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Tavakoli, Hamdollah Manzari. „The relationship between accuracy of numerical magnitude comparisons and children’s arithmetic ability: A study in Iranian primary school children“. Europe’s Journal of Psychology 12, Nr. 4 (18.11.2016): 567–83. http://dx.doi.org/10.5964/ejop.v12i4.1175.
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The relationship between children’s accuracy during numerical magnitude comparisons and arithmetic ability has been investigated by many researchers. Contradictory results have been reported from these studies due to the use of many different tasks and indices to determine the accuracy of numerical magnitude comparisons. In the light of this inconsistency among measurement techniques, the present study aimed to investigate this relationship among Iranian second grade children (n = 113) using a pre-established test (known as the Numeracy Screener) to measure numerical magnitude comparison accuracy. The results revealed that both the symbolic and non-symbolic items of the Numeracy Screener significantly correlated with arithmetic ability. However, after controlling for the effect of working memory, processing speed, and long-term memory, only performance on symbolic items accounted for the unique variances in children’s arithmetic ability. Furthermore, while working memory uniquely contributed to arithmetic ability in one-and two-digit arithmetic problem solving, processing speed uniquely explained only the variance in single-digit arithmetic skills and long-term memory did not contribute to any significant additional variance for one-digit or two-digit arithmetic problem solving.
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Bedore, Lisa M., Elizabeth D. Peña, Christine Fiestas und Mirza J. Lugo-Neris. „Language and Literacy Together: Supporting Grammatical Development in Dual Language Learners With Risk for Language and Learning Difficulties“. Language, Speech, and Hearing Services in Schools 51, Nr. 2 (07.04.2020): 282–97. http://dx.doi.org/10.1044/2020_lshss-19-00055.
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Purpose Early Interventions in Reading (Vaughn et al., 2006), the only literacy intervention with demonstrated effectiveness for U.S. dual language learners, was enhanced to support the development of oral language (vocabulary, grammar, and narrative) and literacy, which we refer to as “Language and Literacy Together.” The primary focus of this study is to understand the extent to which grammatical skills of bilinguals with risk for language and/or reading difficulties improve in the Language and Literacy Together intervention. Method Fifteen first-grade dual language learners with risk for language and/or reading difficulties participated in an enhanced version of Early Interventions in Reading in Spanish. Children completed pre- and postintervention evaluations in Spanish and English, including grammatical testing from the Bilingual English Spanish Oral Screener (Peña et al., 2008) and narrative evaluation Test of Narrative Language story prompts (Gillam & Pearson, 2004; Gillam et al., n.d.). Data from six comparison participants with typical language skills who completed pre- and posttesting demonstrate the stability of the measures. Results The intervention group made gains in English and Spanish as evidenced by significant increases in their cloze and sentence repetition accuracy on the Bilingual English Spanish Oral Screener Morphosyntax subtest. They increased productivity on their narratives in Spanish and English as indexed by mean length of utterance in words but did not make gains in their overall grammaticality. Conclusions Structured intervention that includes an emphasis on grammatical elements in the context of a broader intervention can lead to change in the production of morphosyntax evident in both elicited constructions and narrative productivity as measured by mean length of utterance in words. Additional work is needed to determine if and how cross-linguistic transfer might be achieved for these learners.
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Gupta, Sharad, und Harsh V. Verma. „Mindfulness, mindful consumption, and life satisfaction“. Journal of Applied Research in Higher Education 12, Nr. 3 (24.09.2019): 456–74. http://dx.doi.org/10.1108/jarhe-11-2018-0235.
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Purpose The purpose of this paper is to investigate the effect of mindfulness meditation sessions on students of higher education in terms of their mindfulness, mindful consumption behavior and life satisfaction. Design/methodology/approach Participants of research were higher education students. The research included two studies. The first (screener) study endorsed that mindfulness was higher in students with higher mindfulness meditation frequency. The second study used difference-in-differences experimental design using a treatment and a control group. These groups participated in pre and post-treatment surveys. The treatment was given as guided short mindfulness meditation sessions as suggested by mindfulness guru – Dr Jon Kabat-Zinn. The treatment group received these sessions at the end of regular subject classes for two months. Findings The experiment revealed that mindfulness, mindful consumption and life satisfaction change significantly in the treatment group after treatment as compared to the control group. Research limitations/implications Limitations of the study included sample size and attrition. In total, 149 students participated in the screener study. In total, 94 students were given pre-treatment survey as per research design and 80 participated in post-treatment survey. Practical implications This experiment demonstrated that important traits and behavior like life satisfaction and mindful consumption behavior of higher education students can be improved significantly. The effectiveness of guided short mindfulness sessions, conducted in the classroom environment, was also confirmed. Social implications The inclusion of mindfulness in the regular curriculum by policy makers would benefit students, faculty members and overall quality of learning environment. Originality/value Though previous researches have separately investigated relationships of mindfulness with life satisfaction, there is a lack of research to show association of mindfulness, mindful consumption and life satisfaction.
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Weinman, John, Imran Ali, Anna Hodgkinson, Martha Canfield und Christina Jackson. „Pilot Testing Of A Brief Pre-Consultation Screener For Improving The Identification And Discussion Of Medication Adherence In Routine Consultations“. Patient Preference and Adherence Volume 13 (November 2019): 1895–98. http://dx.doi.org/10.2147/ppa.s219860.
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Āriņa, Dace, Kaspars Kļavenieks und Juris Burlakovs. „The Cost-estimation of Mechanical Pre-treatment Lines of Municipal Solid Waste in Latvia“. Proceedings of the Latvia University of Agriculture 32, Nr. 1 (01.12.2014): 17–28. http://dx.doi.org/10.2478/plua-2014-0009.
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Abstract Production of refuse derived fuel from municipal solid waste in future shall play a strategic role in an integrated waste management system. The amount of landfilled biodegradable materials thus will be diminished according to provisions of the 1999 Waste Landfill Directive. The aim of this article is to evaluate cost effectiveness based on cost evaluation of the different complication of the waste pre-treatment equipment complectation and based on regenerable waste quantities in Latvia. The comparison of cost estimates is done in 3 scenarios considering potential waste quantities in Latvia: Scenario I - planned annual waste quantity is 20 kT; Scenario II - 40 kT and Scenario III - 160 kT. An increase in amount of waste and processing capacity means the decrease in costs of mechanical pre-treatment of 1 ton of waste. Thus, costs of mechanical sorting line under different scenarios with capacities of 10 t h-1, 20 t h-1 and 80 t h-1 are EUR 32 per t, EUR 24 per t and EUR 15 per t, respectively. Most feasible cost for a set of mechanical pre-treatment equipment for the capacity of 10 t h-1 is EUR 32 per t by using rotating drum screener with the following manual sorting. Mechanical pre-treatment equipment of unsorted municipal waste is economically nonbeneficial, when the use of fine (biologically degradable) fraction is not possible. As the sorting of biodegradable kitchen waste is not developed under the current waste management system in Latvia, the lines for mechanical pre-treatment of household waste would be better to install in landfills.
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Meng, Yu, Melinda Manore, John Schuna, Megan Patton-Lopez, Adam Branscum und Siew Wong. „Promoting Healthy Diet, Physical Activity, and Life-Skills in High School Athletes: Results from the WAVE Ripples for Change Childhood Obesity Prevention Two-Year Intervention“. Nutrients 10, Nr. 7 (23.07.2018): 947. http://dx.doi.org/10.3390/nu10070947.
