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Nutrients May 2024The consumption of protein-rich foods stimulates satiety more than other macronutrient-rich foods; however, the underlying mechanisms-of-action are not...
Examining the Direct and Indirect Effects of Postprandial Amino Acid Responses on Markers of Satiety following the Acute Consumption of Lean Beef-Rich Meals in Healthy Women with Overweight.
The consumption of protein-rich foods stimulates satiety more than other macronutrient-rich foods; however, the underlying mechanisms-of-action are not well-characterized. The objective of this study was to identify the direct and indirect effects of postprandial amino acid (AA) responses on satiety. Seventeen women (mean ± SEM, age: 33 ± 1 year; BMI: 27.8 ± 0.1 kg/m) consumed a eucaloric, plant-based diet containing two servings of lean beef/day (i.e., 7.5 oz (207 g)) for 7 days. During day 6, the participants completed a 12 h controlled-feeding, clinical testing day including repeated satiety questionnaires and blood sampling to assess pre- and postprandial plasma AAs, PYY, and GLP-1. Regression and mediation analyses were completed to assess AA predictors and hormonal mediators. Total plasma AAs explained 41.1% of the variance in perceived daily fullness ( < 0.001), 61.0% in PYY ( < 0.001), and 66.1% in GLP-1 ( < 0.001) concentrations, respectively. Several individual AAs significantly predicted fluctuations in daily fullness, PYY, and GLP-1. In completing mediation analyses, the effect of plasma leucine on daily fullness was fully mediated by circulating PYY concentrations (indirect effect = B: 0.09 [Boot 95% CI: 0.032, 0.17]) as no leucine-fullness direct effect was observed. No other mediators were identified. Although a number of circulating AAs predict satiety, leucine was found to do so through changes in PYY concentrations in middle-aged women.
Topics: Humans; Female; Adult; Postprandial Period; Amino Acids; Red Meat; Peptide YY; Satiation; Overweight; Glucagon-Like Peptide 1; Biomarkers; Meals; Animals; Cattle; Satiety Response
PubMed: 38892651
DOI: 10.3390/nu16111718 -
Nutrients May 2024Food marketing targeting children influences their choices and dietary habits, and mainly promotes food high in fat, sugar, and salt as well as ultra-processed food. The...
Food marketing targeting children influences their choices and dietary habits, and mainly promotes food high in fat, sugar, and salt as well as ultra-processed food. The aim of this study was to assess the nutritional quality of food and beverages marketed to children over the age of 3 and available on the Swiss market. Products with at least one marketing technique targeting children on the packaging were selected from five food store chains. Three criteria to assess nutritional quality were used: (1) nutritional composition (using the Nutri-Score), (2) degree of processing (NOVA classification), and (3) compliance with the World Health Organization (WHO) Nutrient Profile Model (NPM). A total of 735 products were found and analyzed. The most common marketing techniques used were childish names/fonts (46.9%), special characters (39.6%), and children's drawings (31.3%). Most products had a Nutri-Score of D or E (58.0%) and were ultra-processed (91.8%). Only 10.2% of products displayed the Nutri-Score. The least processed products generally had a better Nutri-Score ( < 0.001). Most products (92.8%) did not meet the criteria of the WHO NPM. Products that met the WHO NPM criteria, organic products, and products with a nutritional claim generally had a better Nutri-Score and were less processed (p < 0.05). Pre-packaged foods and beverages marketed to children in the Swiss market were mostly of poor nutritional quality. Public health measures should be adopted to improve the nutritional quality of foods marketed to children in Switzerland and restrict the marketing of unhealthy foods to children.
Topics: Switzerland; Nutritive Value; Humans; Child; Marketing; Food Packaging; Child, Preschool; Surveys and Questionnaires
PubMed: 38892589
DOI: 10.3390/nu16111656 -
Medical Science Educator Jun 2024To promote evidence-based practice, medical schools offer students opportunities to undertake either elective or mandatory research projects. One important measure of...
