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BMC Geriatrics Apr 2022Increasingly, literature has focused on community participation in places visited by persons living with and without dementia. Earlier research indicates that multiple...
INTRODUCTION
Increasingly, literature has focused on community participation in places visited by persons living with and without dementia. Earlier research indicates that multiple factors, including socio-demographic aspects and risk perception may influence community participation.
AIM AND METHODS
This cross-sectional, explorative study aims to inquire into how places visited, socio-demographic aspects and risks perception are associated with self-rated community participation for persons living with and without dementia (n = 70) in Switzerland. Data was collected through face-to-face interviews with questionnaires (ACT-OUT, MoCA, sociodemographic). First, we investigated whether the number of places visited was correlated with self-rated participation; then we added socio-demographic and risks perception factors with a bivariate analysis; and searched for a model using multinomial logistic regressions.
RESULTS
For the group of participants living with dementia, risks of falling (p = .014) and of getting lost (p = .037) were significantly associated with self-rated participation. For the group of participants living without dementia, visiting places outside the home was significantly associated with self-rated participation, especially visiting places in domain D/places for recreational and physical activities (p = .005).
DISCUSSION AND CONCLUSIONS
The results of exploring multiple factors and searching for a model highlights the complexity of community participation as a construct. Risks and visiting places for recreational and physical activities seem to play a role in self-rated participation. Mobile interviews might be better suited to gain in-depth understanding on community participation for persons living with dementia.
Topics: Community Participation; Cross-Sectional Studies; Dementia; Demography; Humans; Perception
PubMed: 35397532
DOI: 10.1186/s12877-022-03015-5 -
Circulation. Genomic and Precision... Apr 2021Arrhythmogenic cardiomyopathy (ACM) is an inherited cardiac disease characterized by fibrofatty replacement of the right and left ventricle, often causing ventricular...
BACKGROUND
Arrhythmogenic cardiomyopathy (ACM) is an inherited cardiac disease characterized by fibrofatty replacement of the right and left ventricle, often causing ventricular dysfunction and life-threatening arrhythmias. Variants in desmosomal genes account for up to 60% of cases. Our objective was to establish the prevalence and clinical features of ACM stemming from pathogenic variants in the nondesmosomal cadherin 2 (CDH2), a novel genetic substrate of ACM.
METHODS
A cohort of 500 unrelated patients with a definite diagnosis of ACM and no disease-causing variants in the main ACM genes was assembled. Genetic screening of was performed through next-generation or Sanger sequencing. Whenever possible, cascade screening was initiated in the families of -positive probands, and clinical evaluation was performed.
RESULTS
Genetic screening of led to the identification of 7 rare variants: 5, identified in 6 probands, were classified as pathogenic or likely pathogenic. The previously established p.D407N pathogenic variant was detected in 2 additional probands. Probands and family members with pathogenic/likely pathogenic variants in were clinically evaluated, and along with previously published cases, altogether contributed to the identification of gene-specific features (13 cases from this cohort and 11 previously published, for a total of 9 probands and 15 family members). Ventricular arrhythmic events occurred in most -positive subjects (20/24, 83%), while the occurrence of heart failure was rare (2/24, 8.3%). Among probands, sustained ventricular tachycardia and sudden cardiac death occurred in 5/9 (56%).
CONCLUSIONS
In this worldwide cohort of previously genotype-negative ACM patients, the prevalence of probands with pathogenic/likely pathogenic variants was 1.2% (6/500). Our data show that this cohort of -ACM patients has a high incidence of ventricular arrhythmias, while evolution toward heart failure is rare.
