bluuebunny/crossref_metadata_2025 huggingface dataset:
Safe handling of hazardous drugs
Authors: Kennedy Kardi , Vu Kathy , Coakley Nadia , Daley-Morris Jennifer , Forbes Leta , Hartzell Renee , Lessels Darrilyn
Published: November 2022

Background: This evidence-based practice guideline was developed to update and address new issues in the handling of hazardous drugs including being compliant with NAPRA (National Association of Pharmacy Regulatory Authorities) and USP 800 (United States Pharmacopeia) standards, the use of personal protective equipment and treatment in diverse settings including in the home setting. Methods: This guideline was developed from an adaptation and endorsement of existing guidelines and from three systematic reviews. Prior to publication, this guideline underwent a series of peer, patient, methodological and external reviews to gather feedback. All comments were addressed and the guideline was amended when required. This guideline applies to and is intended for all health care workers who may come into contact with hazardous drugs at any point in the medication circuit. Results: The recommendations represent a reasonable and practical set of procedures that the intended users of this guideline should implement to minimize the opportunity for accidental exposure. These recommendations are not limited to just the point of care, but cover the entire chain of handling of cytotoxics from the time they enter the institution until they leave in the patient or as waste. Conclusions: Decreasing the likelihood of accidental exposure to cytotoxic agents within the medication circuit is the main objective of this evidenced-based guideline. The recommendations differ slightly from previous guidelines due to new evidence.
Photodynamic therapy (PDT) as adjuvant treatment to brachytherapy for amelanotic choroidal melanoma
Authors: Pagliara Monica Maria , Sammarco Maria Grazia , Caputo Carmela Grazia , Pafundi Pia Clara , Giannuzzi Federico , Fionda Bruno , Scupola Andrea , Tagliaferri Luca , Rizzo Stanislao , Blasi Maria Antonietta
Published: November 2022

Purpose

To evaluate the effect of photodynamic therapy (PDT) as adjuvant treatment, after brachytherapy, in posterior amelanotic choroidal melanomas.

Methods

Six patients with posterior amelanotic choroidal melanoma underwent brachytherapy treatment. Tumour response was assessed by fundus examination, fundus photography and A-B scan ultrasonography. The residual tumours were treated with adjuvant PDT performed with infusion of verteporfin intravenously at 6 mg/m2 body surface area. Five minutes after infusion, a 689 nm laser was applied with a light dose of 100 J/cm2 over an interval of 166 s.

Results

At a median follow-up after brachytherapy of 17.5 months (IQR 16.2–22.5, range 5–42 months), tumours showed a partial reduction of tumour thickness (22.5% as compared to baseline value) and persistent low internal reflectivity at A-B scan ultrasonography. Supplementary photodynamic treatment resulted in complete resolution of the lesion with marked decrease of elevation . Mean decrease in thickness after PDT was 49.9% with respect to previous brachytherapy treatment 22.5% (p = 0.007). The results was achieved within a median period of 4 months (range 2–4 months) after PDT, and there has been no recurrence after a median follow-up of 84.7 months ± 18.7 (range 59 to 107 months).

Conclusion

Combined treatment of brachytherapy and adjuvant PDT in amelanotic uveal melanoma seems to be favourable with regard to complete and rapid tumour regression.
Evaluation of Genetic Polymorphisms of the Antioxidant Enzymes and Biomarkers of Oxidative Stress in Preterm Neonates With Respiratory Distress Syndrome Receiving External Surfactant
Authors: Sridharan Kannan , Al Jufairi Mona , Hejab Aamal AbdulGhani Mahdi , Al Madhoob Abdulraoof , Al Marzooq Reem , Taha Safa , Jaber Mulla Aljishi Muna , Abdulhadi Ameera , Al Ansari Eman , Ali Masooma Abdulla , Naser Maryam Ali Ahmed , Al Segai Ola , Dunne Kevin
Published: November 2022

Background:

Preterm neonates, particularly extremely preterm, are susceptible to respiratory distress syndrome (RDS) due to surfactant deficiency. Single nucleotide polymorphisms (SNPs) in the antioxidant enzymes influence the balance between antioxidant and oxidative stress molecules.

Objectives:

To ascertain the role of SNPs of antioxidant enzymes and oxidative stress biomarkers in preterm neonates with RDS.

Design:

Observational, cross-sectional study.

Methods:

Preterm neonates diagnosed with RDS receiving external surfactant within 24 hours were considered as the cases and those without RDS were the control group. Umbilical cord blood and peripheral blood samples before administering surfactant (day 1), and on days 2 and 3 were collected. Plasma malondialdehyde, 8-hydroxy-2-deoxy guanosine (8-OH-dG), advanced oxidation protein products (AOPP), total antioxidant capacity (TAC), visfatin, reduced glutathione, and chaperonin 60 were evaluated using enzyme-linked immunosorbent assay. SNPs in manganese superoxide dismutase (MnSOD), copper/zinc superoxide dismutase (Cu/Zn SOD), glutathione peroxidase (GPX1 and GPX3), catalase (CAT), glutathione S-transferase (GSTP1) were evaluated using real-time polymerase-chain-reaction. The receiver-operating characteristics curve was used for predicting the accuracy of biomarkers using the area under the curve (AUC) and 95% confidence intervals (95% CI).

