Digital Commons Network^™

A Protocol For The Inclusion Of Minoritized Persons In Alzheimer Disease Research From The Adni3 Diversity Taskforce, Ozioma C Okonkwo, Beau M Ances, Et Al.

2020-Current year OA Pubs

IMPORTANCE: Black or African American (hereinafter, Black) and Hispanic or Latino/a/x (hereinafter, Latinx) adults are disproportionally affected by Alzheimer disease, but most research studies do not enroll adequate numbers of both of these populations. The Alzheimer's Disease Neuroimaging Initiative-3 (ADNI3) launched a diversity taskforce to pilot a multipronged effort to increase the study inclusion of Black and Latinx older adults.

OBJECTIVE: To describe and evaluate the culturally informed and community-engaged inclusion efforts to increase the screening and enrollment of Black and Latinx older adults in ADNI3.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used baseline data from a longitudinal, multisite, …

Medicaid Eligibility Loss Among Dual-Eligible Beneficiaries Before And During Covid-19 Public Health Emergency, Yanlei Ma, Eric T Roberts, Kenton J Johnston, E John Orav, Jose F Figueroa

2020-Current year OA Pubs

IMPORTANCE: Medicaid coverage loss can substantially compromise access to and affordability of health care for dual-eligible beneficiaries. The extent to which this population lost Medicaid coverage before and during the COVID-19 public health emergency (PHE) and the characteristics of beneficiaries more at risk for coverage loss are currently not well known.

OBJECTIVE: To assess the loss of Medicaid coverage among dual-eligible beneficiaries before and during the first year of the PHE, and to examine beneficiary-level and plan-level factors associated with heightened likelihood of losing Medicaid.

DESIGN, SETTING, AND PARTICIPANTS: This repeated cross-sectional study used national Medicare data to estimate annual …

Evaluation Of The Electronic Clinical Dementia Rating For Dementia Screening, Rachel L Nosheny, Daniel Yen, Krista Moulder, Connie Mayo, Maureen Mcmillan, John C Morris, Yan Li, Et Al.

2020-Current year OA Pubs

IMPORTANCE: The Clinical Dementia Rating (CDR) is a well-validated instrument widely used to detect and stage dementia due to Alzheimer disease. The digital Electronic Clinical Dementia Rating (eCDR) can be remotely self-administered and automatically scored, with potential to facilitate efficient dementia screening and staging.

OBJECTIVE: To evaluate the association of the eCDR with the CDR and other in-clinic assessments for screening older adults for cognitive impairment.

DESIGN, SETTING, AND PARTICIPANTS: This multisite, cross-sectional study used baseline data from a longitudinal, observational study from 2020 to 2023, including up to 3 years of follow-up. Participants were enrolled from 3 Alzheimer Disease …

Understanding Disruptions In Cancer Care To Reduce Increased Cancer Burden, Kia L Davis, Nicole Ackermann, Lisa M Klesges, Nora Leahy, Callie Walsh-Bailey, Sarah Humble, Bettina Drake, Vetta L Sanders Thompson

2020-Current year OA Pubs

BACKGROUND: This study seeks to understand how and for whom COVID-19 disrupted cancer care to understand the potential for cancer health disparities across the cancer prevention and control continuum.

METHODS: In this cross-sectional study, participants age 30+residing in an 82-county region in Missouri and Illinois completed an online survey from June-August 2020. Descriptive statistics were calculated for all variables separately and by care disruption status. Logistic regression modeling was conducted to determine the correlates of care disruption.

RESULTS: Participants (N=680) reported 21% to 57% of cancer screening or treatment appointments were canceled/postponed from March 2020 through the end of 2020. …

Proportion Of Physicians Who Treat Patients With Greater Social And Clinical Risk And Physician Inclusion In Medicare Advantage Networks, Jung Ho Gong, Kenton J Johnston, David J Meyers

2020-Current year OA Pubs

IMPORTANCE: Medicare Advantage (MA) plans are expanding rapidly, now serving 50% of all Medicare enrollees. Little is known about how inclusion rates of physicians in MA plan networks vary by the social and clinical risks of their patients.

