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1.
Afr J Prim Health Care Fam Med ; 16(1): e1-e6, 2024 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-38949443

RESUMO

BACKGROUND:  Transgender women - individuals assigned male at birth but who identify as female - are disproportionately affected by, among others, human immunodeficiency virus (HIV), other sexually transmitted diseases (STIs) and mental health issues. Studies show that transgender women often encounter discrimination and stigma when seeking healthcare from health facilities. AIM:  This study assessed the healthcare needs of transgender women, their experiences of the mainstream healthcare system and alternative strategies for navigating the healthcare system. SETTING:  The study was carried out in the City of Ekurhuleni Metropolitan Council in South Africa's Gauteng province. METHODS:  A case study design was followed. Participants were purposively selected and included 10 transgender women aged 26-50. Individual semi-structured interviews were conducted over 2 months. RESULTS:  Participants expressed a need for hormone replacement therapy, HIV treatment and prevention and treatment for STIs. Experiences of participants within the healthcare system were predominantly negative, with instances of discrimination, stigma and privacy violations being commonplace. Alternative strategies to meet their healthcare needs included the use of self-medication, consulting traditional healers and utilising non-governmental organisations. CONCLUSION:  There is an urgent need for equitable and inclusive health management of transgender women in South Africa.Contribution: This study provided a first look in a South African context into how and to what extent transwomen employ alternative healthcare strategies such as self-medication and utilising non-governmental organisations when faced with mainstream healthcare access barriers. The use of traditional doctors was identified as a novel, alternative strategy used by transwomen to access healthcare and treatment.


Assuntos
Infecções por HIV , Acessibilidade aos Serviços de Saúde , Infecções Sexualmente Transmissíveis , Estigma Social , Pessoas Transgênero , Humanos , Feminino , Pessoas Transgênero/psicologia , Adulto , África do Sul , Pessoa de Meia-Idade , Masculino , Infecções Sexualmente Transmissíveis/prevenção & controle , Pesquisa Qualitativa , Necessidades e Demandas de Serviços de Saúde , Entrevistas como Assunto , Terapia de Reposição Hormonal , Aceitação pelo Paciente de Cuidados de Saúde/psicologia
2.
Int J Epidemiol ; 53(4)2024 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-38961645

RESUMO

BACKGROUND: Perceived discrimination in health care settings can have adverse consequences on mental health in minority groups. However, the association between perceived discrimination and mental health is prone to unmeasured confounding. The study aims to quantitatively evaluate the influence of unmeasured confounding in this association, using g-estimation. METHODS: In a predominantly African American cohort, we applied g-estimation to estimate the association between perceived discrimination and mental health, adjusted and unadjusted for measured confounders. Mental health was measured using clinical diagnoses of anxiety, depression and bipolar disorder. Perceived discrimination was measured as the number of patient-reported discrimination events in health care settings. Measured confounders included demographic, socioeconomic, residential and health characteristics. The influence of confounding was denoted as α1 from g-estimation. We compared α1 for measured and unmeasured confounding. RESULTS: Strong associations between perceived discrimination in health care settings and mental health outcomes were observed. For anxiety, the odds ratio (95% confidence interval) unadjusted and adjusted for measured confounders were 1.30 (1.21, 1.39) and 1.26 (1.17, 1.36), respectively. The α1 for measured confounding was -0.066. Unmeasured confounding with α1=0.200, which was over three times that of measured confounding, corresponds to an odds ratio of 1.12 (1.01, 1.24). Similar results were observed for other mental health outcomes. CONCLUSION: Compared with measured confounding, unmeasured that was three times measured confounding was not enough to explain away the association between perceived discrimination and mental health, suggesting that this association is robust to unmeasured confounding. This study provides a novel framework to quantitatively evaluate unmeasured confounding.


