health and well-being. Sexual health services for middle-aged and older adults are not prioritised and optimising available services for this population is often overlooked. Not much is known about preferences for accessing sexual health services among middle-aged and older people or level of satisfaction with current services. The aim of this study is to explore preferences for seeking sexual health services among middle-aged and older adults in the UK. This study will use discrete choice experiments (DCEs) including initial qualitative interviews followed by the survey, which have been used as a tool to explore preferences in various health service delivery.

METHODS AND ANALYSIS: The project will be carried out in two phases. First, we will conduct in-depth semi-structured interviews with 20-30 adults (aged 45+), including disabled people, and those from sexual minority groups resident in the UK. Interviews will explore indications, preferences and factors related to accessing sexual health services. Themes and subthemes emerging from the analysis of the interviews will then be used to design the choice sets and attribute level for the DCEs. For the second phase, for the DCEs, we will design choice sets composed of sexual health service delivery scenarios. The software Ngene will be used to develop the experimental design matrix for the DCE. We will use descriptive statistics to summarise the key sociodemographic characteristics of the study population. Multinomial logit, latent class and mixed logit models will be explored to assess sexual health service preferences and preference heterogeneity.

ETHICS AND DISSEMINATION: Ethical approval for both parts of this study was granted by the Research and Ethics Committee at the London School of Hygiene & Tropical Medicine. Findings from this study will be disseminated widely to relevant stakeholders via scheduled meetings, webinars, presentations and journal publications.

PMID:37156584 | DOI:10.1136/bmjopen-2022-066783

BMJ Open. 2023 May 8;13(5):e067986. doi: 10.1136/bmjopen-2022-067986.

ABSTRACT

OBJECTIVES: The COVID-19 pandemic has required significant modifications of hospital care. The objective of this study was to examine the operational approaches taken by US hospitals over time in response to the COVID-19 pandemic.

DESIGN, SETTING AND PARTICIPANTS: This was a prospective observational study of 17 geographically diverse US hospitals from February 2020 to February 2021.

OUTCOMES AND ANALYSIS: We identified 42 potential pandemic-related strategies and obtained week-to-week data about their use. We calculated descriptive statistics for use of each strategy and plotted percent uptake and weeks used. We assessed the relationship between strategy use and hospital type, geographic region and phase of the pandemic using generalised estimating equations (GEEs), adjusting for weekly county case counts.

RESULTS: We found heterogeneity in strategy uptake over time, some of which was associated with geographic region and phase of pandemic. We identified a body of strategies that were both commonly used and sustained over time, for example, limiting staff in COVID-19 rooms and increasing telehealth capacity, as well as those that were rarely used and/or not sustained, for example, increasing hospital bed capacity.

CONCLUSIONS: Hospital strategies during the COVID-19 pandemic varied in resource intensity, uptake and duration of use. Such information may be valuable to health systems during the ongoing pandemic and future ones.

PMID:37156578 | DOI:10.1136/bmjopen-2022-067986

Open Heart. 2023 May;10(1):e002266. doi: 10.1136/openhrt-2023-002266.

ABSTRACT

OBJECTIVES: To explore the ethnic differences in patients undergoing aortic valve (AV) intervention for severe aortic stenosis (AS) in Leicestershire, UK.

METHODS: Retrospective cohort study of all surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI) at a single tertiary centre between April 2017 and March 2022, using local registry data.

RESULTS: Of the 1231 SAVR and 815 TAVI performed, 6.5% and 3.7% were in ethnic minority patients, respectively. Based on the 2011 Census data for those with a Leicestershire postcode, crude cumulative rate of SAVR (n=489) was 0.64 per 1000 population overall and 0.69, 0.46 and 0.36 in White, Asian and Black populations, respectively; and 0.50 per 1000 population overall for TAVI (n=383), with 0.59, 0.16 and 0.06 for White, Asian and Black populations, respectively. Asians undergoing SAVR and TAVI were 5 and 3 years younger, respectively, than white patients with more comorbidities and a worse functional status.The age-adjusted cumulative rates for SAVR were 0.62 vs 0.72 per 1000 population for White and Asian patients and 0.51 vs 0.39 for TAVI. Asians were less likely to undergo SAVR and TAVI than White patients, with a risk ratio (RR) of 0.66 (0.50-0.87) and 0.27 (0.18-0.43), respectively, but the age-adjusted RR was not statistically significant.

CONCLUSION: The crude rates of AV interventions are lower in Asian patients compared with the White population in Leicestershire, although age-adjusted rates were not statistically different. Further research to determine the sociodemographic differences in prevalence, incidence, mechanisms and treatment of AS across the UK is required.

PMID:37156572 | DOI:10.1136/openhrt-2023-002266

J Sport Rehabil. 2023 May 8:1-13. doi: 10.1123/jsr.2022-0382. Online ahead of print.

