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1.
Int J Environ Health Res ; : 1-12, 2024 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-38627937

RESUMO

This study aimed to investigate the airborne exposure to aerosols according to the particle size distribution of three different spray types (nano-nozzled spray gun, low-temperature steam spray, and fogger) and compare the concentrations of inhaled aerosols between children and adults. Airborne aerosols released from three products were observed using size-segregated particle measurements, and particle concentrations deposited in the respiratory tracts of adults and children were estimated using multi-path particle dosimetry lung deposition models. All types of sprayers generated the most nanoparticles (~100 nm). Due to their higher respiratory rate than adults, a larger number of particles <1.0 µm deposited in the children's respiratory tracts was higher. The sequences of the total number of particles in the respiratory regions after spraying nano-nozzled spray gun and fogger were alveolar (AL)>tracheobronchial (TB)>head airway (HA) in adults and AL>HA>TB in children. Meanwhile, the trend of low-temperature steam spray was AL>TB>HA in adults and AL>TB>HA in children.

2.
Eat Disord ; : 1-19, 2024 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-38736329

RESUMO

Despite a significant amount of research theoretically demonstrating the benefits of positive body image, limited studies have empirically examined its protective role over women's body concerns and behaviors. Based on the objectification theory, this study explored whether the associations between body objectification, disordered eating symptoms, and depression are moderated by positive body image. We considered four specific constructs of positive body image using the Body Positive Scale (BP Scale) which includes BP-Feeling, BP-Acceptance-even if, BP-Response, and BP-Conceptualization. We conducted moderated mediation analysis using PROCESS model on data from an online survey completed by 400 Korean women ages 20-64 years. The results showed that the associations between body objectification and disordered eating symptoms were not significant at high levels of BP-Feeling and BP-Acceptance-even if. The results also revealed that indirect associations between body objectification and depression via disordered eating symptoms were not significant at high levels of BP-Feeling and BP-Acceptance-even if. While the overall results suggest the protective role of positive body image against disordered eating and depression, this study further provides specific information on positive body image that should be included in the prevention and treatment of disordered eating.

3.
J Med Internet Res ; 25: e47158, 2023 08 07.
Artigo em Inglês | MEDLINE | ID: mdl-37549004

RESUMO

BACKGROUND: While mobile health apps have demonstrated their potential in revolutionizing health behavior changes, the impact of a mobile community built on these apps on the level of physical activity and mental well-being in cancer survivors remains unexplored. OBJECTIVE: In this randomized controlled trial, we examine the effects of participation in a mobile health community specifically designed for breast cancer survivors on their physical activity levels and mental distress. METHODS: We performed a single-center, randomized, parallel-group, open-label, controlled trial. This trial enrolled women between 20 and 60 years of age with stage 0 to III breast cancer, an Eastern Cooperative Oncology Group performance status of 0, and the capability of using their own smartphone apps. From January 7, 2019, to April 17, 2020, a total of 2,616 patients were consecutively screened for eligibility after breast cancer surgery. Overall, 202 patients were enrolled in this trial, and 186 patients were randomly assigned (1:1) to either the intervention group (engagement in a mobile peer support community using an app for tracking steps; n=93) or the control group (using the app for step tracking only; n=93) with a block size of 10 without stratification. The mobile app provides a visual interface of daily step counts, while the community function also provides rankings among its members and regular notifications encouraging physical activity. The primary end point was the rate of moderate to severe distress for the 24-week study period, measured through an app-based survey using the Distress Thermometer. The secondary end point was the total weekly steps during the 24-week period. RESULTS: After excluding dropouts, 85 patients in the intervention group and 90 patients in the control group were included in the analysis. Multivariate analyses showed that patients in the intervention group had a significantly lower degree of moderate to severe distress (B=-0.558; odds ratio 0.572; P<.001) and a higher number of total weekly step counts (B=0.125; rate ratio 1.132; P<.001) during the 24-week period. CONCLUSIONS: Engagement in a mobile app-based patient community was effective in reducing mental distress and increasing physical activity in breast cancer survivors. TRIAL REGISTRATION: ClinicalTrials.gov NCT03783481; https://classic.clinicaltrials.gov/ct2/show/NCT03783481.