Assuntos
Negro ou Afro-Americano , Fatores de Confusão Epidemiológicos , Saúde Mental , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ansiedade/epidemiologia , Ansiedade/psicologia , Transtorno Bipolar/psicologia , Transtorno Bipolar/etnologia , Negro ou Afro-Americano/psicologia , Negro ou Afro-Americano/estatística & dados numéricos , Estudos de Coortes , Depressão/epidemiologia , Depressão/psicologia , Depressão/etnologia , Transtornos Mentais/epidemiologia , Racismo/psicologia , Racismo/estatística & dados numéricos , Discriminação Percebida
3.
Sci Rep ; 14(1): 15859, 2024 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-38982127

RESUMO

Computational models and eye-tracking research suggest that encoding variability accounts for the reduced recognition of targets (A) when paired with non-corresponding lures (B') relative to corresponding lures (A'). The current study examined whether neural activity during learning coincided with subsequent performance on the forced-choice Mnemonic Similarity Task (MST). Event-related potential responses were collected during encoding while young adults completed A-B' and A-A' trials of the forced-choice MST. Consistent with previous research, performance was lower on A-B' trials than A-A' trials. The subsequent memory effect was not significant for the A-A' test format. However, for A-B' trials, we observed a significant Accuracy × Stimulus interaction 1000-1200 ms poststimulus onset across frontal and fronto-central electrodes. As hypothesized, subsequently correct A-B' trials were associated with a larger amplitude response at encoding to the target (A) than the original version of the non-corresponding lure (B). However, subsequently incorrect trials were associated with a larger amplitude response to the non-corresponding lure (B) than the target stimulus (A). These findings provide additional support for the effect of encoding variability on mnemonic discrimination.


Assuntos
Comportamento de Escolha , Potenciais Evocados , Humanos , Masculino , Feminino , Potenciais Evocados/fisiologia , Adulto Jovem , Adulto , Comportamento de Escolha/fisiologia , Eletroencefalografia , Memória/fisiologia , Adolescente , Discriminação Psicológica/fisiologia , Reconhecimento Psicológico/fisiologia
4.
Int J Eat Disord ; 2024 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-39022910

RESUMO

OBJECTIVE: Binge-eating disorder (BED) is a strongly stigmatized condition and is often complicated by weight stigma. Research on the intersection between BED and weight stigma is scarce especially in Chinese populations. The present study examined BED stigma in Chinese, whether BED stigma was independent from weight stigma, and whether diagnostic labeling and etiological explanations influenced the degree of BED stigma. METHOD: Using a between-subject experimental vignette study, 642 participants (mean age = 29.74 years, SD = 11.34) were randomly assigned to read one of the 18 vignettes, describing a character with information on BED symptoms, weight status, diagnostic labeling, and etiological explanations, followed by measures of stigma and help-seeking intentions. RESULTS: The character with BED symptoms was ascribed more negative personality characteristics, elicited more negative affective reactions, and triggered greater desired social distance compared to the character without BED symptoms. No evidence for weight stigma was found nor for its interaction with BED stigma. The Cantonese diagnostic label of BED, kwong sik zing, was associated with lower levels of volitional stigma and greater help-seeking intentions than the diagnostic label of eating disorders, jam sik sat tiu, and the absence of labeling. The effect of etiological explanations was only significant in the univariate test, indicating that providing either a psychosocial or a biogenetic etiological explanation lessened the negative evaluations of personality characteristics. DISCUSSION: The present study provided first evidence for BED stigma in Chinese. BED stigma appeared to be attributable to the presence of disordered eating behavior rather than the BED diagnosis.

5.
Artigo em Inglês | MEDLINE | ID: mdl-39023035

RESUMO

OBJECTIVES: Religious exemptions (exceptions to nondiscrimination laws for individual religious/moral beliefs) in healthcare have surged, negatively impacting LGBTQ+ older adults in nursing homes with some of the highest caregiving needs. Given job differences between floor staff and managers, this study asks: How does meaning-making differ between nursing home floor staff and managers when staff refuse to care for LGBTQ+ residents? To answer this question, this study uses social coherence as a conceptual framework to understand the process of reflection that staff employ when a colleague invokes a religious exemption to care. METHODS: This qualitative comparative study uses in-depth semi-structured interviews to compare responses from nursing home floor staff and managers (n=80). Qualitative content analysis incorporated inductive and deductive coding approaches. RESULTS: Staff invoked five frames to reach social coherence: fairness, resident safety and comfort, individual religious beliefs, job obligations, and laws/policies. Floor staff and managers invoked the same two reasons (fairness, resident safety and comfort) to reach social coherence. However, floor staff differed from managers by also invoking individual religious beliefs and job obligations; whereas managers turned to laws and policies to reconcile tensions between religious rights and LGBTQ+ resident rights to care. DISCUSSION: In an increasingly polarized world, findings from this study illuminate nuances (and potential new areas of allyship) in how floor staff and managers understand and use various frames when deciding whether or not to accommodate a colleague who refuses care to an LGBTQ+ resident because of religious or moral reasons.

