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European Journal of Oncology Nursing :... Jun 2024Self-management is an essential component of the curative treatment trajectory of esophageal cancer patients. The aims of this study were to explore expectations and...
PURPOSE
Self-management is an essential component of the curative treatment trajectory of esophageal cancer patients. The aims of this study were to explore expectations and needs of esophageal cancer patients during curative treatment regarding self-management, relevant aspects of self-management in which they need additional support, and to explore their willingness to use eHealth.
METHODS
Semi-structured interviews were conducted with esophageal cancer patients, who had been treated with neoadjuvant chemo(radio)therapy followed by surgery, maximally 1 year after surgery. Based on the general model of self-management, the following themes were discussed: experience-based knowledge, contribution to care, living with the condition, and organization of care and support. A stepwise systematic text condensation guided the data analysis.
RESULTS
All four domains of the general model of self-management were identified. All participants described a remarkable difference between the pre-operative pathway, when it felt like they were taken by the hand, and the postoperative pathway, when it felt like they were thrown into the deep end. They adjusted to their new life situation by learning new experiences, while dealing with their diminished confidence in their bodies. Patients expressed the need for support from different sources, and were open to the idea of using eHealth in addition to usual care. (digital) Self-management support should be easily accessible, person-centered, confidential, and include personal contact.
CONCLUSION
Differences were found among esophageal cancer patients regarding self-management, self-management support and eHealth for self-management purposes, indicating there is no one approach that will meet the needs of all patients at all times.
PubMed: 38943774
DOI: 10.1016/j.ejon.2024.102638 -
Journal of Environmental Management Jun 2024The impact of NaOH-modified biochar on the release of NH and HS from laying hens' manure was examined for 44 days, using a small-scale simulated aerobic composting...
The impact of NaOH-modified biochar on the release of NH and HS from laying hens' manure was examined for 44 days, using a small-scale simulated aerobic composting system. The findings revealed that the NaOH-modified biochar reduced NH and HS emissions by 40.63% and 77.78%, respectively, compared to the control group. Moreover, the emissions of HS were significantly lower than those of the unmodified biochar group (p < 0.05). The increased specific surface area and microporous structure of the biochar, as well as the higher content of alkaline and oxygenated functional groups, were found to facilitate the adsorption of NH and HS. This enhanced adsorption capability was the primary reason for the significant reduction in NH emissions. Furthermore, during the high-temperature phase of composting, there was a notable alteration in the microbial community. The abundance of Limnochordaceae, Savagea, and IMCC26207 increased significantly which aided in the conversion of HS to stable sulfate. These microorganisms also influenced the abundance of functional genes involved in sulfur metabolism, thereby inhibiting cysteine synthesis, along with the decomposition and conversion of sulfate to sulfite. This led to a significant decrease in HS emissions. This study provides valuable data for the selection of deodorizers in the composting process of egg-laying hens. The results have significant implications for the application of NaOH-modified biochar for odor reduction in aerobic composting processes.
PubMed: 38943752
DOI: 10.1016/j.jenvman.2024.121634 -
Journal of Environmental Management Jun 2024This study explores the comprehensive effects of green finance (GF) on the low-carbon transition of the energy system (LTES) by analyzing panel data from 281 cities in...
This study explores the comprehensive effects of green finance (GF) on the low-carbon transition of the energy system (LTES) by analyzing panel data from 281 cities in China from 2006 to 2021. It is found that GF significantly reduces overall energy consumption and exhibits a U-shaped association with energy efficiency, while its relationship with the energy consumption structure is inverted U-shaped. After accounting for endogeneity in the robustness tests, these findings remain consistent and are therefore deemed reliable. A mechanistic analysis reveals that GF promotes industrial upgrading, technological progress, and economic agglomeration, collectively facilitating the LTES. The impact of GF on LTES shows considerable variation among regions, influenced by their levels of economic growth, extents of marketization, and governmental environmental preferences. Our findings provide new evidence for the relationship between GF and LTES, offering a scientific basis for formulating GF policies to accelerate this transformation.
PubMed: 38943748
DOI: 10.1016/j.jenvman.2024.121577 -
Journal of Environmental Management Jun 2024Achieving net-zero greenhouse gas emissions in the construction sector is essential to sustainable development policy. Previous studies have ignored the impact of the...