Assuntos
Neoplasias da Mama , Sobreviventes de Câncer , Aplicativos Móveis , Feminino , Humanos , Neoplasias da Mama/terapia , Exercício Físico , Grupos de Autoajuda , Adulto Jovem , Adulto , Pessoa de Meia-Idade
4.
J Women Aging ; 34(6): 810-827, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34890533

RESUMO

Based on the life course perspective, this study used a mixed method approach to (1) arrive at a deeper understanding of body image in each of three adult life stages among older white women living in a Midwest state of the United States of America, (2) investigate how these women's body images have changed during aging, and (3) identify major life transitions affecting women's body image throughout the adult life span. This study used retrospective, self-reported data. Both open-ended and scale ratings questions were incorporated into the paper-based survey questionnaire. Older white women (n = 102) aged 65 to 94 years completed a survey questionnaire. Written responses to seven open-ended questions assessing the older women's past and current body images were analyzed, and 14 themes emerged. A quantitative scale of body satisfaction with five body attributes was included to provide a validity check with written responses. The women's body images significantly changed across the adult life span, reflecting different body concerns and evaluations at each life stage. This study revealed contrasting results to previous cross-generational comparisons which concluded that women's perceived level of body satisfaction remains stable through life. Many of the women expressed some degree of positive body image at all stages but became less satisfied with several aspects of their bodies as they aged, including aging appearance, decline in physical function, and several health problems. The study provided a general picture of white women's body image development throughout the adult life span.


Assuntos
Imagem Corporal , Longevidade , Idoso , Envelhecimento , Feminino , Humanos , Satisfação Pessoal , Estudos Retrospectivos , Estados Unidos
5.
Omega (Westport) ; : 302228221127824, 2022 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-36137974

RESUMO

There is a paucity of literature examining the experiences of children who lost a parent on 9/11. The primarily quantitative research has not allowed for a deeper understanding of how children who lost a parent on 9/11 make meaning of their experiences, especially in the context of a national tragedy. This study investigates how eight children who were between the ages of 5 and 12 when they lost a parent on 9/11 developed a personal narrative about this loss in the context of the collective narrative about 9/11. Using narrative inquiry, cases demonstrated patterns of narrative development about grief, tragedy, and collective themes of American exceptionalism, patriotism, triumph, and resiliency. These cases highlight de-personalized narratives of grief, tension between the grand narrative provided to them and their personal story of loss, and distance between the reality of their loss and the collective meaning-making of the tragedy. This study extends Bronfenbrenner's (1977) ecological systems theory by highlighting how a lack of bidirectionality between larger social and cultural systems and the individual negatively impacts personal experiences of grief and loss.

6.
J Community Health ; 45(6): 1178-1186, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33026553

RESUMO

Colorectal cancer (CRC) is the second and fourth most common cancer in Vietnamese American women and men, respectively. Recent research has highlighted the importance of modifiable lifestyle behaviors such as smoking, alcohol use, dietary behaviors, and physical activities in CRC prevention for the general population. However, it is not well understood how well Vietnamese Americans knew about CRC prevention and risk factors, and whether there were any disparities in knowledge within this vulnerable population. This study examined whether comprehensive measures of acculturation and knowledge of CRC risk are associated with different health behaviors, specifically physical activity, protective dietary behaviors, and risky dietary behaviors in Vietnamese Americans. We recruited 374 Vietnamese Americans aged 50 or above from community-based organizations in the Vietnamese American communities in the greater Philadelphia metropolitan area. Through a cross-sectional survey, we collected data on their knowledge of CRC prevention and risk factors, acculturation-related factors, and sociodemographic characteristics. We found limited knowledge of CRC prevention and risk factors, and suboptimal physical activity and healthy dietary behaviors in the Vietnamese Americans. We also found that higher levels of knowledge about CRC and risk factors were associated with less unhealthy diets but not with more protective diets or physical activity. Acculturation was not significantly associated with overall dietary behaviors in our study. Our findings addressed gaps in current literature concerning the impact of knowledge about CRC risk factors and acculturation on different dimensions of dietary behaviors as well as physical activity. Research and practical implications were discussed.