6.
Clin Transplant ; 38(7): e15403, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39023089

RESUMO

BACKGROUND: The application of posttransplant predictive models is limited by their poor statistical performance. Neglecting the dynamic evolution of demographics and medical practice over time may be a key issue. OBJECTIVES: Our objective was to develop and validate era-specific predictive models to assess whether these models could improve risk stratification compared to non-era-specific models. METHODS: We analyzed the United Network for Organ Sharing (UNOS) database including first noncombined heart transplantations (2001-2018, divided into four transplant eras: 2001-2005, 2006-2010, 2011-2015, 2016-2018). The endpoint was death or retransplantation during the 1st-year posttransplant. We analyzed the dynamic evolution of major predictive variables over time and developed era-specific models using logistic regression. We then performed a multiparametric evaluation of the statistical performance of era-specific models and compared them to non-era-specific models in 1000 bootstrap samples (derivation set, 2/3; test set, 1/3). RESULTS: A total of 34 738 patients were included, 3670 patients (10.5%) met the composite endpoint. We found a significant impact of transplant era on baseline characteristics of donors and recipients, medical practice, and posttransplant predictive models, including significant interaction between transplant year and major predictive variables (total serum bilirubin, recipient age, recipient diabetes, previous cardiac surgery). Although the discrimination of all models remained low, era-specific models significantly outperformed the statistical performance of non-era-specific models in most samples, particularly concerning discrimination and calibration. CONCLUSIONS: Era-specific models achieved better statistical performance than non-era-specific models. A regular update of predictive models may be considered if they were to be applied for clinical decision-making and allograft allocation.


Assuntos
Transplante de Coração , Humanos , Transplante de Coração/efeitos adversos , Transplante de Coração/mortalidade , Masculino , Feminino , Pessoa de Meia-Idade , Seguimentos , Prognóstico , Fatores de Risco , Sobrevivência de Enxerto , Obtenção de Tecidos e Órgãos/estatística & dados numéricos , Adulto , Taxa de Sobrevida , Rejeição de Enxerto/etiologia , Rejeição de Enxerto/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Medição de Risco/métodos , Estudos Retrospectivos
7.
Cureus ; 16(5): e61325, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38947667

RESUMO

Despite the societal progress made in recent years, gender discrimination is still common in healthcare, especially in some surgical specialties such as orthopaedics. In Brazil, where the participation of women in the medical profession has been increasing, little is known about women's perceptions on the issue of gender discrimination. This study aims to examine women orthopaedic surgeons' experiences in dealing with conflict in the workplace and contextualize the impact that gender discrimination has had or currently has on their careers and well-being. As a secondary objective, the work seeks to understand whether there are differences in the perception of the issue among practicing women orthopaedic surgeons and those in training. For a cross-sectional qualitative study, a survey was distributed exclusively to 300 practicing orthopaedic surgeons and orthopaedists in training (residents and fellows). A total of 99 women participated in the survey, of whom 66 were practicing orthopaedic surgeons and 33 were orthopaedists in training. The study showed that women orthopaedic surgeons in training in Brazil have a lower number of publications and a moderate level of involvement in academic society activity. In addition, orthopaedic surgeons in training experience a statistically significantly higher number of conflicts in the workplace. The comments from the questionnaires highlighted the physical and psychological consequences arising from these situations of professional conflict, most frequently occurring with orthopaedic surgeons who are men. Our findings indicate that respondents expressed a feeling of inequality towards women in the workplace, ultimately reducing the level of job satisfaction among female orthopaedic surgeons, which may contribute to disinterest and abandonment of the specialty. The results of this work support recent evidence that there is an implicit and often overlooked bias against the participation of women and ethnic minorities in the orthopaedic community in Brazil.

