Tag: pubmed

Arch Gerontol Geriatr. 2021 May 4;95:104428. doi: 10.1016/j.archger.2021.104428. Online ahead of print.

ABSTRACT

BACKGROUND: The concurrence of several chronic conditions is a rising concern that poses a serious burden on ageing populations. Analysing how these conditions appear together and how they change through time may provide useful information to design successful multimorbidity-management programs.

OBJECTIVE: To identify multimorbidity patterns and their related characteristics from a longitudinal perspective.

SUBJECTS: 25,931 older adults aged 50+ drawn from the Survey of Health, Ageing and Retirement in Europe (SHARE), a population-based longitudinal European study.

METHODS: A sex-stratified Latent Transition Analysis was conducted to fit latent classes based on 15 self-reported chronic conditions across three time points. Health-related and socioeconomic variables were assessed as covariates of those patterns.

RESULTS: We identified 4 time-constant latent classes for each sex. A “severely impaired” class (with a weighted prevalence percentage of 7.24% for females and 3.30% for males at the first time point), a “metabolic” class (26.15% and 23.82%) and a “healthy” class (50.92% and 54.32%). The fourth class was named “osteoarticular” for females (15.70%) and “articular-COPD-ulcer” for males (18.56%). Age, smoke, material deprivation and a high body mass index were associated with worse health patterns, whereas education, being employed and physical activity were related to less multimorbid classes. Few class changes were detected when modelling transitions.

CONCLUSIONS: We reported information of multimorbidity classes and their characteristics that may help to develop targeted health strategies. Within a time window of four years, the identified latent classes were consistent between time points.

PMID:33991948 | DOI:10.1016/j.archger.2021.104428

J Forensic Leg Med. 2021 May 8;80:102181. doi: 10.1016/j.jflm.2021.102181. Online ahead of print.

ABSTRACT

of autopsy files at Forensic Science SA was undertaken over a 20-year period (2000-2019) in five representative time periods to determine the average ages for all adults (≥18 years) where methamphetamine was detected. There were 239 cases with statistically significant increased mean ages over the time of the study ranging from 32.6yrs in 2000 to 42.2yrs in 2019 (p < 0.0001). Although methamphetamine use may be considered predominantly a feature of younger individuals this does not appear to be the case. Whether this apparent increase in the age of methamphetamine users was due to natural aging of methamphetamine users, an increase in use of methamphetamine by older individuals, or to an increased capture of older cases due to wider toxicological screening is uncertain. However, the importance of these results is to alert practitioners to the presence of methamphetamine use in older individuals which may predispose to death given the increased incidence of underlying cardiovascular diseases with age. In addition, in clinical settings there exists a cohort of older individuals who may be at risk of exacerbating their heart disease and precipitating cardiac events by using methamphetamine.

PMID:33991928 | DOI:10.1016/j.jflm.2021.102181

Plant Physiol Biochem. 2021 Apr 28;164:147-159. doi: 10.1016/j.plaphy.2021.04.025. Online ahead of print.

ABSTRACT

The terrestrial fern Pityrogramma calomelanos, a cosmopolitan tropical species, is one of the strongest known arsenic (As) hyperaccumulator plants. This study aimed to determine whether P. calomelanos preferentially forages for arsenite (As³⁺) or arsenate (As⁵⁺) in As-contaminated soils, and whether a positive root response to As enhances accumulation in P. calomelanos. Therefore, an experiment using rhizoboxes divided in two halves were constructed with a control soil (C) and As³⁺ or As⁵⁺ dosed soil at either 50 and 100 μg g^-1 As. Micro-X-ray Fluorescence elemental mapping (μXRF) was employed to analyze the distribution of As in roots and fronds, and Scanning Electron Microscopy with Energy Dispersive Spectroscopy (SEM-EDS) was used to determine As distribution in the reproductive tissues of P. calomelanos. The results showed that Pityrogramma roots do not specifically forage for As-contaminated soil; the area based on pixel counts was similar across all the treatments with no statistical differences. However, frond biomass was slightly higher in the treatments C ǀ As³⁺ and C ǀ As⁵⁺, and the highest accumulation of As in fronds was in the As⁵⁺ ǀ As³⁺ (100 μg g^-1) treatment, with 3418 and 2370 μg g^-1 in old and young fronds respectively. Arsenic cycling across the roots was observed by the μXRF mapping; in C ǀ As⁵⁺ (100) the As was higher and evenly distributed in both sections, whilst in C ǀ As³⁺ (50), the As was higher in the As³⁺ side. The μXRF mapping showed a broader As distribution in older fronds, where As was highest in the rachis and extended into the pinnule through the midrib. Pityrogramma calomelanos does not specifically root forage for As-enriched zones in the soil and grows healthily without signs of toxicity at lower (50 μg g^-1) and higher (100 μg g^-1) concentrations of As³⁺ and As⁵⁺ in the soil.