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The purpose of this study was to compare changes in diet and daily physical activity (PA) in high school (HS) soccer players who participated in either a two-year obesity prevention intervention or comparison group, while controlling for sex, race/ethnicity, and socioeconomic status. Participants (n = 388; females = 58%; Latino = 38%; 15.3 ± 1.1 years, 38% National School Breakfast/Lunch Program) were assigned to either an intervention (n = 278; 9 schools) or comparison group (n = 110; 4 schools) based on geographical location. Pre/post intervention assessment of diet was done using Block Fat/Sugar/Fruit/Vegetable Screener, and daily steps was done using the Fitbit-Zip. Groups were compared over-time for mean changes (post-pre) in fruit/vegetables (FV), saturated fat (SF), added sugar, and PA (daily steps, moderate-to-vigorous PA) using analysis of covariance. The two-year intervention decreased mean added sugar intake (−12.1 g/day, CI (7.4, 16.8), p = 0.02); there were no differences in groups for FV or SF intake (p = 0.89). For both groups, PA was significantly higher in-soccer (9937 steps/day) vs. out-of-soccer season (8117 steps/day), emphasizing the contribution of organized sports to youth daily PA. At baseline, Latino youth had significantly higher added sugar intake (+14 g/day, p < 0.01) than non-Latinos. Targeting active youth in a diet/PA intervention improves diet, but out of soccer season youth need engagement to maintain PA (200).
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Kızıltepe, Gozde Inal. „Validity and Reliability Study for the Turkish Version of Number Sense Screener for 60-71 Months Old Children“. Journal of Education and Training Studies 7, Nr. 2 (17.12.2018): 24. http://dx.doi.org/10.11114/jets.v7i2.3888.
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In this study, it was aimed to carry out the validity and reliability study of Number Sense Screener (NSS)’s Turkish version for 60-71 year-old children. The universe of the study in which general survey model was used consists of children at 60-71 years of age, who were continuing their education during the spring term of academic year 2017-2018 in public and private kindergartens under the Ministry of National Education within the central district of Aydin/Turkey. As for the sample of the study, 658 children contunuing their education in 12 different preschools pre-determined according to socioeconomic status (low-middle-high) were included through systematic sampling method. Validity and reliability studies were carried out using data from the NSS application. Drawing from the analyses, it was determined that item difficulty values of the assessment tool ranged between 0.08 and 0.96, item discrimination indices ranged between 0.17 and 0.53 and item infit and outfit values ranged between 0.50-1.50. Having used Guttman's lambda-2, Alpha coefficient, Feldt-Gilmer coefficient, Feldt-Brennan coefficient and Raju's beta coefficient, it was determined that reliability coefficient calculated for the entire assessment tool varied between .826 and .837. Following DIF analysis, it was concluded that assessment tool items were not biased towards gender. According to the results of the study, it was concluded that the Turkish version of NSS is a valid and reliable assessment tool for assessing the number sense of children at 60-71 months of age.
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Stonbraker, Samantha, Elizabeth Haight, Alana Lopez, Linda Guijosa, Eliza Davison, Diane Bushley, Kari Aquino Peguero, Vivian Araujo, Luz Messina und Mina Halpern. „Digital Educational Support Groups Administered through WhatsApp Messenger Improve Health-Related Knowledge and Health Behaviors of New Adolescent Mothers in the Dominican Republic: A Multi-Method Study“. Informatics 7, Nr. 4 (05.11.2020): 51. http://dx.doi.org/10.3390/informatics7040051.
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(1) Background: In limited-resource settings such as the Dominican Republic, many factors contribute to poor health outcomes experienced by adolescent mothers, including insufficient support and/or health knowledge. In response, we designed a digital educational support group, administered through WhatsApp Messenger, for new adolescent mothers. The purpose of this study was to assess if participation in this digital support group could improve health outcomes and health behaviors. (2) Methods: Participants completed questionnaires with a health literacy screener, demographic items, knowledge questions, the Index of Autonomous Functioning, and five Patient Reported Outcomes Measurement Information System scales before and after the moderator-led intervention. Differences between pre- and post-intervention scores were calculated and perceptions of the intervention were explored through in-depth interviews analyzed with content analysis. Participants’ well-baby visit attendance and contraceptive use were compared to that of controls and a national sample. (3) Results: Participants’ (N = 58) knowledge scores increased (p < 0.05). Participants were 6.58 times more likely to attend well-baby visits than controls (95% CI: 2.23–19.4) and their contraceptive use was higher than that of the national sample (p < 0.05). Participants indicated the intervention was enjoyable and beneficial. (4) Conclusion: This adolescent-centered digital intervention is a promising method to improve health outcomes and health behaviors of young mothers in limited-resource settings.
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Schlaudt, Victoria A., Rahel Bosson, Monnica T. Williams, Benjamin German, Lisa M. Hooper, Virginia Frazier, Ruth Carrico und Julio Ramirez. „Traumatic Experiences and Mental Health Risk for Refugees“. International Journal of Environmental Research and Public Health 17, Nr. 6 (16.03.2020): 1943. http://dx.doi.org/10.3390/ijerph17061943.
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Refugees who settle in Western countries exhibit a high rate of mental health issues, which are often related to experiences throughout the pre-displacement, displacement, and post-displacement processes. Early detection of mental health symptoms could increase positive outcomes in this vulnerable population. The rates and predictors of positive screenings for mental health symptoms were examined among a large sample of refugees, individuals with special immigrant visas, and parolees/entrants (N = 8149) from diverse nationalities. Logistic regression analyses were used to determine if demographic factors and witnessing/experiencing violence predicted positive screenings. On a smaller subset of the sample, we calculated referral acceptance rate by country of origin. Refugees from Syria, Iraq, and Afghanistan were most likely to exhibit a positive screening for mental health symptoms. Refugees from Sudan, Iraq, and Syria reported the highest rate of experiencing violence, whereas those from Iraq, Sudan, and the Democratic Republic of Congo reported the highest rate of witnessing violence. Both witnessing and experiencing violence predicted positive Refugee Health Screener-15 (RHS-15) scores. Further, higher age and female gender predicted positive RHS-15 scores, though neither demographic variable was correlated with accepting a referral for mental health services. The findings from this study can help to identify characteristics that may be associated with risk for mental health symptoms among a refugee population.
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Schnieders, Elena, Elyesa Ünal, Volker Winkler, Peter Dambach, Valérie R. Louis, Olaf Horstick, Florian Neuhann und Andreas Deckert. „Performance of alternative COPD case-finding tools: a systematic review and meta-analysis“. European Respiratory Review 30, Nr. 160 (25.05.2021): 200350. http://dx.doi.org/10.1183/16000617.0350-2020.
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RationaleGuidelines recommend pre-/post-bronchodilator spirometry for diagnosing COPD, but resource constraints limit the availability of spirometry in primary care in low- and middle-income countries. Although spirometry is the diagnostic gold standard, we shall assess alternative tools for settings without spirometry.MethodsA systematic literature review and meta-analysis was conducted, utilising Cochrane, CINAHL, Google Scholar, PubMed and Web of Science (search cut-off was May 01, 2020). Published studies comparing the accuracy of diagnostic tools for COPD with post-bronchodilator spirometry were considered. Studies without sensitivity/specificity data, without a separate validation sample and outside of primary care were excluded. Sensitivity, specificity and area under the curve (AUC) were assessed.ResultsOf 7578 studies, 24 were included (14 635 participants). Hand devices yielded a larger AUC than questionnaires. The meta-analysis included 17 studies and the overall AUC of micro-spirometers (0.84, 95% CI 0.80–0.89) was larger when compared to the COPD population screener (COPD-PS) questionnaire (0.77, 95% CI 0.63–0.85) and the COPD diagnostic questionnaire (CDQ) (0.72, 95% CI 0.64–0.78). However, only the difference between micro-spirometers and the CDQ was significant.ConclusionsThe CDQ and the COPD-PS questionnaire were approximately equally accurate tools. Questionnaires ensured testing of symptomatic patients, but micro-spirometers were more accurate. A combination could increase accuracy but was not evaluated in the meta-analysis.