8.
Am J Ind Med ; 2024 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-38953171

RESUMO

BACKGROUND: Hypertension has been linked to socially patterned stressors, including discrimination. Few studies have quantified the risk of hypertension associated with exposure to perceived job discrimination. METHODS: We used prospective cohort data from the Sister Study (enrollment from 2003-2009) to estimate self-reported incident hypertension associated with perceived job discrimination based on race, gender, age, sexual orientation, or health status. Job discrimination in the prior 5 years was assessed in 2008-2012, and incident doctor-diagnosed hypertension was ascertained in previously hypertension-free participants. RESULTS: Among the 16,770 eligible participants aged 37-78 years at the start of follow-up, 10.5% reported job discrimination in the past 5 years, and 19.2% (n = 3226) reported incident hypertension during a median follow-up of 9.7 years (interquartile range 8.2-11.0 years). Self-reported poor health or inclusion in minoritized groups based on race/ethnicity or sexual orientation were more frequent among those reporting job discrimination. In a Cox proportional hazards model adjusting for covariates, report of at least one type of job discrimination (compared to none) was associated with a 14% (hazard ratio = 1.14 [95% confidence: 1.02-1.27]) higher hypertension risk. Results from sensitivity analyses reinforced the findings. CONCLUSIONS: Results suggest that interventions addressing job discrimination could have workplace equity and health benefits.

9.
Heliyon ; 10(11): e32430, 2024 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-38961966

RESUMO

Facility location, particularly in the context of international investments by global enterprises, stands out as a paramount concern within the purview of top management's strategic decision-making process. The selection of a suitable location plays a pivotal role in determining the ultimate achievement of organizational objectives. The process of selecting an appropriate location requires the comprehensive analysis of a substantial volume of data, encompassing diverse tangible and intangible evaluation criteria that may exhibit inherent conflicts. This paper addresses the challenge of determining the best location for a manufacturing facility by employing alternative performance measures within the framework of the data envelopment analysis (DEA) model. In a performance evaluation process, not only positive but also negative aspects should be determined. This paper, therefore, proposes a double-frontier DEA-AR model, which is an integrated approach that incorporates the efficient frontier, anti-efficient frontier, and assurance region weight restrictions, with the aim of increasing the discrimination ability of the DEA method. An efficient frontier evaluates the information of each location from a positive viewpoint, while the worst side is evaluated by an anti-efficient frontier. The technique of weight restrictions, which allows incorporating expert opinion into the assessment, is also applied with both frontiers to restrict the regions of weights to some specific area. The prescribed approach is illustrated by a numerical example of selecting the best location among ten different countries under consideration of 22 selection criteria obtained from PEST analysis. The results show that the proposed alternative performance measures significantly improve discrimination capability, enabling the ranking of candidates based on their suitability for the optimal location.

10.
BMC Nurs ; 23(1): 450, 2024 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-38956549

RESUMO

AIM: This study explored the relationship between language confidence and job satisfaction, the mediating role of workplace discrimination, and the moderating role of immigration duration among foreign-born nurses in Japan. INTRODUCTION: Job satisfaction is an important factor in preventing migrant nurses' turnover intentions; however, the relationships among language confidence, immigration duration, workplace discrimination, and job satisfaction among foreign-born nurses remain unclear. METHODS: A cross-sectional study was conducted. Data were collected between June and August 2022 through an online survey of nurses who were born outside of Japan but were currently working as registered nurses in Japan. PROCESS v4.0 Macro for SPSS 28.0 was applied to analyze the effect of language confidence on job satisfaction, the mediator effect of workplace discrimination (model 4), and the moderator effect of immigration duration (model 15). RESULTS: Data from 187 participants were analyzed. The results showed that 1) foreign-born nurses' language confidence was negatively correlated with workplace discrimination and positively correlated with job satisfaction; 2) workplace discrimination played a partially mediating role between language confidence and job satisfaction; and 3) immigration duration positively moderated the relationship between language confidence and job satisfaction. CONCLUSION: Foreign-born nurses with stronger confidence in their proficiency in Japanese perceived less workplace discrimination and higher job satisfaction. Workplace discrimination acted as a mediator in the relationship between language confidence and job satisfaction, and this relationship was strengthened with longer migration periods. Managers and policymakers should implement policies and strategies to combat workplace discrimination and provide tailored support to improve foreign-born nurses' job satisfaction, which may contribute to their retention in Japan.

