Yoxas/statistical_literacy huggingface dataset:
Humor has been commonly used in palliative care and identified as a coping strategy of palliative care patients and family caregivers. However, the use of humor or laughter in palliative care settings is still limited. The aim of this study was to examine the effect of laughter therapy involving spontaneous laughter on mood disturbances and pain in terminally ill patients with cancer and mood disturbances and the levels of burnout in family caregivers. This quasi-experimental study used a nonequivalent control group pretest-posttest design. The laughter therapy developed was provided for 20 to 30 minutes a day for 5 consecutive days. Twenty-six pairs of terminally ill cancer patients and family caregivers in the intervention group and 23 pairs in the comparison group from the hospice ward of a tertiary teaching hospital participated in this study. The data were collected using structured questionnaires and analyzed using descriptive statistics and 2-way repeated-measures analysis of variance. There were significant decreases in mood disturbances in the patients ( P < .001) and family caregivers ( P < .001), pain in the patients ( P < .001), and levels of burnout in the caregivers ( P < .001) in the intervention group. Laughter therapy can be an alternative intervention to support both terminally ill patients with cancer and their family caregivers experiencing multidimensional distress in palliative care settings. The appropriate use of laughter or humor therapy needs to be encouraged as a support tool in palliative care. Palliative care teams must be properly trained to provide spontaneous laughter therapy or planned humor therapy.
Hybrids between species are often sterile or inviable. This form of reproductive isolation is thought to evolve via the accumulation of mutations that interact to reduce fitness when combined in hybrids. Mathematical formulations of this "Dobzhansky-Muller model" predict an accelerating buildup of hybrid incompatibilities with divergence time (the "snowball effect"). Although the Dobzhansky-Muller model is widely accepted, the snowball effect has only been tested in two species groups. We evaluated evidence for the snowball effect in the evolution of hybrid male sterility among subspecies of house mice, a recently diverged group that shows partial reproductive isolation. We compared the history of subspecies divergence with patterns of quantitative trait loci (QTL) detected in F2 intercrosses between two pairs of subspecies (Mus musculus domesticus with M. m. musculus and M. m. domesticus with M. m. castaneus). We used a recently developed phylogenetic comparative method to statistically measure the fit of these data to the snowball prediction. To apply this method, QTL were partitioned as either shared or unshared in the two crosses. A heuristic partitioning based on the overlap of QTL confidence intervals produced unambiguous support for the snowball effect. An alternative approach combining data among crosses favored the snowball effect for the autosomes, but a linear accumulation of incompatibilities for the X chromosome. Reasoning that the X chromosome analyses are complicated by low mapping resolution, we conclude that hybrid male sterility loci have snowballed in house mice. Our study illustrates the power of comparative genetic mapping for understanding mechanisms of speciation.
Hygiene is the science of health and its maintenance. Hygiene status of children is an index of national investment in the development of its man power. It is influenced by social, familial and individual factors as well as the children's knowledge of health on personal hygiene, comfort and basic needs. The utility of games is as a teaching strategy of health professionals. The main objectives of the study were to assess existing level of awareness regarding healthy habits among school children and to check the effect of Modified snake & ladder game in improving the awareness of children regarding healthy habits. Research design selected for this study was pre experimental one group pretest posttest design with a sample size of 60. Samples of the study were given opportunity to play and earn awareness through the modified snake & ladder game. Their awareness was assessed before and after the game section. Data was analyzed by using descriptive and inferential statistics such as mean, standard deviation and chi square test. In data analysis the mean of pre-test score was 13.83 and mean of post-test score was 18.63. The mean difference was 4.8. The standard deviation of pre-test stress score was 01.07 and post-test stress score was 01.60. The calculated' 't' value was 21.24, which was greater than the table value(1.67).The study concluded that snake and ladder game was effective in improving the awareness of school children on healthy habits.
