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1.
J Telemed Telecare ; : 1357633X241255411, 2024 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-38767152

RESUMO

INTRODUCTION: Since 2021, the world has been facing a cost-of-living crisis which has negatively affected population health. Meanwhile, little is known about its impact on patients' preferences to access care. We aimed to analyse public preference for the modality of consultation (virtual vs face-to-face) before and after the onset of crisis and factors associated with these preferences. METHODS: An online cross-sectional survey was administered to the public in the United Kingdom, Germany, Italy and Sweden. McNemar tests were conducted to analyse pre- and post-crisis differences in preferences; logistic regression was used to examine the demographic factors associated with public preferences. RESULTS: Since the onset of crisis, the number of people choosing virtual consultations has increased in the United Kingdom (7.0% vs 9.5% P < 0.001), Germany (6.6% vs 8.6%, P < 0.008) and Italy (6.0% vs 9.8%, P < 0.001). Before the crisis, a stronger preference for virtual consultations was observed in people from urban areas (OR 1.28, 95% CI 1.05-1.56), while increasing age was associated with a lower preference for virtual care (OR 0.966, 95% CI 0.961-0.972). Younger people were more likely to switch to virtual care, while change to face-to-face was associated with younger age and lower income (OR 1.34, 95% CI 1.12-1.62). Older adults were less likely to change preference. CONCLUSIONS: Since the onset of the cost-of-living crisis, public preference for virtual consultations has increased, particularly in younger population. This contrasts with older adults and people with lower-than-average incomes. The rationale behind patients' preferences should be investigated to ensure patients can access their preferred modality of care.

2.
J Appl Behav Anal ; 2024 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-38767337

RESUMO

Although decades of behavior-analytic studies have focused on decreasing the aggressive behavior of clients, relatively little research has been conducted on preventing injuries for the staff members who implement treatment plans. In this study, three direct-care staff members working with clients presenting with aggressive behavior were taught targeted blocking and distance management techniques designed to keep the clients safe while preventing injuries to the participants. Findings indicated that all staff members acquired the target skills in simulations, after which the skills for two participants generalized to the natural work environment.

3.
Clin Nutr ESPEN ; 61: 237-252, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38777440

RESUMO

BACKGROUND: Food waste is a pivotal contributor to environmental degradation in the modern world. Vast amounts of food are wasted and many individual efforts and collective initiatives being underway to deal with this challenge. Hospitals are institutions that produce and provide food, but at the same time contribute greatly to food waste. The objective of this scoping review is to present available data regarding quantity of food waste generated in public hospitals and summarizes studies that assess and quantify the greenhouse gas emissions (carbon footprint) associated to food service management in hospitals. METHODS: A systematic literature research was conducted by two qualified researchers in PubMed, Scopus, ISI Web of Science and Science Direct. The publication date was set to the last ten years, i.e., 2013-2023. All the abstracts retrieved were screened, and the eligible articles were selected after a two-step process. Abstracts from the retrieved full papers' references were also screened for eligibility. The selected papers were included in the final scoping review. RESULTS: Overall, 2870 studies were identified and 69 were included in the review. Most of the studies (n = 33) assessed the causes and quantified the amount of food waste generated in hospitals. A small number of studies (5) estimated carbon dioxide equivalent (CO2-eq) produced by food waste. Although several studies suggested strategies and measures to reduce the environmental impact of foodservice operations, none of them implemented a comprehensive foodservice management system. CONCLUSION: This scoping review suggests that hospital diets contribute to food waste and may have a negative environmental impact. There are several internal and external factors and practices that influence positively or negatively the sustainability of hospital food service systems. Systematic efforts are needed to identify and enhance parameters that could improve the environmental footprint of hospitals in terms of more effective management of food waste.


