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1.
J Trauma Stress ; 2024 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-38652068

RESUMO

In 2009, a fire occurred in the ABC Day Care Center in Hermosillo, Mexico, that killed and injured many children who were in attendance that day. This study investigated the association between the posttraumatic stress symptoms (PTSS) of socially connected parents and caregivers whose children were affected by the fire. Parents and caregivers of the children who were in attendance the day of the fire were interviewed 8-11 months and 20-23 months postfire. Linear network autocorrelation modeling was used to test for autocorrelations of the outcome variable count of PTSS within different configurations of the network of caregivers. No significant network effects appeared in models from the first interview period, but effects did appear in the second period, specifically in the three models in which network ties consisted of "receive informational support" (.220), "give and receive emotional support" (.167), and "give and receive both informational and emotional support" (.213). The findings suggest that in these three network configurations, as relationships grew in strength from the first interview to the second, the level of one's own PTSS was more comparable to the level of PTSS of one's social connections. Two theoretical mechanisms that may explain this result are homophily and social influence.

3.
Eur Child Adolesc Psychiatry ; 33(3): 725-737, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36933151

RESUMO

Previous studies indicate that obesity is a risk factor of suicide behaviors among adolescents. Whether this association has remained consistent during the ongoing obesity epidemic remains unknown. The time trends of the obesity-suicide association were examined using the 1999-2019 biannual Youth Risk Behavior Survey data (n = 161,606). Prevalence odds ratio of suicide behaviors among adolescents with obesity (vs. adolescents with no obesity) for each survey year and time trends using National Cancer Institute Joinpoint regression analysis was calculated. For each year post-baseline, there was a significant increase of prevalence odds ratio of 1.4 (1.2-1.6)-1.6 (1.3-2.0) for suicide ideation, 1.3 (1.1-1.7) -1.7 (1.4-2.0) for plan, and 1.3 (1.0-1.7) -1.9 (1.5-2.4) for an attempt, except for the 2013 survey for attempt (1.19 [0.9-1.6]). Significant positive trends were found from1999 to 2019 for ideation and plan, with biannual %-changes of + 0.92 and + 1.22%, respectively. Adolescents with obesity have consistently higher odds of engaging in suicide behaviors than their peers without obesity since the beginning of the United States obesity epidemic, and this association grew stronger as the obesity epidemic continued.


Assuntos
Obesidade Infantil , Tentativa de Suicídio , Humanos , Adolescente , Estados Unidos/epidemiologia , Obesidade Infantil/epidemiologia , Ideação Suicida , Fatores de Risco , Assunção de Riscos
4.
Sci Rep ; 13(1): 21340, 2023 12 04.
Artigo em Inglês | MEDLINE | ID: mdl-38049502

RESUMO

In exponential population growth, variability in the timing of individual division events and environmental factors (including stochastic inoculation) compound to produce variable growth trajectories. In several stochastic models of exponential growth we show power-law relationships that relate variability in the time required to reach a threshold population size to growth rate and inoculum size. Population-growth experiments in E. coli and S. aureus with inoculum sizes ranging between 1 and 100 are consistent with these relationships. We quantify how noise accumulates over time, finding that it encodes-and can be used to deduce-information about the early growth rate of a population.


Assuntos
Escherichia coli , Staphylococcus aureus , Modelos Biológicos , Processos Estocásticos , Densidade Demográfica
5.
Disaster Med Public Health Prep ; 17: e516, 2023 10 23.
Artigo em Inglês | MEDLINE | ID: mdl-37870127

RESUMO

OBJECTIVE: This study sought to better understand the types of locations that serve as hubs for the transmission of COVID-19. METHODS: Contact tracers interviewed individuals who tested positive for SARS-CoV-2 between November 2020 and March 2021, as well as the people with whom those individuals had contact. We conducted a 2-mode social network analysis of people by the types of places they visited, focusing on the forms of centrality exhibited by place types. RESULTS: The most exposed locations were grocery stores, commercial stores, restaurants, commercial services, and schools. These types of locations also have the highest "betweenness," meaning that they tend to serve as hubs between other kinds of locations since people would usually visit more than 1 location in a day or when infected. The highest pairs of locations were grocery store/retail store, restaurant/retail store, and restaurant/grocery store. Schools are not at the top but are 3 times in the top 7 pairs of locations and connected to the 3 types of locations in those top pairs. CONCLUSIONS: As the pandemic progressed, location hotspots shifted between businesses, schools, and homes. In this social network analysis, certain types of locations appeared to be potential hubs of transmission.