Achieving net-zero greenhouse gas emissions in the construction sector is essential to sustainable development policy. Previous studies have ignored the impact of the digital economy on carbon emissions in the construction industry. Using relevant city-level data from China from 2011 to 2021 and employing ArcGIS and Stata software, this study examines the current status of carbon emissions from the construction industry and investigates the impact of the digital economy on these emissions. The findings reveal that (1) from 2011 to 2021, carbon emissions of the construction industry have a pattern of decreasing-increasing-decreasing-increasing across the country. There is an increasing concentration of areas with high and relatively high carbon discharges in Heilongjiang, Jilin, Ningxia, Inner Mongolia, Shanxi, Guangxi, and Guizhou. (2) The standard deviation ellipse indicates the core area of carbon emissions in China's construction industry is moving northeast and becoming more decentralized. (3) Through a series of robustness tests, the digital economy has been proven to effectively reduce carbon emissions from the construction sector in municipal areas. (4) In severely cold regions, mild regions, and high-population-density cities, the digital economy reduces building sector's carbon output. However, it stimulates carbon emissions in the hot summer and cold winter regions. (5) Mechanism tests show that the digital economy reduces China's urban construction carbon emissions by fostering technological progress and green innovation. Urban resilience further strengthens the contribution of the digital economy to reducing carbon discharges in the urban construction sector of China. This article presents empirical evidence demonstrating how the digital economy empowers the construction industry to curtail emissions.
PubMed: 38943745
DOI: 10.1016/j.jenvman.2024.121548 -
Journal of Environmental Management Jun 2024Sustainable management of critical raw materials is of paramount importance to ensure a steady supply and reduce environmental impact. The application of newly...
Sustainable management of critical raw materials is of paramount importance to ensure a steady supply and reduce environmental impact. The application of newly synthesized and environmentally friendly ALG@CS material as a bio-adsorbent for the effective rare earth elements removal from aqueous solution has been presented. The synthesized material underwent FTIR, XPS, EDX, and SEM analysis to determine its suitability for metal uptake. To evaluate the adsorption capacity of ALG@CS for rare earth elements several factors were taken into consideration. These factors included alginate:chitosan ratios, bead size, pH level, composite mass, interaction time, metal ion concentration, and temperature, being all varied during the batch mode evaluation process. Under the optimal conditions, the maximum adsorption capacities were found to be 145.90 mg La(III)/g, 168.44 mg Ce(III)/g, 132.51 mg Pr(III)/g, 128.40 mg Nd(III)/g, 154.36 mg Sm(III)/g, and 165.10 mg Ho(III)/g. The equilibrium data fits well with non-linear three-parameter Sips and Redlich-Peterson isotherm models. The PSO model finds the highest process suitability. The synthesized ALG@CS bio-adsorbent showed excellent regenerative capacity in ten cycles, making it a suitable adsorbent for rare earth elements uptake. The unique bio-adsorbents combination allows for efficient critical raw materials adsorption providing a promising solution for their recovery and recycling.
PubMed: 38943744
DOI: 10.1016/j.jenvman.2024.121609 -
JAMA Health Forum Jun 2024States resumed Medicaid eligibility redeterminations, which had been paused during the COVID-19 public health emergency, in 2023. This unwinding of the pandemic...
IMPORTANCE
States resumed Medicaid eligibility redeterminations, which had been paused during the COVID-19 public health emergency, in 2023. This unwinding of the pandemic continuous coverage provision raised concerns about the extent to which beneficiaries would lose Medicaid coverage and how that would affect access to care.
OBJECTIVE
To assess early changes in insurance and access to care during Medicaid unwinding among individuals with low incomes in 4 Southern states.
DESIGN, SETTING, AND PARTICIPANTS
This multimodal survey was conducted in Arkansas, Kentucky, Louisiana, and Texas from September to November 2023, used random-digit dialing and probabilistic address-based sampling, and included US citizens aged 19 to 64 years reporting 2022 incomes at or less than 138% of the federal poverty level.
EXPOSURE
Medicaid enrollment at any point since March 2020, when continuous coverage began.
MAIN OUTCOMES AND MEASURES
Self-reported disenrollment from Medicaid, insurance at the time of interview, and self-reported access to care. Using multivariate logistic regression, factors associated with Medicaid loss were evaluated. Access and affordability of care among respondents who exited Medicaid vs those who remained enrolled were compared, after multivariate adjustment.
