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Journal of Medical Internet Research Jun 2024The Nordic countries are, together with the United States, forerunners in online record access (ORA), which has now become widespread. The importance of accessible and...
The Nordic countries are, together with the United States, forerunners in online record access (ORA), which has now become widespread. The importance of accessible and structured health data has also been highlighted by policy makers internationally. To ensure the full realization of ORA's potential in the short and long term, there is a pressing need to study ORA from a cross-disciplinary, clinical, humanistic, and social sciences perspective that looks beyond strictly technical aspects. In this viewpoint paper, we explore the policy changes in the European Health Data Space (EHDS) proposal to advance ORA across the European Union, informed by our research in a Nordic-led project that carries out the first of its kind, large-scale international investigation of patients' ORA-NORDeHEALTH (Nordic eHealth for Patients: Benchmarking and Developing for the Future). We argue that the EHDS proposal will pave the way for patients to access and control third-party access to their electronic health records. In our analysis of the proposal, we have identified five key principles for ORA: (1) the right to access, (2) proxy access, (3) patient input of their own data, (4) error and omission rectification, and (5) access control. ORA implementation today is fragmented throughout Europe, and the EHDS proposal aims to ensure all European citizens have equal online access to their health data. However, we argue that in order to implement the EHDS, we need more research evidence on the key ORA principles we have identified in our analysis. Results from the NORDeHEALTH project provide some of that evidence, but we have also identified important knowledge gaps that still need further exploration.
Topics: Humans; Scandinavian and Nordic Countries; Europe; Electronic Health Records; European Union
PubMed: 38935430
DOI: 10.2196/49084 -
JMIR Public Health and Surveillance Jun 2024Information on the public's preferences for current public health and social measures (PHSMs) and people's mental health under PHSMs is insufficient.
BACKGROUND
Information on the public's preferences for current public health and social measures (PHSMs) and people's mental health under PHSMs is insufficient.
OBJECTIVE
This study aimed to quantify the public's preferences for varied PHSMs and measure the level of pandemic fatigue in the COVID-19 normalization stage in China.
METHODS
A nationwide cross-sectional study with a discrete choice experiment and psychometric scales was conducted to assess public preferences for and attitudes toward PHSMs, using the quota sampling method. The COVID-19 Pandemic Fatigue Scale (CPFS) was used to screen fatigue levels among respondents. The multinomial logit model, latent class model, and Mann-Whitney test were used for statistical analysis. We also conducted subgroup analysis based on sex, age, monthly income, mental health status, and pandemic fatigue status.
RESULTS
A total of 689 respondents across China completed the survey. The discrete choice experiment revealed that respondents attached the greatest importance to the risk of COVID-19 infection within 3 months (45.53%), followed by loss of income within 3 months (30.69%). Vulnerable populations (low-income populations and elderly people) were more sensitive to the risk of infection, while younger respondents were more sensitive to income loss and preferred nonsuspension of social places and transportation. Migrants and those with pandemic fatigue had less acceptance of the mandatory booster vaccination and suspension of transportation. Additionally, a higher pandemic fatigue level was observed in female respondents, younger respondents, migrants, and relatively lower-income respondents (CPFS correlation with age: r=-0.274, P<.001; correlation with monthly income: r=-0.25, P<.001). Mandatory booster COVID-19 vaccination was also not preferred by respondents with a higher level of pandemic fatigue, while universal COVID-19 booster vaccination was preferred by respondents with a lower level of pandemic fatigue.
CONCLUSIONS
Pandemic fatigue is widely prevalent in respondents across China, and respondents desired the resumption of normal social life while being confronted with the fear of COVID-19 infection in the normalization stage of COVID-19 in China. During future pandemics, the mental burden and adherence of residents should be considered for the proper implementation of PHSMs.
Topics: Humans; COVID-19; China; Male; Female; Adult; Cross-Sectional Studies; Middle Aged; Public Health; Young Adult; Fatigue; Pandemics; Adolescent; Aged; Choice Behavior; Surveys and Questionnaires
PubMed: 38935420
DOI: 10.2196/45840 -
JMIR Research Protocols Jun 2024Individuals at high risk for type 2 diabetes are also at an increased risk for developing cardiovascular disease (CVD). Although there are separate trials examining the...
