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Global Health, Science and Practice Jun 2024Countries that are high burden for TB must reverse the COVID-19 pandemic's devastating effects to accelerate progress toward ending TB. Vietnam's Double X (2X) strategy...
Countries that are high burden for TB must reverse the COVID-19 pandemic's devastating effects to accelerate progress toward ending TB. Vietnam's Double X (2X) strategy uses chest radiography (CXR) and GeneXpert (Xpert) rapid diagnostic testing to improve early detection of TB disease. Household contacts and vulnerable populations (e.g., individuals aged 60 years and older, smokers, diabetics, those with alcohol use disorders, and those previously treated for TB) with and without TB symptoms were screened in community campaigns using CXRs, followed by Xpert for those with a positive screen. In public non-TB district facilities, diabetics, respiratory outpatients, inpatients with lung disease, and other vulnerable populations underwent 2X evaluation. During COVID-19 restrictions in Vietnam, the 2X strategy improved access to TB services by decentralization to commune health stations, the lowest level of the health system, and enabling self-screening using a quick response mobile application. The number needed to screen (NNS) with CXRs to diagnose 1 person with TB disease was calculated for all 2X models and showed the highest yield among self-screeners (11 NNS with CXR), high yield for vulnerable populations in communities (60 NNS) and facilities (19 NNS), and moderately high yield for household contacts in community campaigns (154 NNS). Computer-aided diagnosis for CXRs was incorporated into community and facility implementation and improved physicians' CXR interpretations and Xpert referral decisions. Integration of TB infection and TB disease evaluation increased eligibility for TB preventive treatment among household contacts, a major challenge during implementation. The 2X strategy increased the rational use of Xpert, employing a health system-wide approach that reached vulnerable populations with and without TB symptoms in communities and facilities for early detection of TB disease. This strategy was effectively adapted to different levels of the health system during COVID-19 restrictions and contributed to post-pandemic TB recovery in Vietnam.
Topics: Humans; Vietnam; COVID-19; Tuberculosis, Pulmonary; Mass Screening; SARS-CoV-2; Middle Aged; Radiography, Thoracic; Tuberculosis; Female; Pandemics; Male; Vulnerable Populations
PubMed: 38936961
DOI: 10.9745/GHSP-D-24-00024 -
Journal of Medical Internet Research Jun 2024The US health care delivery system does not systematically engage or support family or friend care partners. Meanwhile, the uptake and familiarity of portals to personal...
The US health care delivery system does not systematically engage or support family or friend care partners. Meanwhile, the uptake and familiarity of portals to personal health information are increasing among patients. Technology innovations, such as shared access to the portal, use separate identity credentials to differentiate between patients and care partners. Although not well-known, or commonly used, shared access allows patients to identify who they do and do not want to be involved in their care. However, the processes for patients to grant shared access to portals are often limited or so onerous that interested patients and care partners often circumvent the process entirely. As a result, the vast majority of care partners resort to accessing portals using a patient's identity credentials-a "do-it-yourself" solution in conflict with a health systems' legal responsibility to protect patient privacy and autonomy. The personal narratives in this viewpoint (shared by permission) elaborate on quantitative studies and provide first-person snapshots of challenges faced by patients and families as they attempt to gain or grant shared access during crucial moments in their lives. As digital modalities increase patient roles in health care interactions, so does the importance of making shared access work for all stakeholders involved-patients, clinicians, and care partners. Electronic health record vendors must recognize that both patients and care partners are important users of their products, and health care organizations must acknowledge and support the critical contributions of care partners as distinct from patients.
Topics: Humans; Patient Portals; Electronic Health Records; Caregivers; Patient Participation
PubMed: 38935963
DOI: 10.2196/49394 -
JMIR MHealth and UHealth Jun 2024Rising rates of psychological distress (symptoms of depression, anxiety, and stress) among adults in the United States necessitate effective mental wellness...
BACKGROUND
Rising rates of psychological distress (symptoms of depression, anxiety, and stress) among adults in the United States necessitate effective mental wellness interventions. Despite the prevalence of smartphone app-based programs, research on their efficacy is limited, with only 14% showing clinically validated evidence. Our study evaluates Noom Mood, a commercially available smartphone-based app that uses cognitive behavioral therapy and mindfulness-based programming. In this study, we address gaps in the existing literature by examining postintervention outcomes and the broader impact on mental wellness.
