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PloS One 2024[This corrects the article DOI: 10.1371/journal.pone.0254201.].
[This corrects the article DOI: 10.1371/journal.pone.0254201.].
PubMed: 38935593
DOI: 10.1371/journal.pone.0306474 -
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 2024Adjuvant endocrine therapy (AET) use among women with early-stage, hormone receptor-positive breast cancer reduces the risk of cancer recurrence, but its adverse... (Randomized Controlled Trial)
Randomized Controlled Trial
IMPORTANCE
Adjuvant endocrine therapy (AET) use among women with early-stage, hormone receptor-positive breast cancer reduces the risk of cancer recurrence, but its adverse symptoms contribute to lower adherence.
OBJECTIVE
To test whether remote monitoring of symptoms and treatment adherence with or without tailored text messages improves outcomes among women with breast cancer who are prescribed AET.
DESIGN, SETTING, AND PARTICIPANTS
This nonblinded, randomized clinical trial (RCT) following intention-to-treat principles included English-speaking women with early-stage breast cancer prescribed AET at a large cancer center with 14 clinics across 3 states from November 15, 2018, to June 11, 2021. All participants had a mobile device with a data plan and an email address and were asked to use an electronic pillbox to monitor AET adherence and to complete surveys at enrollment and 1 year.
INTERVENTIONS
Participants were randomized into 3 groups: (1) an app group, in which participants received instructions for and access to the study adherence and symptom monitoring app for 6 months; (2) an app plus feedback group, in which participants received additional weekly text messages about managing symptoms, adherence, and communication; or (3) an enhanced usual care (EUC) group. App-reported missed doses, increases in symptoms, and occurrence of severe symptoms triggered follow-ups from the oncology team.
MAIN OUTCOMES AND MEASURES
The primary outcome was 1-year, electronic pillbox-captured AET adherence. Secondary outcomes included symptom management abstracted from the medical record, as well as patient-reported health care utilization, symptom burden, quality of life, physician communication, and self-efficacy for managing symptoms.
RESULTS
Among 304 female participants randomized (app group, 98; app plus feedback group, 102; EUC group, 104), the mean (SD) age was 58.6 (10.8) years (median, 60 years; range, 31-83 years), and 60 (19.7%) had an educational level of high school diploma or less. The study completion rate was 87.5% (266 participants). There were no statistically significant differences by treatment group in AET adherence (primary outcome): 76.6% for EUC, 73.4% for the app group (difference vs EUC, -3.3%; 95% CI, -11.4% to 4.9%; P = .43), and 70.9% for the app plus feedback group (difference vs EUC, -5.7%; 95% CI, -13.8% to 2.4%; P = .17). At the 1-year follow-up, app plus feedback participants had fewer total health care encounters (adjusted difference, -1.23; 95% CI, -2.03 to -0.43; P = .003), including high-cost encounters (adjusted difference, -0.40; 95% CI, -0.67 to -0.14; P = .003), and office visits (adjusted difference, -0.82; 95% CI, -1.54 to -0.09; P = .03) over the previous 6 months compared with EUC participants.
CONCLUSIONS AND RELEVANCE
This RCT found that a remote monitoring app with alerts to the patient's care team and tailored text messages to patients did not improve AET adherence among women with early-stage breast cancer; however, it reduced overall and high-cost health care encounters and office visits without affecting quality of life.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT03592771.
Topics: Humans; Female; Breast Neoplasms; Middle Aged; Medication Adherence; Antineoplastic Agents, Hormonal; Mobile Applications; Aged; Text Messaging; Adult; Chemotherapy, Adjuvant
PubMed: 38935379
DOI: 10.1001/jamanetworkopen.2024.17873 -
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 2023Effective antimicrobials play an important element in modern medicine's success in treating infections, without which the patients would be put at risk. Along with the...
Effective antimicrobials play an important element in modern medicine's success in treating infections, without which the patients would be put at risk. Along with the naturally occurring process of antibiotic resistance, the misuse/overuse of these antibiotics also leads to them losing their effectiveness. It limits the treatment options as the microbe that had previously been sensitive becomes resistant. This bibliometric study was performed by searching the Scopus database according to a specific search strategy. A total of 4200 articles were retrieved from the search, and after applying inclusion and exclusion criteria, 1355 articles were included in the study. All of the bibliometric variables examined in this study revealed significant growth in this research field, especially during COVID-19, in terms of increasing scientific output and research collaboration. The study findings indicate an adequate quality and amount of antimicrobial resistance (AMR) research on microbiology and pharmacodynamics in India, whereas more research needs to be conducted on measures to tackle AMR, its public health, and policy aspects.
Topics: Bibliometrics; India; Humans; Drug Resistance, Microbial; Anti-Bacterial Agents; Biomedical Research; SARS-CoV-2; COVID-19; Drug Resistance, Bacterial
PubMed: 38934838
DOI: 10.4103/ijph.ijph_1758_22 -
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 Workload Indicators of Staffing Need (WISN) human resource planning and management tool developed by Shipp (1998) and popularized by the World Health Organization...
Nursing Personnel Workload and Staffing Need for Rural Hospitals of Darjeeling District, India: Assessment by Application of Workload Indicators of Staffing Need Tool (World Health Organization).
BACKGROUND
The Workload Indicators of Staffing Need (WISN) human resource planning and management tool developed by Shipp (1998) and popularized by the World Health Organization gives health managers a way to analyze and calculate correct staffing levels in health facilities.
OBJECTIVES
This study aimed to assess the current workload and staffing need of staff nurses for rural hospitals in Darjeeling district, West Bengal.