Assuntos
COVID-19 , SARS-CoV-2 , Humanos , COVID-19/epidemiologia , Texas/epidemiologia , Análise de Rede Social
6.
Dermatol Ther (Heidelb) ; 13(11): 2753-2768, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37759099

RESUMO

INTRODUCTION: Near-complete skin clearance has become a rapidly achievable treatment goal for patients with psoriasis receiving systemic biologic therapies. However, real-world evidence for durability of near-complete skin clearance and risk factors associated with loss of near-complete skin clearance is limited. METHODS: This study described durability of near-complete skin clearance (≥ 90% improvement in Psoriasis Area and Severity Index from initiation; PASI90) and identified clinical factors or patient characteristics associated with loss of PASI90 among patients with psoriasis from the CorEvitas Psoriasis Registry (April 2015-August 2021). Included patients had PASI > 5 at biologic initiation and achieved PASI90 at approximately 6 months from initiation (index). A Kaplan-Meier estimate described time to loss of treatment response over 24 months follow-up from index. Proportional hazards regression was used to identify independent predictors of loss of treatment response. RESULTS: This study included 687 patient initiations (instances of patients initiating a biologic). Following achievement of PASI90, treatment response was maintained in more than half of patient initiations (54%). Treatment response was maintained at 6, 12, and 18 months from index in an estimated 73% (95% [confidence interval] CI 70-77%), 60% (95% CI 56-63%), and 50% (95% CI 47-54%) of patient initiations, respectively. Adjusted hazards regression suggested non-White race, full-time employment, greater body weight, concomitant psoriatic arthritis, prior use of biologics, and clinically meaningful skin symptoms were associated with loss of treatment response. CONCLUSIONS: Among real-world patients with psoriasis who achieved PASI90 with biologic therapy, about one-quarter lost response at 6 months, and half lost response at 18 months. Prior use of a biologic therapy and clinically meaningful skin symptoms at index, including itch and skin pain, were associated with loss of treatment response. Therefore, dermatologists may consider focusing on patient-reported symptoms as part of any intervention designed to reduce the likelihood of loss of response to biologic therapies. TRIAL REGISTRATION: ClinicalTrials.gov identifier, NCT02707341.


Many people with psoriasis are treated with biologic medications that work to improve symptoms associated with psoriasis, including inflammation. These medications can lead to almost clear skin for many people. However, there is limited information available about how long almost clear skin can be maintained with biologic medications, and what predicts who is likely to lose it. To explore these questions, we examined a database of patients with psoriasis (the CorEvitas Psoriasis Registry) that records how clear patients' skin is and the medications they take. Out of every 100 patients, 54 maintained almost clear skin and stayed on their original medication for 2 years after first having almost clear skin. Out of every 100 patients, 73, 60, and 50 maintained almost clear skin and remained on their original medication at 6, 12, and 18 months after they had achieved this response. The results indicated that patients who were not White, worked full time, previously used a biologic medication, or had itchy and/or painful skin after they had achieved almost-clear skin were more likely to change their medication and/or no longer have almost-clear skin. These results suggest that dermatologists may consider focusing on patient-reported characteristics when deciding how to treat their patients, to reduce the likelihood that they lose their response to the medication they are prescribed.