Results:

GSTP1, MnSOD, and eNOS (rs1799983) SNPs were observed to significantly influence the oxidative biomarker concentrations in the entire study population. SNPs in GSTP1, MnSOD, and eNOS (rs1799983) were significantly associated with differences in oxidative stress biomarkers. MnSOD (rs4880) significantly increased the risk of pulmonary complications in neonates with RDS. DNA damage product (8-OH-dG) concentrations before surfactant administration has the best predictive accuracy (AUC: 0.8; 95% CI: 0.7-1; P = .001) for pulmonary complications with a cut-off value of 5008.8 pg/mL. TAC concentrations are significantly greater on day 2 and day 3 amongst neonates receiving surfactant compared to the control group. AOPP in the umbilical cord blood was observed to significantly predict the severity of RDS (AUC: 0.8; 95% CI: 0.6-1; P = .01) with an optimal cut-off value of 88.78 µmol/L.

Conclusion:

We observed that SNPs in eNOS and MnSOD significantly influence the production of oxidative stress biomarkers in preterm neonates. Baseline 8-OH-dG concentrations best predict the risk of pulmonary complications and AOPP concentrations in the umbilical cord blood predict the risk of RDS severity.
Combination of Baseline and Variation of Prognostic Nutritional Index Enhances the Survival Predictive Value of Patients With Advanced Non-Small Cell Lung Cancer Treated With Programmed Cell Death Protein 1 Inhibitor
Authors: Fang Qiyu , Yu Jia , Luo Jie , Deng Qinfang , Chen Bin , He Yayi , Zhang Jie , Zhou Caicun
Published: November 2022

Background:

Low baseline prognostic nutritional index (PNI) scores are associated with poor survival for various malignancies; however, they vary based on the cohort and time resulting in inaccurate results. We determined the predictive value of the PNI score variations in addition to the baseline PNI scores for patients with advanced non-small cell lung cancer (NSCLC) who received programmed cell death protein 1 (PD-1) inhibitor.

Methods:

We retrospectively analysed 115 patients with advanced NSCLC who received PD-1 inhibitor. The median follow-up period was 28 months. Patients were clustered into four groups based on the combined PNI scores (combination of baseline and variation of PNI scores): ΔPNI-L-L, ΔPNI-L-H, ΔPNI-H-L, and ΔPNI-H-H subgroups. For instance, if PNI scores of patients with high baseline PNI score increased from baseline to 6 weeks after treatment, they were included in the ΔPNI-H-H subgroup. Cox regression models were used to identify the factors associated with survival.

Results:

The baseline PNI score was only related to the overall survival (OS) ( P = .026), and not to the overall response rate (ORR) ( P = .299) and progression-free survival (PFS) ( P = .207). The ORR was associated with the combined PNI scores ( P = .017). A multivariable Cox regression analysis confirmed that the combined PNI scores were independent factors for PFS (ΔPNI-L-H, 12 months, hazard ratio [HR] = 0.449, P = .009; ΔPNI-H-L, 14 months, HR = 0.500, P = .019; and ΔPNI-H-H, 17 months, HR = 0.390, P = .012; vs ΔPNI-L-L, 8 months) and OS (ΔPNI-L-H, 27 months, HR = 0.403, P = .019; ΔPNI-H-L, 28 months, HR = 0.369, P = .010; and ΔPNI-H-H, not reached, HR = 0.087, P = .002; vs ΔPNI-L-L, 15 months).

Conclusions:

Patients with high baseline PNI and increased PNI score had the better survival outcome. On dynamic monitoring and comprehensive assessment, the combined PNI scores significantly enhanced the survival predictive ability of patients with NSCLC treated with PD-1 inhibitor.
Real-World Data of Trifluridine/Tipiracil for Patients With Advanced Gastric Cancer: A Multi-Institutional Retrospective Study
Authors: Matsumoto Toshihiko , Yamamura Shogo , Ikoma Tatsuki , Kurioka Yusuke , Doi Keitaro , Yasuda Tomoyo , Boku Shogen , Kawai Takashi , Shibata Nobuhiro , Nagai Hiroki , Tsuduki Takao , Shimada Takanobu , Matsumoto Yusuke , Tsumura Takehiko , Takatani Masahiro , Yasui Hisateru , Satake Hironaga
Published: November 2022

Background:

A trial with trifluridine/tipiracil (FTD/TPI) versus placebo in patients with heavily pretreated metastatic gastric cancer showed that FTD/TPI is effective with manageable toxicity in these patients. However, real-world data on the effects of FTD/TPI in patients with advanced gastric cancer (AGC) are limited.

Methods:

We retrospectively collected and analyzed the clinicopathological data of patients with AGC who received FTD/TPI monotherapy at our institutions (Kobe City Medical Center General Hospital, Osaka Red Cross Hospital, Himeji Red Cross Hospital, and Kansai Medical University Hospital) between September 2019 and July 2021. Tumor responses were evaluated based on the Response Evaluation Criteria in Solid Tumors, version 1.1. Overall survival (OS) and progression-free survival were estimated using the Kaplan-Meier method.

Results:

A total of 53 patients were included in the study. The median age was 70 (range, 37-85) years; 39 patients (74%) were men; the numbers of patients with Eastern Cooperative Oncology Group performance status scores of 0, 1, and 2 were 10 (19%), 39 (74%), and 4 (8%), respectively; and 27 patients (51%) had diffuse-type histology. A total of 29 patients (56%) had ascites. Prior nivolumab therapy was administered to 49 patients (92%). The response rate and disease control rate (DCR) were 2% and 35%, respectively. The median progression-free survival was 2.4 months, and OS was 5.8 months. Patients with ascites exhibited significantly shorter OS (8.6 vs 4.7 months, P = .0291) than those without ascites, and DCR (54% vs 18%, P = .0055) was significantly worse in patients with ascites. There was no significant difference in the frequency of adverse events of grade 3 or higher between patients with and without ascites.

