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2.
Mol Pharm ; 21(5): 2065-2080, 2024 May 06.
Artículo en Inglés | MEDLINE | ID: mdl-38600804

RESUMEN

Physiologically based biopharmaceutics modeling (PBBM) is used to elevate drug product quality by providing a more accurate and holistic understanding of how drugs interact with the human body. These models are based on the integration of physiological, pharmacological, and pharmaceutical data to simulate and predict drug behavior in vivo. Effective utilization of PBBM requires a consistent approach to model development, verification, validation, and application. Currently, only one country has a draft guidance document for PBBM, whereas other major regulatory authorities have had limited experience with the review of PBBM. To address this gap, industry submitted confidential PBBM case studies to be reviewed by the regulatory agencies; software companies committed to training. PBBM cases were independently and collaboratively discussed by regulators, and academic colleagues participated in some of the discussions. Successful bioequivalence "safe space" industry case examples are also presented. Overall, six regulatory agencies were involved in the case study exercises, including ANVISA, FDA, Health Canada, MHRA, PMDA, and EMA (experts from Belgium, Germany, Norway, Portugal, Spain, and Sweden), and we believe this is the first time such a collaboration has taken place. The outcomes were presented at this workshop, together with a participant survey on the utility and experience with PBBM submissions, to discuss the best scientific practices for developing, validating, and applying PBBMs. The PBBM case studies enabled industry to receive constructive feedback from global regulators and highlighted clear direction for future PBBM submissions for regulatory consideration.


Asunto(s)
Biofarmacia , Industria Farmacéutica , Humanos , Biofarmacia/métodos , Industria Farmacéutica/métodos , Modelos Biológicos , Equivalencia Terapéutica , Preparaciones Farmacéuticas/química , Estados Unidos
3.
Health Psychol ; 43(6): 462-475, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38619489

RESUMEN

OBJECTIVE: Sexual minority men experience disproportionately elevated rates of skin cancers, likely driven by excess ultraviolet radiation exposure-namely through tanning behaviors. However, limited integrated theoretical models exist to explain sexual minority men's elevated skin cancer risk. The aim of the current study is to further test and refine an integrated theory of skin cancer risk behaviors among sexual minority men by incorporating minority stress into the integrated health behavior model of tanning. METHOD: The study employed a parallel mixed methods design, with a Phase 1 qualitative stage (N = 30) and a Phase 2 quantitative stage (Model 1: N = 320; Model 2: N = 319). In both phases, participants were sexual minority men, equally stratified as those with versus without recent tanning exposure and were recruited from across the United States. RESULTS: Qualitative and quantitative data supported the overall integrated model, with some quantitative paths varying depending on the tanning behavior outcome. Overall, appearance-related motives to tan and beliefs that tanning regulates affect emerged as the most consistent proximal predictors. Minority stress significantly predicted holding more positive attitudes toward tanning as an effective affect regulation strategy. CONCLUSIONS: The results from this mixed methods study support the inclusion of minority stressors into the adapted integrative health behavior model of tanning. Replication within prospective designs would strengthen the evidence for this model, which may be helpful in guiding future skin cancer prevention programs tailored to sexual minority men. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Asunto(s)
Minorías Sexuales y de Género , Neoplasias Cutáneas , Baño de Sol , Humanos , Masculino , Minorías Sexuales y de Género/psicología , Neoplasias Cutáneas/prevención & control , Adulto , Baño de Sol/psicología , Adulto Joven , Persona de Mediana Edad , Estados Unidos , Estrés Psicológico/psicología , Asunción de Riesgos , Adolescente
4.
Contemp Clin Trials ; 141: 107523, 2024 06.
Artículo en Inglés | MEDLINE | ID: mdl-38608752

