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AJPM Focus Jun 2024Consumption of fast food has been linked to psychiatric distress, violent behaviors, and impulsivity in adolescents. The relationship between eating fast food, anger,...
INTRODUCTION
Consumption of fast food has been linked to psychiatric distress, violent behaviors, and impulsivity in adolescents. The relationship between eating fast food, anger, and impulsivity has not been widely investigated. The National Consortium on Alcohol and Neurodevelopment in Adolescence community-based cohort consists of 831 youth, half at elevated risk factors for substance use disorders during adolescence, followed annually.
METHODS
Impulsivity using Urgency, Premeditation, Perseverance, and Sensation Seeking Impulsive Behavior scale from annual assessments was examined in relation to self-reported fast-food consumption frequency and mobile application questions of anger. This study tested the hypotheses that youth anger may be predicted by fast-food consumption frequency and impulsivity using multiple regression, in addition to whether adolescent fast-food consumption frequency may be predicted by anger and impulsivity.
RESULTS
Among youth, higher anger levels and impulsivity predicted greater frequency of fast-food consumption, and greater fast-food consumption frequency and impulsivity predicted higher anger levels.
CONCLUSIONS
This study's longitudinal findings are consistent with those of other studies that have found fast-food consumption and anger associated with impulsivity and also reveal a bidirectional link between anger and fast-food consumption. These results may point attention to food selection considerations for those at risk of anger and poorer psychiatric outcomes.
PubMed: 38560402
DOI: 10.1016/j.focus.2024.100208 -
Research Square Aug 2023Identification of children with sepsis-associated multiple organ dysfunction syndrome (MODS) at risk for poor outcomes remains a challenge. Data-driven phenotyping...
OBJECTIVE
Identification of children with sepsis-associated multiple organ dysfunction syndrome (MODS) at risk for poor outcomes remains a challenge. Data-driven phenotyping approaches that leverage electronic health record (EHR) data hold promise given the widespread availability of EHRs. We sought to externally validate the data-driven 'persistent hypoxemia, encephalopathy, and shock' (PHES) phenotype and determine its association with inflammatory and endothelial biomarkers, as well as biomarker-based pediatric risk-strata.
DESIGN
We trained and validated a random forest classifier using organ dysfunction subscores in the EHR dataset used to derive the PHES phenotype. We used the classifier to assign phenotype membership in a test set consisting of prospectively enrolled pediatric septic shock patients. We compared biomarker profiles of those with and without the PHES phenotype and determined the association with established biomarker-based mortality and MODS risk-strata.
SETTING
25 pediatric intensive care units (PICU) across the U.S.
PATIENTS
EHR data from 15,246 critically ill patients sepsis-associated MODS and 1,270 pediatric septic shock patients in the test cohort of whom 615 had biomarker data.
INTERVENTIONS
None.
MEASUREMENTS AND MAIN RESULTS
The area under the receiver operator characteristic curve (AUROC) of the new classifier to predict PHES phenotype membership was 0.91(95%CI, 0.90-0.92) in the EHR validation set. In the test set, patients with the PHES phenotype were independently associated with both increased odds of complicated course (adjusted odds ratio [aOR] of 4.1, 95%CI: 3.2-5.4) and 28-day mortality (aOR of 4.8, 95%CI: 3.11-7.25) after controlling for age, severity of illness, and immuno-compromised status. Patients belonging to the PHES phenotype were characterized by greater degree of systemic inflammation and endothelial activation, and overlapped with high risk-strata based on PERSEVERE biomarkers predictive of death and persistent MODS.
CONCLUSIONS
The PHES trajectory-based phenotype is reproducible, independently associated with poor clinical outcomes, and overlap with higher risk-strata based on validated biomarker approaches.
PubMed: 37577648
DOI: 10.21203/rs.3.rs-3216613/v1 -
Health Research Policy and Systems Aug 2023Tunisia has been engaged in the Societal Dialogue (SD) for Health process since 2012, a participatory health governance process aimed at bringing in people's voice into...