Assuntos
Pegada de Carbono , Serviço Hospitalar de Nutrição , Humanos , Conservação dos Recursos Naturais , Hospitais , Gerenciamento de Resíduos , Gases de Efeito Estufa , Desenvolvimento Sustentável
4.
Tob Use Insights ; 17: 1179173X241253962, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38746596

RESUMO

Objective: Smoking habits have widely changed over time; however, they remain a well-known fashion that risks people's health. In addition, nicotine addiction depends on the interplay between several factors. Our study aimed to understand the smoking habits and nicotine dependence in the Lebanese population before (September 2019) and during (June 2020) the economic crisis and COVID-19 pandemic. Methods: This observational cross-sectional survey-based study included 1560 Lebanese individuals aged between 13 and 75 years old from June till October 2020. Data collection was performed through an electronic survey including patients' demographics and validated instruments to assess addiction to nicotine (CAGE, Four C's, Fagerström test, and Smoker's profile scores). Results: Out of 1560 participants, 794 (50.9%) were males. The mean age was 26.5 ± 11.69 years, and 67.8% were aged between 18 and 25 years old. We found that 865 (55.4%) participants were smokers. In addition, smoking cigarettes or vaping, significantly increased between September 2019 and June 2020. Our smoker group showed a high CAGE positivity (P < .001), marked compulsion (P < .001), and a considerable lack of self-control to surcease smoking (P < .001). Furthermore, the nicotine dependence score (NDS) increased with age (B = .166) and decreased with higher educational levels (B = -.219). Conclusion: During the economic crisis and the COVID-19 pandemic, the Lebanese population showed an increased prevalence of smoking, a high level of CAGE positivity, strong compulsion, and a significant lack of self-control when it came to quitting smoking. This strongly entails public health measures for smoking cessation through national awareness campaigns.

5.
Int J Nurs Stud Adv ; 6: 100197, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38746825

RESUMO

Background: Being a relative to a trauma patient may be a dramatic experience. Often, trauma centre nurses do not feel they have the competences needed to meet relatives experiencing a crisis. Therefore, a need exists to enhance their crisis management competencies. Objective: To investigate relatives' experiences of a nursing crisis management intervention on information, inclusion and support, including the importance of these needs in two Danish trauma centres. Design: A prospective intervention study based on interrupted time series. The intervention, conducted in 2020-2021, consisted of a crisis management training programme. Settings: The Trauma Centre of the Aarhus University Hospital and Aalborg University Hospital in Denmark. Participants: Relatives (18+ years) of critically ill or injured patients (n = 293). Methods: Data were collected using a 32-item questionnaire. The primary outcome was relatives' overall experience of the quality of the information, inclusion and support measured on a visual analogue scale (VAS) (0-10). Secondary outcomes were changes in risk ratios and scores between the periods for each of the three main variables. The outcome was measured as weighted and non-weighted scores, taking into account the importance of each variable. Besides use of interrupted time series, predictive and weight-adjusted analyses were performed. Time series comprised a before-period (6 months), an implementation period (3 months) and an after-period (6 months). Due to ceiling effect, the predictive analysis was dichotomized using the median scores for information, inclusion and support. Results: Overall, no differences were observed between the participants' characteristics in each of the three periods. Comparing the implementation period with the after-period revealed a statistically significant positive difference between the relatives' assessment of crisis management [p = 0.009]. Additionally, the probability of scoring >8 from before to after the intervention increased statistically significantly [Risk ratio 1.21, 95 % confidence interval 1.16-1.27]. The secondary outcomes showed that the greatest change over time was inclusion of relatives [Risk ratio, 1.25 95 % confidence interval 1.15-1.35]. Information had the greatest effect on relatives' experience of nurses' provision of crisis management and was also the needs area that relatives considered most important. However, information was also the needs area that evolved least during the study. Conclusions: Based on the selected cut-off levels, the intervention appeared to have a positive effect on relatives' experiences - especially inclusion of relatives. In the weighted analyses, information was considered most important and also had the greatest effect on relatives' overall experience. Nurses' crisis management competencies should be prioritized in trauma centres.