Conclusion:

In a real-world setting, FTD/TPI has similar effectiveness as late-line chemotherapy for patients with AGC, including those who previously had received nivolumab.
Acute enhancement of executive functions through cognitively challenging physical activity games in elementary physical education
Authors: Kolovelonis Athanasios , Goudas Marios
Published: November 2022

This study examined the effects of cognitively challenging physical activity games on students’ executive functions and situational interest in physical education. Participants were 144 fourth- and fifth-grade students (75 boys, 69 girls) from four elementary schools. A four-group, repeated measures, cross-over quasi-experimental design was used in this acute experiment including a physical education session. One fourth- and one fifth-grade class from each school were randomly assigned to Group 1 with cognitively challenging physical activity games, Group 2 with a session for teaching soccer skills, Group 3 with a session for teaching track and field skills, and Group 4 (waiting-list control group) with cognitively challenging physical activity games after the post-test. Pre- and post-test measures for executive functions and a post-test measure for situational interest were included. Group 1 students, who were involved in cognitively challenging physical activity games, improved their scores in the executive functions more than students who participated in the sessions with soccer or track and field skills and waiting-list control group students. The positive effects on students’ executive functions were replicated when the cognitively challenging physical activity games session was implemented in the waiting-list control group. Some improvements on executive functions for students who participated in the soccer skills session were found. Students who played the cognitively challenging physical activity games reported higher scores on novelty compared to students in the soccer or track and field groups. These results support the effectiveness of the cognitive challenging physical activity games for triggering students’ executive functions in physical education.
Mechanical aspiration thrombectomy for the treatment of pulmonary embolism: A systematic review and meta-analysis
Authors: Chandra Vishnu M , Khaja Minhaj S , Kryger Marc C , Sista Akhilesh K , Wilkins Luke R , Angle John F , Sharma Aditya M
Published: November 2022

Introduction:

There are no randomized trials studying the outcomes of mechanical aspiration thrombectomy (MAT) for management of pulmonary embolism (PE).

Methods:

We performed a systematic review and meta-analysis of existing literature to evaluate the safety and efficacy of MAT in the setting of PE. Inclusion criteria were as follows: studies reporting more than five patients, study involved MAT, and reported clinical outcomes and pulmonary artery pressures. Studies were excluded if they failed to separate thrombectomy data from catheter-directed thrombolysis data. Databases searched include PubMed, EMBASE, Web of Science until April, 2021.

Results:

Fourteen case series were identified, consisting of 516 total patients (mean age 58.4 ± 13.6 years). Three studies had only high-risk PE, two studies had only intermediate-risk PE, and the remaining nine studies had a combination of both high-risk and intermediate-risk PE. Six studies used the Inari FlowTriever device, five studies used the Indigo Aspiration system, and the remaining three studies used the Rotarex or Aspirex suction thrombectomy system. Four total studies employed thrombolytics in a patient-specific manner, with seven receiving local lysis and 17 receiving systemic lysis, and 40 receiving both. A random-effects meta-analyses of proportions of in-hospital mortality, major bleeding, technical success, and clinical success were calculated, which yielded estimate pooled percentages [95% CI] of 3.6% [0.7%, 7.9%], 0.5% [0.0%, 1.8%], 97.1% [94.8%, 98.4%], and 90.7% [85.5%, 94.3%].

Conclusion:

There is significant heterogeneity in clinical, physiologic, and angiographic data in the currently available data on MAT. RCTs with consistent parameters and outcomes measures are still needed.
What parents want in an autism diagnostic report: An interview-based study of parents accessing a neurodevelopmental assessment service
Authors: Wilson Alexander C , Gunn Stef
Published: November 2022

Diagnostic reports are a key outcome of autism assessment services. However, there is limited evidence regarding what key stakeholders, including families, want to see in reports. In this project, 30 parents whose young person had recently received a diagnosis of autism from a Neurodevelopmental Assessment Service in the North East of England took part in a telephone-based interview to explore what they want from a report. Interviews were analysed using thematic analysis. Ten key recommendations for reports were identified. Parents indicated that they want a detailed, balanced, sensitively written report. They highlighted that reports needed to be accessible and clearly structured. In this respect, it might be helpful to include a parent-driven summary of key points at the top, clear signposting of the structure of the report, and a description of what happened in the assessment process. Parents also valued practical, personalised recommendations based on the young person’s strengths and difficulties. Future research might explore perspectives on reports in families accessing other services, in other client groups (e.g., families of pre-schoolers diagnosed with autism), and with different stakeholders, including schools, referrers and autistic people.
Pre-task planning effects on learner engagement in face-to-face and synchronous computer-mediated communication
Authors: Qiu Xuyan , Bui Gavin
Published: November 2022