To promote evidence-based practice, medical schools offer students opportunities to undertake either elective or mandatory research projects. One important measure of the research program success is student publication rates. In 2006, UNSW Medicine implemented a mandatory research program in the 4th year of the undergraduate medical education program. This study identified student publication rates and explored student and supervisor experiences with the publication process. A retrospective audit of student publications from the 2007, 2011, and 2015 cohorts was undertaken to look at trends over time. Data collected included type of publication and study methodology. Semi-structured interviews were conducted with a sample of undergraduate students ( = 11), medical graduates ( = 14), and supervisors ( = 25) and analysed thematically. Student publication rates increased significantly ( = 0.002) from 28% in 2007 to 50.2% in 2015. Students able to negotiate their own project were more likely to publish ( = 0.02). Students reported personal affirmation and development of research skills from publishing their research findings, while graduates noted improved career opportunities. Supervisors expected students to publish but identified the time to publications and student motivation as key factors in achieving publication(s). A high publication rate is possible in a mandatory research program where students can negotiate their own topic and are given protected time. Publications happen after the research project has finished. Critical factors in successful publication include supervisor support and student motivation. Given the importance of the supervisor's role, staff development and faculty support to train and develop a body of skilled supervisors is required.
PubMed: 38887404
DOI: 10.1007/s40670-024-02029-5 -
BMC Public Health Jun 2024Structural and behavioral interventions to manage work-related stress are effective in employees. Nonetheless, they have been implemented insufficiently, particularly in...
BACKGROUND
Structural and behavioral interventions to manage work-related stress are effective in employees. Nonetheless, they have been implemented insufficiently, particularly in micro- and small-sized enterprises (MSE). Main barriers include a lack of knowledge and limited resources, which could potentially be overcome with simplified web-based alternatives for occupational stress prevention. However, there is a lack of implementation research about web-based prevention in realistic settings of MSE.
OBJECTIVE
The aim of this study is to evaluate the implementation process and success of an integrated web-based platform for occupational stress prevention ("System P") and to identify potential barriers for its uptake and use in MSE in Germany.
METHODS
This study with a mixed-methods approach investigates eight process-related outcomes in a quantitative part I (adoption, reach, penetration, fidelity/dose, costs, acceptability) and a qualitative part II (acceptability, appropriateness and feasibility). Part I has a pre-post design with two measurements (6 months apart) with 98 individual participants and part II consists of 12 semi-structured interviews with managers and intercorporate stakeholders.
RESULTS
Part I revealed shortcomings in the implementation process. Adoption/Reach: Despite extensive marketing efforts, less than 1% of the contacted MSE responded to the offer of System P. A total of 40 MSE registered, 24 of which, characterized by good psychosocial safety climate, adopted System P. Penetration: Within these 24 MSE, 15% of the employees used the system. Fidelity/Dose: 11 MSE started a psychosocial risk-assessment (PRA), and no MSE finished it. The stress-management training (SMT) was started by 25 users and completed by 8.
COSTS
The use of System P was free of charge, but the time required to engage with was an indirect cost. Part II added insights on the perception of the web-based intervention: Acceptance of System P by users and stakeholders was good and it was assessed as appropriate for MSE. Results for feasibility were mixed.
CONCLUSIONS
Although System P was generally perceived as useful and appropriate, only a small number of contacted MSE implemented it as intended. Prior experience and sensitivity for occupational (stress) prevention were mentioned as key facilitators, while (perceived) indirect costs were a key barrier. Enabling MSE to independently manage stress prevention online did not result in successful implementation. Increasing external support could be a solution. ⁺ FULL PROJECT NAME: "PragmatiKK - Pragmatische Lösungen für die Implementation von Maßnahmen zur Stressprävention in Kleinst- und Kleinbetrieben" (= Pragmatic solutions for the implementation of stress prevention interventions in micro and small-sized enterprises).
TRIAL REGISTRATION
German Register of Clinical Studies (DRKS) DRKS00026154, date of registration 2021-09-16.
Topics: Humans; Germany; Occupational Stress; Female; Male; Adult; Middle Aged; Small Business; Internet; Program Evaluation; Internet-Based Intervention; Qualitative Research
PubMed: 38886711
DOI: 10.1186/s12889-024-19102-8 -
Cureus Apr 2024Introduction Due to the COVID-19 pandemic, the American Association of Medical Colleges (AAMC) recommended that all interviews for residencies and fellowships be...