11.
J Adolesc Health ; 2024 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-39001757

RESUMO

PURPOSE: Sleep is essential to adolescent development. Sexual and gender minority (SGM; e.g., lesbian, gay, bisexual, transgender) adults are at high risk for poor sleep, partially due to minority stress (e.g., discrimination). However, sleep has rarely been studied among SGM adolescents. In a national sample of early adolescents, we analyzed sexual minority (SM) and gender minority (GM) identity, gender incongruence, and gender nonconformity in association with sleep and tested minority and general stressors as mediators. METHODS: We cross-sectionally analyzed data from 10,070 adolescents aged 10-14 in the Adolescent Brain Cognitive Development℠ Study. Using logistic regression models, we analyzed associations between identity (SM and GM), sexual identity discrimination, minority and general stressors (sexual identity discrimination, teasing, and conflict with parents) and sleep health (duration, latency, and disturbance). We used Baron and Kenny's method to test for mediation. RESULTS: Participants reported sexual identity (4% SM, 4% questioning) and gender identity (0.4% GM, 0.6% questioning); 65% were White, 20% were Hispanic, and 52% were assigned male at birth. Compared to heterosexual, SM participants had higher odds of short sleep duration, long sleep latency, and sleep disturbance. GM participants and those reporting gender incongruence and nonconformity had higher odds of long sleep latency and sleep disturbance. Sexual identity discrimination and general social stressors partially mediated some associations. DISCUSSION: SGM participants reported poorer sleep. Minority and general social stressors partially accounted for some disparities. Policies need to address SGM identity-based discrimination and challenge social norms that produce minority stress for SGM early adolescents.

12.
Artigo em Inglês | MEDLINE | ID: mdl-39003177

RESUMO

This study illustrates the lack of racial diversity in the veterinary field, the historical and present-day causes of this unfortunate trend, and the various problems it causes in our practices and communities.

13.
BMC Pediatr ; 24(1): 449, 2024 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-38997661

RESUMO

BACKGROUND: Language delay affects near- and long-term social communication and learning in toddlers, and, an increasing number of experts pay attention to it. The development of prosody discrimination is one of the earliest stages of language development in which key skills for later stages are mastered. Therefore, analyzing the relationship between brain discrimination of speech prosody and language abilities may provide an objective basis for the diagnosis and intervention of language delay. METHODS: In this study, all cases(n = 241) were enrolled from a tertiary women's hospital, from 2021 to 2022. We used functional near-infrared spectroscopy (fNIRS) to assess children's neural prosody discrimination abilities, and a Chinese communicative development inventory (CCDI) were used to evaluate their language abilities. RESULTS: Ninety-eight full-term and 108 preterm toddlers were included in the final analysis in phase I and II studies, respectively. The total CCDI screening abnormality rate was 9.2% for full-term and 34.3% for preterm toddlers. Full-term toddlers showed prosody discrimination ability in all channels except channel 5, while preterm toddlers showed prosody discrimination ability in channel 6 only. Multifactorial logistic regression analyses showed that prosody discrimination of the right angular gyrus (channel 3) had a statistically significant effect on language delay (odd ratio = 0.301, P < 0.05) in full-term toddlers. Random forest (RF) regression model presented that prosody discrimination reflected by channels and brain regions based on fNIRS data was an important parameter for predicting language delay in preterm toddlers, among which the prosody discrimination reflected by the right angular gyrus (channel 4) was the most important parameter. The area under the model Receiver operating characteristic (ROC) curve was 0.687. CONCLUSIONS: Neural prosody discrimination ability is positively associated with language development, assessment of brain prosody discrimination abilities through fNIRS could be used as an objective indicator for early identification of children with language delay in the future clinical application.