This study investigates the effects of pre-task planning on English as a second language (ESL) learners’ engagement in oral tasks in the face-to-face real-time communication (FTF) and synchronous video-based computer-mediated communication (SvCMC) modes. A total of 36 ESL learners performed two decision-making tasks (with versus without pre-task planning) in dyads in the FTF or the SvCMC mode. Their oral discourse of tasks was analysed via seven indicators in terms of behavioral, cognitive and social engagement. Their emotional engagement was captured via an interview immediately after the task performance. As the results showed, pre-task planning did not significantly affect the learners’ behavioral, cognitive and social engagement in either the FTF or the SvCMC condition. In SvCMC, more negotiations on content were produced when there was no planning time, but such a difference was not observed among the FTF learners. Mixed affective responses were reported on pre-task planning and the two task modalities. The findings yield pedagogical implications for second language (L2) teaching in the face-to-face and online contexts.
Autistic women’s experiences of self-compassion after receiving their diagnosis in adulthood
Authors: Wilson Rosemarie B , Thompson Andrew R , Rowse Georgina , Smith Richard , Dugdale Amber-Sophie , Freeth Megan
Published: November 2022

Knowledge of autistic individuals’ experiences of self-compassion is very limited. This study investigated autistic women’s experiences of self-compassion after receiving their diagnosis in adulthood. Eleven autistic women completed semi-structured interviews analysed using interpretative phenomenological analysis. Three super-ordinate themes were identified: ‘Disconnect between the autistic self and experience of societal expectations’ (the burden of conformity; autism is misunderstood; social challenges; mental health impact); ‘Unmasking: the process of self-understanding’ (autonomy and self-compassion; validation and grief) and ‘Impact on relationships’ (diagnosis disclosure dilemmas; connection and understanding). Frustration with society’s misconceptions of autism and unhelpful thinking styles were presented as barriers to self-compassion. Most participants reported that their diagnosis had led to the development of a greater sense of self-understanding, which facilitated self-compassion. Some participants suggested their own increased understanding of autism facilitated their compassion towards others. Findings from this study have clinical implications for increasing understanding about autistic women’s experiences of self-compassion and possibly ways to facilitate its development, to enhance well-being.

Lay abstract

Knowledge of autistic individuals’ experiences of self-compassion is very limited. This study investigated autistic women’s experiences of self-compassion after receiving their diagnosis in adulthood. Eleven autistic women were interviewed about their experiences of receiving their diagnosis in adulthood and their experiences of self-compassion. Systematic analysis of the interview transcripts revealed common themes in the participants’ experiences. Participants reported that their autism diagnosis helped them to better understand themselves, particularly when reflecting on problematic past experiences. After receiving an autism diagnosis, participants described being able to relate to themselves with greater self-kindness compared to previous self-criticism; this included allowing themselves to assert their needs and engage in self-care activities. Participants spoke about having difficult social experiences, including feeling pressure to conform to expectations in society and often feeling misunderstood. The findings highlight the barriers autistic women face obtaining their diagnoses and demonstrate the need for autism training for professionals to support early identification. Findings from this study suggest that interventions aimed at developing self-compassion could support and enhance autistic women’s well-being.
Remedying disinformation and fake news? The cultural frameworks of fake news crisis responses and solution-seeking
Authors: Cover Rob , Haw Ashleigh , Thompson Jay Daniel
Published: November 2022

For the past half-decade, disinformation and misinformation have been discussed in the public sphere as the construct ‘fake news’, through a discourse of crisis and, increasingly, in terms of responses, remedies, solutions, interventions and preventative affordances. This article explores the emergence of the crisis–remedy discourse of disinformation, arguing that responsiveness is grounded in a solutionism that positions ‘fake news’ as crisis. Drawing on select examples, we use a cultural approach to analyse a range of remedies put forward in public sphere, policy and scholarly discourse. We identify three frameworks of the crisis–remedy discourse: alarmism, regulation/eradication, and adaptation. The article presents examples of five remedial approaches and theorises their alignment with different crisis frameworks. By thinking through the cultural formation of different remedies, we aim to draw out cultural studies’ utility in future efforts to determine the efficacy and ethics of current and future solutions to disinformation.
Asylum seekers in the machinery of the state: administrative capacity vs. preferences. Recognition rates in EU member states
Authors: Van Wolleghem Pierre Georges , Sicakkan Hakan G.
Published: November 2022

Studies have sought to explain variation in protection recognition rates between EU member states with, however, limited explanatory power. Surprisingly, few have contemplated the role of the administration, despite it being at the centre of the process through which asylum claims are examined. We posit that recognition rates are significantly affected by administrative capacity, although the administration's action may be mitigated by political factors. Our findings show that administrative effectiveness and experience in asylum matters yield higher recognition rates. We show that government preferences and the overall political context affect protection recognition, too. Importantly, we also find that the mechanisms at play are different if we consider the different forms of protection.
Living in the skin of dictatorship: an encounter with the Belarus Free Theatre
Authors: Birksted-Breen Noah
Published: November 2022

On 12 March 2022, I attended Dogs of Europe, a performance by Belarus Free Theatre (BFT) at London’s Barbican Theatre. Adapted from the novel by Belarusian writer Alhierd Bacharevič, the play imagines a dystopian future in which Russia’s imperial expansion swallows up swathes of eastern Europe to create a ‘Russian Reich’. The timing of the work is uncanny and unsettling – it unintentionally (but astutely) coincided with the horrifying Russian invasion of Ukraine. The novel and stage adaptation depict a Europe that has become a fragmented European League of States with little unifying purpose or moral compass (‘people in Europe no longer read’, as one character announces). My encounter with Dogs of Europe considers how the BFT uses performance techniques to offer an affecting and intimate geopolitics, with the aspiration of motivating audiences towards an activist stance.
Some desiderata for a taxonomy of conscientious objection in health care: A reply to Gamble and Saad
Authors: Robinson Michael , Byrnes Jeffrey
Published: November 2022

