articles+ search results

KIDNEY transplants, ORGAN donors, PEDIATRICS, KIDNEY failure, TRANSPLANTATION of organs, tissues, etc., STATISTICAL significance, DESCRIPTIVE statistics, and COVID-19 pandemic

Background: In March 2020, COVID-19 infections began to rise exponentially in the USA, placing substantial burden on the healthcare system. As a result, there was a rapid change in transplant practices and policies, with cessation of most procedures. Our goal was to understand changes to pediatric kidney transplantation (KT) at the national level during the COVID-19 epidemic. Methods: Using SRTR data, we examined changes in pediatric waitlist registration, waitlist removal or inactivation, and deceased donor and living donor (DDKT/LDKT) events during the start of the disease transmission in the USA compared with the same time the previous year. Results: We saw an initial decrease in DDKT and LDKT by 47% and 82% compared with expected events and then a continual increase, with numbers reaching expected prepandemic levels by May 2020. In the early phase of the pandemic, waitlist inactivation and removals due to death or deteriorating condition rose above expected values by 152% and 189%, respectively. There was a statistically significant decrease in new waitlist additions (IRR 0.49 0.65 0.85) and LDKT (IRR 0.17 0.38 0.84) in states with high vs. low COVID activity. Transplant recipients during the pandemic were more likely to have received a DDKT, but had similar calculated panel–reactive antibody (cPRA) values, waitlist time, and cause of kidney failure as before the pandemic. Conclusions: The COVID-19 pandemic initially reduced access to kidney transplantation among pediatric patients in the USA but has not had a sustained effect. [ABSTRACT FROM AUTHOR]

ACCELEROMETERS, FOOD habits, GLOBAL Positioning System, HEALTH behavior, INGESTION, POPULATION geography, SCHOOL environment, BUILT environment, HOME environment, CROSS-sectional method, SEDENTARY lifestyles, PHYSICAL activity, DESCRIPTIVE statistics, and ADOLESCENCE

Background: Investigation of physical activity and dietary behaviors across locations can inform "setting-specific" health behavior interventions and improve understanding of contextual vulnerabilities to poor health. This study examined how physical activity, sedentary time, and dietary behaviors differed across home, school, and other locations in young adolescents. Methods: Participants were adolescents aged 12–16 years from the Baltimore-Washington, DC and the Seattle areas from a larger cross-sectional study. Participants (n = 472) wore an accelerometer and Global Positioning Systems (GPS) tracker (Mean days = 5.12, SD = 1.62) to collect location-based physical activity and sedentary data. Participants (n = 789) completed 24-h dietary recalls to assess dietary behaviors and eating locations. Spatial analyses were performed to classify daily physical activity, sedentary time patterns, and dietary behaviors by location, categorized as home, school, and "other" locations. Results: Adolescents were least physically active at home (2.5 min/hour of wear time) and school (2.9 min/hour of wear time) compared to "other" locations (5.9 min/hour of wear time). Participants spent a slightly greater proportion of wear time in sedentary time when at school (41 min/hour of wear time) than at home (39 min/hour of wear time), and time in bouts lasting ≥30 min (10 min/hour of wear time) and mean sedentary bout duration (5 min) were highest at school. About 61% of daily energy intake occurred at home, 25% at school, and 14% at "other" locations. Proportionately to energy intake, daily added sugar intake (5 g/100 kcal), fruits and vegetables (0.16 servings/100 kcal), high calorie beverages (0.09 beverages/100 kcal), whole grains (0.04 servings/100 kcal), grams of fiber (0.65 g/100 kcal), and calories of fat (33 kcal/100 kcal) and saturated fat (12 kcal/100 kcal) consumed were nutritionally least favorable at "other" locations. Daily sweet and savory snacks consumed was highest at school (0.14 snacks/100 kcal). Conclusions: Adolescents' health behaviors differed based on the location/environment they were in. Although dietary behaviors were generally more favorable in the home and school locations, physical activity was generally low and sedentary time was higher in these locations. Health behavior interventions that address the multiple locations in which adolescents spend time and use location-specific behavior change strategies should be explored to optimize health behaviors in each location. [ABSTRACT FROM AUTHOR]

Carcinogens, Dust, Environmental exposure, Confidence intervals, Disasters, Mass casualties, Questionnaires, Regression analysis, Rescue work, Research funding, Terrorism, Tumors, Disease incidence, Data analysis software, and Descriptive statistics