Hyperbaric oxygen treatment (HBOT) has fourteen approved indications in the management of acute and chronic diseases in various medical specialties. However, lack of physician knowledge and exposure to hyperbaric medicine may hinder the ability of patients to access this treatment option for approved indications. We aimed to determine the prevalence and nature of HBOT-related learning objectives in Canadian undergraduate medical education programs. Pre-clerkship and clerkship learning objectives from responding Canadian medical schools' curricula were reviewed. These were acquired through the school websites or by emailing the faculties. Descriptive statistics were used to summarise the number of hyperbaric medicine objectives taught in Canadian medical schools, and within each institution. Learning objectives from seven of the 17 Canadian medical schools were received and reviewed. From the curriculum of the responding schools, only one objective was found to be related to hyperbaric medicine. Hyperbaric medicine was absent from the other six schools' objectives. Based on the responding Canadian medical schools, hyperbaric medicine objectives were mostly absent from undergraduate medical curricula. These findings illustrate a possible gap in HBOT education and the need for discussion regarding the design and implementation of HBOT educational initiatives in medical training.
Hyperfluorescence (HF) and reduced autofluorescence (RA) are important biomarkers in fundus autofluorescence images (FAF) for the assessment of health of the retinal pigment epithelium (RPE), an important indicator of disease progression in geographic atrophy (GA) or central serous chorioretinopathy (CSCR). Autofluorescence images have been annotated by human raters, but distinguishing biomarkers (whether signals are increased or decreased) from the normal background proves challenging, with borders being particularly open to interpretation. Consequently, significant variations emerge among different graders, and even within the same grader during repeated annotations. Tests on in-house FAF data show that even highly skilled medical experts, despite previously discussing and settling on precise annotation guidelines, reach a pair-wise agreement measured in a Dice score of no more than 63-80% for HF segmentations and only 14-52% for RA. The data further show that the agreement of our primary annotation expert with herself is a 72% Dice score for HF and 51% for RA. Given these numbers, the task of automated HF and RA segmentation cannot simply be refined to the improvement in a segmentation score. Instead, we propose the use of a segmentation ensemble. Learning from images with a single annotation, the ensemble reaches expert-like performance with an agreement of a 64-81% Dice score for HF and 21-41% for RA with all our experts. In addition, utilizing the mean predictions of the ensemble networks and their variance, we devise ternary segmentations where FAF image areas are labeled either as confident background, confident HF, or potential HF, ensuring that predictions are reliable where they are confident (97% Precision), while detecting all instances of HF (99% Recall) annotated by all experts.
Hypertension (HT) can cause renal complications or deterioration of kidney function. HT management is very important because it reduces the severity of illnesses. This study aimed to investigate the relationship between health literacy (HL), self-care behaviors (SCB), and biochemical parameters in hypertensive patients with renal complications. A cross-sectional study of 405 hypertensive patients with renal complications among Tai Lue people living in Thailand was conducted using simple random sampling. Face-to-face interviews with questionnaires were used to collect information. Blood pressure (BP) and biochemical parameters, such as fasting blood sugar (FBS) and estimated glomerular filtration rate (eGFR), were measured. The participants' mean age was 68.3 years. A significant correlation was found between HL score, SCB score, systolic BP (SBP), diastolic BP (DBP), FBS, and eGFR (p<0.01). Multiple linear regression revealed that eating salty foods was a risk factor for SBP in males and for SBP and DBP in females. Body mass index (BMI) (B = 0.54), sweet food consumption (B = 13.90), and SCB score (B = -0.29) were significantly associated with FBS level (R2 = 17.8%, p<0.05). Employment (B = 2.55), eating bland food (B = 4.07), receiving information from family (B = 3.53), SCB (B= 0.31), and age (B = -0.51) were all significant factors for eGFR (R2 = 35.0%, p<0.05). HL and SCB levels were associated with the health of hypertensive patients with renal complications in the Tai Lue ethnic community. The significance of organizing health education programs is to emphasize increasing HL to lead to self-care decisions and reduce complications in patients, resulting in improved SCB and quality of life in the future.