In a recent issue of this journal, Gamble and Saad offer a taxonomy of conscientious objection in health care with the aim of increasing the common ground in the debate over conscientious objection to prevent parties from talking past each other and help facilitate greater progress on this issue. Although we agree that this is an important and worthwhile project, Gamble and Saad's proposal suffers from several serious weaknesses that limit its ability to do the work set out for it. In this paper, we identify some of the major problems with this particular attempt in order to highlight some desiderata for a taxonomy of conscientious objection in health care that can serve as a guide for developing improved taxonomies of this kind in the future.
Risk Markers for Victimization and Perpetration of Male-to-Female Physical Intimate Partner Violence in Sub-Saharan Africa: A Meta-Analysis
Authors: Mootz Jennifer J. , Spencer Chelsea M. , Ettelbrick Julia , Kann Bianca , Fortunato dos Santos Palmira , Palmer Megan , Stith Sandra M.
Published: November 2022

Exposure to intimate partner violence (IPV) incurs significant public health consequences. Understanding risk markers can accelerate prevention and response efforts, important in settings like Sub-Saharan Africa (SSA) where resources are scarce. In this study, four databases were searched to identify studies that examined risk markers for male-to-female physical IPV. With application of the socioecological model, we analyzed 11 risk markers for male physical IPV perpetration (with 71 effect sizes) and 16 risk markers for female physical IPV victimization (with 131 effect sizes) in SSA from 51 studies. For male IPV perpetration, we found medium-to-large effect sizes for six risk markers: perpetrating emotional abuse and sexual IPV, witnessing parental IPV, being abused as a child, cohabitating (not married), and exhibiting controlling behaviors. We found small effect sizes for substance use. Employment, age, marital status, and education were not significant risk markers. For female IPV victimization, a medium effect size was found for post-traumatic stress symptoms. Small effect sizes were found for reporting depressive symptoms, being abused as a child, witnessing parental IPV, and reporting drug and alcohol use. Rural residence, approval of violence, length of relationship, income, education, employment, age, marital status, and religiosity were not significant risk markers. Findings highlight opportunities for screening and intervention at the couple level, show the need to test and incorporate interventions for IPV in mental health treatment, and emphasize the importance of further research on sociodemographic risk markers and the interventions that target them.
The Prevalence of Prison-based Physical and Sexual Victimization in Males and Females: A Systematic Review and Meta-Analysis
Authors: Caravaca-Sánchez Francisco , Aizpurua Eva , Wolff Nancy
Published: November 2022

This systematic review investigated the prevalence of prison-based interpersonal harm by type of victimization (physical and sexual) and sex, along with the heterogeneity among studies using meta-regression. Using Preferred Reporting Items for Systematic Reviews and the Meta-Analysis guidelines, 24 articles met the selection criteria. Study quality was assessed using the Joana Briggs Institute (20.8% deemed low quality, 33.3% moderate, and 45.9% high). Searches were conducted in Criminal Justice Abstracts, PsycINFO, PubMed, and Web of Science. The 24 articles comprised 36 separate samples inclusive of 23,967 incarcerated individuals. The random-effects pooled prevalence estimate of prison-based physical victimization was 18.8%, with slightly higher rates for females (20.3%) than males (18.1%). For sexual victimization, the pooled prevalence estimate was 12.4%, with higher rates among females (15.3%) than males (9.7%). For females, younger individuals reported higher rates of physical and sexual victimization and studies using smaller samples had higher rates of physical victimization. Rates of physical and sexual victimization for men were higher if perpetrators included residents and staff, the recall period was since admission, data was collected using self-administered surveys, and in low-quality studies (sexual victimization only). Rates of prison-based interpersonal harm, while high, varied significantly by type of victimization, sex, and study methodology. High heterogeneity will be reduced only if future studies adhere to best methodological practices in defining and collecting data on interpersonal harm and consistently test risk and prevention factors instrumental to prevention efforts. Study limitations include the exclusion of unpublished and non-English-language studies, small sample sizes for female studies, and methodological “noise” within the literature that reduce predictive precision.
Implementing Locally Tailored Strategies to Promote Redemption of Farmers’ Market Nutrition Program Vouchers Among WIC Participants in Central Pennsylvania
Authors: Calo William A. , Marin Evelyn , Aumiller Betsy , Murray Andrea , Baptiste Claire , Bermudez Madeline , Crawford Laurie , DeLoatch Vicki , Kraschnewski Jennifer L.
Published: November 2022