Effects of Lifestyle Interventions on Cardiovascular Disease Risk and Risk Factors Among Individuals at High Risk for Type 2 Diabetes: Protocol for a Systematic Review and Meta-Analysis of Randomized Controlled Trials.
BACKGROUND
Individuals at high risk for type 2 diabetes are also at an increased risk for developing cardiovascular disease (CVD). Although there are separate trials examining the effects of lifestyle interventions on absolute CVD risk among people at high risk for type 2 diabetes, a comprehensive evidence synthesis of these trials is lacking.
OBJECTIVE
We will systematically synthesize the evidence on the effects of lifestyle interventions in reducing absolute CVD risk and CVD risk factors among people at high risk for type 2 diabetes.
METHODS
We adhered to the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) statement in reporting the details of this protocol. Randomized controlled trials of diabetes prevention that examined the effects of lifestyle interventions for at least 6 months on absolute CVD risk and CVD risk factors among individuals at high risk for type 2 diabetes will be eligible. We will systematically search the MEDLINE, Embase, PsycINFO, CENTRAL, and Scopus databases and ClinicalTrials.gov using a mix of Medical Subject Headings and text words. Two authors will independently screen the abstract and title of the articles retrieved from the search, followed by full-text reviews using the inclusion and exclusion criteria and data extraction from the eligible studies. Article screening and data extraction will be performed in the Covidence software. The primary outcome will be the changes in absolute 10-year CVD risk, as estimated by risk prediction models. The secondary outcomes are the changes in CVD risk factors, including behavioral, clinical, biochemical, and psychosocial risk factors, and incidence of type 2 diabetes.
RESULTS
An initial database search was conducted in July 2023. After screening 1935 articles identified through the database search, 42 articles were considered eligible for inclusion. It is anticipated that the study findings will be submitted for publication in a peer-reviewed journal by the end of 2024.
CONCLUSIONS
This study will provide up-to-date, systematically synthesized evidence on the effects of lifestyle interventions on absolute CVD risk and CVD risk factors among individuals at high risk for type 2 diabetes.
TRIAL REGISTRATION
PROSPERO CRD42023429869; https://tinyurl.com/59ajy7rw.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)
DERR1-10.2196/53517.
Topics: Humans; Diabetes Mellitus, Type 2; Cardiovascular Diseases; Systematic Reviews as Topic; Randomized Controlled Trials as Topic; Meta-Analysis as Topic; Risk Factors; Life Style; Risk Reduction Behavior; Female; Male; Heart Disease Risk Factors
PubMed: 38935416
DOI: 10.2196/53517 -
JAMA Network Open Jun 2024
Topics: Humans; Female; United States; Adult; Male; Adolescent; Minors; Prevalence; Young Adult; Child; Transgender Persons; Middle Aged; Sex Reassignment Surgery; Cross-Sectional Studies; Gender Dysphoria
PubMed: 38935380
DOI: 10.1001/jamanetworkopen.2024.18814 -
JAMA Network Open Jun 2024The US has the highest maternal mortality rate among developed countries. The Centers for Disease Control and Prevention deems nearly all of these deaths preventable,... (Observational Study)
Observational Study
IMPORTANCE
The US has the highest maternal mortality rate among developed countries. The Centers for Disease Control and Prevention deems nearly all of these deaths preventable, especially those attributable to mental health conditions. Coordination between US health care and social service systems could help further characterize circumstances and risks associated with perinatal suicide mortality.
OBJECTIVE
To examine contextual and individual precipitating circumstances and risks associated with perinatal suicide.
DESIGN, SETTING, AND PARTICIPANTS
This cross-sectional observational study used a convergent mixed methods design to explore factors contributing to maternal suicides and deaths of undetermined intent (hereinafter, undetermined deaths) identified in National Violent Death Reporting System (NVDRS) data for January 1, 2003, to December 31, 2021. Analyses included decedents who were aged 10 to 50 years and pregnant or post partum at death (collectively, the perinatal group) and demographically matched female decedents who were not pregnant or recently pregnant (nonperinatal group) at death. Analyses were performed between December 2022 and December 2023.