Assuntos
Aculturação , Neoplasias do Colo/prevenção & controle , Neoplasias Colorretais/prevenção & controle , Comportamentos Relacionados com a Saúde , Estilo de Vida , Adulto , Idoso , Asiático/estatística & dados numéricos , Neoplasias do Colo/psicologia , Neoplasias Colorretais/psicologia , Estudos Transversais , Feminino , Nível de Saúde , Estilo de Vida Saudável , Humanos , Masculino , Pessoa de Meia-Idade , Philadelphia , Pobreza , Fatores de Risco , Assunção de Riscos , Fumar
7.
Int J Aging Hum Dev ; 91(3): 317-339, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-31464144

RESUMO

This retrospective study examined developmental trajectories of women's body image perceptions throughout the adult life span from life course and self-discrepancy theory perspectives. Data were collected from women over 65 years of age, recruited from 15 senior communities and centers in a Midwest U.S. state in 2012. A total of 102 older women completed a survey about their past and current body image perceptions. To examine developmental trajectories of the repeated body image measures, a latent growth modeling analysis was adopted. Distinct and significant trajectories in each body image measure during the entire adult life course were found, confirming that a retrospective account of women's body image perceptions significantly change with age. The individual differences in the trajectories over time and the relationship between an individual's initial mean level and the rate of change on each variable were also examined. The findings advanced understanding of the retrospective age effects on women's body image throughout the adult life span.


Assuntos
Imagem Corporal/psicologia , Desenvolvimento Humano , Individualidade , Modelos Psicológicos , Mulheres/psicologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Meio-Oeste dos Estados Unidos , Estudos Retrospectivos
8.
J Community Health ; 44(3): 525-533, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30915676

RESUMO

Low cervical cancer screening rates among Vietnamese American women have been attributed, in part, to inadequate knowledge about cervical cancer and health beliefs that hinder screening. A community-based educational program was developed to improve knowledge and attitudes toward cervical cancer screening in this underserved population. It was hypothesized that the program would result in increases in knowledge, as well as enhanced health beliefs and self-efficacy toward obtaining cervical cancer screening. Using a group-randomized design, 1488 women from 30 Vietnamese community-based organizations were assigned to either the intervention (n = 816) or control (n = 672) conditions. The intervention group received cervical cancer education delivered by bilingual community health educators. Intervention content addressed individual beliefs and expectancies regarding cervical cancer screening (e.g., perceived risk of developing cervical cancer; perceived benefits and barriers to screening; social and cultural norms regarding screening). The control group received general health education, including information about cancer screening. Knowledge and health beliefs were assessed at baseline and post-intervention. Among women in the intervention group, overall knowledge about cervical cancer and screening guidelines increased from pre- to post-program (30% vs. 88%, p < 0.001), perceived benefits of screening increased (3.50 vs. 4.49, p < 0.001), and perceived barriers to screening decreased (3.13 vs. 2.25, p < 0.001). Changes in knowledge and health beliefs were not observed among women in the control group. A community-based educational program can help increase knowledge about cervical cancer and screening, promote positive changes in women's beliefs about the benefits of cervical cancer screening, and reduce perceived barriers to screening. Such programs may play an important role in addressing health disparities and informing underserved populations about recommended screening tests.


Assuntos
Asiático/educação , Detecção Precoce de Câncer/psicologia , Educação em Saúde/organização & administração , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Neoplasias do Colo do Útero/etnologia , Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Autoeficácia , Fatores Socioeconômicos , Estados Unidos/epidemiologia , Neoplasias do Colo do Útero/prevenção & controle , Vietnã/etnologia
9.
J Med Internet Res ; 21(9): 13463, 2019 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-31493319