Assuntos
Transtornos do Desenvolvimento da Linguagem , Desenvolvimento da Linguagem , Espectroscopia de Luz Próxima ao Infravermelho , Humanos , Feminino , Masculino , Pré-Escolar , Transtornos do Desenvolvimento da Linguagem/diagnóstico , Lactente , Percepção da Fala/fisiologia , Encéfalo/fisiologia , Encéfalo/diagnóstico por imagem
14.
AIDS Care ; : 1-14, 2024 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-38961835

RESUMO

People with HIV smoke cigarettes at a high prevalence, and it is important to identify modifiable variables related to smoking in this population. Race/ethnicity-based discrimination is common among people with HIV from minoritized racial and ethnic groups and results in significant adverse effects. The goal of this study was to examine the relationship between race/ethnicity-based discrimination, depression, and smoking-related variables among people with HIV who smoke. This was a secondary analysis of data from a prospective, randomized controlled smoking cessation trial for people with HIV. Participants were recruited from three HIV clinical care sites and randomly assigned to an HIV-tailored group therapy intervention or a control condition. Participants completed measures of demographics, smoking-related variables, race/ethnicity-based discrimination, and depressive symptoms at baseline and were followed up 3- and 6-months after study completion. Depressive symptoms had an indirect effect on the relationship between race/ethnicity-based discrimination and self-efficacy to quit smoking at 3-month follow-up. Depressive symptoms mediated the relationship between race/ethnicity-based discrimination and both nicotine dependence and self-efficacy to quit smoking at 6-month follow-up. Findings highlight the importance of considering race/ethnicity-based discrimination and depressive symptoms in the development and implementation of smoking cessation treatment interventions for people with HIV.

15.
J Am Geriatr Soc ; 2024 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-38958541

RESUMO

BACKGROUND: Ageism is a major but oft-overlooked social determinant of health. In fact, it is widely accepted among scholars that ageism is one of the least acknowledged forms of inequality, although few empirical attempts have been made to substantiate this claim. This is the first study that quantifies the amount of discourse dedicated to ageism, sexism, and racism on Twitter. Specifically, we rely on the usage of hashtags as a proxy for the frequency of discussions surrounding each form of inequality over a 15-year period from 2007 to 2022. We also identify key events that triggered spikes in Twitter activity for each form of inequality. METHODS: Hashtags related to racism and sexism were extracted from past scholarship. We also employed a snowball sampling method whereby we queried the hashtags using Twitter's search function to identify other hashtags. As limited research has been conducted on ageism-related hashtags, we queried hashtags utilized by advocacy groups and adopted a snowball sampling method to compile other relevant hashtags. Tweets collected (N = 154,353,047) spanned 15 years, from August 23, 2007 to December 31, 2022. RESULTS: From 2007 to 2022, racism-related hashtags were used the most, followed by sexism-related hashtags and ageism-related hashtags. Racism-related hashtags (N = 99,250,348) were mentioned about 60 times more than ageism-related hashtags (N = 1,648,926). Sexism-related hashtags (N = 38,933,113) were mentioned 24 times more than ageism-related hashtags. The increasing linear trend of tweets associated with ageism (p < 0.001), sexism (p < 0.05), and racism (p < 0.05) reached significance. Incidents of racism and sexism often generated widespread public outrage. Conversely, instances of ageism rarely caused spikes in social media activity. Rather, these spikes were mainly observed during events such as the release of a report on ageism, a conference related to aging, or observances such as International Day of Older Persons. CONCLUSION: There is a need to hasten moves to raise awareness of ageism. To ensure that discussions on ageism are not confined to academic and policy circles, advocacy campaigns could be held to educate the public on the issue and its negative concomitants.

16.
Physiother Theory Pract ; : 1-12, 2024 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-38953518

RESUMO

BACKGROUND: Sensorimotor dysfunction, as measured by tactile acuity and active joint repositioning, has been identified as a contributing factor of chronic low back pain (CLBP). Existing research suggests that further research is necessary to improve the characterization of sensorimotor perception in patients with CLBP. OBJECTIVES: The main aim is to investigate whether tactile acuity and repositioning errors differ between individuals with CLBP and controls without CLBP. A secondary aim was to investigate the association between age, body mass index (BMI) and physical activity, and tactile acuity and repositioning sense. METHODS: Cross-sectional study. Sixty-eight participants (36 with, 32 without CLBP) were examined. Two-Point Discrimination (TPD) test (four measures: horizontal and vertical run, left and right side) and Active Joint Reposition Sense (AJRS) test (2 directions: to flexion and to extension) were used. RESULTS: No differences were found for TPD (right horizontal run: p = .069; left horizontal run: p = .066; right vertical run: p = .933; left vertical run: p = .285) or AJRS (flexion: p = .792; extension: p = .956) between participants with and without CLBP. Older subjects had significantly worse tactile acuity (3 sites, p = .018, p = .004, p = .041) and worse repositioning sense (2 directions, p = .026, p = .040,) than younger subjects. Individuals with BMI ≥ 25 had significantly worse TPD compared to individuals with normal weight (2 sites, p = .028, p = .020). CONCLUSIONS: Individuals with CLBP did not have impaired tactile and repositioning accuracy when compared to controls without CLBP. Future studies comparing sensorimotor performance should consider age and BMI as potential confounding factors.