Hypertension (HT) is an orchestrator of atherosclerotic cardiovascular disease (ASCVD) in people living with type 2 diabetes (T2D). Control of systolic blood pressure (SBP) and HT as a whole is suboptimal in diabetes, partly due to the scarcity of doctors. While nurse-led interventions are pragmatic and cost-effective in the control of HT in primary health care, their effectiveness on SBP control among patients with T2D in Uganda is scantly known. We evaluated the effectiveness of a nurse-led management intervention on SBP among T2D patients with a high ASCVD risk in Uganda. A two-armed cluster randomized controlled trial compared the nurse-led management intervention with usual doctor-led care. The intervention involved training nurses to provide structured health education, protocol-based HT/CVD management, 24-h phone calls, and 2-monthly text messages for 6 months. The primary outcome was the mean difference in SBP change among patients with T2D with a high ASCVD risk in the intervention and control groups after 6 months. The secondary outcome was the absolute difference in the number of patients at target for SBP, total cholesterol (TC), fasting blood glucose (FBG), glycated hemoglobin (HbA1C), low-density lipoprotein (LDL), triglycerides (TG), and body mass index (BMI) after the intervention. The study was analyzed according to the intention-to-treat principle. Generalized estimating equations were used to assess intra-cluster effect modifiers. Statistical significance was set at 0.05 for all analyses. Eight clinics (n = 388 patients) were included (intervention 4 clinics; n = 192; control 4 clinics; n = 196). A nurse-led intervention reduced SBP by -11.21 ± 16.02 mmHg with a mean difference between the groups of -13.75 mmHg (95% CI -16.48 to -11.02, p < 0.001). An increase in SBP of 2.54 ± 10.95 mmHg was observed in the control group. Diastolic blood pressure was reduced by -6.80 ± 9.48 mmHg with a mean difference between groups of -7.20 mmHg (95% C1 -8.87 to -5.48, p < 0.001). The mean differences in the change in ASCVD score and glycated hemoglobin were -4.73% (95% CI -5.95 to -3.51, p = 0.006) and -0.82% (95% CI -1.30 to -0.35, p = 0.001), respectively. There were significant absolute differences in the number of patients at target in SBP (p = 0.001), DBP (p = 0.003), and TC (p = 0.008). A nurse-led management intervention reduces SBP and ASCVD risk among patients with T2D. Such an intervention may be pragmatic in the screening and management of HT/ASCVD in Uganda. Pan African Clinical Trial Registry, PACTR202001916873358, registered on 6th October 2019.
Hypertension (HTN) affects millions of Americans. Our Whole Lives: an eHealth toolkit for Hypertension and Cardiac Risk Factors (OWL-H) is an eHealth platform that teaches evidence-based lifestyle strategies, such mindfulness and cooking skills, to improve self-management of HTN. The primary goal of this pilot study was to evaluate the feasibility of OWL-H combined with teaching kitchen medical group visits (TKMGVs) in a low-income population of participants with HTN. We conducted a pre-post 8-week study to assess the feasibility of a hybrid program (a web-based 9-module self-management program, which includes mindfulness and Mediterranean and Dietary Approaches to Stop Hypertension diet) accompanied by 3 in-person TKMGVs among patients with HTN. Data including demographics, platform use, and satisfaction after using OWL-H were examined. Outcome data collected at baseline and 8 weeks included the Mediterranean Diet Questionnaire, Hypertension Self-Care Profile Self-Efficacy Instrument, Blood Pressure Knowledge Questionnaire, and the number of self-reported blood pressure readings. For the statistical analysis, we used descriptive statistics, paired sample t tests (1-tailed), and qualitative methods. Of the 25 enrolled participants, 22 (88%) participants completed the study. Participants' average age was 57 (SD 12.1) years, and 46% (11/24) of them reported a household income <US $30,000 per year. Among the 22 participants who logged in to OWL-H, the average number of mindfulness practices completed was 7 and the average number of module sessions accessed was 4. In all, 73% (16/22) of participants reported that they were "very satisfied" with using OWL-H to help manage their HTN. Participants' blood pressure knowledge significantly increased from baseline (mean 5.58, SD 1.44) to follow-up (mean 6.13, SD 1.23; P=.03). Participants significantly increased their adherence to a Mediterranean diet from baseline (mean 7.65, SD 2.19) to follow-up (mean 9, SD 1.68; P=.004). Participants' self-efficacy in applying heart-healthy habits, as measured by the Hypertension Self-Care Profile Self-Efficacy Instrument, increased from baseline (mean 63.67, SD 9.06) to follow-up (mean 65.54, SD 7.56; P=.14). At the 8-week follow-up, 82% (18/22) of the participants had self-reported their blood pressure on the OWL-H platform at least once during the 8 weeks. The eHealth platform for HTN self-management, OWL-H, and accompanying in-person TKMGVs have the potential to effectively improve lifestyle management of HTN. ClinicalTrials.gov NCT03974334; https://clinicaltrials.gov/ct2/show/NCT03974334.