The Pennsylvania Farmers’ Market Nutrition Program (FMNP) provides vouchers to participants of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) to purchase locally grown fruits, vegetables (F&V), and herbs every year from June to November. Voucher redemption is suboptimal among WIC participants in Lebanon County, a community with high numbers of low-income and Hispanic families. Supported by a Racial and Ethnic Approaches to Community Health (REACH) award, our community–academic coalition partnered with the local WIC provider to implement locally tailored strategies to promote redemption of FMNP vouchers. In 2019, we surveyed FMNP participants ( n = 100) to examine opportunities for improved voucher redemption. Increasing sites for voucher use (47%) and a larger variety of F&V (27%) were the most commonly selected improvements participants identified. Participants also supported improvements to increase awareness of available seasonal produce (14%), text/phone reminders to redeem vouchers (13%), and having recipes to cook meals with FMNP-approved F&V (12%). These findings led us to implement a weekly, Farm-to-WIC “grab bag” program in 2020/2021. We partnered with a local farmer to offer a variety of FMNP-approved produce in $3 and $6 grab bags at the local WIC provider. Each grab bag included healthy recipes using the included produce. In 2021, we launched a text/phone reminder intervention to encourage voucher redemption among FMNP participants (n = 57). Our work demonstrates the value of community–academic partnerships to identify and implement feasible strategies that are responsive to local needs as well as supporting existing programs providing greater access to affordable produce.
Alaska’s Play Every Day Campaign Encourages Parents to Serve Healthy Drinks to Young Children
Authors: Potempa Ann E. , Kelsey Lauren C. , Fink Karol J. , Pickle Kathryn E. , Reilly Katie L. , Young Margaret B. , Dilley Julia A.
Published: November 2022

Background

Sugary drink consumption by young children is a public health concern. The State of Alaska, partnering with the Alaska Native Tribal Health Consortium, implemented the Play Every Day social marketing campaign in 2019–2021 to encourage parents to serve healthy drinks to young children. The campaign’s intended audience was parents who experience disproportionately poor nutrition outcomes: Alaska Native people, those living in rural communities, and those with low incomes and/or educational attainment. We described campaign development, implementation, and performance.

Method

Parents from the identified disproportionately affected populations participated in formative research. Campaign awareness and engagement questions were added to Alaska’s child health surveillance system. Regression models assessed associations between campaign exposure and outcomes.

Results

The sample included 476 Alaska mothers of 3-year-old children. Of the 34% who reported seeing the campaign, 21% said they changed drinks served to their child because of the campaign. Campaign awareness, engagement, and reported changes in drinks given to children because of the campaign were greater among Alaska Native mothers than White mothers. Among all mothers, those who said the campaign gave them new information or that they shared the campaign had 7 to 8 times greater odds for reporting changes in behavior than those not engaged with the campaign.

Implications for Practice

Social marketing campaigns that encourage parents to serve healthy drinks to young children may change behavior. Resources should be systematically dedicated to research, implementation, and evaluation focused on specific populations. Partnering with trusted community-serving organizations likely improves outcomes in disproportionately affected populations.
Food Insecurity and Diabetes: An Investigation of Underserved Asian Americans in Michigan
Authors: Wu Tsu-Yin , Bessire Rachel , Ford Olivia , Rainville Alice Jo , Man Chong Chow , Caboral-Stevens Meriam
Published: November 2022

Asian Americans are at increased risk for nutrition-related chronic diseases, including type 2 diabetes. The prevalence of type 2 diabetes among Asian Americans in the United States is 16.7% compared to 11.3% among the general U.S. population. Genetic factors such as higher body fat and lower muscle mass result in a predisposition for the development of diabetes at a lower body mass index (BMI). Social determinants including food insecurity and physical environment may also impact risk and need further examination. This study investigated type 2 diabetes–related indicators and food insecurity and satisfaction with types and quality of foods provided through food box distributions with a focus on Asian American populations in Michigan. Data were collected via a survey implemented in partnership with community organizations that administer food box distributions. Nearly half of respondents were not aware that Asian Americans are at increased risk of developing type 2 diabetes. The mean BMI for overall study participants was 25.6, and 61.8% of participants had a BMI of ≥23. Food insecurity was also negatively associated with BMI with study participants who were overweight reporting less food insecurity. Overall, participants reported being satisfied with both the types and quality of foods provided in the food boxes. Findings support the need for increased diabetes education and testing among Asian Americans and assessment of the types of culturally relevant foods offered by food distribution organizations.
Navajo Nation Stores Show Resilience During COVID-19 Pandemic
Authors: John Brianna , Etsitty Sean O. , Greenfeld Alex , Alsburg Robert , Egge Malyssa , Sandman Sharon , George Carmen , Curley Caleigh , Curley Cameron , de Heer Hendrik D. , Begay Gloria , Ashley Martin E. , Yazzie Del , Antone-Nez Ramona , Sunhi Shin Sonya , Bancroft Carolyn
Published: November 2022

On April 8, 2020, the Navajo Nation issued an administrative order limiting business operations. Facing high coronavirus disease 2019 (COVID-19) rates and limited food infrastructure, a survey was conducted among Navajo Nation store managers to assess: (1) COVID-19 adaptations; (2) challenges; (3) changes in customer volume and purchasing; and (4) suggestions for additional support. Purposive sampling identified 29 stores in Navajo communities. Representatives from 20 stores (19 store managers/owners, 1 other; 7 grocery, and 13 convenience/other stores) were interviewed by phone or in-person to reach saturation (new information threshold < 5%). Responses were coded using frequencies and inductive thematic analysis. All 20 stores implemented COVID-19 guidelines (Centers for Disease Control and Prevention [CDC]/Navajo Nation) and most received orientation/support from local chapters, community organizations, or health centers. Stores implemented staff policies (50%, handwashing, vaccinations, protective personal equipment (PPE), sick leave, temperature checks), environmental changes (50%, hand sanitizer, checkout dividers), customer protocols (40%, limit customers, mask requirements, closed restrooms), and deep cleaning (40%). Most stores (65%) reported challenges including stress/anxiety, changing guidelines, supply chain and customer compliance; 30% reported infection or loss of staff. Weekday customer volume was slightly higher vs. pre-COVID, but weekend lower. Stores reported consistent or more healthy food purchases (50%), more nonfood essentials (20%), or shelf-stable foods (10%). Desired support included further orientation (30%), leadership support (20%), overtime/time to learn guidelines (20%), and signage/handouts (15%). Despite a high COVID-19 burden and limited food store infrastructure, Navajo Nation stores adapted by implementing staff, environmental and customer policies. Local support, staffing, and small store offerings were key factors in healthy food access.
Examining Changes in Food Security, Perceived Stress, and Dietary Intake in a Cohort of Low-Wage Workers Experiencing an Increase in Hourly Wage
Authors: Chapman Leah Elizabeth , Berkowitz Seth A. , Ammerman Alice , De Marco Molly , Ng Shu Wen , Zimmer Catherine , Caspi Caitlin E.
Published: November 2022