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Godbole, Maneesha, N. P. Kavya, Manjunath S. Nekar und D. D. Bant. „A cross sectional study to assess prevalence and pattern of ocular morbidity among pre-school children attending anganwadi centres of Hubballi taluk in South India“. International Journal Of Community Medicine And Public Health 6, Nr. 2 (24.01.2019): 545. http://dx.doi.org/10.18203/2394-6040.ijcmph20190097.
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Background: About 30% of blind population of India loses their eyesight before the age of 20 years and many of them are under 5 when they become blind. Childhood blindness will have serious impact on development, education and quality of life. Therefore it is essential that ocular morbidity is detected and treated at an early stage.Methods: A cross-sectional study was conducted among 120 children aged 3-5 years attending 6 anganwadi centres of Hubballi taluk which were selected by stratified random sampling. Data was collected using pretested semi-structured questionnaire. Ocular examination was conducted to identify ocular morbidity. Test for visual acuity, colour blindness and refractive status was done using lea chart, ischihara charts and plusoptix mobile vision screener respectively. Nutrition status was assessed by clinical examination and anthropometry. Statistical analysis was done using SPSS package.Results: Out of 120 children 51.7% were male. Majority, 63.3% were residing in urban area and 40% belonged to class IV of modified B G Prasad classification of socio-economic status scale. The prevalence of ocular morbidity was found to be 20%. 15.8% of children had refractive error, 2.5% had vitamin A deficiency and 1.7% had squint. No statistically significant association was found between ocular morbidity and any risk factors.Conclusions: Refractive error was found to be the most common ocular morbidity among pre-school children. This if detected early can be corrected. Therefore it is important to screen for refractive error at the preschool age itself and to create awareness among parents and anganwadi teachers regarding common ocular symptoms.
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Nitzke, Susan, Karen Kritsch, Linda Boeckner, Geoffrey Greene, Sharon Hoerr, Tanya Horacek, Kendra Kattelmann et al. „A Stage-Tailored Multi-Modal Intervention Increases Fruit and Vegetable Intakes of Low-Income Young Adults“. American Journal of Health Promotion 22, Nr. 1 (September 2007): 6–14. http://dx.doi.org/10.4278/0890-1171-22.1.6.
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Purpose. Assess effectiveness of an intervention to improve fruit and vegetable consumption in economically disadvantaged young adults. Design. Randomized treatment-control, pre-post design. Setting. Ten states. Subjects. Young adults (n = 2024, ages 18–24) were recruited from noncollege venues; 1255 (62%) completed assessment interviews at baseline and at 4 and 12 months. Intervention. Treatment participants received a series of mailed materials and two educational calls in 6 months. Controls received a mailed pamphlet. Measures. Assessment calls determined two measures of fruit and vegetable intakes, demographics and stage of change at baseline, 4 and 12 months, plus treatment participants' decisional balance, processes, and self-efficacy. Analysis. Repeated measure analysis of variance, intent-to-treat, χ2, and logistic regression. Results. At follow-up, participants in the experimental group had higher intakes of fruit and vegetables than controls (perceived daily intakes of 4.90 vs. 4.60 servings per day, F = 3.49, p < .05 and 4.31 vs. 3.92 servings/day via 5-A-Day Screener, F = 4.78, p < .01) and greater progression to action or maintenance stages (66% progress in fruit for intervention vs. 55% progress in fruit for controls; 47% vs. 32% progress for vegetables, p = .0080 and .0001, respectively). Lower education, non-White ethnicity, male gender, living with children, and experimental group assignment predicted attrition (X26df = 288, p < .001, Cox R2 = .132). Conclusions. Tailored educational messages and research-extension partnerships are advantageous for improving fruit and vegetable intakes of young adults.
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Khalbuss, Walid E., Jackie Cuda und Ioan C. Cucoranu. „Screening and dotting virtual slides: A new challenge for cytotechnologists“. CytoJournal 10 (29.10.2013): 22. http://dx.doi.org/10.4103/1742-6413.120790.
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Digital images are increasingly being used in cytopathology. Whole-slide imaging (WSI) is a digital imaging modality that uses computerized technology to scan and convert entire cytology glass slides into digital images that can be viewed on a digital display using the image viewer software. Digital image acquisition of cytology glass slides has improved significantly over the years due to the use of liquid-based preparations and advances in WSI scanning technology such as automatic multipoint pre-scan focus technology or z-stack scanning technology. Screening cytotechnologists are responsible for every cell that is present on an imaged slide. One of the challenges users have to overcome is to establish a technique to review systematically the entire imaged slide and to dot selected abnormal or significant findings. The scope of this article is to review the current user interface technology available for virtual slide navigation when screening digital slides in cytology. WSI scanner vendors provide tools, built into the image viewer software that allow for a more systematic navigation of the virtual slides, such as auto-panning, keyboard-controlled slide navigation and track map. Annotation tools can improve communication between the screener and the final reviewer or can be used for education. The tracking functionality allows recording of the WSI navigation process and provides a mechanism for confirmation of slide coverage by the screening cytotechnologist as well as a useful tool for quality assurance. As the WSI technology matures, additional features and tools to support navigation of a cytology virtual slide are anticipated.
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Housten, Ashley J., Geetanjali R. Kamath, Therese B. Bevers, Scott B. Cantor, Nickell Dixon, Andre Hite, Michael A. Kallen, Viola B. Leal, Liang Li und Robert J. Volk. „Does Animation Improve Comprehension of Risk Information in Patients with Low Health Literacy? A Randomized Trial“. Medical Decision Making 40, Nr. 1 (03.12.2019): 17–28. http://dx.doi.org/10.1177/0272989x19890296.
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Introduction. Enhanced visual effects, like animation, have the potential to improve comprehension of probabilistic risk information, particularly for those with lower health literacy. We tested the effect of presentation format on comprehension of colorectal cancer (CRC) screening probabilities to identify optimal risk communication strategies. Methods. Participants from a community foodbank and a cancer prevention center were randomized to 1 of 3 CRC screening risk presentations. The presentations used identical content but varied in format: 1) video with animated pictographs, 2) video with static pictographs, and 3) audiobooklet with static pictographs. Participants completed pre- and postpresentation surveys. The primary outcome was knowledge of probability/risk information regarding CRC screening, calculated as total, verbatim, and gist scores. Results. In total, 187 participants completed the study and were included in this analysis. Median age was 58 years (interquartile range [IQR]: 14 years), most participants were women (63%), and almost half had a high school education or less (46%). Approximately one-quarter had inadequate health literacy (Short Test of Functional Health Literacy in Adults marginal/inadequate: 28%; Brief Health Literacy Screener low: 18%), and about half had low numeracy (Subjective Numeracy Scale low: 54%; Graphical Literacy Measure low: 50%). We found no significant differences in total, verbatim, or gist knowledge across presentation formats (all P > 0.05). Discussion. Use of an animated pictograph to communicate risk does not appear to augment or impede knowledge of risk information. Regardless of health literacy level, difficulty understanding pictographs presenting numerical information persists. There may be a benefit to teaching or priming individuals on how to interpret numerical information presented in pictographs before communicating risk using visual methods. Trial Registry: NCT02151032
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McGeary, Donald D., Patricia A. Resick, Donald B. Penzien, Blessen C. Eapen, Carlos Jaramillo, Cindy A. McGeary, Paul S. Nabity et al. „Reason to doubt the ICHD-3 7-day inclusion criterion for mild TBI-related posttraumatic headache: A nested cohort study“. Cephalalgia 40, Nr. 11 (31.08.2020): 1155–67. http://dx.doi.org/10.1177/0333102420953109.