6.
J Med Internet Res ; 26: e42049, 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38748472

RESUMO

BACKGROUND: Building therapeutic relationships and social presence are challenging in digital services and maybe even more difficult in written services. Despite these difficulties, in-person care may not be feasible or accessible in all situations. OBJECTIVE: This study aims to categorize crisis counselors' efforts to build rapport in written conversations by using deidentified conversation transcripts from the text and chat arms of the National Child Abuse Hotline. Using these categories, we identify the common characteristics of successful conversations. We defined success as conversations where help-seekers reported the hotline was a good way to seek help and that they were a lot more hopeful, a lot more informed, a lot more prepared to address the situation, and experiencing less stress, as reported by help-seekers. METHODS: The sample consisted of transcripts from 314 purposely selected conversations from of the 1153 text and chat conversations during July 2020. Hotline users answered a preconversation survey (ie, demographics) and a postconversation survey (ie, their perceptions of the conversation). We used qualitative content analysis to process the conversations. RESULTS: Active listening skills, including asking questions, paraphrasing, reflecting feelings, and interpreting situations, were commonly used by counselors. Validation, unconditional positive regard, and evaluation-based language, such as praise and apologies, were also often used. Compared with less successful conversations, successful conversations tended to include fewer statements that attend to the emotional dynamics. There were qualitative differences in how the counselors applied these approaches. Generally, crisis counselors in positive conversations tended to be more specific and tailor their comments to the situation. CONCLUSIONS: Building therapeutic relationships and social presence are essential to digital interventions involving mental health professionals. Prior research demonstrates that they can be challenging to develop in written conversations. Our work demonstrates characteristics associated with successful conversations that could be adopted in other written help-seeking interventions.


Assuntos
Pesquisa Qualitativa , Humanos , Feminino , Masculino , Adulto , Linhas Diretas/estatística & dados numéricos , Intervenção em Crise/métodos , Redação , Comunicação , Pessoa de Meia-Idade
8.
Work ; 2024 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-38759083

RESUMO

BACKGROUND: When faced with a health crisis, most people tend to seek solutions through modern or traditional medicine. However, there is a group of people who tend to take a fatalistic approach to health crises and tend not to do what is necessary. When such approaches are exhibited in disadvantaged groups, there may be a chain reaction resulting in much more important problems. OBJECTIVE: The aim of this study is to determine whether the fatalistic approach is realized during a health crisis period in people 65 years and older, pregnant women, people with chronic diseases, and healthcare workers who are considered disadvantaged. Researchers also examined whether there were sociodemographic characteristics that made a difference in these attitudes among those who were determined to have a fatalistic approach. METHODS: The research was conducted with a quantitative method. The sample calculation was performed and it was decided to reach 196 people. A self-report scale was used for fatalism. RESULTS: It was determined that the participants had a moderate level of fatalism. It was seen that there was a difference between the groups in terms of fatalistic behavior. It was observed that women, divorced people, people without alcohol and smoking habits, people who live alone, and people who think their health is poor tend to behave more fatalistic. CONCLUSION: The tendency to show fatalistic behavior was found to be higher in the group of 65 years and older. Sociodemographic characteristics are associated with fatalistic behavior.