RESULTS
The sample contained 2210 adults (1282 women [58.0%]; 505 Black non-Hispanic individuals [22.9%], 393 Hispanic individuals [17.8%], and 1133 White non-Hispanic individuals [51.3%]) with 2022 household incomes less than 138% of the federal poverty line. On a survey-weighted basis, 1564 (70.8%) reported that they and/or a dependent child of theirs had Medicaid at some point since March 2020. Among adult respondents who had Medicaid, 179 (12.5%) were no longer enrolled in Medicaid at the time of the survey, with state estimates ranging from 7.0% (n = 19) in Kentucky to 16.2% (n = 82) in Arkansas. Fewer children who had Medicaid lost coverage (42 [5.4%]). Among adult respondents who left Medicaid since 2020 and reported coverage status at time of interview, 47.8% (n = 80) were uninsured, 27.0% (n = 45) had employer-sponsored insurance, and the remainder had other coverage as of fall 2023. Disenrollment was higher among younger adults, employed individuals, and rural residents but lower among non-Hispanic Black respondents (compared with non-Hispanic White respondents) and among those receiving Supplemental Nutrition Assistance Program benefits. Losing Medicaid was significantly associated with delaying care due to cost and worsening affordability of care.
CONCLUSIONS AND RELEVANCE
The results of this survey study indicated that 6 months into unwinding, 1 in 8 Medicaid beneficiaries reported exiting the program, with wide state variation. Roughly half who lost Medicaid coverage became uninsured. Among those moving to new coverage, many experienced coverage gaps. Adults exiting Medicaid reported more challenges accessing care than respondents who remained enrolled.
Topics: Humans; Medicaid; United States; Health Services Accessibility; Adult; Female; Male; Insurance Coverage; Middle Aged; COVID-19; Poverty; Young Adult; Arkansas
PubMed: 38943683
DOI: 10.1001/jamahealthforum.2024.2193 -
Journal of Burn Care & Research :... Jun 2024Burn survivors can experience social participation challenges throughout their recovery. The aim of this study was to develop a novel Australian English translation of...
Burn survivors can experience social participation challenges throughout their recovery. The aim of this study was to develop a novel Australian English translation of the Life Impact Burn Recovery Evaluation (LIBRE) Profile, the Aus-LIBRE Profile. This study consisted of three stages: 1) translation of the LIBRE Profile from American to Australian English by Australian researchers/burns clinicians; 2) piloting and cognitive evaluation of the Aus-LIBRE Profile with burn survivors to assess the clarity and consistency of the interpretation of each individual item, and 3) review of the Aus-LIBRE Profile by colleagues who identify as Aboriginal Australians for cross-cultural validation. In stage 2, investigators administered the translated questionnaire to 20 Australian patients with burn injuries in the outpatient clinic (10 patients from xx and 10 patients from yy). Face validity of the Aus-LIBRE Profile was tested in 20 burns survivors (11 females) ranging from 21 to 74 years (median age 43 years). The total body surface area (TBSA) burned ranged from 1% to 50% (median 10%). Twelve language changes were made based on the feedback from the burn clinicians/researchers, study participants and colleagues who identify as Aboriginal Australians. Using a formal translation process, the Aus-LIBRE Profile was adapted for use in the Australian burn population. The Aus-LIBRE Profile will require psychometric validation and testing in the Australian burn patient population before broader application of the scale.
PubMed: 38943673
DOI: 10.1093/jbcr/irae134 -
Cancer Jun 2024Telehealth technologies offer efficient ways to deliver health-related social needs (HRSN) screening in cancer care, but these methods may not reach all populations. The...
BACKGROUND
Telehealth technologies offer efficient ways to deliver health-related social needs (HRSN) screening in cancer care, but these methods may not reach all populations. The authors examined patient characteristics associated with using an online patient portal (OPP) to complete HRSN screening as part of gynecologic cancer care.
METHODS
From June 2021 to June 2023, patients in a gynecologic oncology clinic completed validated HRSN screening questions either (1) using the OPP (independently before the visit) or (2) in person (verbally administered by clinic staff). The authors examined the prevalence of HRSN according to activated OPP status and, in a restricted subgroup, used stepwise multivariate Poisson regression to identify associations between patient and visit characteristics and using the OPP.