BACKGROUND
Tunisia has been engaged in the Societal Dialogue (SD) for Health process since 2012, a participatory health governance process aimed at bringing in people's voice into health policy-making. Its first success was the recently released National Health Policy 2030. This paper aims to document the SD process and to bring out the lessons learned to inspire other countries.
METHODS
This study was based essentially on a qualitative analysis of semi-structured interviews with citizen jury members and health experts that took place from May to September 2018. The qualitative analysis adopted an inductive-deductive approach according to a cross-matrix between the themes of the interview of the two groups of interviewees.
RESULTS
The qualitative analysis of the data highlighted that the Societal Dialogue created a health democracy dynamic with inclusive dialogue spaces for the population, communities, and civil society to participate in health system design. It constituted a multi-actor and multidisciplinary coordination platform to increase consensus building among actors. Initial government support and high levels of volunteer commitment allowed the process to achieve a certain level of sustainability. However, this process faced and still faces many challenges such as overreliance on volunteers; a crisis of trust; political instability and the lack of an effective communication strategy. These challenges negatively influence the policy uptake of recommendations made by the Societal Dialogue for Health.
CONCLUSION
The Tunisian societal dialogue experience highlights both the successes and challenges of a structured participatory platform, as well as the effort and perseverance it takes to keep such a process functional and relevant. A key lesson from this study is that this model of participatory health governance eventually reaches a stage where population, community, and civil society participation needs to be more institutionalized within the government routine so that it can credibly feed into health policy review processes and inform decision-makers on a regular basis.
Topics: Humans; Qualitative Research; Consensus; Government; Health Policy; Policy Making
PubMed: 37641114
DOI: 10.1186/s12961-023-00996-6 -
Cureus Apr 2024This investigation aimed to compare the neuropsychological dysfunctions of coronavirus (COVID-19)-recovered nurses to those of healthy nurses.
OBJECTIVE
This investigation aimed to compare the neuropsychological dysfunctions of coronavirus (COVID-19)-recovered nurses to those of healthy nurses.
METHODOLOGY
The present research method was descriptive and causal-comparative, in which the statistical population consisted of nurses with a history of COVID disease and working in the COVID department of public hospitals in Isfahan city. The available method selected 30 nurses with a history of illness and compared them with 30 other nurses from the same hospitals. We collected data using the "go/no go" test, the Wisconsin card sorting test (WCST), and direct and inverted word reading tests. We also analyzed the collected data using multivariate analysis of variance.
RESULTS
The results showed a significant difference between nurses with a history of COVID disease and normal nurses in memory performance, the total error of the Wisconsin card sorting test, and the error of committing and inappropriately inhibiting the go/no go task (P < 0.01). However, there is no significant difference between the two groups in the number of classes, the error of perseveration in the Wisconsin test, or the reaction time of the go/no task (P < 0.05).
CONCLUSION
Therefore, the present study's results indicate that nurses recovering from COVID-19 perform worse than normal nurses in memory functions, cognitive flexibility, and response inhibition within one to three months of recovery.
PubMed: 38800204
DOI: 10.7759/cureus.58929 -
Sports (Basel, Switzerland) Jan 2024(1) Background: Insufficient physical activity in adolescents remains an important issue for health promotion. Given the current relevance of understanding the adoption...
(1) Background: Insufficient physical activity in adolescents remains an important issue for health promotion. Given the current relevance of understanding the adoption and maintenance of moderate and vigorous physical activity (MVPA), the aim of this study was to analyze, in a sample of adolescents, the role of grit personality as an antecedent of healthy eating and healthy weight (HEW) self-efficacy and its implications for the practice of MVPA. (2) Methods: Participants were 987 adolescents (597 girls, 390 boys) aged between 15 and 19 years from Mexico and Spain. The Spanish versions of the grit personality scale, the healthy eating and weight self-efficacy scale and the global physical activity questionnaire were used to measure the variables of interest. (3) Results: Mediated regression analysis showed that grit personality was not directly related to MVPA practice. However, the results indicate the significant relationship between grit personality and HEW self-efficacy, as well as the positive and significant relationship of this self-efficacy on MVPA practice. HEW self-efficacy totally mediated the relationship between grit personality and MVPA in both boys and girls. (4) Conclusions: These results suggest that having a grit personality (i.e., having interest and perseverance) is not enough for adolescents to be physically active, but that perceiving oneself as effective in having a healthy diet and healthy weight may be the key for adolescents to move more. At the intervention level, we suggest targeting an enhancement of young people's competence to eat healthily and regulate their weight as a strategy to enhance the performance of more MVPA, with a possible transfer between healthy behaviors (spill over).