OBJECTIVE: To examine the association of physicians caring for patients with higher levels of social and clinical risk in traditional Medicare (TM) with the likelihood of inclusion in MA plan networks.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study evaluated the number of patients of physicians participating in TM Part B in 2019. The data analysis was conducted between June 2022 and March …

Comparison Of Patient Exit Interviews With Unannounced Standardised Patients For Assessing Hiv Service Delivery In Zambia: A Study Nested Within A Cluster Randomised Trial, Kombatende Sikombe, Aaloke Mody, Ingrid Eshun-Wilson, Elvin Geng, Et Al.

2020-Current year OA Pubs

OBJECTIVES: To compare unannounced standardised patient approach (eg, mystery clients) with typical exit interviews for assessing patient experiences in HIV care (eg, unfriendly providers, long waiting times). We hypothesise standardised patients would report more negative experiences than typical exit interviews affected by social desirability bias.

SETTING: Cross-sectional surveys in 16 government-operated HIV primary care clinics in Lusaka, Zambia providing antiretroviral therapy (ART).

PARTICIPANTS: 3526 participants aged ≥18 years receiving ART participated in the exit surveys between August 2019 and November 2021.

INTERVENTION: Systematic sample (every n

OUTCOME MEASURES: We compared patient experience among patients who received brief training prior to …

Are Cross-Sectional Safety Climate Survey Results In Operating Room Staff Associated With The Surgical Site Infection Rates In Swiss Hospitals?, Yvonne Pfeiffer, Andrew Atkinson, Judith Maag, Michael A. Lane, David Schwappach, Jonas Marschall

2020-Current year OA Pubs

OBJECTIVES: The aim of this study was to investigate the association between surgical site infections (SSIs), a major source of patient harm, and safety and teamwork climate. Prior research has been unclear regarding this relationship.

DESIGN: Based on the Swiss national SSI surveillance and a survey study assessing (a) safety climate and (b) teamwork climate, associations were analysed for three kinds of surgical procedures.

SETTING AND PARTICIPANTS: SSI surveillance data from 20 434 surgeries for hip and knee arthroplasty from 41 hospitals, 8321 for colorectal procedures from 28 hospitals and 4346 caesarean sections from 11 hospitals and survey responses from …

The Co-Morbidity Of Dsm-V Gambling With Dsm-V Mental Disorders And Substance Abuse In A Kenyan Context Of High Risk Schizophrenia, David M Ndetei, Victoria Mutiso, Reinpeter Momanyi, Pascalyne Nyamai, Christine Musyimi, Daniel Mamah

2020-Current year OA Pubs

INTRODUCTION: There is evidence that gambling disorder shares similarities with other types of addictive behavior, such as occurs in substance abuse. In addition, co-morbidity of gambling with mental disorders has been established in school-going students.

AIM: This study aimed at determining the comorbidity of DSM-V gambling disorder with DSM-V mental disorders and substance abuse in high school, college and university students in Kenya.

METHODS: This was a cross-sectional study among 536 high school, college and university students. We collected data on socio-demographic characteristics, economic indicators, DSM-V diagnosis including DSM-V gambling disorder and substance use disorders using the WHO ASSIST tool. …

Validation Of A Farsi Version Of The Eating Pathology Symptoms Inventory (F-Epsi) Among Iranian Adolescents, Reza N Sahlan, Jessica F Saunders, Ellen E Fitzsimmons-Craft

2020-Current year OA Pubs

PURPOSE: Limited research has validated eating pathology assessments in Iranian adolescent boys and girls. In particular, the measures that have been validated do not capture both boys' and girls' eating behaviors in adolescence. The purpose of the current study was to validate a Farsi version of the Eating Pathology Symptoms Inventory (F-EPSI) for use in Iranian adolescents.

METHODS: Participants (N = 913; 85.3% girls) were adolescents who completed a battery of questionnaires including the F-EPSI. In addition, F-EPSI data for Iranian adolescents were compared with those of previously published data of adult Iranian college students.