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Background Posttraumatic headache is difficult to define and there is debate about the specificity of the 7-day headache onset criterion in the current definition. There is limited evidence available to guide decision making about this criterion. Method A nested cohort study of 193 treatment-seeking veterans who met criteria for persistent headache attributed to mild traumatic injury to the head, including some veterans with delayed headache onset up to 90 days post-injury, was undertaken. Survival analysis examined the proportion of participants reporting headache over time and differences in these proportions based on sex, headache phenotype, and mechanism of injury. Result 127 participants (66%; 95% CI: 59–72%) reported headache onset within 7 days of head injury and 65 (34%) reported headache onset between 8 days and 3 months after head injury. Fourteen percent of participants reported pre-existing migraine before head injury, and there was no difference in the proportion of veterans with pre-existing migraine based on headache onset. Headache onset times were not associated with sex, headache phenotype, or mechanism of injury. There were no significant differences in proportion of veterans with headache onset within 7 days of head injury based on headache phenotype (70% migraine onset within 7 days, 70% tension-type headache within 7 days, 56% cluster headache within 7 days; p ≥ .364). Similar findings were observed for head injury (64% blast, 60% blunt; p = .973). There were no significant differences observed between headache onset groups for psychiatric symptoms (Posttraumatic Stress Disorder Checklist for DSM-5 = 1.3, 95% CI = −27.5, 30.1; Patient Health Questionnaire-9 Item = 3.5, 95% CI = −6.3, 3.7; Generalized Anxiety Disorder Screener = 6.5, 95% CI = −2.7, 15.6). Conclusions Although most of the sample reported headache onset within 7 days of head injury, one-third experienced an onset outside of the diagnostic range. Additionally, veterans with headache onset within 7 days of head injury were not meaningfully different from those with later onset based on sex, headache phenotype, or mechanism of head injury. The ICHD-3 diagnostic criteria for 7-day headache onset should be expanded to 3 months. ClinicalTrials.gov Identifier NCT02419131
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Li, Yihan, Megan Miller und Nicole Torrence. „755 A Novel Modularized Intervention to Improve Sleep in Older Hospitalized Veterans“. Sleep 44, Supplement_2 (01.05.2021): A294. http://dx.doi.org/10.1093/sleep/zsab072.752.
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Abstract Introduction Disturbed sleep in hospitalized patient populations is a highly prevalent phenomenon, with patients commonly reporting problems with shorter sleep duration, more frequent awakenings, and overall poorer sleep quality during hospital stay compared to at home. Sleep disturbance during hospitalization is especially problematic as sleep is associated with both physical and psychological well-being. Poorer sleep has been found to impact recovery outcomes in a number of patient populations including mild traumatic brain injury, chronic pain, and most recently, in hospitalized COVID-19 patients. The current analyses examined pilot data from a novel brief modularized sleep intervention implemented with older adult Veterans living on a subacute rehabilitation unit. Methods Participants were screened for sleep problems upon admission to the unit. Veterans who screened positive were invited to participate in the sleep intervention. Components of the intervention were selected based on screener responses and included group sleep hygiene psychoeducation, environmental accommodations (e.g. ear plugs, eye mask, soothing music), and CPAP use education. Measures completed at pre- and post- intervention assessed sleep quality (Pittsburgh Sleep Quality Index, PSQI), global health functioning (PROMIS Global Health Scale), and depressive symptoms (Patient Health Questionnaire, PHQ-9). Pre- and post- scores were compared using paired sample t-tests. Two samples t-tests compared change scores in PHQ-9 between groups. Results A total of 33 Veterans were included in the analyses (Mage = 69.6, 3 female, intervention group n = 21). Participants showed a trend toward decreased PHQ-9 scores following the intervention (t(16) = 1.58, p = 0.100). There were no significant effects of the intervention on sleep quality or global health. Compared to the non-intervention group, the intervention group showed greater decrease in PHQ-9 scores at the time of post-intervention (t(25) = .828, p = .025). Conclusion Preliminary data suggests that a brief modularized sleep intervention may benefit depressive symptoms for older adults during hospitalization. Additional research is needed to better understand the impact of a brief intervention on self-reported sleep quality during the hospitalization period. Support (if any) This project was funded by a VISN 20 Seed Grant as a Whole Health promotion in alignment with the National VA Office of Patient Centered Care & Cultural Transformation.
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Colvonen, P. J., G. Rivera, M. Haller und S. Norman. „0582 Examining OSA Screening and Treatment for Individuals on a PTSD and Alcohol Disorder Residential Treatment Unit“. Sleep 43, Supplement_1 (April 2020): A223. http://dx.doi.org/10.1093/sleep/zsaa056.579.
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Abstract Introduction Obstructive sleep apnea (OSA) is highly co-occurring with both alcohol use disorder (AUD) and posttraumatic stress disorder (PTSD) and has been shown to interfere with both PTSD and AUD outcomes. However, OSA often goes undiagnosed and untreated in residential treatment facilities. Our study aimed to assess the feasibility of incorporating OSA screening and treatment onto a substance abuse residential rehabilitation treatment program (SARRTP). Further, we examine the relationship between adherence rates of CPAP on PTSD outcomes. Methods Participants were 35 consecutive veterans admitted to the SARRTP PTSD track who consented to screening. Veterans were on the unit for 4-6 weeks. OSA was diagnosed using Nox T3 recorders, a Type-3 portable OSA screener (using Apnea Hypopnea Index >= 5). Insomnia Severity Index and PTSD checklist were given at pre- and post-treatment. Results 64.7% of Veterans screened positive for OSA. 11.8% were previously diagnosed with OSA, but did not use a CPAP machine; 17.6% were previously diagnosed and were using a CPAP machine; and 35.3% were newly diagnosed with OSA. Individuals with untreated OSA had significantly more days drinking in the last 30 days (M = 21.17 days, SD = 11.41) compared to no OSA/Treated OSA group (M = 8.82 days, SD = 10.92). There was no difference in change in PCL scores from baseline to post-treatment by the no-OSA/high compliance group and the low compliance group. Conclusion Taken together, OSA screening on the unit was accepted by the participants, feasible, and effective in diagnosing OSA. OSA screening and treatment should be considered as necessary on SUD and PTSD units. We did not find that OSA adherence predicted change in PTSD score, this is most likely due to veterans receiving their CPAP late into their stay on the unit. Future studies will need to examine OSA treatment on long term treatment outcomes. Support: Support This work is supported by UCSD Academic Senate Grant and a Veterans Affairs RR&D CDA (1lK2Rx002120-01) to Peter Colvonen.
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Davis, Jaimie, Katie Nikah, Fiona Asigbee, Matthew Landry, Sarvenaz Vandyousefi, Amy Hoover, Matthew Jeans et al. „TX Sprouts: A School-Based Cluster Randomized Gardening, Nutrition, and Cooking Intervention: Effects on Obesity, Blood Pressure and Diet“. Current Developments in Nutrition 4, Supplement_2 (29.05.2020): 1296. http://dx.doi.org/10.1093/cdn/nzaa059_013.
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Abstract Objectives To assess the effects of a one-year school-based gardening, nutrition, and cooking cluster randomized controlled trial, called TX Sprouts, on dietary intake, obesity markers, and blood pressure. Methods Sixteen schools were randomly assigned to either the TX Sprouts intervention (n = 8 school) or to delayed intervention (n = 8 schools). The intervention arm received: formation/training of Garden Leadership Committees; a 0.25-acre outdoor teaching garden; 18 student lessons including gardening, nutrition, and cooking activities, taught weekly during school hours; and nine parent lessons. The delayed intervention received the same protocol one year later. Primary child outcomes were measured at baseline and after one school year included: changes in dietary intake (fruit and vegetables servings via screener), height, weight, waist circumference, body composition, and blood pressure. Ten multiple imputations and generalized linear mixed models with schools as the random cluster were used to assess differences in changes in primary outcomes between intervention and control groups. Results Of the 4239 eligible students, 3135 (74%) of students consented and completed baseline clinical measures and child surveys. Participants were 47.4% male and average age was 9.2 years. Approximately 64% were Hispanic, and 69% were economically disadvantaged with attendance to TX Sprouts lessons was 95% of the intervention children. Ninety-one % of children completed both pre and post measures. Intervention group compared to control group resulted in increases, mean change (SE), in vegetable intake [+0.33(0.13) vs. 0.03(0.11) serv/d; P = 0.003]. There was a significant race/ethnicity by sex interaction (P = 0.01) for diastolic blood pressure, with Hispanic males in the intervention group compared to Hispanic males in the control group having reductions in diastolic blood pressure [−2.5(1.0) vs. +0.8(1.10) Hg/mm; P = 0.021). There was no effect of the intervention on any of the obesity parameters. Conclusions The TX Sprouts intervention targets the school nutrition environment, and may provide a sustainable approach to increase vegetable intake and reduce blood pressure in low-income, primarily Hispanic children. Funding Sources NIH/NHLBI (1R01HL123865, 2015-2020), Whole Kids Foundation, Home Depot, Sprouts Healthy Communities Foundation.