Objective

To determine whether an increase in hourly wages was associated with changes in food security and perceived stress among low-wage workers. We also determined whether changes in food security and stress were associated with changes in diet.

Setting

Wages is a prospective cohort study following 974 low-wage workers in Minneapolis, MN, where an ordinance is incrementally increasing minimum wage to US$15/hr from 2018 to 2022, and a comparison community with no minimum wage ordinance (Raleigh, NC). Interaction models were estimated using generalized estimating equations.

Participants

Analyses used two waves of data (2018 [baseline], 2019) and included 219 and 321 low-wage workers in Minneapolis and Raleigh (respectively).

Results

Average hourly wages increased from US$9.77 (SD US$1.69) to US$11.67 (SD US$4.02). Changes in wages were not associated with changes in food security (odds ratio = 1.05, 95% confidence interval [CI] [0.89, 1.23], p = .57) or stress (β = −0.01, 95% CI [−0.04, 0.03], p = .70) after 1 year of policy implementation. Changes in food security were not associated with changes in diet. However, we found significant changes in the frequency of fruit and vegetable intake across time by levels of stress, with decreased intake from Wave 1 to 2 at low levels of stress, and increased intake at high levels of stress (incidence rate ratio = 1.17, 95% CI [1.05, 1.31], p = .01).

Conclusions

Changes in wages were not associated with changes in food security or stress in a sample of low-wage workers. Future research should examine whether full implementation of a minimum wage increase is associated with changes in these outcomes.
Hispanic Serving Institutions and Philanthropic Support: A Retrospective Overview, 2006–2018
Authors: Gasman Marybeth , Samayoa Andrés Castro , Benyehudah Kemuel , Fowlkes Anthony
Published: November 2022

In this paper, we focused on the decade of philanthropic funding before the current increase in philanthropy to HSIs (2006/2018). We offered a descriptive overview detailing which philanthropic foundations have provided the largest share of support, the HSIs receiving these gifts, and the areas of focus targeted by these donations. We contributed to the scholarship on philanthropic giving to HSIs using an original dataset.
Multimodal Agility-Based Exercise Training for Persons With Multiple Sclerosis: A New Framework
Authors: Wolf Florian , Eschweiler Mareike , Rademacher Annette , Zimmer Philipp
Published: November 2022

Introduction

Multimodal agility-based exercise training (MAT) has been described as a framework for fall prevention in the elderly but might also be a valuable concept for exercise training in persons with Multiple Sclerosis (pwMS).

The Problem

Current recommendations advise pwMS to perform a multitude of different exercise training activities, as each of these has its separate evidence. However, pwMS struggle even more than the general population to be physically active. Additionally, Multiple Sclerosis often leads to co-occurring mobility and cognitive dysfunctions, for which simultaneous, time-efficient, and engaging training approaches are still limited in clinical practice and healthcare.

The solution

The MAT framework has been developed to integratively improve cardiovascular, neuromuscular, and cognitive function by combining aspects of perception and orientation, change of direction, as well as stop-and-go patterns (ie, agility), in a group-training format. For pwMS, the MAT framework is conceptualized to include 3 Components: standing balance, dynamic balance (including functional leg strength), and agility-based exercises. Within these Components sensory, cognitive, and cardiovascular challenges can be adapted to individual needs.

Recommendations

We recommend investigating multimodal exercise interventions that go beyond easily standardized, unimodal types of exercise (eg, aerobic or resistance exercise), which could allow for time-efficient training, targeting multiple frequent symptoms of persons with mild disability at once. MAT should be compared to unimodal approaches, regarding sensor-based gait outcomes, fatigue-related outcomes, cognition, as well as neuroprotective, and (supportive) disease-modifying effects.
Hemostatic Agents in Orthopedic Surgery
Authors: Tanghe Kira K. , Chalmers Brian P. , Blevins Jason L. , Figgie Mark P. , Carli Alberto V. , Agrusa Christopher J. , Sculco Peter K. , Gausden Elizabeth B.
Published: November 2022