9.
Front Sociol ; 9: 1243760, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38751995

RESUMO

Background: Particularly at the beginning of the pandemic, adults aged 65 and older were portrayed as a homogeneously vulnerable population due to the elevated health risks associated with contracting the COVID-19 disease. This portrayal, combined with travel restrictions, closures of economic sectors, country-wide lockdowns, and suggestions by governmental authorities to limit social contact, had important implications for the wellbeing of older individuals. However, older adults are a heterogeneous population who relies on different resources to cope with stressful periods, like the COVID-19 pandemic. Simultaneously, countries also employed different measures to contain the virus. Research thus far has focused on the short-term consequences of the pandemic, but studies have yet to address its long-term consequences. Objectives: We explore older adults' lived experiences nearly 2 years after the pandemic onset. Moreover, we focus on the bordering countries of Switzerland and Italy, who employed contrasting containment measures. This paper analyzes (1) How the COVID-19 pandemic impacted the experiences of wellbeing of older adults in these regions and (2) How older adults coped with the stressors brought about by the pandemic, in particular social distancing. Methods: The paper draws on 31 semi-structured interviews with 11 Swiss natives residing in Switzerland, 10 Italian migrants residing in Switzerland, and 10 Italian natives residing in Italy. Interviews were conducted from December 2021 to March 2022. Results: Coping mechanisms of the three groups related to acceptance, hobbies, cognitive reframing, telephone use, vaccine use and social distancing. However, results show heterogeneous experiences of wellbeing, with Swiss natives sharing more positive narratives than the other two groups. Moreover, Italian migrants and Italian natives expressed the long-term negative consequences of the pandemic on their experienced wellbeing.

10.
J Ren Care ; 2024 May 26.
Artigo em Inglês | MEDLINE | ID: mdl-38796744

RESUMO

BACKGROUND: Several countries are experiencing challenges in maintaining standard haemodialysis services for people with kidney failure. OBJECTIVE: This study aimed to investigate the health profile of people receiving haemodialysis and to identify factors associated with interdialytic weight gain. DESIGN: A cross-sectional study. PARTICIPANTS: A total of 166 adults with kidney failure and receiving haemodialysis for at least 3 months were included. MEASUREMENTS: A structured chart audit form collected, demographic and haemodialysis treatment characteristics, recent biochemical and haematological results, and prescribed treatment regimens from clinical records. Data were analysed descriptively. Odds ratios (OR) were calculated to identify independent risk factors for interdialytic weight gain. RESULTS: Mean age was 52 years (SD = 12.5), over half were male (60.2%, n = 100), and most were receiving 4 h of haemodialysis once per week (87.3%, n = 145). Approximately half (51.8%, n = 86) had an interdialytic weight gain >2%. Being female (OR = 3.39; 95% CI, 1.51-7.61), increased comorbidities (OR = 1.50; 95% CI, 1.22-1.84) and having BMI outside of the normal range (overweight/obese [OR = 8.49; 95% CI, 3.58-20.13] or underweight [OR = 4.61; 95% CI, 1.39-15.31]) were independent risk factors for increased interdialytic weight gain. CONCLUSION: Most patients were receiving 4 h of haemodialysis once per week although only modest alterations in potassium, phosphate, and fluid status were observed. Understanding the patient profile and predictors of interdialytic weight gain will inform the development of self-management interventions to optimise clinician support.