OBJECTIVE
Noom Mood is a smartphone-based mental wellness program designed to be used by the general population. This prospective study evaluates the efficacy and postintervention outcomes of Noom Mood. We aim to address the rising psychological distress among adults in the United States.
METHODS
A 1-arm study design was used, with participants having access to the Noom Mood program for 16 weeks (N=273). Surveys were conducted at baseline, week 4, week 8, week 12, week 16, and week 32 (16 weeks' postprogram follow-up). This study assessed a range of mental health outcomes, including anxiety symptoms, depressive symptoms, perceived stress, well-being, quality of life, coping, emotion regulation, sleep, and workplace productivity (absenteeism or presenteeism).
RESULTS
The mean age of participants was 40.5 (SD 11.7) years. Statistically significant improvements in anxiety symptoms, depressive symptoms, and perceived stress were observed by week 4 and maintained through the 16-week intervention and the 32-week follow-up. The largest changes were observed in the first 4 weeks (29% lower, 25% lower, and 15% lower for anxiety symptoms, depressive symptoms, and perceived stress, respectively), and only small improvements were observed afterward. Reductions in clinically relevant anxiety (7-item generalized anxiety disorder scale) and depression (8-item Patient Health Questionnaire depression scale) criteria were also maintained from program initiation through the 16-week intervention and the 32-week follow-up. Work productivity also showed statistically significant results, with participants gaining 2.57 productive work days from baseline at 16 weeks, and remaining relatively stable (2.23 productive work days gained) at follow-up (32 weeks). Additionally, effects across all coping, sleep disturbance (23% lower at 32 weeks), and emotion dysregulation variables exhibited positive and significant trends at all time points (15% higher, 23% lower, and 25% higher respectively at 32 weeks).
CONCLUSIONS
This study contributes insights into the promising positive impact of Noom Mood on mental health and well-being outcomes, extending beyond the intervention phase. Though more rigorous studies are necessary to understand the mechanism of action at play, this exploratory study addresses critical gaps in the literature, highlighting the potential of smartphone-based mental wellness programs to lessen barriers to mental health support and improve diverse dimensions of well-being. Future research should explore the scalability, feasibility, and long-term adherence of such interventions across diverse populations.
Topics: Humans; Prospective Studies; Male; Female; Adult; Middle Aged; Surveys and Questionnaires; Mobile Applications; Health Promotion; Cognitive Behavioral Therapy; Program Evaluation; United States; Mindfulness; Quality of Life
PubMed: 38935946
DOI: 10.2196/54634 -
JMIR Research Protocols Jun 2024Sound therapy methods have seen a surge in popularity, with a predominant focus on music among all types of sound stimulation. There is substantial evidence documenting... (Review)
Review
BACKGROUND
Sound therapy methods have seen a surge in popularity, with a predominant focus on music among all types of sound stimulation. There is substantial evidence documenting the integrative impact of music therapy on psycho-emotional and physiological outcomes, rendering it beneficial for addressing stress-related conditions such as pain syndromes, depression, and anxiety. Despite these advancements, the therapeutic aspects of sound, as well as the mechanisms underlying its efficacy, remain incompletely understood. Existing research on music as a holistic cultural phenomenon often overlooks crucial aspects of sound therapy mechanisms, particularly those related to speech acoustics or the so-called "music of speech."
OBJECTIVE
This study aims to provide an overview of empirical research on sound interventions to elucidate the mechanism underlying their positive effects. Specifically, we will focus on identifying therapeutic factors and mechanisms of change associated with sound interventions. Our analysis will compare the most prevalent types of sound interventions reported in clinical studies and experiments. Moreover, we will explore the therapeutic effects of sound beyond music, encompassing natural human speech and intermediate forms such as traditional poetry performances.
METHODS
This review adheres to the methodological guidance of the Joanna Briggs Institute and follows the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) checklist for reporting review studies, which is adapted from the Arksey and O'Malley framework. Our search strategy encompasses PubMed, Web of Science, Scopus, and PsycINFO or EBSCOhost, covering literature from 1990 to the present. Among the different study types, randomized controlled trials, clinical trials, laboratory experiments, and field experiments were included.