Topics: Adolescent; Adult; Arrhythmogenic Right Ventricular Dysplasia; Cadherins; Female; Gene Frequency; Genetic Variation; Humans; Male; Middle Aged; Pedigree; Prevalence; Protein Domains; Young Adult
PubMed: 33566628
DOI: 10.1161/CIRCGEN.120.003097 -
Frontiers in Public Health 2023The long-term effects of SARS-CoV-2 are unclear, as are the factors influencing the evolution. Objective: to assess health-related quality of life 1 year after a... (Observational Study)
Observational Study
INTRODUCTION
The long-term effects of SARS-CoV-2 are unclear, as are the factors influencing the evolution. Objective: to assess health-related quality of life 1 year after a hospital admission due to COVID-19 and to identify factors that may influence it.
MATERIALS AND METHODS
Retrospective observational study in a tertiary hospital from March 2021 to February 2022. Inclusion criteria: ≥18 years old and admitted for SARS-CoV-2 infection. Exclusion criteria: death, not located, refusal to participate, cognitive impairment, and language barrier. Variables: demographic data, medical history, clinical and analytical outcomes during hospital admission, treatment received, and vaccination against SARS-CoV-2 following admission. Participants were interviewed by phone 1 year after admission, using the SF-36 quality of life questionnaire.
RESULTS
There were 486 included patients. The domains yielding the lowest scores were general health (median 65%, interquartile range [IQR] 45-80), vitality (median 65%, IQR 45-80), and mental health (median 73.5%, IQR 60-100). Multivariable analysis showed that female sex and fibromyalgia/fatigue had a negative influence on all domains. Obesity was associated with worse outcomes in physical functioning, physical role, bodily pain, and vitality. Other factors associated with worse scores were an older age in physical functioning and high age-adjusted Charslon comorbidity in physical functioning and general health. Age was associated with better results in emotional role and High C-reactive protein at admission on vitality.
CONCLUSION
One year after admission for COVID-19, quality of life remains affected, especially the domains of general health, vitality, and mental health. Factors associated with worse outcomes are female sex, fibromyalgia/chronic fatigue, and obesity.
Topics: Adolescent; Female; Humans; Male; COVID-19; Fibromyalgia; Hospitalization; Obesity; Quality of Life; SARS-CoV-2; Adult
PubMed: 37869178
DOI: 10.3389/fpubh.2023.1236527 -
PloS One 2017Positive mental health (PMH) is a combination of emotional, psychological and social well-being that is necessary for an individual to be mentally healthy. The current...
BACKGROUND
Positive mental health (PMH) is a combination of emotional, psychological and social well-being that is necessary for an individual to be mentally healthy. The current study aims to examine the socio-demographic differences of PMH among mental health professionals and to explore the association between job satisfaction and total PMH.
METHODS
Doctors, nurses and allied health staff (n = 462) completed the online survey which included the multidimensional 47-item PMH instrument as well as a single item job satisfaction question. Associations of PMH with job satisfaction were investigated via linear regression models.
RESULTS
Significant differences in PMH total and domain specific scores were observed across socio-demographic characteristics. Age and ethnicity were significantly correlated with PMH total scores as well as various domain scores, while gender, marital and residency status and the staff's position were only significantly correlated with domain specific scores. Job satisfaction was also found to be a significantly associated with total PMH.
CONCLUSION
The workplace is a key environment that affects the mental health and well-being of working adults. In order to promote and foster PMH, workplaces need to consider the importance of psychosocial well-being and the wellness of staff whilst providing an environment that supports and maintains overall health and work efficiency.
Topics: Adult; Demography; Female; Health Personnel; Hospitals, Psychiatric; Humans; Job Satisfaction; Male; Mental Health
PubMed: 28591203
DOI: 10.1371/journal.pone.0178359 -
BMC Public Health Mar 2020Hajj pilgrimage faces numerous challenges including a high prevalence of respiratory tract infection as well as its prevention strategies. The aim of this study was to...
BACKGROUND
Hajj pilgrimage faces numerous challenges including a high prevalence of respiratory tract infection as well as its prevention strategies. The aim of this study was to develop and validate a questionnaire to evaluate knowledge, attitude and practice (KAP) towards respiratory tract infections (RTIs) prevention among Malaysian Hajj pilgrims.