11.
J Med Internet Res ; 26: e51698, 2024 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-38718390

RESUMO

BACKGROUND: Nonprofit organizations are increasingly using social media to improve their communication strategies with the broader population. However, within the domain of human service nonprofits, there is hesitancy to fully use social media tools, and there is limited scope among organizational personnel in applying their potential beyond self-promotion and service advertisement. There is a pressing need for greater conceptual clarity to support education and training on the varied reasons for using social media to increase organizational outcomes. OBJECTIVE: This study leverages the potential of Twitter (subsequently rebranded as X [X Corp]) to examine the online communication content within a sample (n=133) of nonprofit sexual assault (SA) centers in Canada. To achieve this, we developed a typology using a qualitative and supervised machine learning model for the automatic classification of tweets posted by these centers. METHODS: Using a mixed methods approach that combines machine learning and qualitative analysis, we manually coded 10,809 tweets from 133 SA centers in Canada, spanning the period from March 2009 to March 2023. These manually labeled tweets were used as the training data set for the supervised machine learning process, which allowed us to classify 286,551 organizational tweets. The classification model based on supervised machine learning yielded satisfactory results, prompting the use of unsupervised machine learning to classify the topics within each thematic category and identify latent topics. The qualitative thematic analysis, in combination with topic modeling, provided a contextual understanding of each theme. Sentiment analysis was conducted to reveal the emotions conveyed in the tweets. We conducted validation of the model with 2 independent data sets. RESULTS: Manual annotation of 10,809 tweets identified seven thematic categories: (1) community engagement, (2) organization administration, (3) public awareness, (4) political advocacy, (5) support for others, (6) partnerships, and (7) appreciation. Organization administration was the most frequent segment, and political advocacy and partnerships were the smallest segments. The supervised machine learning model achieved an accuracy of 63.4% in classifying tweets. The sentiment analysis revealed a prevalence of neutral sentiment across all categories. The emotion analysis indicated that fear was predominant, whereas joy was associated with the partnership and appreciation tweets. Topic modeling identified distinct themes within each category, providing valuable insights into the prevalent discussions surrounding SA and related issues. CONCLUSIONS: This research contributes an original theoretical model that sheds light on how human service nonprofits use social media to achieve their online organizational communication objectives across 7 thematic categories. The study advances our comprehension of social media use by nonprofits, presenting a comprehensive typology that captures the diverse communication objectives and contents of these organizations, which provide content to expand training and education for nonprofit leaders to connect and engage with the public, policy experts, other organizations, and potential service users.


Assuntos
Organizações sem Fins Lucrativos , Mídias Sociais , Mídias Sociais/estatística & dados numéricos , Humanos , Canadá , Aprendizado de Máquina
12.
Plant Physiol Biochem ; 211: 108699, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38749375

RESUMO

Climate change is currently considered as one of the main concerns of the agriculture sector, as it limits crop production and quality. Furthermore, the current context of global crisis with international political instability and war conflicts over the world is pushing the agriculture sector even more to urgently boost productivity and yield and doing so in a sustainable way in the current frame of climate change. Biostimulants can be an effective tool in alleviating the negative effects of environmental stresses to which plants are exposed, such as drought, salinity, heavy metals and extreme temperatures etc. Biostimulants act through multiple mechanisms, modifying gene expression, metabolism and phytohormone production, promoting the accumulation of compatible solutes and antioxidants and mitigating oxidative stress. However, it is important to keep in mind that the use and effect of biostimulants has limitations and must be accompanied by other techniques to ensure crop yield and quality in the current frame of climate change, such as proper crop management and the use of other sustainable resources. Here, we will not only highlight the potential use of biostimulants to face future agricultural challenges, but also take a critical look at their limitations, underlining the importance of a broad vision of sustainable agriculture in the context of climate change.


Assuntos
Agricultura , Mudança Climática , Produtos Agrícolas , Agricultura/métodos , Produtos Agrícolas/crescimento & desenvolvimento , Produtos Agrícolas/metabolismo , Reguladores de Crescimento de Plantas/metabolismo
13.
Cogn Res Princ Implic ; 9(1): 27, 2024 05 03.
Artigo em Inglês | MEDLINE | ID: mdl-38700660

RESUMO

The .05 boundary within Null Hypothesis Statistical Testing (NHST) "has made a lot of people very angry and been widely regarded as a bad move" (to quote Douglas Adams). Here, we move past meta-scientific arguments and ask an empirical question: What is the psychological standing of the .05 boundary for statistical significance? We find that graduate students in the psychological sciences show a boundary effect when relating p-values across .05. We propose this psychological boundary is learned through statistical training in NHST and reading a scientific literature replete with "statistical significance". Consistent with this proposal, undergraduates do not show the same sensitivity to the .05 boundary. Additionally, the size of a graduate student's boundary effect is not associated with their explicit endorsement of questionable research practices. These findings suggest that training creates distortions in initial processing of p-values, but these might be dampened through scientific processes operating over longer timescales.