7.
J Dermatolog Treat ; 34(1): 2246601, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37691405

RESUMO

BACKGROUND: Real-world data on the effectiveness of systemic therapy in atopic dermatitis (AD) are limited. METHODS: Adult patients with AD in the CorEvitas AD registry (2020-2021) who received systemic therapies for 4-12 months prior to enrollment were included based on disease severity: body surface area (BSA) 0%-9% and BSA ≥10%. Demographics, clinical characteristics, and outcomes were assessed using descriptive statistics. Pairwise effect sizes (ES) were used to compare BSA groups. RESULTS: The study included 308 patients (BSA 0%-9%: 246 [80%]; BSA ≥10%: 62 [20%]). Despite systemic therapy, both BSA groups reported the use of additional topical therapy and the presence of lesions at difficult locations. Moderate-to-severe AD (vIGA-AD®) was reported by 11% (BSA 0%-9%) and 66% (BSA ≥10%; ES = 0.56) of patients. Mean disease severity scores: total BSA (2% and 22%; ES = 3.59), EASI (1.1 and 11.1; ES = 2.60), and SCORAD (12.1 and 38.0; ES = 1.99). Mean scores for PROs: DLQI (3.7 and 7.5; ES = 0.75), and peak pruritus (2.2 and 4.5; ES = 0.81). Inadequate control of AD was seen in 27% and 53% of patients (ES = 0.23). CONCLUSIONS: Patients with AD experience a high disease burden despite systemic treatment for 4-12 months. This study provides potential evidence of suboptimal treatment and the need for additional effective treatment options for AD.


This real-world study assessed clinical characteristics and overall disease burden in adult patients with atopic dermatitis (AD) who were receiving systemic therapy for 4­12 months.Patients reported greater involvement of back and anterior trunk, and lesions at difficult locations. Irrespective of body surface area involvement, patients continued to experience inadequate control of AD, varied disease severity, and impact on quality of life.The study provides potential evidence of suboptimal treatment and the need for effective treatment options for the management of AD. Besides clinical outcomes, treating dermatologists and dermatology practitioners should include patient-reported outcomes in routine clinical care to determine the best treatment options for their patients.


Assuntos
Dermatite Atópica , Adulto , Humanos , Dermatite Atópica/tratamento farmacológico , Prurido , Administração Cutânea , Efeitos Psicossociais da Doença , Sistema de Registros
8.
Nat Commun ; 14(1): 1557, 2023 03 21.
Artigo em Inglês | MEDLINE | ID: mdl-36944617

RESUMO

The gut is continuously invaded by diverse bacteria from the diet and the environment, yet microbiome composition is relatively stable over time for host species ranging from mammals to insects, suggesting host-specific factors may selectively maintain key species of bacteria. To investigate host specificity, we used gnotobiotic Drosophila, microbial pulse-chase protocols, and microscopy to investigate the stability of different strains of bacteria in the fly gut. We show that a host-constructed physical niche in the foregut selectively binds bacteria with strain-level specificity, stabilizing their colonization. Primary colonizers saturate the niche and exclude secondary colonizers of the same strain, but initial colonization by Lactobacillus species physically remodels the niche through production of a glycan-rich secretion to favor secondary colonization by unrelated commensals in the Acetobacter genus. Our results provide a mechanistic framework for understanding the establishment and stability of a multi-species intestinal microbiome.


Assuntos
Microbioma Gastrointestinal , Microbiota , Animais , Drosophila melanogaster/microbiologia , Trato Gastrointestinal/microbiologia , Bactérias , Drosophila , Mamíferos
9.
Trop Anim Health Prod ; 55(2): 80, 2023 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-36786899