Introduction Due to the COVID-19 pandemic, the American Association of Medical Colleges (AAMC) recommended that all interviews for residencies and fellowships be conducted in a virtual format. As of March 2024, the Society of Maternal-Fetal Medicine (SMFM) continues to request that all fellowship interviews occur virtually. Without in-person interviews, prospective Maternal-Fetal Medicine (MFM) fellowship applicants must largely rely on program websites to gain insight into each program's offerings, culture, and application requirements. The purpose of this study was to evaluate the content of American College of Graduate Medical Education (ACGME)-accredited Maternal-Fetal Medicine (MFM) fellowship program websites and assess if regional differences exist among website content. Methods All ACGME-accredited MFM fellowship program websites were assessed for 21 defined criteria as of March 2024 and further compared by geographic regions (Midwest, Northeast, South, and West). Analyses were completed using chi-squared univariate tests, with a p < 0.05. Results Of the 108 accredited MFM fellowship programs, 106 programs had a dedicated website (98.15%). Most MFM programs (over 80%) included contact information (102/106), program director name (98/106), faculty names (95/106), application requirements (92/106), current fellow names (91/106), and the program coordinator name (89/106) on their website. Less programs (less than 30%) included diversity, equity, inclusion (DEI) content (28/106), interview dates (28/106), and current fellow research projects or publications (27/106). Western programs were less likely to include the program coordinator's name (12/18 (67%), p = 0.046), but more likely to include DEI content (10/18 (56%), p = 0.005). Northeastern programs were less likely to include their application requirements (24/32 (75%), p = 0.049) and less likely to include pictures of their current fellows (20/32 (63%), p = 0.045). Southern programs were more likely to include the yearly rotation schedule (19/32 (59%), p = 0.040). Midwestern programs were more likely to include information on fellowship benefits or salary (15/24 (63%), p = 0.046). Conclusion This study demonstrated that the content available on MFM fellowship websites varies greatly between programs and geographic regions. Efforts should be made by MFM training institutions to enhance website DEI content, curriculum information, recent fellow publications, and information on program alumni. A detailed and well-structured website may help applicants compare individual programs more equitably in the age of virtual interviewing.
PubMed: 38884023
DOI: 10.7759/cureus.58527 -
Frontiers in Cardiovascular Medicine 2024In recent years, the use of artificial intelligence (AI) models to generate individualised risk assessments and predict patient outcomes post-Transcatheter Aortic Valve...
OBJECTIVES
In recent years, the use of artificial intelligence (AI) models to generate individualised risk assessments and predict patient outcomes post-Transcatheter Aortic Valve Implantation (TAVI) has been a topic of increasing relevance in literature. This study aims to evaluate the predictive accuracy of AI algorithms in forecasting post-TAVI mortality as compared to traditional risk scores.
METHODS
Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses for Systematic Reviews (PRISMA) standard, a systematic review was carried out. We searched four databases in total-PubMed, Medline, Embase, and Cochrane-from 19 June 2023-24 June, 2023.
RESULTS
From 2,239 identified records, 1,504 duplicates were removed, 735 manuscripts were screened, and 10 studies were included in our review. Our pooled analysis of 5 studies and 9,398 patients revealed a significantly higher mean area under curve (AUC) associated with AI mortality predictions than traditional score predictions (MD: -0.16, CI: -0.22 to -0.10, < 0.00001). Subgroup analyses of 30-day mortality (MD: -0.08, CI: -0.13 to -0.03, = 0.001) and 1-year mortality (MD: -0.18, CI: -0.27 to -0.10, < 0.0001) also showed significantly higher mean AUC with AI predictions than traditional score predictions. Pooled mean AUC of all 10 studies and 22,933 patients was 0.79 [0.73, 0.85].
CONCLUSION
AI models have a higher predictive accuracy as compared to traditional risk scores in predicting post-TAVI mortality. Overall, this review demonstrates the potential of AI in achieving personalised risk assessment in TAVI patients.