Assuntos
Estatística como Assunto , Humanos , Adulto , Adulto Jovem , Interpretação Estatística de Dados , Masculino , Psicologia , Feminino
14.
Diagnostics (Basel) ; 14(9)2024 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-38732319

RESUMO

A 15-year-old young girl was found dead at home. There were no indications of any intervention or the application of force. On the previous day, she was admitted to hospital because of palpitations, fatigue, a headache, and a swollen neck. During a physical examination, a swollen thyroid gland and tachycardia were found. In the family history, her mother had thyroid disease. According to the laboratory values, she had elevated thyroid hormone levels. After administration of beta-blockers, the patient was discharged and died at home during the night. The parents denounced the hospital for medical malpractice; therefore, a Forensic Autopsy was performed. Based on the available clinical data, the autopsy, histological and toxicological results, the cause of death was stated as multiorgan failure due to disseminated intravascular coagulation (DIC) caused by the autoimmune Graves disease. The forensic assessment of the case does not reveal medical malpractice. Post-mortem diagnoses of thyroid disorders in cases of sudden death can be challenging. However, as the reported case illustrates, the diagnosis could be established after a detailed evaluation of antemortem clinical data, autopsy results, histology, and a toxicological examination.

15.
CJEM ; 26(5): 349-358, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38704790

RESUMO

PURPOSE: We utilized quality improvement (QI) approaches to increase emergency department (ED) provider engagement with research participant enrollment during the opioid crisis and coronavirus disease (COVID-19) pandemic. The context of this work is the Evaluating Microdosing in the Emergency Department (EMED) study, a randomized trial offering buprenorphine/naloxone to ED patients through randomization to standard or microdosing induction. Engaging providers is crucial for participant recruitment to our study. Anticipating challenges sustaining long-term engagement after a 63% decline in provider referrals four months into enrollments, we applied Plan-Do-Study-Act (PDSA) cycles to develop and implement an engagement strategy to increase and sustain provider engagement by 50% from baseline within 9 months. METHODS: Our engagement strategy was centered on Coffee Carts rounds: 5-min study-related educational presentations for providers on shift; and a secondary initiative, a Suboxone Champions program, to engage interested providers as study-related peer educators. We used provider referrals to our team as a proxy for study engagement and report the percent change in mean weekly referrals across two PDSA cycles relative to our established referral baseline. RESULTS: A QI approach afforded real-time review of interventions based on research and provider priorities, increasing engagement via mean weekly provider referrals by 14.5% and 49% across two PDSA cycles relative to baseline, respectively. CONCLUSIONS: Our Coffee Carts and Suboxone Champions program are efficient, low-barrier, educational initiatives to convey study-related information to providers. This work supported our efforts to maximally engage providers, minimize burden, and provide life-saving buprenorphine/naloxone to patients at risk of fatal overdose.