PMID:33991860 | DOI:10.1016/j.plaphy.2021.04.025

Eur J Oncol Nurs. 2021 May 4;52:101972. doi: 10.1016/j.ejon.2021.101972. Online ahead of print.

ABSTRACT

PURPOSE: Although stigma has attracted considerable scholarly attention, few studies have focused on its influencing factors among discharged breast cancer survivors, especially in a Chinese cultural context. The present study therefore explores stigma and its influencing factors among breast cancer survivors in China.

METHOD: Between December 2017 and May 2018, 103 breast cancer survivors at the outpatient clinic of a tertiary cancer center in southern China were enrolled in a cross-sectional study. The research instruments comprised the Social Impact Scale (SIS), the General Self-Efficacy Scale (GSES), the Medical Coping Modes Questionnaire (MCMQ), and sociodemographic and disease-related questionnaires. Descriptive statistics, univariate analysis, and multivariable linear regression were used to explore the current status of stigma and to identify influencing factors.

RESULTS: Of the respondents, 76.7% and 8.7%, respectively, reported moderate and high levels of stigma. The mean SIS score was 55.20 ± 12.15 (moderate), and the SIS subscale with the highest average score was financial insecurity. The results of a multivariable linear regression showed that body image (β = 0.32, P＜0.001), spousal support (β = -0.47, P < 0.001), personal acceptance of the disease (β = -0.22, P＜0.001), coping modes (resignation) (β = 0.14, P < 0.001), support from medical staff (β = -0.23, P < 0.001) and self-efficacy (β = -0.10, P = 0.037) were the main factors influencing stigma among breast cancer survivors (R² = 0.83).

CONCLUSIONS: Stigma, among breast cancer survivors, which is influenced by various sociocultural factors, is a neglected issue requiring attention. Healthcare professionals should therefore formulate effective measures for alleviating stigma in this group by improving their self-efficacy and acceptance of the disease, reducing their poor body image and negative coping mode, and eliciting more support from their spouses and medical staff.

PMID:33991869 | DOI:10.1016/j.ejon.2021.101972

J Exp Child Psychol. 2021 May 12;209:105166. doi: 10.1016/j.jecp.2021.105166. Online ahead of print.

ABSTRACT

Difficulties in processing humor have been associated with individuals with autism. The current study investigated whether humor comprehension and appreciation could be augmented in children with autism by providing contextual support suggesting that humor was to be expected. A verbally presented riddle task was used in which participants were assessed for their subjective ratings and comprehension of the materials. They were also filmed to record any smiling or laughing. Both riddles and control stimuli were presented with supporting verbal context and also without it. The results showed that (a) the greater subjective appreciation of riddles than of control stimuli was dependent on the provision of context for the participants with autism and that (b) context statistically equated these ratings of riddles between participants with autism and matched typically developing controls. However, context had no effect on comprehension or affective response. The results of the current study demonstrate that children with autism are, even in the most conservative interpretation, able to use verbal context to recognize verbal humor. This lays the foundation of possible interventions based on training sensitivity to context.

PMID:33991842 | DOI:10.1016/j.jecp.2021.105166

Comput Biol Med. 2021 May 7;134:104430. doi: 10.1016/j.compbiomed.2021.104430. Online ahead of print.