17.
J Subst Use Addict Treat ; : 209448, 2024 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-38955251

RESUMO

INTRODUCTION: Although Black Americans tend to consume less alcohol than non-Hispanic/Latine White Americans, Black Americans who do drink alcohol appear at especially high risk for negative alcohol-related problems. This alcohol-based health disparity indicates a need to identify psycho-sociocultural factors that may play a role in drinking and related problems to inform prevention and treatment efforts. Minority stress-based models posit that stressors such as racism increase negative emotions, which may be associated with using substances such as alcohol to cope with negative emotions. Yet, little research has directly assessed emotional reactions to racism and whether it plays a role in drinking-related behaviors. METHOD: Participants were 164 Black American undergraduates at a racially/ethnically diverse university who endorsed current alcohol use 18-48 (M = 21.7, SD = 4.3). Participants completed an online survey regarding their experiences with racism and alcohol-related behaviors. RESULTS: Experiencing more frequent racism was related to greater negative emotions experienced in response to racism (i.e., negative emotional reactivity to racism) and alcohol-related problems. More frequent racism was related to more alcohol-related problems via the sequential effects of negative emotional reactivity to racism and coping motivated drinking. CONCLUSIONS: These data indicate that the experience of negative emotions that occur after experiencing racism and attempts to cope with those negative emotions by consuming alcohol play important roles in drinking behaviors among Black Americans.

18.
Arch Dermatol Res ; 316(7): 445, 2024 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-38955839

RESUMO

Hidradenitis suppurativa (HS) is a chronic inflammatory cutaneous disease that often leads to decreased quality of life. Prior research assessing stress and discrimination related to stigmatization of those with HS is limited. The aim of this study was to examine the association between HS and the following factors related to psychosocial well-being: stress, discrimination, and loneliness. We performed secondary analysis of participants 18 years and older registered in the National Institutes of Health's All of Us Research Program in March 2024. The study sample was limited to individuals who had completed ≥ 1 of 4 psychosocial well-being surveys. Among 1,352 individuals with HS, 135 were included in the sample. Among 208,290 individuals without HS, 56,902 were included. The following surveys assessed loneliness, stress, perceived discrimination in everyday settings, and perceived discrimination in medical settings, respectively: the UCLA Loneliness Scale, Cohen Perceived Stress Scale, Everyday Discrimination Scale, and Discrimination in Medical Settings Scale. The association between HS and survey scores was modeled using multivariable linear regression adjusted for self-reported sex, self-reported race and ethnicity, age, and income. In an unadjusted model, those with HS reported a significantly higher degree of stress (MeanHS (SD) = 21.5 (4.74); Meannon-HS (SD) = 19.8 (3.98); p < 0.001), discrimination in everyday settings (MeanHS (SD) = 18.9 (8.16); Meannon-HS (SD) = 16.0 (7.06); p < 0.0001), and discrimination in healthcare settings (MeanHS (SD) = 1.77 (0.64); Meannon-HS (SD) = 1.56 (0.62); p < 0.001). After adjusting for sex, race, age, and income, the association between HS and discrimination in healthcare settings was non-significant; however, associations between HS and increased levels of perceived stress and everyday discrimination remained significant. Low survey completion rates and demographic differences between those who did and did not complete the study surveys may limit generalizability of results. Findings suggest that those with HS may benefit from regular screening for psychosocial well-being and provision of support resources.