RESUMO

Tanniferous browse leaves are reported to inhibit methanogens and protozoa activity in the rumen, thus contributing to a reduction of methane emission. This study evaluated the influence of feeding dried browse leaves to sheep on rumen ammonia concentration, the base pair at which protozoa and methanogens were amplified and double stranded DNA concentration (dsDNA) from rumen fluid and faeces. The eight treatments were urea treated rice straw, Albizzia lebbek (AL), Moringa oleifera (MO), Millettia thonningii (MT), AL + MO, AL + MT, AL + MO + MT and MO + MT. After feeding 32 ram lambs for 3 months, one ram lamb on each of the eight experimental diets was randomly selected and slaughtered to obtain rumen fluid. Genomic DNAs were extracted from methanogen and protozoa strains obtained from rumen liquor and from faecal matter of sheep. Rumen ammonia was determined using spectrophotometer. Methanogens and protozoa from rumen fluid and faeces were amplified at 1100 base pair, 200-1100 base pair, 320-1100 base pair and 200-750 base pair respectively. Rumen ammonia concentration, dsDNA from rumen fluid and faeces ranged from 14.51 to 23.01 mg/dl, 65 to 900 µg/ml and 100 to 950 µg/g respectively. The rumen ammonia concentration met the requirements for efficient growth of microbes. The presence of methanogens and protozoa in the rumen fluid and in the faeces indicated that dried browse diets were able to inhibit the growth of both protozoa and methanogens in the rumen by eliminating them, and thus, were excreted in the faeces. Hence, feeding of dried browse leaves can contribute to lower methane emission.


Assuntos
Amônia , Rúmen , Ovinos , Animais , Masculino , Rúmen/metabolismo , Amônia/metabolismo , Gana , Folhas de Planta , Metano/metabolismo , Fermentação
10.
J Adolesc Health ; 72(4): 526-534, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36646564

RESUMO

BACKGROUND: Adolescents with obesity are more likely to exhibit suicide behaviors, but this association may be confounded by psychosocial stigma related to obesity. We examined whether the obesity is independently associated with suicide behaviors among United States adolescents, after adjusting for the psychosocial factors. METHODS: We analyzed data from 2019 Youth Risk Behavior Survey data (N = 13,871 United States adolescents) on recent (past year) suicide behavior (attempt, ideation, and plan); demographics (age, sex, and race/ethnicity); and psychosocial factors (feeling sad/hopeless, alcohol and illegal drug use, being bullied, and sexually abused). Participants were classified as having obesity (Y/N) per standardized percentiles. Logistic regression was employed to examine the association between obesity and suicide attempt, ideation, and plan, while adjusting for psychosocial covariates. RESULTS: The prevalence of suicide attempt, ideation, and plan was 8.90%, 18.75%, and 15.71%, respectively. Obesity prevalence was 15.5%. The odds of suicide attempt, ideation, and plan were 1.65 (1.30-2.11), 1.31 (0.89-1.61), and 1.27 (1.02-1.57), respectively, among those with obesity versus without obesity. DISCUSSION: Obesity is significantly associated with a suicide attempt, ideation, and plan among United States adolescents, even after adjusting for confounding psychosocial factors. Further research on the temporality and causality of this association is needed.


Assuntos
Transtornos Relacionados ao Uso de Substâncias , Ideação Suicida , Humanos , Estados Unidos/epidemiologia , Adolescente , Fatores de Risco , Tentativa de Suicídio , Obesidade/epidemiologia , Modelos Logísticos , Transtornos Relacionados ao Uso de Substâncias/psicologia
11.
Biochem Mol Biol Educ ; 51(2): 128-136, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36484398

RESUMO

Course-based undergraduate research experiences (CUREs) can provide undergraduate students access to research opportunities when student and faculty resources are limited. In addition to expanding research opportunities, CUREs may also be explored as a pedagogical tool for improving student learning of course content and laboratory skills, as well as improving meta-cognitive features such as confidence. We examined how a 6-week CURE in an upper-level undergraduate biochemistry lab affected student gains in content knowledge and confidence in scientific abilities, compared to a non-CURE section of the same course. We find that gains in content knowledge were similar between CURE and non-CURE sections, indicating the CURE does not negatively impact student learning. The CURE was associated with a statistically significant gain in student confidence, compared to non-CURE group. These results show that even a relatively short CURE can be effective in improving student confidence at scientific research skills, in addition to expanding access to research.