RESUMO

BACKGROUND: Although distress screening is crucial for cancer survivors, it is not easy for clinicians to recognize distress. Physical activity (PA) data collected by mobile devices such as smart bands and smartphone apps have the potential to be used to screen distress in breast cancer survivors. OBJECTIVE: The aim of this study was to assess data collection rates of smartphone apps and smart bands in terms of PA data, investigate the correlation between PA data from mobile devices and distress-related questionnaires from smartphone apps, and demonstrate factors associated with data collection with smart bands and smartphone apps in breast cancer survivors. METHODS: In this prospective observational study, patients who underwent surgery for breast cancer at Asan Medical Center, Seoul, Republic of Korea, between June 2017 and March 2018 were enrolled and asked to use both a smartphone app and smart band for 6 months. The overall compliance rates of the daily PA data collection via the smartphone walking apps and wearable smart bands were analyzed in a within-subject manner. The longitudinal daily collection rates were calculated to examine the dropout pattern. We also performed multivariate linear regression analysis to examine factors associated with compliance with daily collection. Finally, we tested the correlation between the count of daily average steps and distress level using Pearson correlation analysis. RESULTS: A total of 160 female patients who underwent breast cancer surgeries were enrolled. The overall compliance rates for using a smartphone app and smart bands were 88.0% (24,224/27,513) and 52.5% (14,431/27,513), respectively. The longitudinal compliance rate for smartphone apps was 77.8% at day 180, while the longitudinal compliance rate for smart bands rapidly decreased over time, reaching 17.5% at day 180. Subjects who were young, with other comorbidities, or receiving antihormonal therapy or targeted therapy showed significantly higher compliance rates to the smartphone app. However, no factor was associated with the compliance rate to the smart band. In terms of the correlation between the count of daily steps and distress level, step counts collected via smart band showed a significant correlation with distress level. CONCLUSIONS: Smartphone apps or smart bands are feasible tools to collect data on the physical activity of breast cancer survivors. PA data from mobile devices are correlated with participants' distress data, which suggests the potential role of mobile devices in the management of distress in breast cancer survivors. TRIAL REGISTRATION: ClinicalTrials.gov NCT03072966; https://clinicaltrials.gov/ct2/show/NCT03072966.


Assuntos
Coleta de Dados/métodos , Exercício Físico/fisiologia , Smartphone/normas , Adulto , Neoplasias da Mama/mortalidade , Sobreviventes de Câncer , Feminino , Humanos , Pessoa de Meia-Idade , Aplicativos Móveis/estatística & dados numéricos , Estudos Prospectivos , Inquéritos e Questionários
10.
Cancer ; 124(5): 973-982, 2018 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-29131316

RESUMO

BACKGROUND: The primary objective of the current study was to evaluate the efficacy of a community-based participatory intervention program in improving hepatitis B virus (HBV) screening and vaccination among Korean Americans who were not previously screened. METHODS: A cluster randomized trial involving 32 Korean church-based community organizations (1834 participants) was conducted. Sixteen churches were randomly assigned to an HBV screening and vaccination multicomponent intervention condition (972 participants) and 16 were assigned to a general cancer education control condition (862 participants). The main components of the intervention program included interactive group education; patient navigation; and the engagement of health care providers, church leadership, and church members in the medical field. The application of community-based participatory research principles was monitored and evaluated. HBV screening and vaccination rates (self-reported and medical record verification) were assessed at 6-month and 12-month follow-ups, respectively. RESULTS: The results of the current study demonstrated significant efficacy in the HBV screening rate (92.5% in the intervention group vs 5.5% in the control group), 3-series HBV vaccination completion rate (84% in the intervention group vs 17.6% in the control group), and overall screening and vaccination compliance rate (87% in the intervention group vs 3.8% in the control group). Participants in the intervention group were significantly more likely to receive HBV screening (92.5%) compared with those in the control group (5.5%). In multivariate mixed-effect logistic regression analysis, the odds ratio for an intervention effect on HBV screening was 512.3 after adjusting for cluster effect and other demographic variables. With regard to vaccination rates, of the 332 participants who were screened with no immunity in the intervention group, 308 (92.8%) received at least 1 HBV vaccination, 300 (90.4%) received at least 2 shots, and 279 participants (84%) received all 3 shots. CONCLUSIONS: A combination of community-based participatory research and a multilevel approach may produce the most optimal results and be essential in producing a considerable effect for enhancing HBV screening and vaccination, particularly for Korean American populations with limited language proficiency and insurance coverage. Cancer 2018;124:973-82. © 2017 American Cancer Society.