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Cronin, Kevin J., Brian R. Wolf, Justin A. Magnuson, Cale A. Jacobs, Shannon Ortiz, Julie Y. Bishop, Matthew J. Bollier et al. „The Prevalence and Clinical Implications of Comorbid Back Pain in Shoulder Instability: A Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Instability Cohort Study“. Orthopaedic Journal of Sports Medicine 8, Nr. 2 (01.02.2020): 232596711989473. http://dx.doi.org/10.1177/2325967119894738.
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Background: Understanding predictors of pain is critical, as recent literature shows that comorbid back pain is an independent risk factor for worse functional and patient-reported outcomes (PROs) as well as increased opioid dependence after total joint arthroplasty. Purpose/Hypothesis: The purpose of this study was to evaluate whether comorbid back pain would be predictive of pain or self-reported instability symptoms at the time of stabilization surgery. We hypothesized that comorbid back pain will correlate with increased pain at the time of surgery as well as with worse scores on shoulder-related PRO measures. Study Design: Cross-sectional study; Level of evidence, 3. Methods: As part of the Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Instability cohort, patients consented to participate in pre- and intraoperative data collection. Demographic characteristics, injury history, preoperative PRO scores, and radiologic and intraoperative findings were recorded for patients undergoing surgical shoulder stabilization. Patients were also asked, whether they had any back pain. Results: The study cohort consisted of 1001 patients (81% male; mean age, 24.1 years). Patients with comorbid back pain (158 patients; 15.8%) were significantly older (28.1 vs 23.4 years; P < .001) and were more likely to be female (25.3% vs 17.4%; P = .02) but did not differ in terms of either preoperative imaging or intraoperative findings. Patients with self-reported back pain had significantly worse preoperative pain and shoulder-related PRO scores (American Shoulder and Elbow Surgeons score, Western Ontario Shoulder Instability Index) ( P < .001), more frequent depression (22.2% vs 8.3%; P < .001), poorer mental health status (worse scores for the RAND 36-Item Health Survey Mental Component Score, Iowa Quick Screen, and Personality Assessment Screener) ( P < .01), and worse preoperative expectations ( P < .01). Conclusion: Despite having similar physical findings, patients with comorbid back pain had more severe preoperative pain and self-reported symptoms of instability as well as more frequent depression and lower mental health scores. The combination of disproportionate shoulder pain, comorbid back pain and mental health conditions, and inferior preoperative expectations may affect not only the patient’s preoperative state but also postoperative pain control and/or postoperative outcomes.
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Nawabi, Farah, Adrienne Alayli, Franziska Krebs, Laura Lorenz, Arim Shukri, Anne-Madeleine Bau und Stephanie Stock. „Health literacy among pregnant women in a lifestyle intervention trial: protocol for an explorative study on the role of health literacy in the perinatal health service setting“. BMJ Open 11, Nr. 7 (Juli 2021): e047377. http://dx.doi.org/10.1136/bmjopen-2020-047377.
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IntroductionPregnancy is a vulnerable period that affects long-term health of pregnant women and their unborn infants. Health literacy plays a crucial role in promoting healthy behaviour and thereby maintaining good health. This study explores the role of health literacy in the GeMuKi (acronym for ‘Gemeinsam Gesund: Vorsorge plus für Mutter und Kind’—Strengthening health promotion: enhanced check-up visits for mother and child) Project. It will assess the ability of the GeMuKi lifestyle intervention to positively affect health literacy levels through active participation in preventive counselling. The study also explores associations between health literacy, health outcomes, health service use and effectiveness of the intervention.Methods and analysisThe GeMuKi trial has a hybrid effectiveness–implementation design and is carried out in routine prenatal health service settings in Germany. Women (n=1860) are recruited by their gynaecologist during routine check-up visits before 12 weeks of gestation. Trained healthcare providers carry out counselling using motivational interviewing techniques to positively affect health literacy and lifestyle-related risk factors. Healthcare providers (gynaecologists and midwives) and women jointly agree on Specific, Measurable, Achievable Reasonable, Time-Bound goals. Women will be invited to fill in questionnaires at two time points (at recruitment and 37th−40th week of gestation) using an app. Health literacy is measured using the German version of the Health Literacy Survey-16 and the Brief Health Literacy Screener. Lifestyle is measured with questions on physical activity, nutrition, alcohol and drug use. Health outcomes of both mother and child, including gestational weight gain (GWG) will be documented at each routine visit. Health service use will be assessed using social health insurance claims data. Data analyses will be conducted using IBM SPSS Statistics, version 26.0. These include descriptive statistics, tests and regression models. A mediation model will be conducted to answer the question whether health behaviour mediates the association between health literacy and GWG.Ethics and disseminationThe study was approved by the University Hospital of Cologne Research Ethics Committee (ID: 18-163) and the State Chamber of Physicians in Baden-Wuerttemberg (ID: B-F-2018-100). Study results will be disseminated through (poster) presentations at conferences, publications in peer-reviewed journals and press releases.Trail registrationGerman Clinical Trials Register (DRKS00013173). Registered pre-results, 3rd of January 2019, https://www.drks.de
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Irizarry-Pérez, Carlos, Mirza Lugo-Neris und Lisa Bedore. „Establishing Diagnostic Skills in Novice Bilingual Clinicians: A Scaffolded Approach“. Teaching and Learning in Communication Sciences and Disorders 5, Nr. 1 (2021). http://dx.doi.org/10.30707/tlcsd5.1.1624982519.487027.
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This study sought to scaffold administration performance of a standardized bilingual screener to sufficient levels of accuracy for data collection using principles of Cognitive Load Theory by managing task complexity when training pre-service clinicians. Before training administration skills, two students were given copies of the manual for the Bilingual English Spanish Oral Screener (BESOS) and asked to administer the protocol independently. During the intervention phase, students were scaffolded through administration tasks of increasing complexity and given explicit instruction, which included tailored goals, modeling and feedback. Performance for four skills was assessed using a fidelity rubric and analyzed using visual analysis. Performance varied per skill but overall scores were higher during the intervention phases than during the baseline phase for both students. In addition, accuracy of performance maintained across client participants showing patterns of generalization. Although the data are limited, scaffolding training skills for pre-service clinicians appears supportive in training administration skills for bilingual tasks. The level of support may vary per skill and per language. Future research may seek to investigate other clinical skills and tasks.
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El-Nimr, Nessrin A., und Iman Wahdan. „Identifying children with Special Health Care Needs in Alexandria, Egypt“. Online Journal of Public Health Informatics 11, Nr. 1 (30.05.2019). http://dx.doi.org/10.5210/ojphi.v11i1.9793.
