Health Care Research Articles

Preliminary observations on the influence of maternal pregnancy factors and birth factors on pediatric astigmatism

Objective: To investigate the impact of maternal factors during pregnancy and birth factors on astigmatism in children. Methods: It was a case-control study. Patients aged 3 to 12 years old were continuously selected from October 2023 to January 2024 in the Pediatric Eye Care Department of Qinhuangdao Maternal and Child Health Care Hospital. Children with astigmatism were included as the case group, and children without astigmatism were included as the control group. All children underwent cycloplegic autorefraction. Astigmatism was defined as a cylinder refractive error with an absolute value of≥1.00 diopter. Only the right eye were included in the analysis. The maternal factors during pregnancy [maternal age at delivery, delivery mode, paternal age, progesterone during pregnancy, pre-pregnancy body mass index (BMI), gestational weight gain, smoking during pregnancy, hypertensive disorders of pregnancy, gestational diabetes mellitus] and children's birth history [birth weight, birth order, BMI, preterm birth, nuchal cord] were recorded. The independent t-test, non-parametric test, and Chi-square test were used for comparison between groups. Multiple logistic regression analysis was performed and risk factors during pregnancy for astigmatism in children were identified by calculating the odds ratio (OR) and its 95% confidence interval (95%CI). Results: A total of 146 children (146 eyes) were included in the case group, consisting of 73 males and 73 females with a median age of 6 (5, 9) years, and 161 children (161 eyes) were included in the control group, consisting of 73 males and 88 females with a median age of 7 (5, 9) years. No statistically significant differences in age and gender were found between the two groups (all P>0.05). Multiple logistic regression analysis, with adjustment for confounding factors, showed that the maternal pre-pregnancy BMI 24.0 to <28.0 kg/m2 (OR=2.79, 95% CI: 1.46 to 5.35, P=0.002) or ≥28.0 kg/m2 (OR=3.97, 95% CI: 1.19 to 13.21, P=0.024), birth weight <2.5 kg (OR=5.44, 95% CI: 1.10 to 26.88, P=0.038), and birth order ≥ 2 (OR=2.06, 95% CI: 1.16 to 3.66, P=0.013) were risk factors of astigmatism in children. Conclusions: Higher maternal pre-pregnancy weight, lower birth weight, and non-firstborn status were associated with pediatric astigmatism.

An Ounce of Prevention: The Growing Need for Preventive Neurologists.

The global burden of neurologic disorders is rising, driven by aging populations and improved survival following acute neurologic events. As a result, more individuals are living with long-term disabilities from conditions such as stroke, dementia, and other neurodegenerative diseases. Despite significant advances in neurology, there remains an urgent need for a preventive approach to mitigate these trends. Growing evidence highlights the effectiveness of preventive strategies, including lifestyle modifications and risk factor management, in preserving brain health and reducing the risk of stroke, neurodegenerative conditions, and cognitive decline. Preventive neurology operates within a multilevel framework, ranging from direct patient-centered interventions to systemic policy actions requiring organizational and societal support. Neurologists are uniquely positioned as advocates for brain health, promoting preventive strategies in line with the American Academy of Neurology's Brain Health Initiative. This article explores how neurologists can drive change across individual, family, community, and policy levels by leveraging their clinical expertise, community engagement, and health policy influence. Sustainable progress in brain health will also require system-level changes that integrate preventive goals into the fabric of health care delivery, public health infrastructure, and policy frameworks. Special attention is given to underserved populations, who bear a disproportionate burden of neurologic diseases. Through targeted interventions, public health initiatives, and collaborative care models, preventive neurologists can shape brain health outcomes across the lifespan. Training neurologists with a preventive focus will integrate brain health promotion into standard neurology practice, complementing disease management. By addressing the root causes and risk factors of neurologic conditions, preventive neurology provides a pathway to improving quality of life while reducing the global health care burden.

Remote Monitoring of Amyotrophic Lateral Sclerosis Using Digital Health Technologies: Shifting Toward Digitalized Care and Research?