Assuntos
Participação da Comunidade/métodos , Hepatite B/diagnóstico , Programas de Rastreamento/métodos , Vacinação/métodos , Adulto , Asiático , Análise por Conglomerados , Feminino , Hepatite B/prevenção & controle , Hepatite B/virologia , Vacinas contra Hepatite B/administração & dosagem , Vírus da Hepatite B/imunologia , Vírus da Hepatite B/fisiologia , Humanos , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , República da Coreia
11.
J Transl Med ; 16(1): 351, 2018 12 12.
Artigo em Inglês | MEDLINE | ID: mdl-30541555

RESUMO

BACKGROUND: Demineralized dentin matrix (DDM) is commonly used as a bone-graft substitute. This study measured and compared human hepatitis B viruses (HBV) DNA in fresh dentin to that of dentin processed into DDM extracted during dental treatment from HBV-infected patients. The hypothesis was that the processing procedure for DDM would inactivate or eliminate HBV in the dentin matrix obtained from infected patients. METHODS: Dentin from eighteen HBV-infected patients was collected and each dentin specimen was divided into two fragments. One fragment was used before processing as fresh dentin (control group) and the other was processed into DDM (experimental group). DNA was extracted and purified from each fresh and processed dentin specimen and the HBV DNA copy number quantitated by real time polymerase chain reaction. The HBV DNA copy number in the fresh dentin specimens were compared relative to serologic test results. The second parameter was to evaluate the effectiveness of the processing procedure (defatting, demineralization, freeze-drying, and sterilization) to inactivate or eliminate HBV by comparing the DNA copy number in the processed DDM with that in the matched fresh dentin specimens. All results were analyzed using Mann-Whitney U test to compare numerical measurements between groups and differences were considered statistically significant at P-values less than 0.05. RESULTS: The presence of HBV DNA was detected in 55.56% (10/18) of the fresh dentin specimens. For the ten HBV DNA-positive fresh dentin specimens, HBV DNA was detected in two (20%) of the matched processed dentin specimens. The copy number of HBV DNA in the two positive processed dentin specimens was 1.79 and 4.03, which were statistically lower than that of the fresh dentin specimens (P = 0.0167). CONCLUSIONS: The results from this study suggested that fresh dentin may be a carrier of HBV and that the procedure used to generate DDM extensively reduced the levels of HBV DNA. Further studies are needed to evaluate the infectivity of HBV in processed dentin.


Assuntos
DNA Viral/análise , Dentina/virologia , Vírus da Hepatite B/genética , Hepatite B Crônica/virologia , Adulto , Idoso , Feminino , Dosagem de Genes , Humanos , Masculino , Pessoa de Meia-Idade
12.
Clin Chem ; 64(10): 1513-1521, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30097497

RESUMO

BACKGROUND: Biomarkers are needed for noninvasive early detection of gastric cancer (GC). We investigated salivary extracellular RNA (exRNA) biomarkers as potential clinical evaluation tools for GC. METHODS: Unstimulated whole saliva samples were prospectively collected from 294 individuals (163 GC and 131 non-GC patients) who underwent endoscopic evaluation at the Samsung Medical Center in Korea. Salivary transcriptomes of 63 GC and 31 non-GC patients were profiled, and mRNA biomarker candidates were verified with reverse transcription quantitative real-time PCR (RT-qPCR). In parallel, microRNA (miRNA) biomarkers were profiled and verified with saliva samples from 10 GC and 10 non-GC patients. Candidate biomarkers were validated with RT-qPCR in an independent cohort of 100/100 saliva samples from GC and non-GC patients. Validated individual markers were configured into a best performance panel. RESULTS: We identified 30 mRNA and 15 miRNA candidates whose expression pattern associated with the presence of GC. Among them, 12 mRNA and 6 miRNA candidates were verified with the discovery cohort by RT-qPCR and further validated with the independent cohort (n = 200). The configured biomarker panel consisted of 3 mRNAs (SPINK7, PPL, and SEMA4B) and 2 miRNAs (MIR140-5p and MIR301a), which were all significantly down-regulated in the GC group, and yielded an area under the ROC curve (AUC) of 0.81 (95% CI, 0.72-0.89). When combined with demographic factors, the AUC of the biomarker panel reached 0.87 (95% CI, 0.80-0.93). CONCLUSIONS: We have discovered and validated a panel of salivary exRNA biomarkers with credible clinical performance for the detection of GC. Our study demonstrates the potential utility of salivary exRNA biomarkers in screening and risk assessment for GC.