RESULTS
Data collection began in October 2022. We found a total of 2027 items. Our initial search uncovered an asymmetry in the distribution of studies, with a larger number focused on music therapy compared with those exploring prosody in spoken interventions such as guided meditation or hypnosis. We extracted and selected papers using Rayyan software (Rayyan) and identified 41 eligible papers after title and abstract screening. The completion of the scoping review is anticipated by October 2024, with key steps comprising the analysis of findings by May 2024, drafting and revising the study by July 2024, and submitting the paper for publication in October 2024.
CONCLUSIONS
In the next step, we will conduct a quality evaluation of the papers and then chart and group the therapeutic factors extracted from them. This process aims to unveil conceptual gaps in existing studies. Gray literature sources, such as Google Scholar, ClinicalTrials.gov, nonindexed conferences, and reference list searches of retrieved studies, will be added to our search strategy to increase the number of relevant papers that we cover.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)
DERR1-10.2196/54030.
Topics: Humans; Stress, Psychological; Music Therapy; Adult
PubMed: 38935945
DOI: 10.2196/54030 -
JCO Clinical Cancer Informatics Jun 2024The expanding presence of the electronic health record (EHR) underscores the necessity for improved interoperability. To test the interoperability within the field of...
Minimal Common Oncology Data Elements Genomics Pilot Project: Enhancing Oncology Research Through Electronic Health Record Interoperability at Vanderbilt University Medical Center.
PURPOSE
The expanding presence of the electronic health record (EHR) underscores the necessity for improved interoperability. To test the interoperability within the field of oncology research, our team at Vanderbilt University Medical Center (VUMC) enabled our Epic-based EHR to be compatible with the Minimal Common Oncology Data Elements (mCODE), which is a Fast Healthcare Interoperability Resources (FHIR)-based consensus data standard created to facilitate the transmission of EHRs for patients with cancer.
METHODS
Our approach used an extract, transform, load tool for converting EHR data from the VUMC Epic Clarity database into mCODE-compatible profiles. We established a sandbox environment on Microsoft Azure for data migration, deployed a FHIR server to handle application programming interface (API) requests, and mapped VUMC data to align with mCODE structures. In addition, we constructed a web application to demonstrate the practical use of mCODE profiles in health care.
RESULTS
We developed an end-to-end pipeline that converted EHR data into mCODE-compliant profiles, as well as a web application that visualizes genomic data and provides cancer risk assessments. Despite the complexities of aligning traditional EHR databases with mCODE standards and the limitations of FHIR APIs in supporting advanced statistical methodologies, this project successfully demonstrates the practical integration of mCODE standards into existing health care infrastructures.
CONCLUSION
This study provides a proof of concept for the interoperability of mCODE within a major health care institution's EHR system, highlighting both the potential and the current limitations of FHIR APIs in supporting complex data analysis for oncology research.
Topics: Humans; Electronic Health Records; Pilot Projects; Medical Oncology; Genomics; Academic Medical Centers; Neoplasms; Common Data Elements; Software; Health Information Interoperability
PubMed: 38935887
DOI: 10.1200/CCI.23.00249 -
PloS One 2024The Youth Risk Behavior Survey (YRBS) among high school students includes standard questions about sexual identity and sex of sexual contacts, but these questions are...
PURPOSE
The Youth Risk Behavior Survey (YRBS) among high school students includes standard questions about sexual identity and sex of sexual contacts, but these questions are not consistently included in every state that conducts the survey. This study aimed to develop and apply a method to predict state-level proportions of high school students identifying as lesbian, gay, or bisexual (LGB) or reporting any same-sex sexual contacts in those states that did not include these questions in their 2017 YRBS.
METHODS
We used state-level high school YRBS data from 2013, 2015, and 2017. We defined two primary outcomes relating to self-reported LGB identity and reported same-sex sexual contacts. We developed machine learning models to predict the two outcomes based on other YRBS variables, and comparing different modeling approaches. We used a leave-one-out cross-validation approach and report results from best-performing models.