ABSTRACT

Early detection of sepsis can facilitate early clinical intervention with effective treatment and may reduce sepsis mortality rates. In view of this, machine learning-based automated diagnosis of sepsis using easily recordable physiological data can be more promising as compared to the gold standard rule-based clinical criteria in current practice. This study aims to develop such a machine learning framework that demonstrates the quantification of heterogeneity within the tabular electronic health records (EHR) data of clinical covariates to capture both linear relationships and nonlinear correlation for the early prediction of sepsis. Here, the statistics of pairwise association for each hour-covariate pair within the EHR data for every 6-hours window-duration with selected 24 covariates is described using pointwise mutual information (PMI) matrix. This matrix gives the heterogeneity of data as a two-dimensional map. Such matrices are fused horizontally along the z-axis as vertical slices in the xy plane to form a 3-way tensor for each record with the corresponding Length of Stay (L). Tensor factorization of such fused tensor for every record is performed using Tucker decomposition, and only the core tensors are retained later, excluding the 3 unitary matrices to provide the latent feature set for the prediction of sepsis onset. A five-fold cross-validation scheme is employed wherein the obtained 120 latent features from the reshaped core tensor, are fed to Light Gradient Boosting Machine Learning models (LightGBM) for binary classification, further alleviating the involved class imbalance. The machine-learning framework is designed via Bayesian optimization, yielding an average normalized utility score of 0.4519 as defined by challenge organizers and area under the receiver operating characteristic curve (AUROC) of 0.8621 on publicly available PhysioNet/Computing in Cardiology Challenge 2019 training data. The proposed tensor decomposition of 3-way fused tensor formulated using PMI matrices leverages higher-order temporal interactions between the pairwise associations among the clinical values for early prediction of sepsis. This is validated with improved risk prediction power for every hour of admission to the ICU in terms of utility score, AUROC, and F1 score. The results obtained show a significant improvement particularly in terms of utility score of ~1.5-2% under a 5-fold cross-validation scheme on entire training data as compared to a top entrant research study that participated in the challenge.

PMID:33991856 | DOI:10.1016/j.compbiomed.2021.104430

Soc Sci Med. 2021 May 7;279:113959. doi: 10.1016/j.socscimed.2021.113959. Online ahead of print.

ABSTRACT

Result Based Financing (RBF) has been implemented in health systems across low and middle-income countries (LMICs), with the objective of improving population health. Most evaluations of RBF schemes have focused on average programme effects for incentivised services. There is limited evidence on the potential effect of RBF on health outcomes, as well as on the heterogeneous effects across socio-economic groups and time periods. This study analyses the effect of Zimbabwe’s national RBF scheme on neonatal, infant and under five mortality, using Demographic and Health Survey data from 2005, 2010 and 2015. We use a difference in differences design, which exploits the staggered roll-out of the scheme across 60 districts. We examine average programme effects and perform sub-group analyses to assess differences between socio-economic groups. We find that RBF reduced under-five mortality by two percentage points overall, but that this decrease was only significant for children of mothers with above median wealth (2.7 percentage points) and education (2.1 percentage points). RBF increased institutional delivery by seven percentage points – with a statistically significant effect for poorer socio-economic groups and least educated. We also find that RBF reduced c-section rates by three percentage points. We find no detectable effect of RBF on other incentivised services. When considering programme effects over time, we find that effects were only observed during the second phase of the programme (March 2012) with the exception of c-sections, which only reduced in the longer term. Further research is needed to examine whether these findings can be generalised to other settings.

PMID:33991792 | DOI:10.1016/j.socscimed.2021.113959

Acta Psychol (Amst). 2021 May 12;217:103330. doi: 10.1016/j.actpsy.2021.103330. Online ahead of print.

ABSTRACT

Merely observing how another person responds to a stimulus results in incidental stimulus-response (SR) bindings in memory. These observationally acquired SR bindings can be retrieved on a later occasion. Retrieval will bias current behavioral response tendencies towards re-execution of the observed response. Previous demonstrations of this effect endorsed a dyadic interaction paradigm in which two co-actors respond in alternating fashion. The present paper investigates a video-based version of the observational SR binding task in which videotaped responses are observed on screen. Whereas findings from the dyadic paradigm indicate that retrieval of observationally acquired SR bindings is modulated by social relevance, the video-based paradigm is not influenced by social moderators. Data of four experiments show that manipulations of visual perspective, natural and artificial group membership had no modulatory effect on retrieval of observationally acquired SR bindings in the video-based paradigm. The absence of any socially modulated effect in the video-based paradigm is supported by Bayesian statistics in favor of the null hypothesis. Data from a fifth experiment suggests that observational SR binding and retrieval effects in the video-based paradigm reflect the influence of spatial attention allocated towards response keys of observed responses. Implications for the suitability of both paradigms to study observational learning and joint action phenomena are discussed.