PubMed: 38393261
DOI: 10.3390/sports12020041 -
BMC Nursing Jul 2023Nurses in Lebanon are facing multiple crises and the severity of the situation calls for an empirical examination of their resilience status. Evidence indicates that...
BACKGROUND/OBJECTIVES
Nurses in Lebanon are facing multiple crises and the severity of the situation calls for an empirical examination of their resilience status. Evidence indicates that resilience can buffer the negative effect of workplace stressors on nurses and is associated with favorable patient outcomes. The objective of this study was to test the psychometric properties of the Arabic Resilience Scale-14 that was utilized to measure resilience among Lebanese nurses, METHODS: Data was collected from nurses working in health care centers using a cross-sectional survey design. We estimated the confirmatory factor analysis using the Diagonally Weighted least Squares. Fit indices for the confirmatory factor analysis model included Model chi-square, root-mean squared error of approximation and Standardized Root Mean Square Residual. Statistical significance was set at p < 0.05.
RESULTS
1,488 nurses were included in the analysis. The squared multiple correlations values ranged from 0.60 to 0.97 thus supporting the construct validity of the originally hypothesized five factor model (self-reliance, purpose, equanimity, perseverance, and authenticity).
CONCLUSIONS
The Arabic version of the Resilience Scale 14 tool is considered a valid tool for measuring resilience in any situation involving Arabic speaking nurses.
PubMed: 37434167
DOI: 10.1186/s12912-023-01392-9 -
Cognitive Neurodynamics Feb 2024Repetitive thoughts and motor programs including perseveration are bridge symptoms characteristic of obsessive compulsive disorder (OCD), schizophrenia and in the...
Repetitive thoughts and motor programs including perseveration are bridge symptoms characteristic of obsessive compulsive disorder (OCD), schizophrenia and in the co-morbid overlap of these conditions. The above pathologies are sensitive to altered activation and kinetics of dopamine and receptors that differently influence sequence learning and recall. Recognizing start and stop elements of motor and cognitive behaviors has crucial importance. During chunking, frequent components of temporal strings are concatenated into single units. We extended a published computational model (Asabuki et al. 2018), where two populations of neurons are connected and simulated in a reservoir computing framework. These neural pools were adopted to represent D and D striatal neuronal populations. We investigated how specific neural and striatal circuit parameters can influence start/stop signaling and found that asymmetric intra-network connection probabilities, synaptic weights and differential time constants may contribute to signaling of start/stop elements within learned sequences. Asymmetric coupling between the striatal and neural populations was also demonstrated to be beneficial. Our modeling results predict that dynamical differences between the two dopaminergic striatal populations and the interaction between them may play complementary roles in chunk boundary signaling. Start and stop dichotomies can arise from the larger circuit dynamics as well, since neural and intra-striatal connections only partially support a clear division of labor.
PubMed: 38406202
DOI: 10.1007/s11571-022-09865-4 -
Plastic and Reconstructive Surgery.... Aug 2023The history of women in surgery has been documented since ancient times. Despite this, women physicians have historically encountered unique obstacles in achieving the...