RESUMEN

INTRODUCTION: Intensive weight management programs are effective but often have low enrollment and high attrition. Lack of motivation is a key psychological barrier to enrollment, engagement, and weight loss. Mental Contrasting with Implementation Intentions (MCII) is a unique imagery technique that increases motivation for behavior change. We describe our study protocol to assess the efficacy and implementation of MCII to enhance the effectiveness of VA's MOVE! or TeleMOVE! weight management programs using a procedure called "WOOP" (Wish, Outcome, Obstacle, Plan) for Veterans. We hypothesize that WOOP+MOVE! or TeleMOVE! (intervention) will lead to greater MOVE!/TeleMOVE! program engagment and consequently weight loss than MOVE!/TeleMOVE! alone (control). METHOD: Veterans are randomized to either the intervention or control. Both arms receive the either MOVE! or TeleMOVE! weight management programs. The intervention group receives an hour long WOOP training while the control group receives patient education. Both groups receive telephone follow up calls at 3 days, 4 weeks, and 2 months post-baseline. Eligible participants are Veterans (ages 18-70 years) with either obesity (BMI ≥ 30 kg/m2) or overweight (BMI ≥ 25 kg/m2) and an obesity-associated co-morbidity. At baseline, 6 and 12 months, we assess weight, diet, physical activity in both groups. The primary outcome is mean percent weight change at 6 months. Secondary outcomes include changes in waist circumference, diet, physical activity, and dieting self-efficacy and engagement in regular physical activity. We assess implementation using the RE-AIM framework. CONCLUSION: If WOOP VA is found to be efficacious, it will be an important tool to facilitate weight management and improve weight outcomes. CLINICAL TRIAL REGISTRATION: NCT05014984.


Asunto(s)
Intención , Motivación , Veteranos , Programas de Reducción de Peso , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Índice de Masa Corporal , Ejercicio Físico , Obesidad/terapia , Educación del Paciente como Asunto/métodos , Educación del Paciente como Asunto/organización & administración , Estudios Prospectivos , Estados Unidos , United States Department of Veterans Affairs , Veteranos/psicología , Pérdida de Peso , Programas de Reducción de Peso/métodos , Programas de Reducción de Peso/organización & administración , Ensayos Clínicos Controlados Aleatorios como Asunto
5.
Nursing ; 54(5): 45-47, 2024 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-38640034

RESUMEN

ABSTRACT: Walt Whitman is commonly known as a noted American poet of the 19th century, but he also had experience providing nursing care during the American Civil War. He wrote about his experiences and was an early proponent of holistic nursing care. This article reviews the life of Walt Whitman and his legacy related to nursing.


Asunto(s)
Enfermería Holística , Humanos , Estados Unidos , Personajes
6.
Arch Dermatol Res ; 316(5): 126, 2024 Apr 23.
Artículo en Inglés | MEDLINE | ID: mdl-38652183

RESUMEN

Vitiligo is characterized by skin depigmentation, which can lead to profound psychological effects and decreased quality of life, especially for those with skin of color. Individuals with vitiligo may utilize complementary and alternative medicine (CAM) due to limited treatment options with varying efficacy.An anonymous, multiple-choice, cross-sectional questionnaire was distributed to participants with vitiligo in the United States through online forums. Data on disease characteristics, use of prescription medications, use of topical therapies, supplements, and diets, and perceptions of CAM were collected.In total, 625 respondents completed the survey. Overall, 32.5% of participants (203/625) have tried CAM. Commonly reported CAM include supplements of vitamin D (57.7%, 116/203), vitamin B12 (46.3%, 93/203), vitamin C (27.4%, 55/203), topical Nigella sativa oil (26.4%, 53/203), oral omega-3 fatty acids (24.9%, 50/203), folic acid (22.9%, 46/203), and vitamin E (22.9%, 46/203). Frequently cited reasons for CAM use include desire to try "new" (40.4%, 82/203) or "more natural" (26.6%, 54/203) therapies, "frustration with conventional medicine" (24.6%, 50/203), and fear of "adverse side effects of conventional medicine" (23.6%, 48/203). Non-White participants were more likely than their White counterparts to report CAM use and have more positive perceptions of CAM therapies. Less than half (43.3%, 88/203) of CAM users reported that they disclosed their use of CAM with their physician.Dermatologists should be mindful of CAM and ask patients about their use. Further investigation of the role of CAM as adjuvant therapy for vitiligo is warranted to better advise patients.


