Impact of social phone programs on loneliness and mood in older adults: a mixed methods systematic review protocol.

OBJECTIVE: The objective of this mixed methods review is to examine the effectiveness and experience of social phone programs on loneliness and/or mood in community-dwelling older adults. INTRODUCTION: There is a large and growing older adult population that is burdened with loneliness. Loneliness affects both physical and mental health, and it is, therefore, imperative to examine ways of mitigating experiences of loneliness. Social phone programs are being offered through multiple organizations as a way of increasing socialization and decreasing loneliness in older adults. There is a need to examine existing data on social phone programs to determine their effectiveness and optimize their implementation. INCLUSION CRITERIA: Included studies will be original qualitative, quantitative, or mixed methods research, along with gray literature, examining the use of social phone programs to address loneliness and/or mood in older adults. METHODS: A convergent segregated mixed methods approach will be used, in line with the JBI methodology for mixed methods reviews. Articles will be searched in selected databases, sources of clinical trials, and gray literature. No limits have been set for language or date of publication. Two team members will select studies through title and abstract screening and then full-text screening. Critical appraisal will be performed in accordance with the standard JBI critical assessment tools, although no articles will be excluded based on this appraisal. Quantitative articles will be synthesized using meta-analysis, while a process of meta-aggregation will be used for qualitative articles. The findings will be integrated into a final report. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42022335119.

Patient and Caregiver Insights into the Disease Burden of Myelodysplastic Syndrome.

A diagnosis of myelodysplastic syndrome (MDS) is typically unexpected and can be difficult for patients to grasp. Not only is MDS a complicated disease to understand, which can contribute to stress and anxiety, but it also has an uncertain prognosis, which can be emotionally paralyzing. Not surprisingly, emotional distress and the symptom burden of MDS, including extreme fatigue due to cytopenias, negatively impact a patient's quality of life (QOL). Studies have shown that patient-centered care-including greater physician understanding of the disease burden their patients experience, discussing and establishing agreed-on treatment goals, and including patients in the decision-making process about their care-may help improve patient QOL. To better understand patient and caregiver experiences with MDS and how the disease impacts QOL, a small survey was conducted of patients with MDS or leukemia and their caregivers on an online health network. Among the 30 respondents who completed the survey, four had MDS and one was a caregiver for a patient with MDS. Here we focus on the five MDS respondents and contextualize the findings with personal experiences from a patient and physician perspective. The patient perspective was provided by John Soper, PhD, DABCC, who was diagnosed with MDS in 2019. Dr Soper is a retired board-certified clinical chemist and a member of the MDS Foundation. The physician perspective was provided by Dr Ruben Mesa, Executive Director of the Mays Cancer Center at UT Health San Antonio MD Anderson. The survey responses and the accompanying patient and physician perspectives highlight the importance of open communication between patients and their healthcare provider to better serve those with MDS and improve their QOL.

The Experience of Older Adults Socially Distancing during the Early Stages of the COVID-19 Pandemic.

During the early stages of the COVID-19 pandemic, individuals were asked to stay home and restrict outings to limit the spread of the virus. Physical isolation was particularly emphasized for older adults over the age of 60 who, because of their age and related medical conditions, were at increased risk of severe disease and death from the virus. This led to reduced spread of the virus but also to social and emotional health challenges for older adults. Protecting the physical health of older adults was of the utmost importance during the pandemic but supporting social and mental health must not be overlooked. This patient-oriented qualitative study involved 40 interviews with older adults, conducted in the early stages of the pandemic, followed by a thematic analysis. Three themes were derived from the findings: subverted life plan, emotional impacts, and creating a path forward. The findings from this study will help inform current physical and social distancing guidelines during the ongoing COVID-19 pandemic. Moreover, findings indicate that social and emotional challenges with ongoing physical and social isolation must be taken into consideration for future pandemics.

A Postpartum Community-Based Weight Management Intervention Designed for Low-Income Women: Feasibility and Initial Efficacy Testing.

Postpartum weight retention increases a woman's risk of entering subsequent pregnancies overweight or obese, and women who are overweight or obese in pregnancy face higher rates of complications for themselves and their infants. This study assessed the feasibility, acceptability, and initial efficacy of an intervention to prevent postpartum weight retention in predominantly low-income African-American women. A randomized control pilot study was conducted to test the effects of the intervention on weight, adiposity, health behaviors, and eating and exercise self-efficacy from baseline (Time 1) to study completion (Time 2). The women in the experimental group had significantly greater decreases in triceps skinfolds (p = 0.01) and subscapular skinfolds (p = 0.04) and had significantly greater nutrition knowledge (p =0.04) than the control group. The results indicate that women randomized to a postpartum weight management program significantly decreased adiposity, increased nutrition knowledge and action, and, in addition, the women found the intervention acceptable.