Assuntos
Currículo , Aprendizagem , Humanos , Estudantes/psicologia , Bioquímica/educação , Avaliação Educacional
12.
Nat Commun ; 13(1): 4483, 2022 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-35918333

RESUMO

Quantum cellular automata (QCA) evolve qubits in a quantum circuit depending only on the states of their neighborhoods and model how rich physical complexity can emerge from a simple set of underlying dynamical rules. The inability of classical computers to simulate large quantum systems hinders the elucidation of quantum cellular automata, but quantum computers offer an ideal simulation platform. Here, we experimentally realize QCA on a digital quantum processor, simulating a one-dimensional Goldilocks rule on chains of up to 23 superconducting qubits. We calculate calibrated and error-mitigated population dynamics and complex network measures, which indicate the formation of small-world mutual information networks. These networks decohere at fixed circuit depth independent of system size, the largest of which corresponding to 1,056 two-qubit gates. Such computations may enable the employment of QCA in applications like the simulation of strongly-correlated matter or beyond-classical computational demonstrations.

13.
Child Abuse Negl ; 131: 105781, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35820322

RESUMO

BACKGROUND: Caregivers' substance use is associated with child maltreatment. OBJECTIVE: Examine trends from 2005 to 2018 in percentages of three outcomes with caregivers' drug or alcohol use: child protective services (CPS) referrals, substantiated maltreatment reports, and foster care placements. PARTICIPANTS AND SETTING: 22 U.S. states that contributed child-level maltreatment outcomes and caregivers' substance use data to the National Child Abuse and Neglect Data System from 2005 to 2018. METHODS: Joinpoint regression was used to examine the average annual percent change (AAPC) in outcomes with caregivers' drug or alcohol use and to identify temporal changes. RESULTS: From 2005 to 2018, CPS referrals with caregivers' drug use increased (AAPC 2.33, p < .001), while referrals with alcohol use remained unchanged (AAPC -0.11, p = .92) (trend difference p = .04). Substantiated reports with caregivers' drug and alcohol use increased (AAPC drug use 3.63, p < .001, AAPC alcohol use 1.28, p = .03), with a greater increase observed with drug use (difference p = .03). Foster care placements with caregivers' drug use increased (AAPC 2.54, p < .001), while placements with alcohol use did not change (AAPC -1.22, p = .29), (difference p = .005). Within the study period, changes in trends with caregivers' drug use included increased substantiated reports from 2010 to 2018 (p < .001) and increased foster care placements from 2009 to 2018 (p < .001). With caregivers' alcohol use, CPS referrals and foster care placements decreased from 2007 to 2018 (all p < .001). CONCLUSIONS: Trends differed for outcomes with caregivers' drug versus alcohol use. Findings can inform policies to improve care for families affected by substance use.


Assuntos
Maus-Tratos Infantis , Transtornos Relacionados ao Uso de Substâncias , Consumo de Bebidas Alcoólicas , Cuidadores , Criança , Serviços de Proteção Infantil , Proteção da Criança , Humanos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
14.
Orthop Nurs ; 41(4): 302-304, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35869922
15.
Urology ; 166: 246-249, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35537561

RESUMO

Dextranomer/hyaluronic acid (Deflux) has been widely used in the treatment of vesicoureteral reflux in the pediatric population. It has demonstrated acceptable early efficacy with minimal morbidity. Early complications from Deflux have been reported to occur in approximately 1% of cases. However, late complications from Deflux use, including calcification and delayed ureteral obstruction, are less well understood. We present the case of an asymptomatic 11 year old girl with severe ipsilateral hydroureteronephrosis, identified nearly 8 years after treatment. This case details a rare instance of loss of renal function after Deflux use in a patient with no apparent risk factors.