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ObjectiveTo test the feasibility of using an Arabic version of CSHCN Screener in identifying CSHCN in the Egyptian setup and to estimate the prevalence of CSHCN among children aged 6-14 years in Alexandria, Egypt using the Arabic version of the CSHCN Screener.IntroductionChildren with special health care needs (CSHCN) are defined as: “those who have or are at increased risk for a chronic physical, developmental, behavioural, or emotional condition and who also require health and related services of a type or amount beyond that required by children generally.” (1) The care of CSHCN is a significant public health issue. These children are medically complex, require services and supports well beyond those that typically developing children require, and command a considerable proportion of the pediatric health care budget. (2)Different tools were used to identify CSHCN. (3, 4) One of them is the CSHCN screener (5) which uses a non-condition specific approach that identifies children across a range and diversity of childhood chronic conditions and special needs. (6) It identifies children with elevated or unusual needs for health care or educational services due to a chronic health condition. It focuses on health consequences a child experiences as a result of having an ongoing health condition rather than on the presence of a specific diagnosis or type of disability. It allows a more comprehensive assessment of the performance of the health care system than is attainable by focusing on a single diagnosis. (7) The CSHCN screener is only available in English and Spanish. (8)In developing countries, obtaining reliable prevalence rates for CSHCN is challenging. Sophisticated datasets associated with governmental services and high quality research studies are less common due to fewer resources. Egypt has no screening or surveillance systems for identifying CSHCN. (9)MethodsA community based survey was conducted among a representative sample of children aged 6-14 years from the 8 health districts of Alexandria, Egypt using a multistage cluster sampling technique. The final sample amounted to 501 children from 405 families. Data about the children and their families were collected by interviewing the mothers of the selected children using a pre-designed interviewing questionnaire. The questionnaire included their personal and family characteristics in addition to the Arabic translation of CSHCN screener. Permission to translate the questionnaire into the Arabic language was obtained from the Child and Adolescent Health Measurement Initiative. Validation and cultural adaptation of the translated CSHCN screener were done. The survey questions were generally understandable by Arabic speakers. As for the screener questions, the Arabic translation was straightforward and clear. The difference between the Arabic translation for the words “health conditions” and “medical conditions” in the 1st follow up questions was not clear for the respondents and the interviewers had to give an explanation for the two terms to help the respondents. So, it was easier for the respondents to answer the screener questions than the follow up questions.ResultsOut of the 501 children included in the study, 61 were identified by the screener to be CSHCN, making a prevalence of CSHCN of 12.2%. The prevalence of children with dependency on prescription medicine was 11.8%, while the prevalence of children with service use above that considered usual or routine was 11.8%. The prevalence of children with functional limitations was 12%. Among these domains, in almost all children, the reason was a medical, behavioral or health condition (98.3%) and the condition has continued or is expected to continue for at least 12 months in all children. Among CSHCN, the majority (91.8%) had these three domains combined.Sensory impairments ranked first among the most prevalent conditions requiring special health care with a prevalence of 2.8% which represented 23% of the conditions, followed by cognitive impairments with a prevalence of 2% representing 16.4% of all conditions requiring special health care. Impaired mobility was the third most common condition requiring special care with a prevalence of 1.8%.The table shows that CSHCN were more likely to be in the younger age group (6-<10 years), to be males, to be the first in order among their siblings and to have an illiterate or just read and write father. On the other hand, CSHCN were less likely to have a university educated mother, to be living with both parents and to be from a family without an enough income. The only significant factor was the type of family (cOR=0.88, 95% CI = 0.85-0.91).ConclusionsThe study showed the feasibility to use the CSHCN screener in the Egyptian National health care services to easily identify the majority of children that need to be the focus of the National health care services. It could also be an easy tool to assess the quality of the ongoing school health programs in responding to the overall needs of school children.With the present Egyptian policy of reform giving special attention to people in need particularly sensitive groups such as school children, it is therefore recommended that the school health services, in addition to the ongoing diagnostic, preventive and curative services add an additional measure, namely the screener for CSHCN, which is a simple easily administered screening tool which will also assist to depict existing gaps in the health care system to ensure being comprehensive.ReferencesMcPherson M, Arango P, Fox C, et al. A new definition of children with special health care needs. Pediatrics 1998;102:137-40.Goldson E, Louch G, Washington K, et al. Guidelines for the care of the child with special health care needs. Adv Pediatr 2006;53:165-82.Newacheck PW, Strickland B, Shonkoff JP, et al. An epidemiologic profile of children with special health care needs. Pediatrics 1998;102:117-23.Stein REK, Silver EJ. Operationalizing a conceptually based noncategorical definition. A first look at U.S. children with chronic conditions. Arch Pediatr Adolesc Med 1999;153:68-74.Child and Adolescent Health Measurement Initiative. The children with special health care needs (CSHCN) screener. Baltimore: CAHMI; 1998. 10p.Child and adolescent initiative. Who are children with special health care needs (CSHCN). Baltimore: CAHMI; 2012. 2p.Bethell CD, Read D, Neff J, et al. Comparison of the children with special health care needs screener to the questionnaire for identifying children with chronic conditions–revised. Ambul Pediatr 2002;2:49-57.Read D, Bethell C, Blumberg SJ, et al. An evaluation of the linguistic and cultural validity of the Spanish language version of the children with special health care needs screener. Matern Child Health J 2007;11(6):568-85.Kennedy P, editor. The Oxford Handbook of Rehabilitation Psychology. Oxford, New York: Oxford University Press; 2012.
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Hill, Heather M., Laura A. Swink, Karen E. Atler, Abby K. Anderson, Brett W. Fling und Arlene A. Schmid. „Merging Yoga and Occupational Therapy for Parkinson’s Disease improves fatigue management and activity and participation measures“. British Journal of Occupational Therapy, 08.04.2020, 030802262090908. http://dx.doi.org/10.1177/0308022620909086.
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Introduction The purpose of this study was to explore the influence of a falls-risk management intervention, Merging Yoga and Occupational Therapy for Parkinson’s Disease, on fatigue and activity and participation measures, as well as examine the relationship between these constructs. Methods This mixed methods study included 17 participants with Parkinson’s disease. Participants took the Modified Fatigue Impact Scale and the International Classification of Functioning, Disability, and Health Measure of Participation and Activities Screener at three 8-week intervals: baseline (followed by an 8-week control period), pre-intervention, and post-intervention. Focus groups were completed at the conclusion of the study to explore participants’ perception of Merging Yoga and Occupational Therapy for Parkinson’s Disease related to their fatigue and activity and participation. Results Fatigue and activity and participation measures were significantly correlated ( r = 0.76). Activity and participation measures (Measure of Participation and Activities Screener) significantly improved after the intervention ( p = 0.012). Four themes related to fatigue and/or activity and participation emerged following qualitative analysis, including: managing fatigue: paying attention and acting accordingly; creating mindfulness in daily activities; giving and receiving within a community; and strengthening relationship to self and others. Conclusion Participants experienced improvement in activity and participation measures and perceived fatigue management after engagement in the community-based Merging Yoga and Occupational Therapy for Parkinson’s Disease program.
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Ray, Anirban, und Subrata Das. „PSYCHOLOGICAL MORBIDITY FOLLOWING HYSTERECTOMY IN EASTERN INDIAN POPULATION“. PARIPEX INDIAN JOURNAL OF RESEARCH, 15.12.2019, 1–3. http://dx.doi.org/10.36106/paripex/3400956.
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INTRODUCTION: Hysterectomy is the commonest gynecological operation. It can be associated with psychological morbidity due to multiple factors.Though few studied showed on the contrary. MATERIALS AND METHODS: An observational study was conducted in a tertiary care center in West Bengal where 100 post hysterectomy patients who consented to be recruited, had undergone Bengali version of SRQ-20, and a semi structured questionnaire one month after hysterectomy. RESULT AND ANALYSIS: 64% had screener positive psychiatric morbidity.Occupation of the patient,type of operation and nature of histopathology can predict the occurrence of psychiatric morbidity. CONCLUSION: Post hysterectomy associated with significant psychiatric morbidity. Pre-post or case-control study with longer follow up would render stronger results.