Asunto(s)
Terapias Complementarias , Suplementos Dietéticos , Vitíligo , Humanos , Vitíligo/terapia , Vitíligo/psicología , Estudios Transversales , Terapias Complementarias/estadística & datos numéricos , Terapias Complementarias/métodos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Suplementos Dietéticos/estadística & datos numéricos , Encuestas y Cuestionarios/estadística & datos numéricos , Adulto Joven , Estados Unidos , Anciano , Calidad de Vida , Adolescente , Pigmentación de la Piel
7.
Health Aff (Millwood) ; 43(4): 470-476, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38560799

RESUMEN

Perinatal mental illness is a leading cause of death during pregnancy and the first postpartum year in the United States. Although better acute care services for mental health conditions are desperately needed, urgent services alone cannot create the conditions to thrive. Cultivating well-being requires a sustained commitment to reproductive justice, "the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities." To support reproductive justice for pregnant and birthing people, the Rippel Foundation's Vital Conditions for Health and Well-Being framework offers a holistic approach comprising seven domains: a thriving natural world; basic needs for health and safety; humane housing; meaningful work and wealth; lifelong learning; reliable transportation; and, central to all of these, belonging and civic muscle. Here we review the evidence for each of the vital conditions as key drivers of perinatal mental health, and we outline how this public health approach can advance well-being across generations.


Asunto(s)
Trastornos Mentales , Justicia Social , Embarazo , Femenino , Niño , Humanos , Estados Unidos , Derechos Humanos , Salud Mental , Autonomía Personal
8.
J Nepal Health Res Counc ; 21(3): 439-444, 2024 Mar 22.
Artículo en Inglés | MEDLINE | ID: mdl-38615214

RESUMEN

BACKGROUND: Undergraduate nursing students are frequently vulnerable to stress during their education with a high rate of attrition. Mindfulness Mediations based on Stress Reductions have been found to promote psychological well-being and mental health among nursing students. Therefore, the objective of the study was to explore the experiences of Mindfulness among undergraduate nursing students. METHODS: Qualitative Hermeneutic Phenomenology research design was adopted. Data were collected from under graduate nursing students from Chitwan Medical College, Institute of Medicine who had been practicing Mindfulness Meditation for 6 weeks. The duration of data collection was January to June 2022. Data were collected after obtaining ethical approval from Nepal Health Research Council. Focused Group Discussions were conducted to collect data by the researcher using the Focused Group Discussion guide in Nepali language. A total of three Focused Group Discussions was carried out among 12 participants in each Focused Group Discussion with a total of 36 participants. Data were analyzed by thematic analysis technique based on Giorgi's qualitative data analysis technique. RESULTS: Five developed themes were stress managed well in daily life and during examination time, present moment awareness and positivity, self-realization of inner peace and more self-acceptance, and feeling of developed future role for advocating mindfulness meditations. CONCLUSIONS: Mindfulness-based mediations have been found effective strategies among undergraduate nursing for the management of stress during daily living and during examinations, development of self-realization, increase inner peace, self-acceptance and developed skills for future role for advocating mindfulness meditations.


Asunto(s)
Bachillerato en Enfermería , Meditación , Atención Plena , Estudiantes de Enfermería , Estados Unidos , Humanos , Nepal
9.
Sci Rep ; 14(1): 7659, 2024 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-38561511

RESUMEN

Analyze the adverse event (AE) signals of istradefylline based on the FAERS database. By extracting large-scale data from the FAERS database, this study used various signal quantification techniques such as ROR, PRR, BCPNN, and MGPS to calculate and evaluate the ratio and association between istradefylline and specific AEs. In the FAERS database, this study extracted data from the third quarter of 2019 to the first quarter of 2023, totaling 6,749,750 AE reports. After data cleansing and drug screening, a total of 3633 AE reports related to istradefylline were included for analysis. Based on four calculation methods, this study unearthed 25 System Organ Class (SOC) AE signals and 82 potential preferred terms (PTs) related to istradefylline. The analysis revealed new AEs during istradefylline treatment, including reports of Parkinsonism hyperpyrexia syndrome (n = 3, ROR 178.70, PRR 178.63, IC 1.97, EBGM 165.63), Compulsions (n = 5, ROR 130.12, PRR 130.04, IC 2.53, EBGM 123.02), Deep brain stimulation (n = 10, ROR 114.42, PRR 114.27, IC 3.33, EBGM 108.83), and Freezing phenomenon (n = 60, ROR 97.52, PRR 96.76, IC 5.21, EBGM 92.83). This study provides new risk signals and important insights into the use of istradefylline, but further research and validation are needed, especially for those AE that may occur in actual usage scenarios but are not yet explicitly described in the instructions.