RESULTS: Confirmatory Factor Analysis (CFA) …

Care Of Bullet-Related Injuries: A Cross-Sectional Study Of Instructions And Prescriptions Provided On Discharge From The Emergency Department, Jane M. Hayes, L J. Punch, Kristen L. Mueller

2020-Current year OA Pubs

INTRODUCTION: There are more than 80,000 emergency department (ED) visits for non-fatal bullet-related injuries (BRI) per year in the United States. Approximately half of these patients are discharged home from the ED. Our objective in this study was to characterize the discharge instructions, prescriptions, and follow-up plans provided to patients discharged from the ED after BRI.

METHODS: This was a single-center, cross-sectional study of the first 100 consecutive patients who presented to an urban, academic, Level I trauma center ED with an acute BRI beginning on January 1, 2020. We queried the electronic health record for patient demographics, insurance status, …

Association Of Hospital Centrality In Inter-Hospital Patient-Sharing Networks With Patient Mortality And Length Of Stay, Regan W. Bergmark, Ginger Jin, Robert S. Semco, Marc Santolini, Margaret A. Olsen, Amar Dhand

2020-Current year OA Pubs

OBJECTIVE: The interdependence of hospitals is underappreciated in patient outcomes studies. We used a network science approach to foreground this interdependence. Specifically, within two large state-based interhospital networks, we examined the relationship of a hospital's network position with in-hospital mortality and length of stay.

METHODS: We constructed interhospital network graphs using data from the Healthcare Cost and Utilization Project and the American Hospital Association Annual Survey for Florida (2014) and California (2011). The exposure of interest was hospital centrality, defined as weighted degree (sum of all ties to a given hospital from other hospitals). The outcomes were in-hospital mortality and …

Associations Between Mental Health And Hiv Status Among Sexual Minority And Heterosexual Adolescents In Nigeria, Morenike Oluwatoyin Folayan, Olakunle Oginni, Olanrewaju Ibikunle Ibigbami, Uma Philip, Nserd Ntonoba Mfam, Chinedu Mbam, Amos Ganyam, Agada A Salem, Christopher Osuji, Cory Bradley, Joanne Lusher, Nadia Adjoa Sam-Agudu

2020-Current year OA Pubs

BACKGROUND: We aimed to determine associations between the mental health status of adolescents by self-reported sexual identity; and to determine associations between the mental health status of sexual minority adolescents living with and without HIV.

METHODS: This cross-sectional study collected data from Nigerians aged 13-19 years old using an online survey. We collected information on dependent (sexual identity) and independent (presence of depressive symptoms, generalised anxiety disorder, suicidal attempt/ideation, HIV status) study variables. A multivariate regression model determined associations between the dependent and independent variables. A second multivariate regression model was developed to establish associations between HIV status among sexual …

Prevalence Estimates Of Trafficking In Persons Using Statistical Definitions: A Cross-Sectional High-Risk Community Survey In Cape Town, South Africa, Rumi Kato Price, Annah K Bender, Floriana H Milazzo, Edna G Rich, Nicolette V Roman, Sheldon X Zhang, Erica L Koegler

2020-Current year OA Pubs

OBJECTIVES: Current research on trafficking in persons (TIP) relies heavily on legal and prosecutorial definitions. A public health approach has called for population-level assessment; however, identification of TIP victims lacks a standardised operational definition. This study applied the Prevalence Reduction Innovation Forum (PRIF) statistical definitions, developed by the US Department of State, to a community survey in Cape Town, South Africa.

DESIGNS: A high-risk sampling strategy was used. TIP screening questions from two instruments were matched with PRIF domain indicators to generate prevalence estimates. Sensitivity, specificity and receiver operating characteristics analyses were conducted to assess the performance of the two …

Wellness And Coping Of Physicians Who Worked In Icus During The Pandemic: A Multicenter Cross-Sectional North American Survey, Karen E. A. Burns, Rachel K. Mcdonald, Et Al.

2020-Current year OA Pubs

OBJECTIVES: Few surveys have focused on physician moral distress, burnout, and professional fulfilment. We assessed physician wellness and coping during the COVID-19 pandemic.

DESIGN: Cross-sectional survey using four validated instruments.

SETTING: Sixty-two sites in Canada and the United States.

SUBJECTS: Attending physicians (adult, pediatric; intensivist, nonintensivist) who worked in North American ICUs.