RéSUMé: BUT: Nous avons utilisé des approches d'amélioration de la qualité (AQ) pour accroître l'engagement des fournisseurs des services d'urgence (SU) avec l'inscription des participants à la recherche pendant la crise des opioïdes et la pandémie de maladie à coronavirus (COVID-19). Le contexte de ce travail est l'étude Evaluating Microdosing in the Emergency Department (EMED), un essai randomisé offrant de la buprénorphine/naloxone aux patients aux urgences par randomisation à l'induction standard ou au microdosage. L'engagement des fournisseurs est crucial pour le recrutement des participants à notre étude. En anticipant les difficultés à maintenir un engagement à long terme après une baisse de 63 % des recommandations de fournisseurs quatre mois après les inscriptions, nous avons appliqué le Plan-Do-Study-Act (PDSA) cycles d'élaboration et de mise en œuvre d'une stratégie d'engagement visant à accroître et à maintenir l'engagement des fournisseurs de 50 % par rapport au niveau de référence dans les neuf mois. MéTHODES: Notre stratégie de mobilisation était axée sur les tournées de Coffee Carts : des présentations éducatives de cinq minutes sur l'étude pour les fournisseurs sur le quart de travail; et une initiative secondaire, un programme Suboxone Champions, pour mobiliser les fournisseurs intéressés en tant que pairs éducateurs liés à l'étude. Nous avons utilisé les recommandations des fournisseurs à notre équipe comme indicateur de la participation à l'étude et nous avons signalé le pourcentage de changement dans les recommandations hebdomadaires moyennes pour deux cycles PDSA par rapport à notre base de référence établie. RéSULTATS: Une approche d'AQ a permis d'examiner en temps réel les interventions en fonction des priorités de la recherche et des fournisseurs, ce qui a augmenté l'engagement par l'intermédiaire des recommandations hebdomadaires moyennes des fournisseurs de 14,5 % et de 49 % au cours de deux cycles de PDSA par rapport au niveau de référence, respectivement. CONCLUSION: Notre programme Coffee Carts and Suboxone Champions est une initiative éducative efficace et peu contraignante qui permet de transmettre aux fournisseurs des renseignements sur les études. Ce travail a appuyé nos efforts visant à mobiliser au maximum les fournisseurs, à réduire au minimum le fardeau et à fournir de la buprénorphine/naloxone vitale aux patients à risque de surdose mortelle.


Assuntos
COVID-19 , Serviço Hospitalar de Emergência , Overdose de Opiáceos , Melhoria de Qualidade , Humanos , COVID-19/epidemiologia , Overdose de Opiáceos/epidemiologia , Naloxona/uso terapêutico , Naloxona/administração & dosagem , Seleção de Pacientes , Antagonistas de Entorpecentes/uso terapêutico , Antagonistas de Entorpecentes/administração & dosagem , Saúde Pública , Pandemias , SARS-CoV-2 , Masculino , Feminino , Buprenorfina/uso terapêutico
17.
Audiol Res ; 14(3): 432-441, 2024 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-38804460

RESUMO

(1) Background: Patients affected by Ménière's disease can experience Tumarkin's syndrome, which is characterized by postural instability, gait abnormalities, and, occasionally, an abrupt loss of balance known as vestibular drop attack or Tumarkin's crisis. In this study, semicircular canal plugging is proposed as the definitive treatment for this condition. The outcomes of this type of surgery are discussed. (2) Methods: A total of 9 patients with a confirmed diagnosis of Ménière disease suffering from Tumarkin crisis underwent posterior semicircular canal plugging. These patients were assessed with Video Head Impulse Tests, vestibular evoked myogenic potentials, and Pure Tone Audiometry preoperatively and postoperatively. (3) Results: VHIT showed a postoperative decrease in PSC gain median (Preop. 0.86 and postop. 0.52; p < 0.009). No statistically significant differences were described for the anterior semicircular canal and the lateral semicircular canal. No patient experienced new Tumarkin crisis after the surgical treatment. (4) Conclusions: Our ten years of experience with posterior semicircular canal plugging in Ménière disease patients with Tumarkin's syndrome has shown that this type of surgical procedure is successful in controlling Tumarkin's crisis, with high patient satisfaction and little worsening in hearing level.

18.
Soc Sci Med ; 350: 116937, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38710134

RESUMO

The United States is facing a drug overdose crisis, and stigma against people who use drugs is a major roadblock to implementing solutions. Despite the public health importance of understanding and mitigating substance use stigma, prior research has focused mainly on perceptions of individuals with substance use disorders and a limited set of demographic traits. This leaves critical gaps in our understanding of stigma against fentanyl overdose decedents, who represent a much broader group, including people who use substances recreationally. This study develops a more robust understanding of these attitudes through an experimental vignette survey fielded to a national sample of American adults (n = 1432). Respondents were shown two fictional fentanyl overdose obituaries where a complex suite of decedent characteristics-including demographic traits and contexts of substance use-were randomly varied in a conjoint design. Respondents then endorsed one of the two decedents for each of several attitudinal outcomes, including blameworthiness and support for various interventions, and justified their choices in an open-ended format. Results indicate that the public assesses victims of fentanyl overdose meritocratically, making judgments based on personal history and life experience rather than traditional race, class, and gender status beliefs. While certainly a signal of progress on some fronts, this meritocratic lens conflicts with the public health model of addressing the overdose crisis and exposes the alarming persistence of explicit stigma against people who use drugs.