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Jennings, Leah, Sanjana Marpadga, Cissie Bonini, Melissa Akers, Ronli Levi und Kelsey Long. „The Impact of a Community Fruit and Vegetable Voucher Program (Vouchers 4 Veggies) on Improvements in Dietary Intake and Food Security (P04-013-19)“. Current Developments in Nutrition 3, Supplement_1 (01.06.2019). http://dx.doi.org/10.1093/cdn/nzz051.p04-013-19.
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Abstract Objectives Vouchers 4 Veggies (V4V) is a transformative healthy food voucher program aimed at increasing access to and affordability of healthy food in the most vulnerable communities. Between 2015–2018, over 2600 ethnically diverse low-income individuals were enrolled in the program with the goal to increase their fruit and vegetable intake, improve food security status and change health perception. Methods V4V partners with local community-based organizations and clinics that serve as voucher distribution sites as well as neighborhoods stores, grocery stores, and famer's markets where participants can redeem their vouchers. Participants receive $20-$40 worth of vouchers per month for 6 months. Data for this evaluation were collected using pre- and post- surveys (at 0 and 4–6 months) that included a validated fruit and vegetable intake screener, the USDA 7-item food security screener, demographic questions and health perception questions. Results Data from 862 matched surveys indicate that mean fruit and vegetable intake increased from 2.49 to 3.52 servings daily, corresponding to a 1.03 servings increase after six months in the program (0.89,1.77; P < .001). In addition, V4V participants’ food security scores improved, decreasing 0.88 points (−1.07, −0.71; P < 0.001) on a 6 point scale (0 being the most food secure and 6 being very food insecure), from a mean of 5.53 to 4.65 using the USDA validated 6-item scale. When stratified by race, food security improved significantly for all major racial groups except Black/African Americans. Finally, participants reported a statistically significant improvement in self-reported health status (P < 0.001), with a 14% change in status from poor/fair health to good/very good/excellent health. Conclusions This evaluation suggests that a modest supplement for fruits and vegetables may be able to improve dietary intake, support food security, and improve health perception among vulnerable residents of San Francisco. More research is needed to understand differences in maintaining long-term health and behavior changes among program participants. Funding Sources V4V received funding from the SF Department of Public Health, Hellman Foundation, AARP Foundation, and Kaiser Permanente Community Benefits Program.
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Frank, Andrew, Serena Goldlist, Amy E. Mark Fraser und Matthew Bromwich. „Validation of SHOEBOX QuickTest Hearing Loss Screening Tool in Individuals With Cognitive Impairment“. Frontiers in Digital Health 3 (13.09.2021). http://dx.doi.org/10.3389/fdgth.2021.724997.
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Objectives: The aim of this study was to validate a novel iPad-based rapid hearing loss screening tool (SHOEBOX QuickTest) in individuals with cognitive impairment.Design: Cross-sectional validation study.Setting: Bruyère Research Institute, Ottawa, Canada.Subjects and Methods: Twenty-five individuals with mild cognitive impairment (MCI) and mild dementia from the Bruyère Memory Program were included in this study. The study consisted of two components: (1) SHOEBOX QuickTest hearing screener and (2) a conventional hearing test (pure tone audiometry).Measurements: Hearing was assessed at 1,000, 2,000, and 4,000 Hz separately for each ear. The agreement between hearing ability groupings (good vs. reduced) from conventional hearing test and SHOEBOX QuickTest was determined. Specifically, accuracy, sensitivity, specificity, as well as alignment between conventional thresholds and hearing threshold ranges.Results: An overall accuracy of 84% was observed for SHOEBOX QuickTest, and a sensitivity and specificity of 100 and 66.7%, respectively. 72% ([95% CI], 60.0–84.1%) of conventional audiometry thresholds were within the pre-established 10 dB SHOEBOX QuickTest.Conclusion: SHOEBOX QuickTest is a valid hearing loss screening tool for individuals with cognitive impairment. Implementing this iPad-based screening tool in memory clinics could not only aid in the timely diagnosis of hearing loss, but also assist physicians in providing a better assessment of cognitive impairment by ruling out hearing loss as a confounding variable.
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Saxe-Custack, Amy, Jenny LaChance, Mona Hanna-Attisha und Chantel Dawson. „Flint Kids Cook: positive influence of a farmers’ market cooking and nutrition programme on health-related quality of life of US children in a low-income, urban community“. Public Health Nutrition, 08.10.2020, 1–9. http://dx.doi.org/10.1017/s136898002000395x.
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Abstract Objective: To examine changes in health-related quality of life (HRQoL) among youth who participated in Flint Kids Cook, a 6-week healthy cooking programme for children, and assess whether changes in HRQoL were associated with changes in cooking self-efficacy, attitude towards cooking (ATC) and diet. Design: Pre-post survey (Pediatric Quality of Life Inventory, Block Kids Food Screener, 8-item cooking self-efficacy, 6-item ATC) using child self-report at baseline and programme exit. Analysis involved paired sample t-tests and Pearson’s correlations. Setting: Farmers’ market in Flint, Michigan, USA. Participants: Children (n 186; 55·9 % female, 72·6 % African American) participated in Flint Kids Cook from October 2017 to February 2020 (mean age 10·55 ± 1·83 years; range 8–15). Results: Mean HRQoL summary score improved (P < 0·001) from baseline (77·22 ± 14·27) to programme exit (81·62 ± 14·43), as did mean psychosocial health summary score (74·68 ± 15·68 v. 79·04 ± 16·46, P = 0·001). Similarly, physical (P = 0·016), emotional (P = 0·002), social (P = 0·037), and school functioning (P = 0·002) improved. There was a correlation between change in HRQoL summary score and change in ATC (r = –0·194, P = 0·025) as well as change in cooking self-efficacy (r = –0·234, P = 0·008). Changes in HRQoL and psychosocial health summary scores were not correlated with dietary changes, which included decreased added sugar (P = 0·019) and fruit juice (P = 0·004) intake. Conclusions: This study is the first to report modest yet significant improvements in HRQoL among children and adolescents who participated in a healthy cooking programme. Results suggest that cooking programmes for youth may provide important psychosocial health benefits that are unrelated to dietary changes.
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Jacobson, Kara L., Juliette Faughnan, Laurie Myers, Amy Dubost, Lisa Courtade, Scott von Lutcken, Christine McCrary Sisk et al. „An Innovative Health Literacy Approach Designed to Improve Patient Understanding of Medication Labeling“. Therapeutic Innovation & Regulatory Science, 02.08.2021. http://dx.doi.org/10.1007/s43441-021-00325-5.
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Abstract Objective Limited health literacy negatively impacts understanding of medication-related information. We describe an innovative methodology designed to optimize user understanding of patient medication labeling through the systematic application of evidence-based health literacy principles, using the Patient Package Insert (PPI) for bezlotoxumab (ZINPLAVA™, Merck & Co., Inc., Kenilworth, NJ, USA) as an example. Methods We used a mixed-model, iterative approach consisting of three phases: (1) content development; (2) focus group testing; and (3) comprehension testing. Content development was based on evidence-based health literacy principles and conducted through a collaborative partnership between industry and academia professionals. The PPI was then tested in four focus groups, two in Atlanta and two in Chicago, with an emphasis on collecting feedback from respondents with limited health literacy, evaluated using the Newest Vital Sign (NVS) health literacy assessment tool. Subsequent comprehension testing included patients with C. diff, caregivers, and general population members, with a pre-defined target sample of 25% with limited health literacy identified through two health literacy assessment tools: the Single Item Literacy Screener and the NVS. Results Content development of the bezlotoxumab PPI occurred in May 2015. In June 2015, focus group respondents (n = 34) provided generally favorable feedback, with insights revolving around organization and usability; language and comprehension; and volume of information. Comprehension testing of the revised PPI resulted in average comprehension scores of 96% for the overall population (n = 59), 90% for individuals presenting with limited health literacy (n = 14), and 97% for those with adequate health literacy (n = 45). This PPI development approach was similarly effective for subsequent products across diverse therapeutic areas, with comprehension scores ≥ 86% for all participants (n = 1197). Conclusion This methodology represents a significant advancement for the development of understandable patient medication labeling, especially for people with limited health literacy.