Hypertension (HTN) significantly increases the risk of stroke and heart disease, which are the leading causes of death and disability globally, particularly among older adults. Antihypertensive medication is a proven treatment for blood pressure control and preventing complications. However, medication adherence rates in older adults with HTN are low. In this review, we systematically identified factors influencing medication adherence in older adults with HTN. We applied the PRISMA guidelines and conducted systematic searches on PubMed, MEDLINE, and Google Scholar in July 2022 to identify preliminary studies reporting factors influencing medication adherence among older adults with HTN. The convergent integrated analysis framework suggested by the Joanna Briggs Institute for systematic reviews was adopted for data synthesis. Initially, 448 articles were identified, and after title and abstract screening, 16 articles qualified for full-text review. During this phase, three articles were excluded for reporting on irrelevant populations or focusing on issues beyond the review's aim, leaving thirteen studies in the final review. After data synthesis, fifteen themes were extracted from the key findings of the included studies. The most prevalent themes included the number of medications used (53.9%, n=7 studies), financial status (38.5%, n=5), sex (38.5%, n=5), age (30.1%, n=4), duration of disease (23.1%, n=3), comorbidities (23.1%, n=3), and health compliance (23.1%, n=3). Other themes, such as education, health literacy, health belief, medication belief, perception of illness, patient-physician relationship, self-efficacy, and social support, were also identified. The findings of this review highlight critical areas for developing innovative, evidence-based programs to improve medication adherence in hypertensive older adults. Insights from this review can contribute to improving medication adherence and preventing future health complications.
Hypertension and diabetes are modifiable risk factors for dementia. We aimed to assess rural-urban disparities in the diagnosis and treatment of these conditions among aging Indians. Participants (n = 6316) were from two parallel, prospective aging cohorts in rural and urban India. Using self-report and clinical/biochemical assessments, we subdivided participants with diabetes and hypertension into undiagnosed and untreated groups. Logistic regression and Fairlie decomposition analysis were the statistical methods utilized. There was a significant rural-urban disparity in undiagnosed hypertension (25.14%), untreated hypertension (11.75%), undiagnosed diabetes (16.94%), and untreated diabetes (11.62%). Further, sociodemographic and lifestyle factors, such as age and tobacco use were the common contributors to the disparities in both undiagnosed hypertension and undiagnosed diabetes, whereas education and body mass index (BMI) were significant contributors to the disparity in untreated hypertension. Rural Indians face significant healthcare disadvantages as compared to their urban counterparts, which prompts the urgent need for strategies for equitable healthcare.