MATERIALS AND METHODS
Primary data were collected by interviews with nursing personnel using a semi-structured interview schedule. Secondary data were obtained from available records at the rural hospitals. Workload components were established for health service activities, support activities, and additional activities. Staffing needs based on workload was calculated after adjusting allowance multiplier.
RESULTS
WISN findings highlighted varying degrees of health worker shortages and inequities in their distribution at different health facilities. WISN ratio indicated that the work pressure of health staff was highest at Kharibari RH (0.45), followed by Naxalbari RH (0.54). About 43% of nurses' time was occupied with support activities, instead of nursing care.
CONCLUSIONS
WISN method can help policy-makers in optimizing utilization of existing human resources. There is a need to adopt flexible health workforce planning and recruitment policy to manage the patient load and disease burden.
Topics: Humans; India; Workload; Hospitals, Rural; Nursing Staff, Hospital; Personnel Staffing and Scheduling; World Health Organization; Interviews as Topic; Workforce
PubMed: 38934835
DOI: 10.4103/ijph.ijph_1678_22 -
Indian Journal of Public Health Oct 2023A major group of the population, especially antenatal checkup (ANC) mothers and their spouses, people admitted for surgery, and people attending STI clinics, are...
BACKGROUND
A major group of the population, especially antenatal checkup (ANC) mothers and their spouses, people admitted for surgery, and people attending STI clinics, are reluctant to pretest counseling.
OBJECTIVES
This study has been taken up to explore the barriers and possible solutions to improve the utilization of Facility based integrated counseling and testing center (F-ICTC) counseling services.
MATERIALS AND METHODS
Phase 1: In-depth interview and ranking with stakeholders from the F-ICTC center (n = 13) were conducted to identify the barriers to utilization of F-ICTC and solution for the same. Phase 2.
A
Delphi panel with experts (n = 17) was invited through mail to find out the potential solution to improve the utilization of F-ICTC counseling services.
RESULTS
Possible barriers from the stakeholders' perspectives were fear of the disease, violate the privacy, unacceptance, gender bias, fear of social stigma and discrimination, and neglect attached to the disease. At third round of Delphi experts had arrived at a consensus regarding of following possible potential solutions: 1. Those who refuse pretest counseling they should be asked to answer a set of questions(which are usually told during counseling), only those questions not answered correctly by them can be corrected, 2.conducive hospital environment, 3.zero discrimination policy, 4. group counseling for ANC mothers and patients in waiting area of the hospital,5. phone counseling for unwilling patients and relocation of testing center and health education camping.
CONCLUSION
Context-specific proactive evidence-based intervention will help in improving the proper utilization of the F-ICTC center.
Topics: Humans; Delphi Technique; Female; Counseling; Prenatal Care; Male; Pregnancy; Adult; India; Social Stigma; Interviews as Topic; Patient Acceptance of Health Care
PubMed: 38934833
DOI: 10.4103/ijph.ijph_1529_22 -
Indian Journal of Public Health Oct 2023The present study intends to examine whether there exists any gender gap in out-of-pocket spending on hospitalization between elderly men and elderly women. Data were...
The present study intends to examine whether there exists any gender gap in out-of-pocket spending on hospitalization between elderly men and elderly women. Data were drawn from the NSS 75th Round Health Care Survey (2017-2018) consisting of a total number of 45,299 elderly. Bivariate analysis and t-test were used to examine the disease burden and gender gap in health spending. The burden of noncommunicable diseases such as bone disease and anemia is considerably higher among elderly women than elderly men. There is a significant, positive gender gap in inpatient health spending, especially in the rural area across various diseases. Lower level of awareness, male dominance in health-related decision-making, and financial dependence are some possible factors for the gender gap. Generating awareness among households and particularly among women regarding health-care system, chronic diseases, and sources of health financing along with formulating disease-specific policy may reduce the gender gap in health spending.
Topics: Humans; Female; Male; Noncommunicable Diseases; India; Aged; Health Expenditures; Hospitalization; Sex Factors; Middle Aged; Socioeconomic Factors; Health Care Surveys; Aged, 80 and over
PubMed: 38934814
DOI: 10.4103/ijph.ijph_1551_22 -
Heliyon Jun 2024The sports service supply chain faces various potential risks, such as market fluctuations, logistics issues, and partner uncertainties. To address these risks...
The sports service supply chain faces various potential risks, such as market fluctuations, logistics issues, and partner uncertainties. To address these risks effectively, this study employs a combination of fuzzy comprehensive evaluation (FCE) methods and intelligent neural networks to create an innovative risk management framework. By considering diverse uncertainties and leveraging the analytical power of intelligent neural networks, this study aims to optimize the operation of the sports service supply chain and explore the risk factors within the public service supply chain of stadiums. This framework provides policy references to promote the healthy and sustainable development of the sports service industry. The main empirical findings, based on a representative survey of experts in China, are as follows: (1) When determining the weights of risk indicators for managing the public service supply chain of stadiums using the FCE method, the customer risk indicator is of paramount importance, with a weight of 0.286, accounting for 95.2 % of the total significance; and (2) In evaluating various risk indicators of the public service supply chain of stadiums through the neural network method, the customer risk indicator scores the highest, achieving a score of 76.02. Notably, the customer complaint risk indicator scores slightly higher at 79.33. Based on these findings, the study recommends focusing on enhancing customer experience within risk management strategies. Additionally, it suggests strengthening the supervision of platforms and third-party activities to ensure the stability and efficient operation of the stadium service supply chain. This study aims to provide theoretical support and reference indicators for evaluating the public service capabilities of stadiums.
PubMed: 38933972
DOI: 10.1016/j.heliyon.2024.e32068