Assuntos
Biomarcadores Tumorais/genética , Regulação Neoplásica da Expressão Gênica , MicroRNAs/genética , RNA Mensageiro/genética , Saliva/química , Neoplasias Gástricas/genética , Estudos de Casos e Controles , Estudos de Coortes , Perfilação da Expressão Gênica , Humanos , Análise em Microsséries , Estudos Prospectivos , Curva ROC , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Neoplasias Gástricas/diagnóstico , Transcriptoma
13.
J Community Health ; 42(2): 269-277, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27639868

RESUMO

Filipino Americans represent one of the largest and most diverse immigrant populations in the United States. It has been established that chronic diseases are a significant public health issue affecting this population. We conducted a health needs assessment of 200 Filipino Americans aged 18 years or older residing in the greater Philadelphia region. Study participants were recruited from eight Filipino community-based organizations in the region. Information about demographic and acculturative characteristics, health behaviors, self-reported chronic health conditions, and chronic disease perception were collected. Participants were older and highly acculturated. With regards to health behaviors, several did not meet dietary fruit and vegetables intake and physical activity guidelines. The top five health conditions were high blood pressure (67.5 %), high blood cholesterol (57.1 %), arthritis (28.9 %), diabetes (21.8 %), and cancer (14.7 %). Majority of participants perceived high blood pressure, high blood cholesterol, and diabetes to be a concern in their community, and had high awareness of the risk factors associated with these diseases. Reported rates of hypertension, high cholesterol, and diabetes suggest that lifestyle interventions targeting diet and physical activity, in addition to health education, are needed in this population.


Assuntos
Asiático/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença Crônica/epidemiologia , Dieta/etnologia , Dieta/estatística & dados numéricos , Emigrantes e Imigrantes/estatística & dados numéricos , Exercício Físico , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação das Necessidades , Philadelphia/epidemiologia , Filipinas/etnologia , Adulto Jovem
14.
J Community Health ; 42(4): 797-805, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28161775

RESUMO

Despite that Filipino Americans represent an important target group for hypertension, health behaviors associated with hypertension in this population have not been well studied. Two hundred Filipino Americans from eight community-based organizations completed the study. Information was collected to determine whether modifiable behavioral factors, as well as acculturation and demographic characteristics, were associated with hypertension status in Filipino Americans. Approximately 67% of Filipino Americans were hypertensive. Logistic regression analysis showed that adding salt, physical inactivity, and old age were significantly associated with hypertension status after controlling for other covariates. The present study confirmed a high rate of hypertension among Filipino Americans and demonstrates the association of hypertension status with behavioral factors. These findings highlight the need for targeted interventions to prevent and manage hypertension in this high-risk community by facilitating health behaviors, particularly, salt reduction and physical activity.


Assuntos
Asiático , Comportamentos Relacionados com a Saúde/etnologia , Hipertensão/etnologia , Aculturação , Adulto , Fatores Etários , Idoso , Emigrantes e Imigrantes , Exercício Físico , Feminino , Humanos , Masculino , Assistência Médica/estatística & dados numéricos , Pessoa de Meia-Idade , Filipinas/etnologia , Medição de Risco , Fatores Socioeconômicos , Sódio na Dieta , Estados Unidos/epidemiologia
15.
J Community Health ; 42(4): 688-700, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27999991

RESUMO

The present study examined generational differences in the patterns and predictors of formal and informal mental health service utilization among a nationally representative sample of 1850 Asian Americans from the National Latino and Asian American Study. We focused on the effects of perceived need and relational factors on service utilization among 1st-, 1.5-, and 2nd-generation Asian Americans. Results of hierarchical logistic regression showed significant intergenerational differences. Specifically, 1.5-generation Asian Americans exhibited distinctive pattern of service use, with perceived need being associated with a higher likelihood of using formal mental health services, but only for those with high level of social support. First- and second-generation Asian Americans, on the other hand, perceived need was independently associated with formal service use, and a significant predictor of informal service use for first generation. Greater family conflict was also associated with greater use of formal and informal services for both first- and second generations. However, family cohesion was associated with only informal service use among first -generation Asian Americans. Implications for mental health service policy were discussed.