INTERVENTION: None.

MEASUREMENTS AND MAIN RESULTS: We analysed 431 questionnaires (43.3% response rate) from 25 states and eight provinces. Respondents were predominantly male (229 [55.6%]) and in practice for 11.8 ± 9.8 years. Compared with prepandemic, respondents reported significant intrapandemic increases in days worked/mo, ICU bed occupancy, and …

Multilevel Correlates Of Domain-Specific Physical Activity Among Rural Adults - A Cross-Sectional Study, Alan M Beck, Natalicio H Serrano, Audrey Toler, Ross C Brownson

2020-Current year OA Pubs

BACKGROUND: Increasing physical activity (PA) in rural communities is a vital prevention tactic in multiple chronic diseases; however, little is known on the multilevel correlates of PA rural areas. A better understanding of domain-specific PA adds context for promoting PA in rural communities. The current study sought to determine factors associated with domain-specific and overall moderate-vigorous physical activity (MVPA) in rural communities.

METHODS: Surveys were conducted across 14 rural mid-Western communities, with the final analytical sample including 1241 adults (ages 19-96, M = 57.0 [SD = 16.7], 67.8% female, 83.8% white). Generalized linear models with negative binomial distributions examined the …

Preventive Behaviors And Information Sources During Covid-19 Pandemic: A Cross-Sectional Study In Japan, Manae Uchibori, Cyrus Ghaznavi, Michio Murakami, Akifumi Eguchi, Hiroyuki Kunishima, Satoshi Kaneko, Keiko Maruyama-Sakurai, Hiroaki Miyata, Shuhei Nomura

2020-Current year OA Pubs

BACKGROUND: individual preventive behaviors are one of the key measures needed to prevent the spread of COVID-19. This study sought to identify the factors associated with the adoption of COVID-19 preventive measures, focusing specifically on information sources.

METHODS: we conducted a nationally representative cross-sectional survey of 30,053 Japanese adults in February 2021. The survey asked about socioeconomic, health-related, and psychological characteristics, attitudes toward immunization, and the use of information sources regarding COVID-19. We have constructed multivariable logistic regression to estimate the factors associated with the adoption of three preventive measures: 3Cs avoidance, hand hygiene and respiratory hygiene.

RESULTS: socioeconomic variables, …

Public Health Information Seeking, Trust, And Covid-19 Prevention Behaviors: Cross-Sectional Study, Emmanuel Kwabena Tetteh, Todd Combs, Elvin Hsing Geng, Virginia Ruth Mckay

2020-Current year OA Pubs

BACKGROUND: Preventative health measures such as shelter in place and mask wearing have been widely encouraged to curb the spread of the COVID-19 disease. People's attitudes toward preventative behaviors may be dependent on their sources of information and trust in the information.

OBJECTIVE: The aim of this study was to understand the relationship between trusting in COVID-19 information and preventative behaviors in a racially and politically diverse metropolitan area in the United States.

METHODS: We conducted a web-based cross-sectional survey of residents in St. Louis City and County in Missouri. Individuals aged ≥18 years were eligible to participate. Participants were …

Employment Loss And Food Insecurity - Race And Sex Disparities In The Context Of Covid-19, Jacquelyn V Coats, Sarah Humble, Kimberly J Johnson, Havisha Pedamallu, Bettina F Drake, Elvin Geng, Charles W Goss, Kia L Davis

2020-Current year OA Pubs

INTRODUCTION: Applying an intersectional framework, we examined sex and racial inequality in COVID-19-related employment loss (ie, job furlough, layoff, and reduced pay) and food insecurity (ie, quality and quantity of food eaten, food worry, and receipt of free meals or groceries) among residents in Saint Louis County, Missouri.