METHODS
This study was conducted among Malaysian Umrah pilgrims in Malaysia from Kuala Lumpur and Kelantan. The questionnaire then underwent a series of validation process that included content, face validity and exploratory part. Item response theory (IRT) analysis was utilized for the validation of the knowledge domain. The attitude and practice were validated using the exploratory factor analysis (EFA).
RESULTS
The validation process resulted in a questionnaire that comprised of four main sections: demography, knowledge, attitude, and practice. Following IRT analysis of the knowledge domain, all items analyzed were within the acceptable range of difficulty and discrimination. The Kaiser-Meyer-Olkin measure of sampling adequacy (KMO) was 0.72 and 0.84 for attitude and practice domain respectively and Bartlett's test of Sphericity for both domains were highly significant (P < 0.001). The factor analysis resulted in two factors with total of 12 items in attitude domain, and 2 factors with total of 13 items in the practice domain with satisfactory factor loading (> 0.3). The Cronbach's alpha for reliability of the knowledge, attitude and practice domains all showed acceptable values of > 0.6 (0.92, 0.77 and 0.85).
CONCLUSION
The findings of this validation and reliability study showed that the developed questionnaire had a satisfactory psychometric property for measuring KAP of Malaysian Hajj pilgrims.
Topics: Adult; Factor Analysis, Statistical; Female; Health Knowledge, Attitudes, Practice; Humans; Islam; Malaysia; Male; Middle Aged; Prevalence; Psychometrics; Reproducibility of Results; Respiratory Tract Infections; Surveys and Questionnaires; Travel
PubMed: 32114986
DOI: 10.1186/s12889-020-8269-9 -
International Journal of Environmental... Feb 2023The World Health Organization (WHO) created the concept of Integrated Care for Older People and one of its constructs is intrinsic capacity (IC). The study aimed to...
The World Health Organization (WHO) created the concept of Integrated Care for Older People and one of its constructs is intrinsic capacity (IC). The study aimed to carry out a screening with the tools designated by the WHO to assess the IC domains and whether they can be used as indicators for decision-making on integrated care for older people based on risk categorization. The interaction between the risk category and the domain scores was verified. One hundred and sixty three (163) community-dwelling older people of both genders were evaluated. Domains assessed: cognitive, psychological, vitality, locomotion, and sensory. Scores indicating a low, moderate and high risk were assigned to each domain. For all domains, there were individuals in all risk groups. Effect of risk on the domains: cognitive [χ(2) = 134.042; < 0.001], psychological [χ(2) = 92.865; < 0.001], vitality [χ(2) = 129.564; < 0.001], locomotion [χ(2) = 144.101; < 0.001], and sensory [χ(2) = 129.037; < 0.001]. Scores of the CI domains were affected by the risk category. There were individuals in all risk groups, demonstrating the importance of screening as a public health strategy, making it possible to know which risk category each elderly person belongs to and thus develop strategies in the short-, medium- and long-term.
Topics: Humans; Male; Female; Aged; Public Health; Independent Living; Quality of Life; Geriatric Assessment; Risk Factors
PubMed: 36901237
DOI: 10.3390/ijerph20054227 -
Applied Clinical Informatics Jan 2022Social determinants of health (SDoH) can be measured at the geographic level to convey information about neighborhood deprivation. The Ohio Children's Opportunity Index...
OBJECTIVES
Social determinants of health (SDoH) can be measured at the geographic level to convey information about neighborhood deprivation. The Ohio Children's Opportunity Index (OCOI) is a composite area-level opportunity index comprised of eight health domains. Our research team has documented the design, development, and use cases of a dashboard solution to visualize OCOI.
METHODS
The OCOI is a multidomain index spanning the following eight domains: (1) family stability, (2) infant health, (3) children's health, (4) access, (5) education, (6) housing, (7) environment, and (8) criminal justice. Information on these eight domains is derived from the American Community Survey and other administrative datasets. Our team used the Tableau Desktop visualization software and applied a user-centered design approach to developing the two OCOI dashboards-main OCOI dashboard and OCOI-race dashboard. We also performed convergence analysis to visualize the census tracts where different health indicators simultaneously exist at their worst levels.