Asunto(s)
Conducta Compulsiva , Purinas , Estados Unidos , Bases de Datos Factuales , Evaluación Preclínica de Medicamentos , Purinas/efectos adversos , United States Food and Drug Administration
11.
Int J Mol Sci ; 25(7)2024 Mar 28.
Artículo en Inglés | MEDLINE | ID: mdl-38612606

RESUMEN

Vulvovaginal candidiasis (VVC) is a real gynecological problem among women of reproductive age from 15 to 49. A recent analysis showed that 75% of women will have an occurrence at least once per year, while 5% are observed to have recurrent vaginal mycosis-these patients may become unwell four or more times a year. This pathology is caused in 85-90% of cases by fungi of the Candida albicans species. It represents an intractable medical problem for female patients due to pain and pruritus. Due to the observation of an increasing number of strains resistant to standard preparations and an increase in the recurrence of this pathology when using local or oral preferential therapy, such as fluconazole, an analysis was launched to develop alternative methods of treating VVC using herbs such as dill, turmeric, and berberine. An in-depth analysis of databases that include scientific articles from recent years made it possible to draw satisfactory conclusions supporting the validity of herbal therapy for the pathology in question. Although phytotherapy has not yet been approved by the Food and Drug Administration, it appears to be a promising therapeutic solution for strains that are resistant to existing treatments. There is research currently undergoing aimed at comparing classical pharmacotherapy and herbal therapy in the treatment of vaginal candidiasis for the purpose of increasing medical competence and knowledge for the care of the health and long-term comfort of gynecological patients.


Asunto(s)
Berberina , Candidiasis Vulvovaginal , Estados Unidos , Humanos , Femenino , Candidiasis Vulvovaginal/tratamiento farmacológico , Fitoterapia , Candida , Vagina
12.
J Clin Anesth ; 95: 111473, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38613937

RESUMEN

Use of herbal medications and supplements has experienced immense growth over the last two decades, with retail sales in the USA exceeding $13 billion in 2021. Since the Dietary Supplement Health and Education Act (DSHEA) of 1994 reduced FDA oversight, these products have become less regulated. Data from 2012 shows 18% of U.S. adults used non-vitamin, non-mineral natural products. Prevalence varies regionally, with higher use in Western states. Among preoperative patients, the most commonly used herbal medications included garlic, ginseng, ginkgo, St. John's wort, and echinacea. However, 50-70% of surgical patients fail to disclose their use of herbal medications to their physicians, and most fail to discontinue them preoperatively. Since herbal medications can interact with anesthetic medications administered during surgery, the American Society of Anesthesiologists (ASA) and the American Association of Nurse Anesthetists (AANA) recommend stopping herbal medications 1-2 weeks before elective surgical procedures. Potential adverse drug effects related to preoperative use of herbal medications involve the coagulation system (e.g., increasing the risk of perioperative bleeding), the cardiovascular system (e.g., arrhythmias, hypotension, hypertension), the central nervous system (e.g., sedation, confusion, seizures), pulmonary (e.g., coughing, bronchospasm), renal (e.g., diuresis) and endocrine-metabolic (e.g., hepatic dysfunction, altered metabolism of anesthetic drugs). During the preoperative evaluation, anesthesiologists should inquire about the use of herbal medications to anticipate potential adverse drug interactions during the perioperative period.


Asunto(s)
Interacciones de Hierba-Droga , Preparaciones de Plantas , Humanos , Preparaciones de Plantas/efectos adversos , Preparaciones de Plantas/administración & dosificación , Periodo Perioperatorio , Suplementos Dietéticos/efectos adversos , Atención Perioperativa/métodos , Anestésicos/efectos adversos , Anestésicos/administración & dosificación , Fitoterapia/efectos adversos , Estados Unidos , Interacciones Farmacológicas
13.
Am J Nurs ; 124(5): 13, 2024 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-38661686
14.
Emerg Infect Dis ; 30(5): 968-973, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38666613