Controlling blood loss is a crucial aspect of orthopedic surgery. Hemostatic agents can be used intraoperatively in combination with antifibrinolytics as part of an overall strategy to limit blood loss. Several new hemostatic agents have recently come to the market designed specifically for vascular surgery but have found uses in other surgical fields, including orthopedics. This article reviews the mechanisms of action and best uses of various mechanical hemostats, active hemostats, flowable hemostats, and fibrin sealants for achieving hemostasis in orthopedic surgery. Mechanical and active hemostats have been reported to successfully decrease blood loss from cancellous bone, capillaries, and venules. Flowable hemostats are generally favorable for use in small spaces where the swelling capabilities of mechanical and active hemostats can be detrimental to surrounding structures. Sealants are best used for closing defects in tissues.
Prophylactic Left Atrial Appendage Exclusion in Cardiac Surgery Patients With Elevated CHA2DS2-VASc Score: Results of the Randomized ATLAS Trial
Authors: Gerdisch Marc W. , Garrett H. Edward , Mumtaz Mubashir A. , Grehan John F. , Castillo-Sang Mario , Miller Jeffrey S. , Zorn George L. , Gall Stanley A. , Johnkoski John A. , Ramlawi Basel
Published: November 2022

Objective:

Patients with elevated CHA2DS2-VASc scores are at high risk for atrial fibrillation (AF) and thromboembolic events (TE) after cardiac surgery. Left atrial appendage exclusion (LAAE) is a permanent, continuous approach to stroke prevention in AF, overcoming limitations of oral anticoagulation (OAC). We report ATLAS trial results focused on LAAE technical success and perioperative safety and TE rates with and without LAAE in cardiac surgery patients who developed postoperative AF (POAF).

Methods:

ATLAS (NCT02701062) was a prospective, multicenter, feasibility trial. Patients age ≥18 years, undergoing structural heart procedure, with no preoperative AF, CHA2DS2-VASc ≥2, and HAS-BLED ≥2 were randomized 2:1 to LAAE or no LAAE. Patients who developed POAF and/or received LAAE were followed for 1 year. LAAE was evaluated with intraoperative transesophageal echocardiography.

Results:

A total of 562 patients were randomized to LAAE ( n = 376) or no LAAE ( n = 186). Mean CHA2DS2-VASc (3.4 vs 3.4) and HAS-BLED (2.8 vs 2.9) scores were similar for LAAE and no LAAE groups. LAAE success (no flow nor residual stump >10 mm) was 99%. One LAAE-related serious adverse event (0.27%) occurred and was resolved without sequelae. There were 44.3% of patients who developed POAF. Through 1 year, 3.4% of LAAE patients and 5.6% of no LAAE patients had TE. OAC was used by 32.5% of POAF patients. Bleeding was higher with OAC than without (16.1% vs 5.4%, P = 0.008).

Conclusions:

ATLAS demonstrated a high rate of successful LAAE with low LAAE-related serious adverse events in cardiac surgery patients. Study results should be considered in future trial design to further evaluate prophylactic LAAE for stroke prevention in cardiac surgery patients with elevated stroke risk.
The Case for Physician Training and Certification in Lifestyle Medicine
Authors: Lianov Liana , Rosenfeld Richard
Published: November 2022

Certification in lifestyle medicine demonstrates that a physician has achieved a high level of knowledge, abilities, and skills in this area of specialization. Since the American Board of Lifestyle Medicine (ABLM) began certifying physicians in 2017 through January 2022, about 1850 U.S. diplomates have emerged, with an additional 1375 physicians certified in 72 countries in partnership with the International Board of Lifestyle Medicine. Certification by the ABLM is not only a source of personal pride and accomplishment, but facilitates practice growth, employment opportunities, leadership roles, career satisfaction, and credibility among consumers, the public, payors, and within health systems. In this commentary, we make the case for certification as an integral, and logical, corollary to the explosive growth of the lifestyle medicine as an increasingly relevant, and essential, part of mainstream medical practice.
Comorbidities among Egyptian systemic lupus erythematosus: The COMOSLE-EGYPT study
Authors: Gamal Sherif M , Mokbel Abir , Niazy Marwa H. , Elgengehy Fatema T , Elsaid Nora Y , Fouad Nermeen A. , Sobhy Nesreen , Tantawy Marwa , Mohamed Sally S. , Ghaleb Rasha M , Abdelaleem Enas A , El-Zorkany Bassel
Published: November 2022

Objective

To study the prevalence and impact of comorbidities among a cohort of patients with systemic lupus erythematosus (SLE).

Methods

This study is retrospective, multicenter including 902 Egyptian patients with SLE. Medical records were reviewed for demographic data, clinical characteristics, routine laboratory findings, immunological profile, and medications. Moreover, SLE Disease Activity Index (SLEDAI), and the Systemic Lupus International Collaborating Clinics/American College Rheumatology Damage Index scores were calculated.

Results

Comorbidities were found in 75.5% of the studied group with hypertension and dyslipidemia as the most frequent comorbidities (43.1% and 40.1%, respectively), followed by sicca features, avascular necrosis, diabetes, osteoporosis and renal failure (11.5%,9%, 9%,8.9%, and 7.1%, respectively). Multivariate regression model showed statistically significant relation between the presence of comorbid condition and each of age ( P = 0.006), disease duration ( P = 0.041), SLEDAI at onset ( P < 0.001), cyclophosphamide intake ( P = 0.001), and cumulative pulse intravenous methylprednisone ( P < 0.001). Also, when adjusted to age and sex, those with multiple comorbid conditions had 18.5 increased odds of mortality compared to those without comorbidities (odds ratio (OR), 95% confidence interval (CI) = 18.5 (6.65–51.69)].

Conclusion

Patients with SLE suffer from several comorbidities, with an increasing risk with age, longer disease duration, higher SLEDAI at onset, cyclophosphamide intake and cumulative pulse intravenous methylprednisone. Risk of mortality is exponentiated with multiple comorbidities.