EXPOSURES
Pregnancy status at death (perinatal or nonperinatal).
MAIN OUTCOMES AND MEASURES
The main outcomes included contributing circumstances associated with suicides and undetermined deaths cited in coroner, medical examiner, or law enforcement case narratives. The study examined quantitative differences between groups using a matched analysis and characterized key themes of salient suicide circumstances using qualitative content analysis.
RESULTS
This study included 1150 perinatal decedents identified in the NVDRS: 456 (39.6%) were pregnant at death, 203 (17.7%) were pregnant within 42 days of death, and 491 (42.7%) were pregnant within 43 to 365 days before death, yielding 694 postpartum decedents. The nonperinatal comparison group included 17 655 female decedents aged 10 to 50 years. The mean (SD) age was 29.1 (7.4) years for perinatal decedents and 35.8 (10.8) years for nonperinatal decedents. Compared with matched nonperinatal decedents, perinatal decedents had higher odds of the following identified contributing circumstances: intimate partner problems (IPPs) (odds ratio [OR], 1.45 [95% CI, 1.23-1.72]), recent argument (OR, 1.33 [95% CI, 1.09-1.61]), depressed mood (OR, 1.39 [95% CI, 1.19-1.63]), substance abuse or other abuse (OR, 1.21 [95% CI, 1.03-1.42]), physical health problems (OR, 1.37 [95% CI, 1.09-1.72]), and death of a family member or friend (OR, 1.47 [95% CI, 1.06-2.02]). The findings of the qualitative analysis emphasized the importance of mental health and identified 128 decedents (12.4%) with postpartum depression.
CONCLUSIONS AND RELEVANCE
This study provides insights into complex factors surrounding maternal suicide, and it highlights opportunities for further research to understand long-term consequences of perinatal mental health. These findings also underscore the need for targeted evidence-based interventions and effective policies targeting mental health, substance use, and IPPs to prevent maternal suicide and enhance maternal health outcomes.
Topics: Humans; Female; Pregnancy; Cross-Sectional Studies; Adult; Suicide; United States; Adolescent; Middle Aged; Young Adult; Child; Risk Factors; Maternal Mortality; Perinatal Mortality
PubMed: 38935375
DOI: 10.1001/jamanetworkopen.2024.18887 -
International Journal of Implant... Jun 2024This propensity score matching, multicenter, cross-sectional study was performed to examine the effects of various prosthetic methods for dental clinic outpatients with...
Effects of various prosthetic methods for patients with Kennedy Class I partial edentulism on oral hypofunction, subjective symptoms, and oral health-related quality of life.
PURPOSE
This propensity score matching, multicenter, cross-sectional study was performed to examine the effects of various prosthetic methods for dental clinic outpatients with Kennedy Class I partial edentulism (KCIPE) on oral hypofunction, subjective frailty symptoms, and oral health-related quality of life (QOL).
METHODS
Patients (n = 348) were classified into the following three groups for analysis: NT, patients with natural dentition providing intermaxillary contact in four occlusal supporting zones; RPD, patients with KCIPE who received removable partial dentures; and ISFP, patients with KCIPE who received implant-supported fixed prostheses. Participants' basic characteristics were recorded, and oral function tests were conducted. Subjective symptoms of physical and oral frailty were investigated via questionnaire. Oral health-related QOL was assessed using the Japanese short version of the Oral Health Impact Profile (OHIP-JP16). Propensity score matching was performed to adjust for patient background factors that could influence oral hypofunction in each group.
RESULTS
Compared with the ISFP group, the RPD group had significantly higher rates of poor oral hygiene, reduced occlusal force, decreased masticatory function, and declines in swallowing function and oral hypofunction; the odds ratio for oral hypofunction was 4.67. Compared with the ISFP group, the RPD group had significantly greater subjective symptoms of physical frailty and oral frailty, as well as higher OHIP scores.