RESUMEN

We conducted a large surveillance study among members of an integrated healthcare delivery system in Pacific Northwest of the United States to estimate medical costs attributable to medically attended acute gastroenteritis (MAAGE) on the day care was sought and during 30-day follow-up. We used multivariable regression to compare costs of MAAGE and non-MAAGE cases matched on age, gender, and index time. Differences accounted for confounders, including race, ethnicity, and history of chronic underlying conditions. Analyses included 73,140 MAAGE episodes from adults and 18,617 from children who were Kaiser Permanente Northwest members during 2014-2016. Total costs were higher for MAAGE cases relative to non-MAAGE comparators as were costs on the day care was sought and costs during follow-up. Costs of MAAGE are substantial relative to the cost of usual-care medical services, and much of the burden accrues during short-term follow-up.


Asunto(s)
Costo de Enfermedad , Prestación Integrada de Atención de Salud , Gastroenteritis , Costos de la Atención en Salud , Humanos , Gastroenteritis/epidemiología , Gastroenteritis/economía , Prestación Integrada de Atención de Salud/economía , Masculino , Femenino , Adulto , Niño , Preescolar , Estados Unidos/epidemiología , Adolescente , Persona de Mediana Edad , Costos de la Atención en Salud/estadística & datos numéricos , Adulto Joven , Lactante , Anciano , Enfermedad Aguda/epidemiología , Historia del Siglo XXI
15.
Food Chem Toxicol ; 188: 114677, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38641042

RESUMEN

Consumption of rice-based foods provides essential nutrients required for infants and toddlers' growth. However, they could contain toxic and excess essential elements that may affect human health. The study aims to determine the composition of rice-based baby foods in the USA and outside and conduct a multiple-life stages probabilistic exposure and risk assessment of toxic and essential elements in children. Elemental concentrations were measured using Inductively Coupled Plasma Mass Spectrometry (ICP-MS) in thirty-three rice-based baby foods. This includes 2 infant formulas, 11 rice baby cereals, and 20 rice snacks produced primarily in the United States, China, and other countries. A probabilistic risk assessment was conducted to assess risks of adverse health effects. Results showed that infant formula had higher median concentrations of selenium (Se), copper (Cu), zinc (Zn), sodium (Na), magnesium (Mg), calcium (Ca), and potassium (K) compared to rice baby cereal and rice snacks. On the contrary, rice snacks had the highest median concentration of Arsenic (As) (127 µg/kg) while rice baby cereals showed the highest median concentration of Cd (7 µg/kg). A higher lifetime estimated daily intake was observed for samples manufactured in the USA compared to those from China and other countries. Hazard quotient (HQ < 1) values were suggestive of minimal adverse health effects. However, lifetime carcinogenic risk analysis based on total As indicated an unacceptable cancer risk (>1E-04). These findings show a need for ongoing monitoring of rice-based foods consumed by infants and toddlers as supplementary and substitutes for breast milk or weaning food options. This can be useful in risk reduction and mitigation of early life exposure to improve health outcomes.


Asunto(s)
Alimentos Infantiles , Oryza , Oryza/química , Humanos , Estados Unidos , Alimentos Infantiles/análisis , Medición de Riesgo , Lactante , Contaminación de Alimentos/análisis , Oligoelementos/análisis , China , Fórmulas Infantiles/química
16.
Food Chem Toxicol ; 188: 114635, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38582347

RESUMEN

Over 70% of United States military service members (SMs) regularly use dietary supplements (DSs) and about 18% have reported adverse effects (AEs) associated with use. This investigation examined longitudinal changes in AEs reporting among DS users. On two separate occasions 1.3 ± 0.2 years apart (mean ± standard deviation), 5778 SMs completed identical questionnaires on DS use and associated AEs. Among SMs reporting DS use ≥1 time/week, ≥1 AE was reported by 19% and 15% in the baseline and follow-up phases, respectively. The risk of reporting DS use at follow-up was similar among those reporting and not reporting AEs at baseline for most DS categories including prohormones, proteins/amino acids, individual vitamins and minerals, multivitamin/multiminerals, herbals, fish oils, joint health products, and other DSs. An exception was combination products where those reporting AEs at baseline had an increased risk of use at follow-up (risk ratio = 1.13, 95% confidence interval = 1.06-1.09). Those reporting AEs at baseline and continuing DS use in the follow-up were more likely to report AEs at follow-up compared to those not reporting baseline AEs. In conclusion, AEs reported at baseline did not deter many participants from using DSs in the follow-up period, and many SMs reporting AEs at baseline continued reporting them at follow-up.