Current care and research pathways for amyotrophic lateral sclerosis (ALS) primarily rely on regularly scheduled visits to specialized centers. These visits provide intermittent clinical information to health care professionals and require patients to travel to the clinic. Digital health technologies enable continuous data collection directly from the patient's home, bringing new opportunities for personalized, timely care and a refined assessment of disease severity in clinical trials. In this review, we summarize the state of the art in digital health technologies for remote monitoring of patients with ALS, ranging from televisits through videoconferencing to sensor-based wearable devices. We explore how these technologies can benefit clinical care and advance treatment development. Despite significant progress, real-world adoption of these technologies remains limited. An overview is provided of the key barriers hindering their widespread implementation and the opportunities to advance the field. Significantly, there is an urgent need for harmonization across stakeholders through consensus guidelines and consortia. These efforts are essential to accelerate progress and harness the full potential of digital health technologies to better meet the needs of patients.

Detection and Recognition of Multitask Human Action Identification from Preloaded Videos Using CCTV Stationary Cameras

Human activities include group activities, individual actions, and interactions between objects and people. In computer vision technology, recognizing and categorizing these activities is a vital process. This system will aim at developing a model that can recognize and detect such behavior and apply it in surveillance, health care, military operations, and patient monitoring. In the first place, videos were gathered in order to get a better understanding of the various human activities and interactions. Subsequently, we have converted Video frames into images and pre-processed each image. Characteristic features are extracted from video images by capturing spatial and temporal details. Spatio-temporal interest points using three descriptors Harris STIP, Gabor STIP, and HoG3D STIP are extracted as features. Extracted features are passed to a Heatmap generation process which gives confident key features related to human action. Support Vector Machine (SVM) Classifier is used to analyze these confident key features to label and classify human actions. Various classifier performance metrics, such as accuracy, sensitivity, and specificity, were used to evaluate the performance of the system. Classifiers exhibiting accuracy of around 98.60% served as an indicator of the overall reliability of the proposed system in effectively recognizing human actions.

An Oral Healthcare Recommendation Framework Using Lion Inspired Feature Optimization and SVM Classification

Oral health care is indispensable for patients with insulin resistance. This research work presents a novel framework for oral implant recommendation for insulin resistant patients. This framework recommends optimal implant types and customized preoperative strategies which are contemplated for such patients. This framework integrates a synthetic patient data modelling with more clinically significant features like HbA1c, bone density and glycemic control indicators. 3000 data which mimics the clinical data is generated and with which the model is trained. The features are optimized using a Lion’s Pride Inspired Algorithm (LPIA) which imitates the behavioural traits of Lions in their pride. The method of elitism is adopted for obtaining the optimal solution set. The classification is done by using Support Vector Machine. This combo demonstrated a strong performance with LPIA optimized feature space achieving a maximum classification of 81% and F1-weighted score up to 0.31. The ROC analysis was also performed for the implant types like Zirconia which produced AUC scores above 0.90 which validates the discriminatory capacity of the proposed framework. In addition, the clinical recommendation regarding the implant timing, glycemic management were generated dynamically. These results demonstrate the capability of the proposed framework as an intelligent, interpretable and patient specific decision support tool for dental implant planning in diabetic care.

Critical actions for embedding research evidence into practice: how to get the most out of your implementation scientist.

Implementation science has been gaining traction over the last decade to support health care systems in adopting and sustaining evidence-based interventions, programs, and policies. Given the inherent complexity of implementation research and practice, and their associated methodologies, implementation scientists play a central role in translating research into practice. However, many health care system stakeholders often struggle to understand how best to collaborate with implementation scientists. This commentary discusses the significant benefits of such collaboration, outlining ten critical actions drawn from the collective experience of 25 implementation scientists with over 173 years of combined expertise. This project was conducted under the SPHERE Implementation Science Platform, as part of the Sydney Partnership for Health, Education, Research and Enterprise (SPHERE).The ten recommendations for working with an implementation scientist to optimize implementation efforts include the following: (1) involve implementation scientists early during intervention design, (2) recognize the unique nature and value of implementation science data, (3) integrate implementation assessments into the research plan, (4) foster collaborative partnerships inclusive of implementation science, (5) differentiate between factors affecting implementation and wider constraints, (6) work with implementation scientists to address implementation challenges, (7) prioritize implementation scale and sustainment, (8) embrace that implementation requires continuous learning and adaptation, (9) promote knowledge exchange between implementation science and subject matter experts, and (10) focus on capability- and capacity-building for implementation within the system. By following these recommendations, researchers, clinicians, decision-makers, and implementation scientists can foster impactful collaborations that enhance the translation of research into clinical practice and improve the quality of health care delivery. http://links.lww.com/IJEBH/A374.