Assuntos
Asiático/psicologia , Relações Familiares/etnologia , Serviços de Saúde Mental/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Adulto , Fatores Etários , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Percepção , Fatores Sexuais , Apoio Social , Fatores Socioeconômicos , Estados Unidos
16.
Subst Abus ; 37(2): 356-63, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26308425

RESUMO

BACKGROUND: The Substance Abuse and Mental Health Services Administration (SAMHSA) has recently begun to fund programs that train medical residents on how to utilize an evidence-based validated system known as screening, brief intervention, and referral to treatment (SBIRT) for providing early detection and brief treatment of unhealthy substance use. This paper investigates training outcomes of multispecialty SBIRT training at one such program at Albany Medical Center (AMC), one of the initial SAMHSA grantees. METHODS: Training outcomes were measured across 3 domains of learning: trainee satisfaction, acquired knowledge, and perceived usefulness. The authors explored differences in learning experience by postgraduate year and by specialty. RESULTS: Overall, residents were highly satisfied with the training, and learning outcomes met objectives. Residents' ratings of usefulness did not vary by program year. However, the results indicate that relative to residents in other programs, residents in psychiatry and pediatrics found the training components significantly more useful, whereas emergency medicine residents found training components to have less utility. Residents who found the training relevant to their daily work were more satisfied and more receptive to SBIRT training overall, which may help explain difference scores by program. CONCLUSIONS: Residents were highly satisfied with SBIRT skills training, although ratings of usefulness varied by residency program. Specialization by program and on-site modeling by senior faculty may enhance trainee satisfaction and perceived usefulness.


Assuntos
Centros Médicos Acadêmicos , Educação de Pós-Graduação em Medicina/métodos , Internato e Residência , Encaminhamento e Consulta , Transtornos Relacionados ao Uso de Substâncias/terapia , Competência Clínica , Currículo , Feminino , Humanos , Masculino , Medicina , Avaliação de Programas e Projetos de Saúde , Psicoterapia Breve/educação , Transtornos Relacionados ao Uso de Substâncias/diagnóstico
17.
Subst Abus ; 37(2): 306-14, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26176589

RESUMO

BACKGROUND: Screening, brief intervention, and referral to treatment (SBIRT), an evidence-based validated system for providing early detection and brief treatment of substance use disorders, has been widely used in the training of medical residents across specialties at a number of sites. This article investigates the effectiveness of SBIRT training during short-term follow-up at Albany Medical Center, one of the initial Substance Abuse and Mental Health Services Administration (SAMHSA) grantees. METHODS: Training outcomes were measured by training satisfaction following opportunities to apply SBIRT skills in clinical work, the rate at which these techniques were applied in clinical work, and the degree to which residents felt that the SBIRT training provided skills that were applicable to their practice. We examined differences in learning experience by postgraduate year and by program, and conducted a qualitative analysis in a convergent parallel mixed-methods design to elucidate barriers encountered by residents upon using SBIRT techniques in clinical practice. RESULTS: Residents remained highly satisfied with the training at 4-month follow-up, with 80.1% reporting that they had used SBIRT skills in their clinical work. Use of SBIRT techniques was high at 6-month follow-up as well, with 85.9% of residents reporting that they regularly screened their patients for substance use, 74.4% reporting that they had applied brief intervention techniques, and 78.2% indicating that SBIRT training had made them overall more effective in helping patients with substance use issues. Differences in application rates and satisfaction were found by specialty. Qualitative analyses indicated that residents encountered patient readiness and specific contextual factors, such as time constraints, externally imposed values, and clinical norms, as barriers to implementation. CONCLUSIONS: Despite encountering obstacles such as time constraints and patient readiness, residents utilized many of the skills they had learned during SBIRT training in clinical practice and reported finding these skills useful in their management of patients with substance use issues.