RESULTS
The OCOI dashboard has multiple, interactive components as follows: a choropleth map of Ohio displaying OCOI scores for a specific census tract, graphs presenting OCOI or domain scores to compare relative positions for tracts, and a sortable table to visualize scores for specific county and census tracts. A case study using the two dashboards for convergence analysis revealed census tracts in neighborhoods with low infant health scores and a high proportion of minority population.
CONCLUSION
The OCOI dashboards could assist health care leaders in making decisions that enhance health care delivery and policy decision-making regarding children's health particularly in areas where multiple health indicators exist at their worst levels.
Topics: Child; Child Health; Data Visualization; Health Status Disparities; Humans; Infant; Ohio; Poverty Areas; Residence Characteristics; Social Determinants of Health; Surveys and Questionnaires
PubMed: 35081656
DOI: 10.1055/s-0041-1741482 -
JAMA Network Open May 2024Many health care systems are investing resources in identifying social determinants of health (SDoH) needs and facilitating interventions among the populations they...
IMPORTANCE
Many health care systems are investing resources in identifying social determinants of health (SDoH) needs and facilitating interventions among the populations they serve. Because self-reported SDoH information is lacking, area-level measures are often used to estimate needs and direct resources.
OBJECTIVE
To describe the large-scale deployment of SDoH assessments by a health system and determine the extent to which self-reported SDoH needs identified therein are associated with census tract-level social vulnerability measured using the Social Vulnerability Index (SVI).
DESIGN, SETTING, AND PARTICIPANTS
This cross-sectional study assessed SDoH needs between January 1, 2020, and April 30, 2023, in both payer and clinical care settings. Modalities included telephonic outreach, face-to-face clinical interactions, self-entry into a tablet or kiosk, and web-based survey tools. Participants included individuals who responded to the assessment and had sufficient information for census tract identification. Respondents included both Highmark Health Plan members and nonmembers. Health plan members responded to the assessment through health plan programs or platforms, and both members and nonmembers responded to assessments during inpatient or outpatient encounters with the affiliated health system.
MAIN OUTCOMES AND MEASURES
Overall and domain-specific SDoH needs self-reported through assessments, and severity and complexity of needs identified. Residential social vulnerability measures included overall SVI and the 4 conceptual themes comprising overall SVI.
RESULTS
In total, 841 874 assessments were recorded for 401 697 individuals (55.1% women; median [IQR] age, 55 [41-70] years). Social determinants of health needs were identified in 120 769 assessments (14.3%). Across all SDoH domains, increasing SVI was associated with a higher positivity rate (eg, 11.2% of those residing in the lowest-risk SVI quintile reported a need compared with 22.7% among those residing in the highest-risk quintile). Associations varied by SDoH domain and SVI theme. After adjusting for demographic and screening characteristics, odds of positive screening among those residing in the highest-risk SVI quintile were 1.74 (95% CI, 1.62-1.86) to 3.73 (95% CI, 3.48-4.00) times the odds among those residing in lowest risk quintile.
CONCLUSIONS AND RELEVANCE
In this cross-sectional study, the overall level of SDoH needs generally corresponded to area-level vulnerability. Some SDoH domains appeared far more sensitive to community characteristics than others. Notably, even among individuals from the highest-risk areas, the positive screening rate was roughly 1 in 4. These findings underscore the importance of individual-level SDoH data for service provision planning and health services research.