Asunto(s)
Suplementos Dietéticos , Personal Militar , Humanos , Estados Unidos , Adulto , Masculino , Femenino , Estudios Longitudinales , Encuestas y Cuestionarios , Adulto Joven , Persona de Mediana Edad
17.
Obes Res Clin Pract ; 18(2): 88-93, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38565463

RESUMEN

The prevalence of overweight and obesity among military personnel has increased substantially in the past two decades. Following military discharge many personnel can receive integrated health care from the Veterans Health Administration. Prior research related to the economic impacts of obesity has not examined health care costs following the transition into civilian life following military discharge. To address this evidence gap, this study sought to compare longitudinal costs over 10 years across weight categories among VA enrollees recently discharged from the military.


Asunto(s)
Costos de la Atención en Salud , Personal Militar , Obesidad , Humanos , Femenino , Masculino , Personal Militar/estadística & datos numéricos , Costos de la Atención en Salud/estadística & datos numéricos , Estados Unidos , Adulto , Persona de Mediana Edad , Obesidad/economía , Obesidad/epidemiología , United States Department of Veterans Affairs , Estudios Longitudinales , Veteranos/estadística & datos numéricos , Alta del Paciente , Sobrepeso/economía , Sobrepeso/epidemiología
18.
J Womens Health (Larchmt) ; 33(5): 629-638, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38563830

RESUMEN

Background: The U.S. Public Health Service and the Institute of Medicine recommend that all women capable of becoming pregnant consume 400 µg of folic acid daily to help prevent neural tube defects (NTDs). Hispanic women are at higher risk of having babies with NTDs than non-Hispanic White women. This study assessed multivitamin (MV) use, a main source of folic acid, among Hispanic women of reproductive age using a survey of solely U.S. Hispanic adults. Materials and Methods: MV use was assessed as part of Porter Novelli's Estilos survey, fielded annually through the largest online U.S. Hispanic panel, Offerwise's QueOpinas. During the study period of 2013-2022, 9,999 surveys were completed; selection was weighted to match the U.S. Census American Community Survey proportions. Log-binomial regression models were applied to estimate MV use trends by age groups, acculturation levels, and pregnancy intention. Results: Among 3,700 Hispanic women of reproductive age, overall no MV use increased from 39.3% in 2013 to 54.7% in 2022 (p for trend <0.0001), especially among Hispanic women aged 18-34 years and those classified as acculturated. Among women planning to get pregnant, daily MV use was 31.1% in 2013 compared with 18.7% in 2020-2022 (p = 0.04). Conclusions: Given the increase in no MV use among Hispanic women of reproductive age, targeted interventions may help reach at-risk groups for NTDs prevention.


Asunto(s)
Suplementos Dietéticos , Ácido Fólico , Hispánicos o Latinos , Defectos del Tubo Neural , Vitaminas , Humanos , Femenino , Hispánicos o Latinos/estadística & datos numéricos , Adulto , Estados Unidos/epidemiología , Embarazo , Vitaminas/administración & dosificación , Adolescente , Ácido Fólico/administración & dosificación , Adulto Joven , Defectos del Tubo Neural/prevención & control , Defectos del Tubo Neural/etnología , Suplementos Dietéticos/estadística & datos numéricos , Persona de Mediana Edad , Encuestas y Cuestionarios , Aculturación
19.
Brain Behav Immun ; 119: 120-128, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38555990