REGISTRATION AND PROTOCOL
This systematic review and meta-analysis was registered under the International Prospective Register of Systematic Reviews (PROSPERO), under the registration name "All-Cause Mortality in Transcatheter Aortic Valve Replacement Assessed by Artificial Intelligence" and registration number CRD42023437705. A review protocol was not prepared. There were no amendments to the information provided at registration.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/, PROSPERO (CRD42023437705).
PubMed: 38883982
DOI: 10.3389/fcvm.2024.1343210 -
Health Expectations : An International... Jun 2024Patient and public involvement is vital for high-quality research. Integrating patients' and providers' perspectives early in research enhances the feasibility and...
INTRODUCTION
Patient and public involvement is vital for high-quality research. Integrating patients' and providers' perspectives early in research enhances the feasibility and relevance of study results. Within our family practice-based research network ForN, we established a standing patient advisory board (PAB) to include patients with diverse conditions and experiences. In this paper, we aim to describe the establishment and functioning of a standing PAB in family medicine research from patients' and researchers' perspectives.
METHODS
After each PAB meeting, patients and researchers were asked to name anonymously positive and challenging moments in a feedback form with open questions. Researchers were also asked to reflect on how they implemented the discussion content in their research projects. The responses from both groups were transferred to MAXQDA 2018 and analyzed separately using thematic analysis.
RESULTS
We analyzed 40 feedback forms from patients and 14 feedback forms from researchers. The dominant theme in the patients' feedback was 'exchange': They positively emphasized the 'exciting and open discussions' and the exchange of perspectives with one another and researchers. The clarity of the researchers' presentations and the research topics were appreciated. Researchers also positively highlighted the open atmosphere of the discussions. Presenting their research to the PAB helped most researchers reflect on their research topics from patients' perspectives and implement changes. However, researchers also mentioned several barriers to the implementation of PAB members' feedback.
CONCLUSION
The establishment of a standing PAB in family practice research is feasible and productive both from patients' and researchers' perspectives.
PATIENT OR PUBLIC CONTRIBUTION
This study reports the evaluation of the establishment of a standing PAB in family practice research. Board members are involved in the design of studies, the co-production of interventions and information material, and the interpretation of data.
Topics: Humans; Advisory Committees; Qualitative Research; Family Practice; Research Personnel; Male; Female; Patient Participation; Middle Aged; Adult
PubMed: 38881096
DOI: 10.1111/hex.14094 -
Journal of Biomedical Informatics Jun 2024Studies confirm that significant biases exist in online recommendation platforms, exacerbating pre-existing disparities and leading to less-than-optimal outcomes for...
BACKGROUND
Studies confirm that significant biases exist in online recommendation platforms, exacerbating pre-existing disparities and leading to less-than-optimal outcomes for underrepresented demographics. We study issues of bias in inclusion and representativeness in the context of healthcare information disseminated via videos on the YouTube social media platform, a widely used online channel for multi-media rich information. With one in three US adults using the Internet to learn about a health concern, it is critical to assess inclusivity and representativeness regarding how health information is disseminated by digital platforms such as YouTube.
METHODS
Leveraging methods from fair machine learning (ML), natural language processing and voice and facial recognition methods, we examine inclusivity and representativeness of video content presenters using a large corpus of videos and their metadata on a chronic condition (diabetes) extracted from the YouTube platform. Regression models are used to determine whether presenter demographics impact video popularity, measured by the video's average daily view count. A video that generates a higher view count is considered to be more popular.
RESULTS
The voice and facial recognition methods predicted the gender and race of the presenter with reasonable success. Gender is predicted through voice recognition (accuracy = 78 %, AUC = 76 %), while the gender and race predictions use facial recognition (accuracy = 93 %, AUC = 92 % and accuracy = 82 %, AUC = 80 %, respectively). The gender of the presenter is more significant for video views only when the face of the presenter is not visible while videos with male presenters with no face visibility have a positive relationship with view counts. Furthermore, videos with white and male presenters have a positive influence on view counts while videos with female and non - white group have high view counts.
CONCLUSION
Presenters' demographics do have an influence on average daily view count of videos viewed on social media platforms as shown by advanced voice and facial recognition algorithms used for assessing inclusion and representativeness of the video content. Future research can explore short videos and those at the channel level because popularity of the channel name and the number of videos associated with that channel do have an influence on view counts.