Assuntos
Calcinose , Refluxo Vesicoureteral , Calcinose/etiologia , Criança , Dextranos/efeitos adversos , Feminino , Humanos , Ácido Hialurônico/efeitos adversos , Rim/diagnóstico por imagem , Rim/fisiologia , Próteses e Implantes/efeitos adversos , Refluxo Vesicoureteral/complicações , Refluxo Vesicoureteral/terapia
16.
Front Oncol ; 12: 852267, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35463370

RESUMO

Purpose: The purpose of this study was to describe the social support networks and daily support interactions of cancer-affected individuals, including young adult (YA) and LGBTQIA+ survivors and care partners. Methods: Participants were recruited at two United States cancer centers and via social media for a pilot study testing a novel online method for collecting prospective, daily social support interaction data (N=28). All participants were aged 18+; survivors had a current or recent cancer diagnosis and were engaged in treatment and/or services; care partners were identified by the survivors. Enrollment also purposefully targeted YA and LGBTQIA+ survivors. Social network data (up to 10 members) were assessed at baseline. Daily online surveys assessed support interactions between participants and specific network members over 14 days. Descriptive statistics summarized data and explored between-group (YA/non-YA, LGBTQIA+/non-LGBTQIA+) differences in social network characteristics (size, heterogeneity, density, centralization, cohesion) and support interactions (support source and type). Results: There were no significant differences between YA and non-YA participants on any measures. LGBTQIA+ participants' support networks were less dense (Mdn=0.69 vs. 0.82, p=.02), less cohesive (Mdn=0.85 vs. 0.91,.02), more centered on the participant (Mdn=0.40 vs. 0.24, p=.047), and included more LGBTQIA+ members (Mdn=0.35 vs. 0.00, p<.001). LGBTQIA+ participants reported having more interactions with LGBTQIA+ network members (Mdn=14.0 vs. Mdn=0.00, p<.001) and received significantly more of all types of support from LGBTQIA+ vs. non-LGBTQIA+ members. LGBTQIA+ participants also reported receiving more appraisal support than non-LGBTQIA+ (Mdn 21.64 vs. 9.12, p=.008) including more appraisal support from relatives (Mdn=11.73 vs 6.0, p+.037). Conclusions: Important information related to support access, engagement, and needs is embedded within the everyday contexts of the social networks of cancer-affected people. Individualized, accessible, and prospective assessment could help illuminate how their "real world" support systems are working and identify specific strengths and unmet needs. These insights would inform the development of more culturally competent and tailored interventions to help people understand and leverage their unique support systems. This is particularly critical for groups like YA and LGBTQIA+ survivors and care partners that are underserved by formal support services and underrepresented in cancer, caregiving, and social support research.

17.
Proc Natl Acad Sci U S A ; 119(7)2022 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-35135881

RESUMO

Observational studies reveal substantial variability in microbiome composition across individuals. Targeted studies in gnotobiotic animals underscore this variability by showing that some bacterial strains colonize deterministically, while others colonize stochastically. While some of this variability can be explained by external factors like environmental, dietary, and genetic differences between individuals, in this paper we show that for the model organism Drosophila melanogaster, interactions between bacteria can affect the microbiome assembly process, contributing to a baseline level of microbiome variability even among isogenic organisms that are identically reared, housed, and fed. In germ-free flies fed known combinations of bacterial species, we find that some species colonize more frequently than others even when fed at the same high concentration. We develop an ecological technique that infers the presence of interactions between bacterial species based on their colonization odds in different contexts, requiring only presence/absence data from two-species experiments. We use a progressive sequence of probabilistic models, in which the colonization of each bacterial species is treated as an independent stochastic process, to reproduce the empirical distributions of colonization outcomes across experiments. We find that incorporating context-dependent interactions substantially improves the performance of the models. Stochastic, context-dependent microbiome assembly underlies clinical therapies like fecal microbiota transplantation and probiotic administration and should inform the design of synthetic fecal transplants and dosing regimes.