Background: World Trade Center (WTC) rescue and recovery workers were exposed to a complex mix of pollutants and carcinogens. Objective: The purpose of this investigation was to evaluate cancer incidence in responders during the first 7 years after 11 September 2001. Methods: Cancers among 20,984 consented participants in the WTC Health Program were identified through linkage to state tumor registries in New York, New Jersey, Connecticut, and Pennsylvania. Standardized incidence ratios (SIRs) were calculated to compare cancers diagnosed in responders to predicted numbers for the general population. Multivariate regression models were used to estimate associations with degree of exposure. Results: A total of 575 cancers were diagnosed in 552 individuals. Increases above registry-based expectations were noted for all cancer sites combined (SIR = 1.15; 95% CI: 1.06, 1.25), thyroid cancer (SIR = 2.39; 95% CI: 1.70, 3.27), prostate cancer (SIR = 1.21; 95% CI: 1.01, 1.44), combined hematopoietic and lymphoid cancers (SIR = 1.36; 95% CI: 1.07, 1.71), and soft tissue cancers (SIR = 2.26; 95% CI: 1.13, 4.05). When restricted to 302 cancers diagnosed ≥ 6 months after enrollment, the SIR for all cancers decreased to 1.06 (95% CI: 0.94, 1.18), but thyroid and prostate cancer diagnoses remained greater than expected. All cancers combined were increased in very highly exposed responders and among those exposed to significant amounts of dust, compared with responders who reported lower levels of exposure. Conclusion: Estimates should be interpreted with caution given the short follow-up and long latency period for most cancers, the intensive medical surveillance of this cohort, and the small numbers of cancers at specific sites. However, our findings highlight the need for continued follow-up and surveillance of WTC responders. [ABSTRACT FROM AUTHOR]

DIARRHEA -- Risk factors, GERIATRIC assessment, ANTIBIOTICS, CLOSTRIDIUM diseases, CONFIDENCE intervals, DIARRHEA, DRUG prescribing, FACTOR analysis, FRAIL elderly, LONGITUDINAL method, MEDICAL cooperation, NURSING home patients, NURSING care facilities, NUTRITIONAL assessment, PROBABILITY theory, RESEARCH, RESEARCH funding, STATISTICS, PHYSICIAN practice patterns, MULTIPLE regression analysis, PROPORTIONAL hazards models, DATA analysis software, DESCRIPTIVE statistics, and ODDS ratio

Background: the risk factors for and frequency of antibiotic prescription and antibiotic-associated diarrhoea (AAD) among care home residents are unknown. Aim: to prospectively study frequency and risks for antibiotic prescribing and AAD for care home residents. Design and setting: a 12-month prospective cohort study in care homes across South Wales. Method: antibiotic prescriptions and the development of AAD were recorded on case report forms. We defined AAD as three or more loose stools in a 24-h period occurring within 8 weeks of exposure to an antibiotic. Results: we recruited 279 residents from 10 care homes. The incidence of antibiotic prescriptions was 2.16 prescriptions per resident year (95% CI: 1.90-2.46). Antibiotics were less likely to be prescribed to residents from dual-registered homes (OR compared with nursing homes: 0.38, 95% CI: 0.18-0.79). For those who were prescribed antibiotics, the incidence of AAD was 0.57 episodes per resident year (95% CI: 0.41-0.81 episodes). AAD was more likely in residents who were prescribed coamoxiclav (hazards ratio, HR = 2.08, 95% confidence interval, CI: 1.18-3.66) or routinely used incontinence pads (HR = 2.54, 95% CI: 1.26-5.13) and less likely in residents from residential homes (HR compared with nursing homes: 0.14, 95% CI: 0.06-0.32). Conclusion: residents of care homes, particularly of nursing homes, are frequently prescribed antibiotics and often experience diarrhoea following such prescriptions. Co-amoxiclav is associated with greater risk of AAD. [ABSTRACT FROM AUTHOR]

ANALYSIS of variance, ANIMAL behavior, ANIMAL experimentation, BIOLOGICAL assay, ETHANOL, GENES, INSECTS, RESEARCH funding, RNA, STATISTICS, DATA analysis, DATA analysis software, and DESCRIPTIVE statistics

Background The fruit fly Drosophila melanogaster has been used extensively to investigate genetic mechanisms of ethanol ( Et OH)-related behaviors. Many past studies in flies, including studies from our laboratory, have manipulated gene expression using transposons carrying the genetic-phenotypic marker mini-white(mini-w), a derivative of the endogenous gene white(w). Whether the mini-w transgenic marker or the endogenous w gene influences behavioral responses to acute Et OH exposure in flies has not been systematically investigated. Methods We manipulated mini-w and w expression via (i) transposons marked with mini-w, (ii) RNAi against mini-w and w, and (iii) a null allele of w. We assessed Et OH sensitivity and tolerance using a previously described e RING assay (based on climbing in the presence of Et OH) and an assay based on Et OH-induced sedation. Results In e RING assays, Et OH-induced impairment of climbing correlated inversely with expression of the mini-w marker from a series of transposon insertions. Additionally, flies harboring a null allele of w or flies with RNAi-mediated knockdown of mini-w were significantly more sensitive to Et OH in e RING assays than controls expressing endogenous w or the mini-w marker. In contrast, Et OH sensitivity and rapid tolerance measured in the Et OH sedation assay were not affected by decreased expression of mini-w or endogenous w in flies. Conclusions Et OH sensitivity measured in the e RING assay is noticeably influenced by w and mini-w, making e RING problematic for studies on Et OH-related behavior in Drosophila using transgenes marked with mini-w. In contrast, the Et OH sensitivity assay described here is a suitable behavioral paradigm for studies on Et OH sensitivity and rapid tolerance in Drosophila including those that use widely available transgenes marked with mini-w. [ABSTRACT FROM AUTHOR]