RESUMEN

BACKGROUND: Social psychoneuroimmunology suggests an interplay between social deficits (loneliness and isolation) and chronic inflammation, but the direction of these relationships remains unclear. We estimated the reciprocal associations of social deficits and social engagement with levels of C-reactive protein (CRP), compared the consistency of the findings depending on the biological sampling method used, and examined the modifying role of phenotypic and genotypic depression. METHODS: We used longitudinal nationally representative data from the US (Health and Retirement Study, 3 waves, 2006-16) and England (English Longitudinal Study of Ageing, 4 waves, 2004-18). Loneliness, social isolation, and social engagement were self-reported. CRP was measured using dried blood spots (US) and venous blood samples (England). Cross-lagged panel models were fitted and tested interactions with phenotypic depression (above-threshold depressive symptom scores) and genotypic depression (polygenic score for major depressive disorder). RESULTS: We included 15,066 participants (mean age = 66.1 years, SD = 9.8) in the US and 10,290 (66.9 years, SD = 10.5) in England. We found reciprocal associations between loneliness and CRP using dried blood spots and venous blood samples. Higher CRP predicted higher subsequent loneliness and higher loneliness predicted elevated CRP. Both phenotypic and genotypic depression modified this reciprocal association. There were also reciprocal associations for social engagement in venous blood samples: higher CRP predicted lower social engagement and greater social engagement predicted lower subsequent CRP. Associations between social isolation and CRP were inconsistent and unidirectional. CONCLUSIONS: Loneliness may increase chronic inflammation, whereas social engagement may reduce inflammation. As these relationships were reciprocal, there may be a loop between inflammation, loneliness, and social engagement. This loop was stronger in those with depression or at high genetic risk for major depressive disorder. This relationship for loneliness was present in both blood sampling methods despite contrasting methods of CRP measurement, indicating that the finding is not attributable to measurement bias in biomarkers.


Asunto(s)
Proteína C-Reactiva , Depresión , Pruebas con Sangre Seca , Inflamación , Soledad , Fenotipo , Aislamiento Social , Humanos , Masculino , Femenino , Anciano , Estudios Longitudinales , Inflamación/sangre , Soledad/psicología , Persona de Mediana Edad , Aislamiento Social/psicología , Proteína C-Reactiva/análisis , Proteína C-Reactiva/metabolismo , Pruebas con Sangre Seca/métodos , Depresión/sangre , Depresión/psicología , Depresión/genética , Genotipo , Inglaterra , Trastorno Depresivo Mayor/sangre , Trastorno Depresivo Mayor/genética , Estados Unidos
20.
J Subst Use Addict Treat ; 162: 209358, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38548060

RESUMEN

INTRODUCTION: Compared to the general U.S. adolescent population, young people involved in the juvenile justice system are at greater risk of experiencing substance use (SU) issues. There are critical opportunities across the juvenile justice continuum, at points of interface with community-based treatment services, to screen and assess for SU issues, identify unmet treatment needs, and refer those in need to treatment. The treatment referral process is, however, complex, and contingent on a seamless nexus between juvenile justice operations and the wider treatment provider landscape. Given the lack of successful SU referrals among justice-involved youth and the variable referral rates across jurisdictions, this study's aim is to provide a qualitative, explanatory understanding of the conditions that together contribute to successful referring practices. METHODS: The study is based on an analysis of a qualitative dataset comprising focus group data with probation and community-based behavioral health treatment staff working in 31 sites in 6 different states as part of the clustered randomized trial of an organizational change intervention known as JJ-TRIALS (Juvenile Justice Translational Research on Interventions for Adolescents in the Legal System). The data contain respondents' narratives on the achievements, successes, and challenges with implementing the intervention. The data were analyzed through a combination of strategies to identify the conditions that both facilitate and impede referral processes between probation offices and community-based SU treatment providers. RESULTS: Participants across sites discussed the positive impacts that the JJ-TRIALS intervention had on their improved ability to communicate, collaborate, and collect data. From the interviews, seven main conditions were observed to contribute to successful SU treatment referral practices: (1) communication (inter-organizational); (2) collaboration; (3) data-driven practices; (4) family engagement; (5) institutionalized policy and referral documentation; (6) efficient referral policies and procedures; and (7) suitable and accessible system of treatment providers. CONCLUSION: Findings highlight the value of a holistic understanding of successful treatment referrals for justice-involved youth and help inform research and practice efforts to identify and measure the many dimensions of referral-making at the interface of juvenile probation and behavioral health services.


Asunto(s)
Delincuencia Juvenil , Derivación y Consulta , Trastornos Relacionados con Sustancias , Humanos , Delincuencia Juvenil/psicología , Delincuencia Juvenil/rehabilitación , Adolescente , Trastornos Relacionados con Sustancias/terapia , Femenino , Masculino , Investigación Cualitativa , Grupos Focales , Estados Unidos , Personal de Salud/psicología
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