RESULTS
Of 1616 patients, 87.4% (n = 1413) had an activated OPP. Patients with inactive OPPs (vs. activated OPPs) more frequently reported two or more needs (10% vs 5%; p < .01). Of 986 patients in the restricted cohort, 52% used the OPP to complete screening. The final multivariable model indicated that patients were less likely to use the OPP if they were Black (vs. White; adjusted relative risk [aRR], 0.70; 95% confidence interval [CI], 0.59-0.83); not employed (vs. employed; aRR, 0.81; 95% CI, 0.68-0.97), or had low measures of OPP engagement (aRR, 0.80; 95% CI, 0.68-0.92). New versus established patients were 21% more likely to use the OPP (aRR, 1.21; 95% CI, 1.06-1.38).
CONCLUSIONS
Differential use of the OPP suggested that over-reliance on digital technologies could limit the ability to reach those populations that have social factors already associated with cancer outcome disparities. Cancer centers should consider using multiple delivery methods for HRSN screening to maximize reach to all populations.
PubMed: 38943672
DOI: 10.1002/cncr.35376 -
The Journal of Clinical Endocrinology... Jun 2024Although pre-clinical studies have shown a beneficial impact of omega-3 (n-3) polyunsaturated fatty acids (PUFAs) on adipose (AT) inflammation, the current literature...
OBJECTIVES
Although pre-clinical studies have shown a beneficial impact of omega-3 (n-3) polyunsaturated fatty acids (PUFAs) on adipose (AT) inflammation, the current literature from human studies is limited. Therefore, we aimed to evaluate the longitudinal associations of circulating levels of n-3 PUFAs with biomarkers of AT inflammation.
METHODS
Longitudinal data from participants in the PROMISE cohort (n = 474) were used. AT inflammation was measured using circulating biomarkers at baseline and up to 2 follow-up visits. n-3 PUFAs were measured at baseline in four serum lipid fractions. Generalized estimating equations (GEE) analyses evaluated longitudinal associations between n-3 PUFAs and AT inflammation, adjusting for covariates.
RESULTS
Fully adjusted GEE models indicated that higher baseline proportions of eicosapentaenoic acid (EPA), n-3 docosapentaenoic acid (n-3 DPA), and docosahexaenoic acid (DHA) in total serum were significantly inversely associated with longitudinal change in soluble CD163 (sCD163) (all p < 0.05). A significant positive association of n-3 DPA and DHA with longitudinal change in adiponectin (p < 0.05) was also observed. Generally consistent associations were observed between n-3 PUFAs and sCD163 and adiponectin in the four lipid fractions.
CONCLUSIONS
These findings will add to the limited evidence on the potential role n-3 PUFAs have in the prevention and management of AT inflammation in humans and may help inform future interventions targeting chronic inflammation at the level of AT.
PubMed: 38943663
DOI: 10.1210/clinem/dgae445 -
Geriatrics & Gerontology International Jun 2024To identify factors associated with locomotive syndrome (LS) using medical questionnaire data and machine learning.
Identifying factors associated with locomotive syndrome using machine learning methods: The third survey of the research on osteoarthritis/osteoporosis against disability study.
AIM
To identify factors associated with locomotive syndrome (LS) using medical questionnaire data and machine learning.
METHODS
A total of 1575 participants underwent the LS risk tests from the third survey of the research on osteoarthritis/osteoporosis against disability study (ROAD) study. LS was defined as stage 1 or higher based on clinical decision limits of the Japanese Orthopaedic Association. A total of 1335 items of medical questionnaire data came from this study. The number of medical questionnaire items was reduced from 1335 to 331 in data cleaning. From the 331 items, identify factors associated with LS use by light gradient boosting machine-based recursive feature elimination with cross-validation. The performance of each set was evaluated using an average of seven performance metrics, including 95% confidence intervals, using a bootstrapping method. The smallest set of items is determined with the highest average of receiver operating characteristic area under the curve (ROC-AUC) under 20 items as association factors of LS. Additionally, the performance of the selected items was compared with the LS risk tests and Loco-check.
RESULTS
The nine items have the best average ROC-AUC under 20 items. The nine items show an average ROC-AUC of 0.858 (95% confidence interval 0.816-0.898). Age and back pain during walking were strongly associated with the prevalence of LS. The ROC-AUC of nine items is higher than that of existing questionnaire-based LS assessments, including the 25-question Geriatric Locomotor Scale and Loco-check.
CONCLUSIONS
The identified nine items could aid early LS detection, enhancing understanding and prevention. Geriatr Gerontol Int 2024; ••: ••-••.
PubMed: 38943538
DOI: 10.1111/ggi.14923