RESULTS
Modern ensemble models outperformed traditional linear models at predicting state-level proportions for the two outcomes, and we identified prediction methods that performed well across different years and prediction tasks. Predicted proportions of respondents reporting LGB identity in states that did not include direct measurement ranged between 9.4% and 12.9%. Predicted proportions of respondents reporting any same-sex contacts, where not directly observed, ranged between 7.0% and 10.4%.
CONCLUSION
Comparable population estimates of sexual minority adolescents can raise awareness among state policy makers and the public about what proportion of youth may be exposed to disparate health risks and outcomes associated with sexual minority status. This information can help decision makers in public health and education agencies design, implement and evaluate community and school interventions to improve the health of LGB youth.
Topics: Humans; Adolescent; Sexual and Gender Minorities; Male; Female; United States; Sexual Behavior; Surveys and Questionnaires; Machine Learning; Risk-Taking; Students
PubMed: 38935807
DOI: 10.1371/journal.pone.0304175 -
PloS One 2024Lameness in dairy cows is an expression of pain most likely originating from a claw disorder, causing impaired animal wellbeing and substantial economic losses for...
Lameness in dairy cows is an expression of pain most likely originating from a claw disorder, causing impaired animal wellbeing and substantial economic losses for farmers. The aim of this study was to investigate the effects of access to pasture, time spent on pasture, and season on farm level lameness prevalence. The survey was part of a cross-sectional observational study, in which farms in three regions of Germany (North, East and South) were visited by study veterinarians. On each farm (total: 659, N: 240, E: 247, S: 172), management data were recorded, and cows were scored for locomotion, according to Sprecher. Median farm-level lameness prevalence (Score 3/5 or higher) was 29.4% (IQR: 18.7% - 42.0%), and 8.2% (IQR: 3.7% - 14.0%) for severe lameness (Score 4/5 or higher). Farm-level lameness prevalence continuously decreased with increasing time spent on pasture (up to approximately 10 hours per cow per day). On farms that did not offer their cows access to pasture lameness prevalence did not show a seasonal variation. On farms where cows had pasture access for up to three hours per day lameness prevalence peaked in autumn. In contrast, on farms offering their cows access to pasture beyond three hours per day the peak of lameness was observed in spring. Our results revealed that even short periods of pasture access of at least two hours per cow and day (on average per year) are beneficial for the locomotion of dairy cows.
Topics: Animals; Lameness, Animal; Cattle; Germany; Prevalence; Cattle Diseases; Cross-Sectional Studies; Dairying; Female; Seasons
PubMed: 38935805
DOI: 10.1371/journal.pone.0305536 -
PloS One 2024This study examines the 12-month prevalence rates of intimate partner violence (IPV) victimization, including psychological, physical, and sexual forms, in women and...
OBJECTIVES
This study examines the 12-month prevalence rates of intimate partner violence (IPV) victimization, including psychological, physical, and sexual forms, in women and men. It also aims to identify changes in IPV victimization during the COVID-19 pandemic and to explore factors associated with the occurrence of any IPV victimization during this period.
METHODS
Data from the DREAMCORONA study in Germany collected from May 2020 to February 2021 included 737 participants, i.e., (expectant) mothers (64%) and fathers (36%). The Revised Conflict Tactics Scale (CTS2S) short form was used to assess the 12-month IPV victimization. Prevalence of IPV victimization as well as changes in IPV victimization during the pandemic were analyzed descriptively, with results stratified by sex. Multiple logistic regression was employed to identify risk factors for IPV.
RESULTS
Psychological IPV was found to be the most prevalent form of violence, with the occurrence of any psychological IPV affecting 48.5% of women and 39.4% of men, while 2.6% of women and 3.3% of men reported the occurrence of any physical IPV victimization, and 2.8% of women and 1.5% of men reported the occurrence of any sexual IPV victimization. Of those who experienced the occurrence of any IPV in the last 12 months, 89.7% of women and 89.8% of men were victimized by one single act of violence. The majority of affected participants reported no change in psychological and physical IPV victimization during the pandemic. Nevertheless, for certain IPV behaviors on the psychological and physical IPV victimization subscales, both affected women and men also reported higher frequencies during the COVID-19 pandemic. Multiple logistic regression revealed that higher levels of relationship satisfaction were negatively associated with the occurrence of any IPV victimization for women and men, whereas greater levels of own anger-hostility symptoms were positively associated with the occurrence of any IPV victimization.