Assuntos
Hidradenite Supurativa , Solidão , Qualidade de Vida , Estresse Psicológico , Humanos , Hidradenite Supurativa/psicologia , Masculino , Feminino , Estudos Transversais , Adulto , Pessoa de Meia-Idade , Estresse Psicológico/psicologia , Estresse Psicológico/epidemiologia , Solidão/psicologia , Qualidade de Vida/psicologia , Estados Unidos/epidemiologia , Estigma Social , Inquéritos e Questionários/estatística & dados numéricos , Adulto Jovem , Adolescente
19.
BMC Palliat Care ; 23(1): 173, 2024 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-39010044

RESUMO

BACKGROUND: Therapeutic ceiling of care is the maximum level of care deemed appropiate to offer to a patient based on their clinical profile and therefore their potential to derive benefit, within the context of the availability of resources. To our knowledge, there are no models to predict ceiling of care decisions in COVID-19 patients or other acute illnesses. We aimed to develop and validate a clinical prediction model to predict ceiling of care decisions using information readily available at the point of hospital admission. METHODS: We studied a cohort of adult COVID-19 patients who were hospitalized in 5 centres of Catalonia between 2020 and 2021. All patients had microbiologically proven SARS-CoV-2 infection at the time of hospitalization. Their therapeutic ceiling of care was assessed at hospital admission. Comorbidities collected at hospital admission, age and sex were considered as potential factors for predicting ceiling of care. A logistic regression model was used to predict the ceiling of care. The final model was validated internally and externally using a cohort obtained from the Leeds Teaching Hospitals NHS Trust. The TRIPOD Checklist for Prediction Model Development and Validation from the EQUATOR Network has been followed to report the model. RESULTS: A total of 5813 patients were included in the development cohort, of whom 31.5% were assigned a ceiling of care at the point of hospital admission. A model including age, COVID-19 wave, chronic kidney disease, dementia, dyslipidaemia, heart failure, metastasis, peripheral vascular disease, chronic obstructive pulmonary disease, and stroke or transient ischaemic attack had excellent discrimination and calibration. Subgroup analysis by sex, age group, and relevant comorbidities showed excellent figures for calibration and discrimination. External validation on the Leeds Teaching Hospitals cohort also showed good performance. CONCLUSIONS: Ceiling of care can be predicted with great accuracy from a patient's clinical information available at the point of hospital admission. Cohorts without information on ceiling of care could use our model to estimate the probability of ceiling of care. In future pandemics, during emergency situations or when dealing with frail patients, where time-sensitive decisions about the use of life-prolonging treatments are required, this model, combined with clinical expertise, could be valuable. However, future work is needed to evaluate the use of this prediction tool outside COVID-19.


Assuntos
COVID-19 , Hospitalização , Humanos , COVID-19/epidemiologia , COVID-19/terapia , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Hospitalização/estatística & dados numéricos , Espanha/epidemiologia , Adulto , Idoso de 80 Anos ou mais , Estudos de Coortes , SARS-CoV-2 , Comorbidade
20.
Sci Rep ; 14(1): 16462, 2024 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-39014043

RESUMO

The current study tested the hypothesis that the association between musical ability and vocal emotion recognition skills is mediated by accuracy in prosody perception. Furthermore, it was investigated whether this association is primarily related to musical expertise, operationalized by long-term engagement in musical activities, or musical aptitude, operationalized by a test of musical perceptual ability. To this end, we conducted three studies: In Study 1 (N = 85) and Study 2 (N = 93), we developed and validated a new instrument for the assessment of prosodic discrimination ability. In Study 3 (N = 136), we examined whether the association between musical ability and vocal emotion recognition was mediated by prosodic discrimination ability. We found evidence for a full mediation, though only in relation to musical aptitude and not in relation to musical expertise. Taken together, these findings suggest that individuals with high musical aptitude have superior prosody perception skills, which in turn contribute to their vocal emotion recognition skills. Importantly, our results suggest that these benefits are not unique to musicians, but extend to non-musicians with high musical aptitude.


Assuntos
Aptidão , Emoções , Música , Humanos , Música/psicologia , Masculino , Feminino , Emoções/fisiologia , Aptidão/fisiologia , Adulto , Adulto Jovem , Percepção da Fala/fisiologia , Percepção Auditiva/fisiologia , Adolescente , Reconhecimento Psicológico/fisiologia , Voz/fisiologia
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