CONCLUSIONS
Prosthetic treatment of KCIPE affected oral hypofunction, subjective frailty symptoms, and oral health-related QOL in dental clinic outpatients.
Topics: Humans; Quality of Life; Cross-Sectional Studies; Male; Female; Middle Aged; Oral Health; Jaw, Edentulous, Partially; Denture, Partial, Removable; Aged; Surveys and Questionnaires; Propensity Score; Dental Prosthesis, Implant-Supported; Denture, Partial, Fixed; Adult
PubMed: 38935335
DOI: 10.1186/s40729-024-00555-w -
Health & Justice Jun 2024People incarcerated in jails are highly impacted by the opioid epidemic, and overdose education and naloxone distribution (OEND) is an effective strategy to reduce...
BACKGROUND
People incarcerated in jails are highly impacted by the opioid epidemic, and overdose education and naloxone distribution (OEND) is an effective strategy to reduce opioid overdose deaths. This study examines barriers and facilitators of fast-track OEND implementation within the jails in the Wave 1 Kentucky counties of the HEALing Communities Study during the COVID-19 pandemic.
METHODS
Meeting minutes with jail stakeholders were qualitatively coded using the Practical, Robust Implementation and Sustainability Model (PRISM) as the coding framework. The analysis highlighted the top barriers and facilitators to fast-track OEND implementation within the PRISM framework.
RESULTS
Space and staffing shortages related to the COVID-19 pandemic, disruptions in interorganizational programming from pandemic-related service suspensions, and a lack of technological solutions (e.g., reliable Internet access) for socially distanced delivery were the top barriers to fast-track OEND implementation. In addition, there were limitations on non-jail staff access to jails during COVID-19. Top facilitators included jail leadership support, the option to prioritize high-risk groups, and the incorporation of OEND processes into existing communications and management software. While the COVID-19 pandemic strained jail infrastructure, jail and partner agency collaboration led to creative implementation strategies for the successful integration of OEND into jail operations. Urban jails were more likely than rural jails to be early adopters of OEND during the public health emergency.
CONCLUSIONS
Understanding the barriers to and facilitators of OEND within jails will improve implementation efforts seeking to curb opioid overdose deaths. Jail leadership support and interorganizational efforts were key facilitators to implementation; therefore, it is recommended to increase buy-in with multiple agencies to promote success. Challenges brought on by COVID-19 have resulted in a need for innovative solutions for implementation.
CLINICAL TRIAL INFORMATION
ClinicalTrials.gov, NCT04111939, Submitted 30 September 2019, https://clinicaltrials.gov/study/NCT04111939?titles=HEALing%20Communities%20Study&rank=1 .
PubMed: 38935213
DOI: 10.1186/s40352-024-00283-8 -
Indian Journal of Public Health Oct 2023Smartphone use is increasing among transgender women (TGW), including those who engage in sex work. Current government-supported HIV prevention interventions focus on...
Use of Smartphones for Social and Sexual Networking among Transgender Women in South India: Implications for Developing Smartphone-based Online HIV Prevention Interventions.
BACKGROUND
Smartphone use is increasing among transgender women (TGW), including those who engage in sex work. Current government-supported HIV prevention interventions focus on physical venue-based outreach among TGW, missing the opportunity to reach them through smartphone-based interventions.
OBJECTIVE
We examined the use of smartphones among TGW, especially in relation to social and sexual networking, and explored their perspectives on their willingness to use smartphone-based HIV prevention interventions.
MATERIALS AND METHODS
Through an exploratory descriptive-interpretive qualitative research design, we conducted 6 focus groups with a purposive sample of 30 TGW (70% in sex work) and 4 key informant in-depth interviews in Chennai and Hyderabad, India. Data were explored using framework analysis.
RESULTS
Through smartphones, TGW used social media (e.g., WhatsApp and Facebook) and dating applications for socialization, meeting sexual partners, and entertainment. Low-literacy TGW used voice or video messaging. TGW expressed interest in receiving short health-related videos and text messages on HIV, mental health, and gender transition.
CONCLUSION
At-risk TGW could potentially be reached through smartphone-based online health promotion interventions, but those interventions need to be holistic - moving beyond HIV.