METHODS: We used cross-sectional data from adults aged 18 or older (N = 2,146), surveyed by using landlines or cellular phones between August 12, 2020, and October 27, 2020. We calculated survey-weighted prevalence of employment loss and food insecurity for each group (Black female, Black male, White female, White male). Odds ratios …

Depression, Stigma And Social Isolation: The Psychosocial Trifecta Of Primary Chronic Cutaneous Lupus Erythematosus, A Cross-Sectional And Path Analysis, Cristina Drenkard, Kristina A Theis, Timothy T Daugherty, Charles G Helmick, Charmayne Dunlop-Thomas, Gaobin Bao, Laura Aspey, Tené T Lewis, S Sam Lim

2020-Current year OA Pubs

OBJECTIVE: Depression is common in individuals with chronic cutaneous lupus erythematosus (CCLE). However, how CCLE may impact patients' psychological well-being is poorly understood, particularly among disproportionally affected populations. We examined the relationships between depression and psychosocial factors in a cohort of predominantly Black patients with primary CCLE (CCLE without systemic manifestations).

METHODS: Cross-sectional assessment of individuals with dermatologist-validated diagnosis of primary CCLE. NIH-PROMIS short-forms were used to measure depression, disease-related stigma, social isolation and emotional support. Linear regression analyses (ɑ=0.05) were used to test an a priori conceptual model of the relationship between stigma and depression and the effect of …

Patient Preferences For Strategies To Improve Tuberculosis Diagnostic Services In Zambia, Andrew D Kerkhoff, Lophina Chilukutu, Sarah Nyangu, Mary Kagujje, Kondwelani Mateyo, Nsala Sanjase, Ingrid Eshun-Wilson, Elvin H Geng, Diane V Havlir, Monde Muyoyeta

2020-Current year OA Pubs

Importance: Delayed engagement in tuberculosis (TB) services is associated with ongoing transmission and poor clinical outcomes.

Objective: To assess whether patients with TB have differential preferences for strategies to improve the public health reach of TB diagnostic services.

Design, Setting, and Participants: A cross-sectional study was undertaken in which a discrete choice experiment (DCE) was administered between September 18, 2019, and January 17, 2020, to 401 adults (>18 years of age) with microbiologically confirmed TB in Lusaka, Zambia. The DCE had 7 attributes with 2 to 3 levels per attribute related to TB service enhancements. Latent class analysis was …

Hold That Pose: Capturing Cervical Dystonia's Head Deviation Severity From Video, Zheng Zhang, Joel S Perlmutter, Et Al

2020-Current year OA Pubs

OBJECTIVE: Deviated head posture is a defining characteristic of cervical dystonia (CD). Head posture severity is typically quantified with clinical rating scales such as the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS). Because clinical rating scales are inherently subjective, they are susceptible to variability that reduces their sensitivity as outcome measures. The variability could be circumvented with methods to measure CD head posture objectively. However, previously used objective methods require specialized equipment and have been limited to studies with a small number of cases. The objective of this study was to evaluate a novel software system-the Computational Motor Objective Rater …

Comparison Of Performance Of Psychiatrists Vs Other Outpatient Physicians In The 2020 Us Medicare Merit-Based Incentive Payment System, Andrew C Qi, Karen E Joynt Maddox, Laura J Bierut, Kenton J Johnston

2020-Current year OA Pubs

Importance: Medicare's Merit-Based Incentive Payment System (MIPS) is a new, mandatory, outpatient value-based payment program that ties reimbursement to performance on cost and quality measures for many US clinicians. However, it is currently unknown how the program measures the performance of psychiatrists, who often treat a different patient case mix with different clinical considerations than do other outpatient clinicians.

Objective: To compare performance scores and value-based reimbursement for psychiatrists vs other outpatient physicians in the 2020 MIPS.

Design Setting and Participants: In this cross-sectional study, the Centers for Medicare & Medicaid Services Provider Data Catalog was used to identify outpatient …

Stigma Towards Mental Illness And Help-Seeking Behaviors Among Adult And Child Psychiatrists In Hungary: A Cross-Sectional Study, Dorottya Őri, Péter Szocsics, Tamás Molnár, Fanni Virág Ralovich, Zsolt Huszár, Ágnes Bene, Sándor Rózsa, Zsuzsa Győrffy, György Purebl

2020-Current year OA Pubs

OBJECTIVE: Stigma towards people with mental health problems is a growing issue across the world, to which healthcare providers might contribute. The aim of the present study was to explore psychiatrists' attitudes towards their patients and link them to psychosocial and professional factors.