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Elmore, Rebecca, Lena Schmidt, Juleen Lam, Brian E. Howard, Arpit Tandon, Christopher Norman, Jason Phillips et al. „Risk and Protective Factors in the COVID-19 Pandemic: A Rapid Evidence Map“. Frontiers in Public Health 8 (24.11.2020). http://dx.doi.org/10.3389/fpubh.2020.582205.
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Background: Given the worldwide spread of the 2019 Novel Coronavirus (COVID-19), there is an urgent need to identify risk and protective factors and expose areas of insufficient understanding. Emerging tools, such as the Rapid Evidence Map (rEM), are being developed to systematically characterize large collections of scientific literature. We sought to generate an rEM of risk and protective factors to comprehensively inform areas that impact COVID-19 outcomes for different sub-populations in order to better protect the public.Methods: We developed a protocol that includes a study goal, study questions, a PECO statement, and a process for screening literature by combining semi-automated machine learning with the expertise of our review team. We applied this protocol to reports within the COVID-19 Open Research Dataset (CORD-19) that were published in early 2020. SWIFT-Active Screener was used to prioritize records according to pre-defined inclusion criteria. Relevant studies were categorized by risk and protective status; susceptibility category (Behavioral, Physiological, Demographic, and Environmental); and affected sub-populations. Using tagged studies, we created an rEM for COVID-19 susceptibility that reveals: (1) current lines of evidence; (2) knowledge gaps; and (3) areas that may benefit from systematic review.Results: We imported 4,330 titles and abstracts from CORD-19. After screening 3,521 of these to achieve 99% estimated recall, 217 relevant studies were identified. Most included studies concerned the impact of underlying comorbidities (Physiological); age and gender (Demographic); and social factors (Environmental) on COVID-19 outcomes. Among the relevant studies, older males with comorbidities were commonly reported to have the poorest outcomes. We noted a paucity of COVID-19 studies among children and susceptible sub-groups, including pregnant women, racial minorities, refugees/migrants, and healthcare workers, with few studies examining protective factors.Conclusion: Using rEM analysis, we synthesized the recent body of evidence related to COVID-19 risk and protective factors. The results provide a comprehensive tool for rapidly elucidating COVID-19 susceptibility patterns and identifying resource-rich/resource-poor areas of research that may benefit from future investigation as the pandemic evolves.
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Rao, Preethi Mohan, Enis Mumdzic, Daniel Marcus Kelly und Thomas Hugh Jones. „SAT-051 Effects of Testosterone Replacement on Glycemic Control and Other Cardiovascular Risk Factors in Hypogonadal Men with Uncontrolled Type 2 Diabetes (Stride Study): Design, Implementation and Baseline Data“. Journal of the Endocrine Society 4, Supplement_1 (April 2020). http://dx.doi.org/10.1210/jendso/bvaa046.1017.
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Abstract Up to 40% of men with type II diabetes are testosterone deficient. There is growing evidence that testosterone therapy has a beneficial effect on glycemic control, insulin resistance and may have a cardioprotective effect, contrary to the traditional view that testosterone is detrimental to the heart. Our study aims to evaluate the effect of testosterone therapy on glycaemic control other cardiovascular risk factors, symptomatic benefit and quality of life in a randomised double-blind placebo controlled add-on of testosterone therapy to their normal hypoglycemic medication in hypogonadal men with uncontrolled type 2 diabetes. The study population includes 65 eligible men (140 screened) with poorly controlled diabetes (HbA1c between 53 and 80 mmol/mol) and confirmed hypogonadism by early morning [0800−1200h] total testosterone [TT] ≤12 nmol/L or calculated free testosterone ≤255 pmol/L on two occasions ≥1 week apart, with at least two symptoms of hypogonadism. The trial is divided into 2 phases. Phase 1: patients are randomly assigned to either treatment (depot testosterone undecanoate) arm or the placebo arm for 6 months. Phase 2: open label phase for 6 months with subjects on placebo on placebo initiated on to testosterone therapy while subjects in the treatment group continue to receive treatment for the 12 month duration. No change to anti- glycaemic therapy was made during the first phase of the study. The primary endpoint is HbA1c. Secondary endpoints include body composition (bioelectrical impedence DEXA scan), HOMA-IR, lipid profile, blood pressure (24 hr BP monitor), carotid media intima thickness, monocyte mRNA cytokine expression, Questionnaires include AMS (Aging Male Symptom Score), IIEF-5(International Index of Erectile Dysfunction), SF36-Quality of life, Mini mental score, New questionnaire for hypogonadism in diabetes (to be validated), NERI (New England Research Institute) hypogonadal screener. Baseline data indicate the mean age 59 (42-77) years. Mean Duration of diabetes was 8.6(0-21) years. 18 men were on Insulin. The remaining 47 men were either diet controlled or on oral hypoglycaemic medications. 9 men had pre-existing history of MI and 4 had history of angina. Mean HbA1c at baseline was 65(53-80) mmol/mol. Mean total testosterone level was 8.9(2.1-16.9) nmol/l. Mean weight and BMI at baseline were 107(71-187) kg and 34.5(24-52) respectively. Mean waist circumference was 115.7(46-160) cm The primary aim of this is to determine if testosterone therapy improves glycemic control in men with uncontrolled diabetes. Secondly to assess beneficial effects on specific cardiovascular parameters as well as QOL. This could have a major clinical implication on how we treat patients with hypogonadism and type 2 diabetes.
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Babapour Mofrad, Rosha, Philip Scheltens, SangYun Kim, Sungmin Kang, Young Chul Youn, Seong Soo A. An, Jori Tomassen et al. „Plasma amyloid-β oligomerization assay as a pre-screening test for amyloid status“. Alzheimer's Research & Therapy 13, Nr. 1 (26.07.2021). http://dx.doi.org/10.1186/s13195-021-00873-w.
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Abstract Objective We assessed the performance of plasma amyloid oligomerization tendency (OAβ) as a marker for abnormal amyloid status. Additionally, we examined long-term storage effects on plasma OAβ. Methods We included 399 subjects regardless of clinical diagnosis from the Amsterdam Dementia Cohort and European Medical Information Framework for AD project (age, 63.8 ± 6.6; 44% female). Amyloid status was determined by visual read on positron emission tomography (PET; nabnormal = 206). Plasma OAβ was measured using the multimer detection system (MDS). Long-term storage effects on MDS-OAβ were assessed using general linear models. Associations between plasma MDS-OAβ and Aβ-PET status were assessed using logistic regression and receiver operating characteristics analyses. Correlations between plasma MDS-OAβ and CSF biomarker levels were evaluated using Pearson correlation analyses. Results MDS-OAβ was higher in individuals with abnormal amyloid, and it identified abnormal Aβ-PET with an area under the curve (AUC) of 0.74 (95% CI, 0.67–0.81), especially in samples with a storage duration < 4 years. Combining APOEe4 and age with plasma MDS-OAβ revealed an AUC of 81% for abnormal amyloid PET status (95% CI, 74–87%). Plasma MDS-OAβ correlated negatively with MMSE (r = − 0.29, p < .01) and CSF Aβ42 (r = − 0.20, p < 0.05) and positively with CSF Tau (r = 0.20, p = 0.01). Conclusions Plasma MDS-OAβ combined with APOEe4 and age accurately identifies brain amyloidosis in a large Aβ-confirmed population. Using plasma MDS-OAβ as a screener reduced the costs and number of PET scans needed to screen for amyloidosis, which is relevant for clinical trials. Additionally, plasma MDS-OAβ levels appeared affected by long-term storage duration, which could be of interest for others measuring plasma Aβ biomarkers.