Barriers to Receiving Long-acting Reversible Contraception in the Postpartum Period.

OBJECTIVE: To assess why postpartum women who desired long-acting reversible contraception (LARC) did not receive it in the postpartum period and to assess which contraceptive methods they were using instead. STUDY DESIGN: This was a subgroup analysis of 324 women enrolled in a randomized, controlled trial to receive or not receive an educational LARC script during their postpartum hospitalization. Participants in this subgroup analysis stated that they were either using LARC (n = 114) or interested in using LARC (n = 210) during a follow-up survey completed after their scheduled 6-week postpartum visit. Modified Poisson regression analysis was used to assess for characteristics associated with using LARC by the time of the follow-up survey. RESULTS: Women who were interested in LARC but not using it were more likely to be multiparous (relative risk [RR], 1.59; 95% CI, 1.19-2.11) and to have missed their postpartum visit (RR, 25.88; 95% CI, 3.75-178.44) compared with those using LARC. Among the interested 210 who were not using LARC, the most common reasons provided for non-use were that they were told to come back for another insertion visit (45%), missed the postpartum visit (26%), and could not afford LARC (11%). The most common contraceptive methods used instead of LARC were barrier methods (42%) and abstinence (19%); 18% used no contraceptive method. CONCLUSION: Two-thirds (65%) of postpartum women who desired to use LARC did not receive it in the postpartum period and used less effective contraceptive methods. Increasing access to immediate postpartum LARC and eliminating two-visit protocols for LARC insertion may increase postpartum LARC use. As the Affordable Care Act moves toward full implementation, it is necessary to understand the barriers that prevent interested patients from receiving LARC.

Parental influence on models of primary prevention of cardiovascular disease in children.

BACKGROUND: Lifestyle behaviors such as overeating and physical inactivity contribute significantly to CVD, the leading cause of morbidity and mortality among adults globally. CVD risk factors that begin in children often track into adulthood. Parents are believed to influence the health behaviors of their children. OBJECTIVE: To review the literature on parental influence on children's health beliefs and behaviors, particularly eating and exercise behaviors as indicators of CV health, school-based CVD risk reduction programs, and racial/ethnic, gender and socioeconomic considerations for models of primary prevention of CVD in children. METHODS: Seventeen studies that included parents as either a source of information, change agent or participant in a CVD risk reduction intervention were identified searching the Medline, CINAHL and PsycINFO databases from 1980 through 2002. RESULTS: Children's lifestyle health beliefs and behaviors are significantly influenced by positive parental modeling and involvement in exercise and healthy eating; parental influence on children's behavior lasts beyond adolescence; parents are effective teachers of health habits at home when prompted by health educators; and parental influences vary by ethnicity/race, socioeconomics and gender. CONCLUSIONS: A broader base of knowledge that is socioculturally sensitive must be developed about what parents and children believe is healthy, how parents model beliefs and behaviors for their children, and how to build self-efficacy for positive health behaviors.

High levels of transdermal nicotine exposure produce green tobacco sickness in Latino farmworkers.

Green tobacco sickness (GTS) is an occupational illness that affects tobacco workers worldwide. This study tested whether GTS results from nicotine poisoning. Data collection was based on a prospective design in which 182 farmworkers were interviewed up to five times at biweekly intervals. A saliva sample was obtained at each interview. Examining four regression models in which salivary cotinine was evaluated as a mediator between behavioral risk factors and GTS, this analysis showed that nicotine causes GTS: 25 workers had 31 occurrences of GTS. Among nonsmokers, each increment increase in the natural log of cotinine increased the odds of GTS 2.11 times, adjusting for task and wet conditions. Treatment of GTS must address nicotine poisoning. GTS affects laborers with limited resources. Research must disclose the extent of this occupational illness and investigate ways to prevent it.

A clinic-based, case-control comparison of green tobacco sickness among minority farmworkers: clues for prevention.

BACKGROUND: Green tobacco sickness (GTS) is a highly prevalent occupational illness among tobacco workers. Working in wet tobacco is a major risk factor for GTS. Little is known about preventing GTS. This analysis examines possible GTS preventive measures. METHODS: Data were collected from 36 patients with GTS and 40 controls who presented at clinics in eastern North Carolina in 1999 and 2000. Each participant completed an interview that included questions about their personal characteristics, work characteristics, and GTS risk factors. RESULTS: Participants were Mexican men. Those with GTS were much less likely to have worn rain suits while working in wet tobacco and more likely to be in the United States on a work contract. CONCLUSIONS: Wearing a rain suit while working in wet tobacco can significantly reduce the risk of GTS among tobacco workers. Care must be taken that farmworkers do not have heat stress from wearing rain suits.