METHODS: An online questionnaire was used to approach the in- and outpatient psychiatric services across Hungary. A total of 211 trainees and specialists in adult and child psychiatry participated in our study. Their overall stigmatizing attitudes were measured, with focus on attitude, disclosure and help-seeking, and social distance dimensions by using the self-report Opening Minds Stigma Scale …

The Influence Of Green Space On Obesity In China: A Systematic Review, Jing Shen, Mengfei Li, Qianhui Wang, Ruidong Liu, Mengmeng Ji, Ruopeng An

2020-Current year OA Pubs

INTRODUCTION: This study systematically reviewed scientific evidence concerning the influence of green space on obesity in China.

METHODS: Keyword and reference search was conducted in PubMed, Web of Science, Scopus, EBSCO, and CNKI. Predetermined selection criteria included study designs: experimental and observational studies; subjects: people of all ages; exposures: green space (i.e., any open land partly or entirely covered with grass, trees, shrubs, or other vegetation); outcomes: body weight status (e.g., body mass index [BMI], overweight, or obesity); and country: China.

RESULTS: Ten studies met the selection criteria and were included in the review. All studies adopted a cross-sectional design. …

Women And Ethnoracial Minorities With Poor Cardiovascular Health Measures Associated With A Higher Risk Of Developing Mood Disorder, Aixia Guo, Kari A Stephens, Yosef M Khan, James R Langabeer, Randi E Foraker

2020-Current year OA Pubs

BACKGROUND: Mood disorders (MDS) are a type of mental health illness that effects millions of people in the United States. Early prediction of MDS can give providers greater opportunity to treat these disorders. We hypothesized that longitudinal cardiovascular health (CVH) measurements would be informative for MDS prediction.

METHODS: To test this hypothesis, the American Heart Association's Guideline Advantage (TGA) dataset was used, which contained longitudinal EHR from 70 outpatient clinics. The statistical analysis and machine learning models were employed to identify the associations of the MDS and the longitudinal CVH metrics and other confounding factors.

RESULTS: Patients diagnosed with MDS …

Factors Associated With Viremia In People Living With Hiv On Antiretroviral Therapy In Guatemala, Dean W Ortíz, Olivia Roberts-Sano, Hugo E Marroquin, Lindsey Larson, Katherine B Franco, Andrej Spec, Johanna R Melendez, Rodolfo Pinzón, Ana J Samayoa, Carlos Mejia-Chew, Jane A O Halloran

2020-Current year OA Pubs

INTRODUCTION: Viral suppression prevents HIV transmission and disease progression, but socio-economic and clinical factors can hinder the goal of suppression. We evaluated factors associated with viral non suppression (VNS) and persistent viremia (PV) in people living with HIV (PLHIV) receiving antiretroviral therapy (ART) in Guatemala.

METHODS: We conducted a cross sectional analysis using data from an ongoing cohort of PLHIV attending the largest HIV clinic in Guatemala. Univariable and multivariable analyses were conducted between PLHIV with viral suppression and detectable viremia. VNS was defined as most recent HIV RNA ≥ 200 copies/ml and PV as two consecutive HIV RNA ≥ …

Outcomes And Risk Factors Associated With Sars-Cov-2 Infection In A North American Registry Of Patients With Multiple Sclerosis, Amber Salter, Robert J Fox, Scott D Newsome, June Halper, David K B Li, Pamela Kanellis, Kathleen Costello, Bruce Bebo, Kottil Rammohan, Gary R Cutter, Anne H Cross

2020-Current year OA Pubs

Importance: Emergence of SARS-CoV-2 causing COVID-19 prompted the need to gather information on clinical outcomes and risk factors associated with morbidity and mortality in patients with multiple sclerosis (MS) and concomitant SARS-CoV-2 infections.

Objective: To examine outcomes and risk factors associated with COVID-19 clinical severity in a large, diverse cohort of North American patients with MS.

Design, Setting, and Participants: This analysis used deidentified, cross-sectional data on patients with MS and SARS-CoV-2 infection reported by health care professionals in North American academic and community practices between April 1, 2020, and December 12, 2020, in the COVID-19 Infections in MS Registry. …