CONCLUSIONS
Psychological IPV was present in almost every second (expectant) couple. The majority of affected women and men reported no change in their psychological and physical IPV victimization, suggesting that they continued to experience IPV during the pandemic. This underlines the importance of promoting healthier relationship dynamics, coping strategies, and emotional well-being to reduce the risk of IPV, even in times of crisis. Our study sheds light on the early stages of the pandemic and highlights the ongoing need for research into the temporal dynamics of IPV.
Topics: Humans; COVID-19; Female; Male; Intimate Partner Violence; Adult; Prevalence; Risk Factors; Crime Victims; Germany; Middle Aged; Young Adult; Pandemics; SARS-CoV-2; Adolescent
PubMed: 38935801
DOI: 10.1371/journal.pone.0306103 -
PloS One 2024In the context of the United Nations Sustainable Development Goals (UN-SDGs), this study accentuates the role of the tourism and hospitality sector in promoting...
In the context of the United Nations Sustainable Development Goals (UN-SDGs), this study accentuates the role of the tourism and hospitality sector in promoting sustainability. The primary purpose is to unravel the relationship between corporate social responsibility (CSR) and energy-specific sustainable behavior of employees (ESBE), with particular emphasis on the mediating roles of green intrinsic motivation and personal environmental norms. Utilizing a three-wave data collection approach, we secured 325 valid responses from sector employees at various levels (manager-non managers) and applied Structural Equation Modeling through the SMART-PLS tool to assess the hypothesized relationships. The findings highlight a pronounced interconnection between CSR, ESBE, and the designated mediating variables. These results not only augment the academic literature by illustrating the psychological underpinnings bridging CSR to ESBE, but also equip the tourism and hospitality industry with actionable insights. Through informed CSR initiatives aligned with employee values, the sector can galvanize sustainable behaviors and create business models that resonate with the aspirations of the UN-SDGs, pointing the way to a more sustainable industry.
Topics: Motivation; Humans; Sustainable Development; Social Responsibility; Conservation of Natural Resources; Male; Female; Adult; Tourism
PubMed: 38935798
DOI: 10.1371/journal.pone.0295850 -
PloS One 2024The elderly is commonly susceptible to depression, the symptoms for which may overlap with natural aging or other illnesses, and therefore miss being captured by routine...
BACKGROUND
The elderly is commonly susceptible to depression, the symptoms for which may overlap with natural aging or other illnesses, and therefore miss being captured by routine screening questionnaires. Passive sensing data have been promoted as a tool for depressive symptoms detection though there is still limited evidence on its usage in the elderly. Therefore, this study aims to review current knowledge on the use of passive sensing data via smartphones and smartwatches in depressive symptom screening for the elderly.
METHOD
The search of literature was performed in PubMed, IEEE Xplore digital library, and PsycINFO. Literature investigating the use of passive sensing data to screen, monitor, and/or predict depressive symptoms in the elderly (aged 60 and above) via smartphones and/or wrist-worn wearables was included for initial screening. Studies in English from international journals published between January 2012 to September 2022 were included. The reviewed studies were further analyzed by a narrative analysis.
RESULTS
The majority of 21 included studies were conducted in Western countries with a few in Asia and Australia. Most studies adopted a cohort study design (n = 12), followed by cross-sectional design (n = 7) and a case-control design (n = 2). The most popular passive sensing data was related to sleep and physical activity using an actigraphy. Sleep characteristics, such as prolonged wakefulness after sleep onset, along with lower levels of physical activity, exhibited a significant association with depression. However, cohort studies expressed concerns regarding data quality stemming from incomplete follow-up and potential confounding effects.
CONCLUSION
Passive sensing data, such as sleep, and physical activity parameters should be promoted for depressive symptoms detection. However, the validity, reliability, feasibility, and privacy concerns still need further exploration.
Topics: Humans; Smartphone; Depression; Aged; Mass Screening; Wearable Electronic Devices; Sleep; Middle Aged; Exercise; Female
PubMed: 38935797
DOI: 10.1371/journal.pone.0304845