Topics: Humans; India; HIV Infections; Transgender Persons; Female; Smartphone; Adult; Focus Groups; Social Networking; Young Adult; Qualitative Research; Male; Social Media; Health Promotion; Sexual Behavior; Adolescent
PubMed: 38934837
DOI: 10.4103/ijph.ijph_1717_22 -
Indian Journal of Public Health Oct 2023The augmentation of precautionary behaviors through the application of health belief model (HBM) constructs could help in curbing the current pandemic.
BACKGROUND
The augmentation of precautionary behaviors through the application of health belief model (HBM) constructs could help in curbing the current pandemic.
OBJECTIVES
The objectives are to assess adherence to CAB and to evaluate its predictors using the constructs of HBM among COVID-19 vaccinees in Himachal Pradesh.
MATERIALS AND METHODS
A cross-sectional study using a telephone survey, with two-step stratified random sampling, was employed to acquire a sample of 441 respondents from Himachal Pradesh. Formal interviews were conducted using pretested, structured, self-administered questionnaires.
RESULTS
The mean age of respondents was 32.16 years (standard deviation = 12.77; range = 18-78 years). Maximum adherence was seen for wearing masks at 83% (95% confidence interval [CI]: 79.3%-86.3%), followed by maintenance of respiratory hygiene at 72.3% (95% CI 68%-78.4%). Nearly 42.2% (95% CI 37.6%-47.8%) conformed to social distancing norms. We observed minimum adherence for handwashing practices of 12.9% (95% CI 10%-16.3.0%). On bivariate analyses, except for perceived severity, all HBM constructs were significantly associated with CAB. However, after adjusting for gender, age, education, area of residence, and reduced income in multivariate analysis, perceived susceptibility, perceived barriers, and exposure to cues to action remained significant predictors of CAB.
CONCLUSIONS
The study highlights the empirical evidence of the application of HBM constructs to enhance behavioral adherence to COVID-19 precautionary measures.
Topics: Humans; COVID-19; India; Adult; Cross-Sectional Studies; Male; Female; Middle Aged; Health Belief Model; Adolescent; Young Adult; Aged; SARS-CoV-2; Health Behavior; Health Knowledge, Attitudes, Practice; Socioeconomic Factors; Hand Disinfection
PubMed: 38934832
DOI: 10.4103/ijph.ijph_1525_22 -
Indian Journal of Public Health Oct 2023Because of COVID's impact on social behavior, students have become more reliant on computer-facilitated communication to continue their studies and interact with...
INTRODUCTION
Because of COVID's impact on social behavior, students have become more reliant on computer-facilitated communication to continue their studies and interact with friends. While it is known that the association between screen exposure and psychological well-being is both harmful and stronger among adolescents than younger children, what is less studied are the causal factors that may mediate the relationship.
OBJECTIVES
The objectives of this study were to analyze the relationship between screen exposure and two psychological outcomes, sleep quality and loneliness, using digital eye strain as a mediating factor. Eye strain is expected to have a direct and harmful influence on psychological well-being.
MATERIALS AND METHODS
A structured and validated questionnaire was transcribed and administered online. A nonrepresentative sample of 497 female college students in a North Indian city participated in the study. Digital eye strain, quality of sleep, and feeling of loneliness scores were assessed using latent class analysis.
RESULTS
The selected latent model suggested that Class 2 had a high percentage of students with network issues, the problem with space and noise, and various financial hardships, which had almost doubled the rate of loneliness (53.28%) and sleep-wake difficulties (75.41%) among the students affected with computer vision syndrome (89.75%).
CONCLUSION
There is an urgent need to examine the implications of digital exposure across gender and age to prevent future complications. Further, awareness for improving holistic well-being in the digital era should be promoted through various platforms.
Topics: Humans; Female; India; Loneliness; Students; Young Adult; COVID-19; Adolescent; Prevalence; Universities; Sleep Quality; Surveys and Questionnaires; Adult; Asthenopia
PubMed: 38934830
DOI: 10.4103/ijph.ijph_1761_22