PMID:33991796 | DOI:10.1016/j.actpsy.2021.103330

Public Health. 2021 May 12;194:252-259. doi: 10.1016/j.puhe.2021.02.027. Online ahead of print.

ABSTRACT

OBJECTIVES: This project aimed to assess the effectiveness of a community-based theatre intervention to improve attitudes towards and increase knowledge about LGBTQ+ communities among audiences in Mumbai, India.

STUDY DESIGN: This study was a program evaluation using pre- and post-show surveys that incorporated an adapted version of The Riddle Scale: Attitudes Towards Difference and questions assessing self-reported knowledge about LGBTQ+-related issues to assess changes in attitudes and knowledge after viewing the theatre intervention.

METHODS: An original 90-min devised play was created by a company of Indian, American, and Canadian theatre artists using Participatory Action Research methods and was designed to bring audiences to a deeper understanding of LGBTQ+ identity. The show was performed four times in Mumbai, India, and pre-/post-show surveys were collected at each performance. Audience survey responses were analysed using parametric and non-parametric descriptive statistics as appropriate, and Likert scale questions were compared using Wilcoxon Signed Rank for non-parametric data.

RESULTS: A total 184 surveys were completed across four performances between March 7 and 14, 2020. Significant increases in audiences’ self-reported knowledge of LGBTQ+ identity, impacts of discrimination, and struggles faced by LGBTQ+ communities were reported after viewing the show. Furthermore, attitudes towards LGBTQ+ rights, understanding of the challenges of being LGBTQ+ in India, and recognition of the contributions LGBTQ+ individuals make to society improved significantly among our audiences after test. The play further fostered increased acceptance of prosocial behaviours towards LGBTQ+ individuals with higher percentages of audiences recognizing the importance of standing up to homophobia and anti-gay attitudes. While these observations were seen across audiences, they were particularly pronounced among cisgender heterosexual men and audiences ages 18-24.

CONCLUSION: Community-based theatre intervention is highly acceptable and effective as a medium for informing positive attitudes, improving knowledge, and promoting acceptance of and solidarity towards LGBTQ+ communities among young adult heterosexual audiences.

PMID:33991810 | DOI:10.1016/j.puhe.2021.02.027

Aten Primaria. 2021 May 12;53(8):102084. doi: 10.1016/j.aprim.2021.102084. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine the unexpected return rate to the Primary Care Emergency Service of elderly patients over 65 years old within the following 72h of a previous visit, as well as to determine the clinical and assistance requirements of these patients.

PROCEDURE: Retrospective and observational epidemiologic study.

LOCATION: Cotolino’s Primary Care Emergency Service in Cantabria, Spain.

PARTICIPANTS: 1940 elderly patients over 65 years old were included. These patients returned to the Primary Care Emergency Service in 2016.

MAIN DATA FOR THE STUDY: The dependent variable was the return rate to the Primary Care Emergency Service. The independent variables were socio-demographic characteristics, health details and medical assistance information. All data was collected from the Primary Care Emergency Service Management Office database. All variables were analysed applying Pearson’s chi-squared test and Fisher’s exact test, with statistical significance P≤.05.

RESULTS: The rate of unexpected return was 2.3%. The average age was 77.4 years old (standard deviation (SD): 8.4), of which the 37.6% were male. The most frequent range of age was from 75 to 84 years old, with males being the predominant group. A history of polymedication was detected in 54.4% of the cases, as well as a medium cardiovascular risk within this group. Nursing professionals attended the 42.2% of these return cases (P<.001). Patients with dysnea (P=.015), scheduled care or scheduled injection returned with a higher frequency (P<.001). It was as well noticed a higher frequency of return for subsequent attention during the months of December and January (P<.001).

CONCLUSIONS: The rate of unexpected return is low. The main causes why elderly patients returned to the service requiring urgent assistance were issues categorised as unspecific general health indicators and/or respiratory system illnesses. Our proposal is to develop specific protocols combining the work from both Geriatrics and Gerontology professionals, in order to improve the support to this group of population at every Primary Care Emergency Service.

PMID:33991761 | DOI:10.1016/j.aprim.2021.102084