TUMOR risk factors, CHI-squared test, CLUSTER analysis (Statistics), CONFIDENCE intervals, CORRELATION (Statistics), ALCOHOL drinking, EPIDEMIOLOGY, MEDICAL protocols, QUESTIONNAIRES, STATISTICAL sampling, SELF-evaluation, SEX distribution, SOCIAL skills, STATISTICS, LOGISTIC regression analysis, DATA analysis, PREDICTIVE validity, CROSS-sectional method, HEALTH literacy, and DESCRIPTIVE statistics

Objective: To examine self-reported alcohol consumption and relationships between consumption, awareness of the 2009 NHMRC guidelines of no more than two standard drinks per day, drinking in excess of the guideline threshold and perceptions of alcohol as a risk factor for cancer. Methods: Questions were included in annual, cross-sectional surveys of approximately 2,700 South Australians aged 18 years and over from 2004 to 2012. Consumption data for 2011 and 2012 were merged for the majority of analyses. Results: In 2011 and 2012, 21.6% of adults drank in excess of the guideline threshold (33.0% males; 10.7% females). While 53.5% correctly identified the NHMRC consumption threshold for women, only 20.3% did so for men (39.0% nominated a higher amount). A large minority said they did not know the consumption threshold for women (39.2%) or men (40.4%). In 2012, only 36.6% saw alcohol as an important risk factor for cancer. Important predictors of excess consumption for men were: higher household income; and not perceiving alcohol as an important risk factor for cancer. Predictors for women were similar but the role of household income was even more prominent. Conclusions: Men were nearly three times as likely to drink in excess of the guidelines as women. The majority of the population did not see an important link between alcohol and cancer. Awareness of the latest NHMRC guidelines consumption threshold is still low, particularly for men. Implications: A strategy to raise awareness of the NHMRC guidelines and the link between alcohol and cancer is warranted. [ABSTRACT FROM AUTHOR]

HEALTH promotion, ANALYSIS of variance, IMMUNIZATION, MOBILE apps, and DESCRIPTIVE statistics

The article presents a study that will analyze the effectiveness of the immunization app ImmunizeCA and assess role of promotional strategies in driving the use of the app. The study mentions that activities surrounding the app launch and distribution of government flyers played an important role in app downloads. The study concludes that social media strategies were not effective on mobile uptake.

CLINICAL competence, COMMUNICATION, NURSING, QUALITY assurance, TEACHING methods, HUMAN services programs, EVALUATION of human services programs, DESCRIPTIVE statistics, and OUTPATIENT medical care nursing

Supplemental digital content is available in the text. BACKGROUND/PURPOSE: Ongoing dissatisfaction with anonymous peer feedback led to problem solving to equip nurses to provide and receive respectful and meaningful feedback during face-to-face peer review. PROBLEM: Giving and receiving feedback about other's performance and collaboration are a vital aspect of teambuilding; yet, no programmatic training existed to prepare and equip nurses to feel confident and comfortable in providing or receiving face-to-face peer feedback. A search of the literature demonstrated a dearth of evidence related to developing these teambuilding relationships. The facilitator role appeared in some literature outside nursing but was poorly articulated and yet appeared important to the process. METHODS: This was a quality improvement project that utilized online surveys with both multiple-choice and open-ended questions for data collection across 3 time points for 2 different cohorts over a 2-year implementation period. Strategies included education related to providing feedback with positive intent regardless of feedback type. A facilitator role was used to ensure effective communication and provide support to the peers during the process. RESULTS: Nurse participants described increased comfort and knowledge related to providing/receiving face-to-face feedback. Training and use of a facilitator provided the necessary support; 75% of participants reported comfort with giving face-to-face feedback. However, the greater majority, 80% to 92%, of participants reported increased comfort with receiving face-to-face feedback. CONCLUSIONS: Using active peer-to-peer support has become an accepted standard for face-to-face peer feedback as an aspect of the annual review process. [ABSTRACT FROM AUTHOR]