Assuntos
Overdose de Drogas , Fentanila , Estigma Social , Humanos , Fentanila/intoxicação , Masculino , Feminino , Estados Unidos , Adulto , Pessoa de Meia-Idade , Inquéritos e Questionários , Adolescente
19.
Health Res Policy Syst ; 22(1): 56, 2024 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-38711067

RESUMO

BACKGROUND: Health is increasingly affected by multiple types of crises. Community engagement is recognised as being a critical element in successful crisis response, and a number of conceptual frameworks and global guideline documents have been produced. However, little is known about the usefulness of such documents and whether they contain sufficient information to guide effective community engagement in crisis response. We undertake a scoping review to examine the usefulness of conceptual literature and official guidelines on community engagement in crisis response using a realist-informed analysis [exploring contexts, mechanisms, and outcomes(CMOs)]. Specifically, we assess the extent to which sufficient detail is provided on specific health crisis contexts, the range of mechanisms (actions) that are developed and employed to engage communities in crisis response and the outcomes achieved. We also consider the extent of analysis of interactions between the mechanisms and contexts which can explain whether successful outcomes are achieved or not. SCOPE AND FINDINGS: We retained 30 documents from a total of 10,780 initially identified. Our analysis found that available evidence on context, mechanism and outcomes on community engagement in crisis response, or some of their elements, was promising, but few documents provided details on all three and even fewer were able to show evidence of the interactions between these categories, thus leaving gaps in understanding how to successfully engage communities in crisis response to secure impactful outcomes. There is evidence that involving community members in all the steps of response increases community resilience and helps to build trust. Consistent communication with the communities in time of crisis is the key for effective responses and helps to improve health indicators by avoiding preventable deaths. CONCLUSIONS: Our analysis confirms the complexity of successful community engagement and the need for strategies that help to deal with this complexity to achieve good health outcomes. Further primary research is needed to answer questions of how and why specific mechanisms, in particular contexts, can lead to positive outcomes, including what works and what does not work and how to measure these processes.


Assuntos
Participação da Comunidade , Política de Saúde , Humanos
20.
Assessment ; : 10731911241253430, 2024 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-38783515

RESUMO

Campbell's Law explains the replication crisis. In brief, useful tools such as hypotheses, p-values, and multi-study designs came to be viewed as indicators of strong science, and thus goals in and of themselves. Consequently, their use became distorted in unanticipated ways (e.g., hypothesizing after results were known [HARKing], p-Hacking, misuses of researcher degrees of freedom), and fragile findings proliferated. Pre-registration mandates are positioned as an antidote. However, I argue that such efforts, perhaps best exemplified by pre-registration badges (PRBs), are history repeating: Another useful tool has been converted into an indicator of strong science and a goal in and of itself. This, too, will distort its use and harm psychological science in unanticipated ways. For example, there is already evidence that papers seeking PRBs routinely violate the rules and spirit of pre-registration. I suggest that pre-registration mandates will (a) discourage optimal scientific practice, (b) exacerbate the file drawer problem, (c) encourage pre-registering after results are known (PRARKing), and (d) create false trust in fragile findings. I conclude that multiple design features can help support replicability (e.g., adequate sample size, valid measurement, robustness checks, pre-registration), none should be canonized, replication is the only arbiter of replicability, and the most important solution is sociocultural: to foster a field that reveres and reinforces robust science-just as we once revered and reinforced flashy but fragile science.

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