The history of women in surgery has been documented since ancient times. Despite this, women physicians have historically encountered unique obstacles in achieving the same respect and privileges as their male counterparts. Early female physicians overcame many challenges to complete their training following graduation from medical school. The first woman in the field of plastic surgery in the United States was Dr. Alma Dea Morani, who became a member of the American Society of Plastic and Reconstructive Surgeons (ASPRS, now ASPS) in 1948. She applied for plastic surgery training six different times over 6 years, until she was accepted at a position where she had shadowing-only privileges. Yet, her steadfast determination and perseverance led her to build a successful career, becoming a role model and advocate for women in plastic surgery. The Women Plastic Surgeons Forum within ASPRS was officially established in 1992; however, informal events began as early as 1979. This group fostered mentorship among emerging female leaders, allowing women to take on leadership roles within national plastic surgery organizations. These women, in turn, have become role models for subsequent generations of women in this field. Plastic surgery has historically seen a higher percentage of female residents relative to other surgical specialties. Studies have shown that female role models are the most influential factor for female medical students interested in plastic surgery, a powerful fact considering women now comprise over 50% of graduating medical students. Female mentorship is essential in fostering the future generation of female plastic surgeons.
PubMed: 37577242
DOI: 10.1097/GOX.0000000000005165 -
BMC Palliative Care Jan 2024Family caregivers are essential in end-of-life care for cancer patients who wish to die at home. The knowledge is still limited regarding family caregivers needs and...
BACKGROUND
Family caregivers are essential in end-of-life care for cancer patients who wish to die at home. The knowledge is still limited regarding family caregivers needs and preferences for support and whether the preferences change during the patient's illness trajectory. Therefore, the aim was to explore family caregivers' preferences for support from home care services over time when caring for a family member with cancer at the end of life who wished to die at home.
METHODS
A qualitative method was applied according to Grounded Theory. Data was collected longitudinally over the illness trajectory by means of repeated individual interviews (n = 22) with adult family caregivers (n = 11). Sampling, data collection and data analysis were undertaken simultaneously in line with the constant comparative method.
RESULTS
The findings are captured in the core category "hold out in duty and love". The categories "having control and readiness for action" and "being involved in care" describe the family caregivers' preferences for being prepared and able to handle procedures, medical treatment and care, and to be involved by the healthcare personnel in the patient's care and decision making. The categories "being seen and confirmed" and "having a respite" describe family caregivers' preferences for support according to their own needs to be able to persevere in the situation.
CONCLUSION
Despite deterioration in the patient's illness and the increasing responsibility family caregiver struggle to hold out and focus on being in the present. Over time together with deterioration in the patient's illness and changes in the situation, they expressed a need for more intense and extensive support from the home care services. To meet the family caregivers' preferences for support a systematic implementation of a person-centred care model and multicomponent psycho- educational interventions performed by nurses can be proposed. Moreover, we suggest developing a tool based on the conceptual model generated in this study to identify and map family caregivers' needs and preferences for support. Such a tool can facilitate communication and ensure person-centred interventions.
Topics: Adult; Humans; Caregivers; Grounded Theory; Family; Death; Neoplasms; Palliative Care; Qualitative Research
PubMed: 38212707
DOI: 10.1186/s12904-024-01350-5 -
Gaceta Sanitaria Mar 2024The independent evaluation report on the performance of the National Health System in the face of the COVID crisis is rigorous, well thought out and well executed. It...
The independent evaluation report on the performance of the National Health System in the face of the COVID crisis is rigorous, well thought out and well executed. It has benefited from the participation of numerous experts and institutions. The altruistic effort of the coordinators and hundreds of experts, professionals and citizens is noteworthy, which does not justify the asymmetry between "everything for free" when it comes to shared intelligence, and market prices when it comes to commissioning reports from consultancy firms that are sometimes not worth the cost. The valuable work has suffered from unexplained delays and delayed dissemination that do not bode well for whether there is interest in learning from the pandemic or leaving it behind and forgetting it. Indeed, valuable reports provided by the public administration itself (listed in the report) have still not been made public, despite the request of the coordinators. However, the mere fact that the evaluation has been carried out under the influence and pressure of scientists and professionals should encourage the actions of civil society organisations. Advocacy is needed to ensure that public administrations see collective intelligence as an invaluable resource to be nurtured and stimulated. Regular accountability of executive powers at all levels needs to be pursued vigorously. Many sensible proposals to improve healthcare have been ignored, but we learned that achievements are made with perseverance. It is not an option, it is part of the core business of public health.
PubMed: 38458042
DOI: 10.1016/j.gaceta.2024.102375