Assuntos
Educação de Pós-Graduação em Medicina/métodos , Internato e Residência/estatística & dados numéricos , Encaminhamento e Consulta , Detecção do Abuso de Substâncias , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/terapia , Atitude do Pessoal de Saúde , Competência Clínica , Humanos
18.
J Behav Med ; 38(6): 932-43, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26335312

RESUMO

This study evaluated a theory-guided cognitive-behavioral counseling (CBC) intervention for smoking cessation during pregnancy and postpartum. It also explored the mediating role of cognitive-affective variables on the impact of CBC. Underserved inner city pregnant women (N = 277) were randomized to the CBC or a best practice (BP) condition, each of which consisted of two prenatal and two postpartum sessions. Assessments were obtained at baseline, late pregnancy, and 1- and 5-months postpartum. An intent-to-treat analysis found no differences between the two groups in 7-day point-prevalence abstinence. However, a respondents-only analysis revealed a significantly higher cessation rate in the CBC (37.3 %) versus the BP (19.0 %) condition at 5-months postpartum follow-up. This effect was mediated by higher quitting self-efficacy and lower cons of quitting. CBC, based on the Cognitive-Social Health Information Processing model, has the potential to increase postpartum smoking abstinence by assessing and addressing cognitive-affective barriers among women who adhere to the intervention.


Assuntos
Terapia Cognitivo-Comportamental , Período Pós-Parto/psicologia , Gravidez , Abandono do Hábito de Fumar/métodos , Abandono do Hábito de Fumar/psicologia , Prevenção do Hábito de Fumar , População Urbana , Adulto , Cidades , Aconselhamento , Feminino , Humanos , Autoeficácia , Populações Vulneráveis/psicologia , Adulto Jovem
19.
Connect Tissue Res ; 55(2): 147-55, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24409813

RESUMO

Abstract It is very well known that spinal meninges are composed of three layers, dura, arachnoid and pia mater, and that the main components of pia mater are collagen and reticular fibers. However, the distribution of those fibers has not been extensively investigated but just described as a mesh of fibers. In this study, we detected novel structures, which are composed of unidirectionally arranged fibers, in a rat spinal pia mater by using a polarized light microscope. They were seen as three parallel lines, one of which ran along a posterior spinal vein and the rest two of which ran along a pair of posterior spinal arteries. Histological analysis including Masson's trichrome, picrosirius-red staining, Gordon & Sweet's staining and immunohistochemistry with anti-collagen type 1 and 3 antibodies uncovered that they are mainly composed of collagen fibers and some reticular fibers. In addition, a putative primo vessel was detected in the novel fibrous tissue, which was proven out to be different from a blood vessel. In conclusion, we report a newly detected fibrous structure in the spinal pia mater, which may contribute to provide tensile force to the spinal meninges and to harbor the primo vascular system inside.


Assuntos
Colágeno Tipo III/metabolismo , Colágeno Tipo I/metabolismo , Tecido Elástico/metabolismo , Pia-Máter , Medula Espinal , Animais , Masculino , Microscopia de Polarização/métodos , Pia-Máter/irrigação sanguínea , Pia-Máter/citologia , Pia-Máter/metabolismo , Ratos , Ratos Sprague-Dawley , Medula Espinal/irrigação sanguínea , Medula Espinal/citologia , Medula Espinal/metabolismo
20.
J Behav Med ; 37(5): 921-30, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24469329

RESUMO

The present study examined the relationships of positive and negative types of religious coping with depression and quality of life, and the mediating role of benefit finding in the link between religious coping and psychological outcomes among 198 individuals with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). The results of multiple hierarchical analyses revealed that negative religious coping was significantly associated with a high level of depressive symptoms and a low level of quality of life, controlling for demographic and clinical variables. On the other hand, positive religious coping was significantly associated with positive domains of outcome measures such as positive affect and life satisfaction, but not with overall depressive symptoms or quality of life. Tests of mediation analyses showed that benefit finding fully mediated the relationship between positive religious coping and the positive sub-domains of psychological outcomes. The importance of investigating both positive and negative types of religious coping in their relationships with psychological adaptation in people with HIV was discussed, as well as the significance of benefit finding in understanding the link between religious coping and psychological outcomes.


Assuntos
Adaptação Psicológica , Depressão/etiologia , Infecções por HIV/psicologia , Qualidade de Vida/psicologia , Espiritualidade , Adulto , Idoso , Depressão/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Inquéritos e Questionários , Adulto Jovem
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