Hypertension has in the recent past surfaced as one of the conditions that has a significant impact on workforce productivity in emerging economies. Zambia is no different and has in the recent past recorded increasing cases. Despite the impact of hypertension being of great importance in regards to productivity, we have scarcity of data and studies on hypertension-related Productivity-Adjusted Life-Years (PALYs) in Zambia and Africa at large. This study assessed the impact of hypertension on PALYs lost and socioeconomic factors associated with nonadherence to antihypertensive medication (NATAM). This was a cross-sectional study of 198 participants from Livingstone University Teaching Hospital and Maramba Clinic situated in Livingstone, Zambia. Structured questionnaires were used to collect data. Productivity index multiplied by years lived was used to calculate PALYs and descriptive statistics were used to summarize sociodemographic, clinical and economic variables. Multivariable logistic regression was used to determine factors associated with NATAM. The participants had a median age (interquartile range (IQR)) of 49 years (41, 59) and 60.1% (n = 119) were females while 39.9% (n = 79) were male. Our estimated PALYs lost per person due to hypertension were 0.2 (IQR 0.0, 2.7). Cumulative PALYs value lost due to the burden of hypertension was estimated to be at $871,239.58 in gross domestic product (GDP). The prevalence of NATAM was 48% (n = 95). The factors that were significantly associated with NATAM were age (odds ratio (OR) 0.94; 95% confidence interval (CI) 0.90, 0.98), female sex (OR 2.52; 95%CI 1.18, 5.40), self-employment (OR 2.57; 95%CI 1.02, 6.45) and absenteeism from work (OR 3.60; 95%CI 1.16, 11.22). Findings in our study highlight a high economic loss of PALYs due to hypertension with a potential to impact GDP negatively. We also found that NATAM reduced productivity and income among individuals of working age further impacting PALYs lost due to hypertension. The factors associated with NATAM were age, sex, employment status and absenteeism from work. This study underscores the need for interventions targeting young people, females, self-employed individuals, and absentees at work to improve adherence to antihypertensive drugs in order to reduce PALYs lost due to hypertension.
Hypertension is a global public health burden. Angiotensin receptor blockers (ARBs) have proven efficacy in the management of hypertension and related complications. The Internet has become a major source of health information for patients and healthcare professionals. The study aimed to assess the quality and readability of internet-based information related to selected Angiotensin Receptor Blockers (ARBs). The three most widely used ARBs were identified from published literature, after which internet-based patient information was identified from the first five pages of three search engines (Google, Yahoo and Bing). Quality of identified websites were assessed using the DISCERN instrument, while readability was evaluated using the SMOG instrument and the Flesch-Kincaid readability algorithm. Final ratings were then calculated as described by the instruments developers. Further, inter-class correlation coefficients (ICC) were calculated using the Statistical Package for Social Sciences. The average overall DISCERN score in this study was 2.99 (SD±1.05). No website received an excellent rating, 15% were rated good, 66% as moderate and 19% as poor. The inter-class reliability was 0.804 for losartan and 0.695 for valsartan. The mean Flesch Reading Ease score for the websites was 48.87 (SD±16.12), mean Flesch-Kincaid Reading Grade Level was 9.29 (SD±1.98) while mean SMOG value was 11.29 (SD±1.70). Overall, patient information on the reviewed ARBs websites was found to be of moderate quality and suboptimal readability. Content providers on websites should ensure that health information is of favorable quality and easy to read by patients with varying degree of health literacy.
Hypertension is a key risk factor for cardiovascular disease and the leading cause of mortality among Indian adults. The difference in health status between men and women is becoming a great burden in itself worldwide. This study aimed to examine the differences between men and women in the prevalence, awareness, treatment, and control of hypertension and related risk factors among people aged 45 and older in India using data from the Longitudinal Ageing Study in India in 2017-2018. Descriptive statistics were presented separately for males and females. Multivariable logistic regression was used to analyze the socio-demographic, lifestyle behaviours, and biological factors associated with the prevalence of hypertension. All statistical analyses were conducted using Stata Version 16.0 statistical software. The study of the data was conducted using survey weights available in the LASI datasets. Overall, the study found that 45.1% of the study population had hypertension, with 26.9% self-reporting their condition and 30% having hypertension at the time of measurement. Approximately 41% of males and 59% of females had hypertension. The self-reported hypertension of men was found to differ significantly from measured hypertension by 8.7%, while in women the difference was only 1.2%. Diabetes was found to increase the odds of having hypertension in both males (OR = 3.65, 95% CI (3.37-3.97)) and females (OR = 3.46, 95% CI (3.21-3.74)). The difference between self-reported and measured hypertension in men and women is contributing to sex-gender and health inequalities that must be addressed. For adult females with hypertension, it is important to prioritize obesity, education level, physical activity, and regular clinic visits to manage chronic conditions. Based on our findings, policy recommendations can be made to focus on increasing women's literacy, promoting men's screening for hypertension, banning tobacco and alcohol sales, and organizing hypertension awareness campaigns specifically for men and in rural areas.