ABSTRACT

CONTEXT: Slideboards are commonly used in exercise programs, but there is limited information about how they affect muscle activities during exercise. We aim to compare the activation levels of quadriceps and hamstring muscles and hip- and knee-flexion angles during lunge and single-leg squat exercises between normal ground and slideboard in physically active individuals.

DESIGN: Cross-sectional study.

METHODS: Thirty healthy individuals (age: 23.83 [2.84] y, body mass index: 21.75 [1.72] kg/m2) were included in the study. Surface electromyography was used to measure vastus medialis, vastus lateralis, biceps femoris, and semitendinosus activation levels during reaching and returning phases of the forward, lateral, and back lunges and squats that were performed on the normal ground and slideboard. Exercises were performed at a slow pace (60 beats/min). Hip- and knee-flexion angles during the exercises were evaluated by using 2-dimensional motion analysis. Repeated measures of analysis of variance were used for statistical analysis.

RESULTS: Vastus medialis and vastus lateralis activation levels were greater during reaching and returning phases of the exercises on slideboard compared with normal ground (P < .05). However, semitendinosus and biceps femoris activity were greater only during the returning phase of the forward lunge (P < .001) and the returning phase of the back squat (P = .002, P = .009, respectively). Hip-to-knee flexion ratios were closer to 1 when the forward lunge (P < .001), back lunge (P = .004), and forward squat (P = .001) exercises were performed on a slideboard.

CONCLUSION: In exercise programs that target the quadriceps and hamstring muscles, slideboards can be effectively used in exercise progressions as they can increase muscle activity. Moreover, squat and lunge exercises on slideboard with a slow pace may also be helpful for improving the balance between hip- and knee-flexion angles.

PMID:37156537 | DOI:10.1123/jsr.2022-0382

Int J Hyperthermia. 2023;40(1):2207792. doi: 10.1080/02656736.2023.2207792.

ABSTRACT

OBJECTIVES: To investigate the pattern of change over time and predictors for metastasis in indeterminate lymph nodes (LNs) among patients with thyroid cancer post-ablation.

METHODS: We enrolled patients who developed new cervical LNs after papillary thyroid carcinoma (PTC) ablation. Changes in the ultrasound characteristics of the indeterminate LN were recorded at months 1, 3, 6 and 12 after ablation. LN puncture pathology and long-term follow-up were standard of diagnosis. The indeterminate LNs were divided into benign and malignant groups, the differences between the two groups were compared, and the risk characteristics of malignant LNs were screened using generalized estimating equations (GEE).

RESULTS: In total, we included 138 LNs from 99 patients, of which 48 were indeterminate LNs. When following up indeterminate LNs, non-cervical lymph node metastasis (non-CLNM) lesions demonstrated a statistically significant gradual decrease in volume (p = 0.012), though there was no significant change in the volume of CLNM lesions (p = 0.779). Compared to non-CLNM lesions, the diagnostic efficiency was the highest for CLNM lesions at 1-3 months after ablation, when the LN volume changed by -0.08 to 0.12 mL (p = 0.048). The third month after ablation became an important time point for review. Moreover, GEE analysis showed that microcalcifications, cystic changes, and vascularity were strongly associated with CLNMs (p = 0.004, p = 0.002, and p = 0.010, respectively).

CONCLUSIONS: There is a pattern of volume change of indeterminate LNs after PTC ablation, which, together with microcalcifications, cystic changes, and vascularity, can be used as criteria for differentiating the benignity and malignancy of indeterminate LNs.

PMID:37156534 | DOI:10.1080/02656736.2023.2207792

J Appl Microbiol. 2023 May 8:lxad098. doi: 10.1093/jambio/lxad098. Online ahead of print.

ABSTRACT

AIM: This study aimed to simulate deactivation of E. coli in soils amended with cattle manure after burning, anaerobic digestion, composting or without treatment.

METHOD AND RESULTS: The Weibull survival function was used to describe deactivation of E. coli. Parameters for each treatment were determined using E. coli measurements from manure-amended soils and evaluated against measurements at different application rates. A statistically significant correlation and high coincidence between the simulated and measured values was obtained. The simulations revealed that although anaerobic digestion or burning of cattle manure effectively reduced the E. coli loads to background levels, burning retained very little nitrogen, so the ash residue was ineffective as an organic fertiliser. Anaerobic digestion was most effective at reducing E. coli levels while retaining a high proportion of N in the bioslurry residue, but the persistence of E. coli was higher than in compost.

CONCLUSION: The results from this study suggest that the safest method for production of organic fertiliser would involve anaerobic digestion to reduce E. coli followed by composting to reduce its persistence.

PMID:37156529 | DOI:10.1093/jambio/lxad098