Topics: Humans; Social Determinants of Health; Cross-Sectional Studies; Self Report; Male; Female; Social Vulnerability; Middle Aged; Adult; Aged; Needs Assessment
PubMed: 38767915
DOI: 10.1001/jamanetworkopen.2024.12109 -
Health Promotion and Chronic Disease... Mar 2021Stigma has been identified as a key determinant of health and health inequities because of its effects on access to health-enabling resources and stress exposure. Though... (Review)
Review
INTRODUCTION
Stigma has been identified as a key determinant of health and health inequities because of its effects on access to health-enabling resources and stress exposure. Though existing reports offer in-depth summaries of the mechanisms through which stigma influences health, a review of evidence on the upstream drivers of stigma across health and social conditions has been missing. The objective of this review is to summarize known structural determinants of stigma experienced across health and social conditions in developed country settings.
METHODS
We conducted a rapid review of the literature. English- and French-language peer-reviewed and grey literature works published after 2008 were identified using MEDLINE, Embase, PsycINFO, Google and Google Scholar. Titles and abstracts were independently screened by two reviewers. Information from relevant publications was extracted, and a thematic analysis of identified determinants was conducted to identify broad domains of structural determinants. A narrative synthesis of study characteristics and identified determinants was conducted.
RESULTS
Of 657 publications identified, 53 were included. Ten domains of structural determinants of stigma were identified: legal frameworks, welfare policies, economic policies, social and built environments, media and marketing, pedagogical factors, health care policies and practices, biomedical technology, diagnostic frameworks and public health interventions. Each domain is defined and summarized, and a conceptual framework for how the identified domains relate to the stigma process is proposed.
CONCLUSION
At least 10 domains of structural factors influence the occurrence of stigma across health and social conditions. These domains can be used to structure policy discussions centred on ways to reduce stigma at the population level.
Topics: Delivery of Health Care; Health Policy; Humans; Public Health; Social Determinants of Health
PubMed: 33688694
DOI: 10.24095/hpcdp.41.3.03 -
Journal of Exposure Science &... Mar 2023Environmental health disparity research involves the use of metrics to assess exposure to community-level vulnerabilities or inequities. While numerous vulnerability...
BACKGROUND
Environmental health disparity research involves the use of metrics to assess exposure to community-level vulnerabilities or inequities. While numerous vulnerability indices have been developed, there is no agreement on standardization or appropriate use, they have largely been applied in urban areas, and their interpretation and utility likely vary across different geographies.
OBJECTIVE
We evaluated the spatial distribution, variability, and relationships among different metrics of social vulnerability and isolation across urban and rural settings to inform interpretation and selection of metrics for environmental disparity research.
METHODS
For all census tracts in North Carolina, we conducted a principal components analysis using 23 socioeconomic/demographic variables from the 2010 United States Census and American Community Survey. We calculated or obtained the neighborhood deprivation index (NDI), residential racial isolation index (RI), educational isolation index (EI), Gini coefficient, and social vulnerability index (SVI). Statistical analyses included Moran's I for spatial clustering, t-tests for urban-rural differences, Pearson correlation coefficients, and changes in ranking of tracts across metrics.
RESULTS
Social vulnerability metrics exhibited clear spatial patterning (Moran's I ≥ 0.30, p < 0.01). Greater educational isolation and more intense neighborhood deprivation was observed in rural areas and greater racial isolation in urban areas. Single-domain metrics were not highly correlated with each other (rho ≤ 0.36), while composite metrics (i.e., NDI, SVI, principal components analysis) were highly correlated (rho > 0.80). Composite metrics were more highly correlated with the racial isolation metric in urban (rho: 0.54-0.64) versus rural tracts (rho: 0.36-0.48). Census tract rankings changed considerably based on which metric was being applied.
SIGNIFICANCE
High correlations between composite metrics within urban and rural tracts suggests they could be used interchangeably; single domain metrics cannot. Composite metrics capture different facets of vulnerabilities in urban and rural settings, and these complexities should be examined by researchers applying metrics to areas of diverse urban and rural forms.
Topics: Humans; United States; Socioeconomic Factors; Social Vulnerability; Racial Groups; Residence Characteristics; Censuses
PubMed: 35388169
DOI: 10.1038/s41370-022-00435-8