Assuntos
Bactérias/classificação , Drosophila melanogaster/microbiologia , Microbiota , Animais , Fenômenos Fisiológicos Bacterianos/genética , Modelos Biológicos , Especificidade da Espécie , Processos Estocásticos
18.
Orthop Nurs ; 41(1): 4-12, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35045535

RESUMO

There is ample research demonstrating improved patient outcomes when using an enhanced recovery program. However, the literature reporting the impact of preoperative education alone prior to hip and knee arthroplasty is conflicting. With the number of these surgical procedures expected to increase in the next few years, the identification of strategies that positively impact outcomes is important. The aim of this study was to evaluate immediate postoperative physical therapy (PT) performance following a total hip or knee arthroplasty in patients who attended a preoperative education class compared with those who did not. This study was a retrospective chart review of 707 hip and knee arthroplasty patients, comparing outcomes based on preoperative educational session attendance. Demographics, comorbidities, length of stay (LOS), discharge disposition, and PT performance were collected from the chart review. Patients who attended the preoperative education class had significantly greater ambulation distances (p < .001), greater degrees of knee flexion (p < .001), and greater degrees of hip flexion (p = .012) on postoperative Day 1. Both hip (p < .001) and knee (p < .001) patients who attended the class had a significantly shorter LOS. The cost benefit analysis indicated a savings of $921.57 in direct costs per knee arthroplasty in those who attended a class. Patients who received preoperative education had greater mobility in the immediate postoperative period and reduced LOS for both hip and knee arthroplasties. Based on this study's results, preoperative education is effective in improving outcomes and reducing the cost of hip and knee arthroplasties.


Assuntos
Artroplastia de Quadril , Artroplastia do Joelho , Humanos , Tempo de Internação , Período Pós-Operatório , Estudos Retrospectivos
19.
J Cancer Surviv ; 16(4): 904-912, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35064551

RESUMO

PURPOSE: The purpose of this study was to test the feasibility, usability, and acceptability of implementing a web-based method for collecting social network and longitudinal daily interaction data from cancer survivors and their caregivers. METHODS: Young adult and sexual/gender minority cancer survivors and their informal caregivers were recruited as dyads. Feasibility data, including enrollment and retention, were captured. Individual social network data were collected at baseline and used to individualize daily electronically delivered surveys assessing characteristics of daily social support-related interactions with identified network members for 14 days. Follow-up questionnaires assessing usability and exit interviews assessing acceptability were completed at the end of the 2-week study period. RESULTS: Fourteen survivor-caregiver dyads (28 individual participants) were enrolled and completed all baseline and final measures. Participants completed 85.2% of daily diary reports and reported excellent usability ratings. Acceptability was also high. In qualitative interviews, participants reported enjoying the daily reflection on social support facilitated by our methods. CONCLUSIONS: Our method has been shown to be highly feasible, usable, and acceptable. IMPLICATIONS FOR CANCER SURVIVORS: Developing better data collection tools can lead to better understanding of the social support cancer survivors and their caregivers receive, and how the social network structure facilitates or creates barriers to accessing this support.


Assuntos
Cuidadores , Apoio Social , Estudos de Viabilidade , Humanos , Internet , Rede Social , Adulto Jovem
20.
Community Ment Health J ; 58(3): 578-588, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-34176054

RESUMO

There is increased interest over the last decade in the use of Shared Decision Making with individuals with serious mental illness to improve engagement in treatment and clinical outcomes. We conducted semi-structured qualitative interviews with 15 individuals with serious mental illness treated in an outpatient transitional care clinic serving people immediately after discharge from a psychiatric hospitalization. Parallel interviews were conducted with a variety of clinical providers (n = 9). Using latent thematic analysis, six themes were identified including: (1) Differences in the Use of SDM, (2) Consideration of Past Experiences, (3) Decisional Power Preferences, (4) Use of SDM in Psychiatry Versus Other Areas of Medicine, (5) Dignity and Disengagement, and (6) External Forces Impacting SDM. Implications for clinical practice and research using a shared decision-making approach within this treatment setting are further discussed.


Assuntos
Tomada de Decisão Compartilhada , Psiquiatria , Instituições de Assistência Ambulatorial , Tomada de Decisões , Humanos , Participação do Paciente
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