PubMed: 38880237
DOI: 10.1016/j.jbi.2024.104669 -
BMC Health Services Research Jun 2024Universal health visiting has been a cornerstone of preventative healthcare for children in the United Kingdom (UK) for over 100 years. In 2016, Scotland introduced a...
BACKGROUND
Universal health visiting has been a cornerstone of preventative healthcare for children in the United Kingdom (UK) for over 100 years. In 2016, Scotland introduced a new Universal Health Visiting Pathway (UHVP), involving a greater number of contacts with a particular emphasis on the first year, visits within the home setting, and rigorous developmental assessment conducted by a qualified Health Visitor. To evaluate the UHVP, an outcome indicator framework was developed using routine administrative data. This paper sets out the development of these indicators.
METHODS
A logic model was produced with stakeholders to define the group of outcomes, before further refining and aligning of the measures through discussions with stakeholders and inspection of data. Power calculations were carried out and initial data described for the chosen indicators.
RESULTS
Eighteen indicators were selected across eight outcome areas: parental smoking, breastfeeding, immunisations, dental health, developmental concerns, obesity, accidents and injuries, and child protection interventions. Data quality was mixed. Coverage of reviews was high; over 90% of children received key reviews. Individual item completion was more variable: 92.2% had breastfeeding data at 6-8 weeks, whilst 63.2% had BMI recorded at 27-30 months. Prevalence also varied greatly, from 1.3% of children's names being on the Child Protection register for over six months by age three, to 93.6% having received all immunisations by age two.
CONCLUSIONS
Home visiting services play a key role in ensuring children and families have the right support to enable the best start in life. As these programmes evolve, it is crucial to understand whether changes lead to improvements in child outcomes. This paper describes a set of indicators using routinely-collected data, lessening additional burden on participants, and reducing response bias which may be apparent in other forms of evaluation. Further research is needed to explore the transferability of this indicator framework to other settings.
Topics: Humans; Scotland; Child, Preschool; Infant; Routinely Collected Health Data; Universal Health Care; Female; Child Health Services; Male; Outcome Assessment, Health Care; Breast Feeding; Infant, Newborn; Child; Quality Indicators, Health Care; House Calls
PubMed: 38877550
DOI: 10.1186/s12913-024-11178-7 -
International Journal of Surgery Case... Jul 2024Perineal hernias are protrusions of intra-abdominal contents resulting from weakness of the pelvic floor muscles. They are an uncommon complication after ultraradical...
INTRODUCTION AND IMPORTANCE
Perineal hernias are protrusions of intra-abdominal contents resulting from weakness of the pelvic floor muscles. They are an uncommon complication after ultraradical pelvic surgeries, with no established gold standard for surgical treatment. This case describes a rare anterior perineal hernia that developed after radical surgery for bladder carcinoma.
CASE PRESENTATION
A 77-year-old Caucasian woman presented with a painful 10 cm bulge in the perineal region. The hernial sac involved the entire left labia majora and developed 4 years after radical surgery for bladder carcinoma. She had been misdiagnosed twice in the past with vaginal prolapse, leading to two unsuccessful vaginoplasty procedures due to recurrence. She underwent hernia repair with perineal approach and polypropylene mesh placement. The postoperative period was uncomplicated, and the patient was discharged after five days, with histology showing no malignancy.
CLINICAL DISCUSSION
Perineal hernias are protrusions of intra- or extraperitoneal contents into the perineum due to a defect in the pelvic musculature. Various surgical modalities exist for perineal hernia repair, which adhere to the fundamental principles of hernia surgery: sac mobilization, precise incision, sac debridement and excision, and defect repair. Here, we successfully applied the perineal approach in a complicated case of a misdiagnosed perineal hernia after radical surgery.
CONCLUSION
The perineal approach for hernia repair, involving an implantation of a polypropylene mesh and tissue flap was successfully applied, confirming its main place in the surgical treatment of perineal hernias. During the two-year follow-up no postoperative complications or recurrence hernia were registered.
PubMed: 38875825
DOI: 10.1016/j.ijscr.2024.109859