Health-promoting and adverse pathways in the healthcare experiences of LGBTQIA+ individuals: a qualitative investigation

ABSTRACT The current study investigated the healthcare experiences of LGBTQIA+ individuals from the perspective of the health equity promotion model, focusing on the factors that promote or hinder equitable healthcare pathways across diverse settings. A sample of 154 LGBTQIA+ individuals living in Italy responded to two open questions concerning their positive and negative experiences within healthcare settings related to their LGBTQIA+ identities. Thematic analysis identified two main themes: (1) health-promoting pathways, encompassing three subthemes (i.e. affirmation of LGBTQIA+ identities, non-judgemental attitudes and lack of prejudice, professional competence and education about LGBTQIA+ health needs); and (2) adverse pathways, encompassing four subthemes (i.e. cis-heteronormative assumptions, homo-transphobic attitudes, lack of competence and information, consequences of negative healthcare experiences). Barriers to accessing and utilising healthcare services were linked to professionals’ affirming attitudes, validation of LGBTQIA+ identities, (lack of) professionalism and prejudice, quality of information provided, and patient perceptions of competence in LGBTQIA+ health needs. The findings suggest that training on the specific health needs of LGBTQIA+ populations should be included in mental and medical healthcare curricula to enhance care quality, dismantle cis-heteronormative beliefs, and mitigate homo-transphobic attitudes that negatively impact the health trajectories of LGBTQIA+ individuals.

Telehealth for the management of patients with type 2 diabetes in remote areas of Taiwan: a best practice implementation project.

Telehealth services integrate technology with specialized medical care, and can be used to improve blood sugar management and reduce complications in patients with type 2 diabetes. This study aimed to improve telemedicine care for patients with type 2 diabetes in public health centers in remote Indigenous communities in Taiwan through evidence-based practices. This included increasing the rates of ophthalmic examinations and enhancing the capacity of health care providers. This project followed the JBI Evidence Implementation Framework and was supported by the JBI Practical Application of Clinical Evidence System (PACES). Baseline and follow-up audits were conducted among health care providers and patients with type 2 diabetes to measure compliance with best practices and determine any improvements in practice after implementation. HbA1c levels in patients with type 2 diabetes were analyzed using paired sample t-tests, with statistical significance set at p < 0.05. The follow-up audit revealed that compliance rates for the six audit criteria improved, with Criteria 1-5 increasing from 62.5% to 87.5% or 100%. Additionally, Criterion 6 improved from 37.5% to 62.5%. The HbA1c values of the patients showed pre- and post-intervention means of 7.8291% and 7.3236%, respectively. Using a coaching leadership model along with JBI audit criteria to enhance the knowledge and skills of health care providers was essential for the success of the project. This approach resulted in significant advancements in caring for people with type 2 diabetes. http://links.lww.com/IJEBH/A377.

A Physician Conduct Improvement Program to Address Disruptive Behavior in a Health Care Setting.

In an effort to provide comprehensive and consistently high-quality health care, the need to address professional behavior is rising. The physician conduct program was designed to reduce physician conduct concerns while providing an organizational culture in which physicians would thrive. This program includes a trained team, an event-reporting system, and a physician advisory council. Root causes, perspectives, and corrective strategies for each reported incident are explored with identified individuals in each incident. Over the 4 past years, complaints (n = 583) have included: rude or disrespectful comments to colleagues (52%), lack of physician communication with colleagues (15%), disrespectful interactions (23%) and inadequate communication with patients (5%), and violation of organizational policies (5%). The professional conduct program has provided a cohesive, systematic resource aligned with the health system's focus on teamwork, collegiality, and excellence in patient care.

A Community-Led Approach to Addressing Health Disparities among Adolescent and Young Adult Cancer Survivors.

Purpose: Adolescent and young adult (AYA) cancer survivors (i.e., those diagnosed between the ages of 15 and 39 years) experience significant health and health care disparities. Formal evaluation of the role of community-based organizations in addressing these disparities is limited. Through a novel Health Equity Initiative, which included a series of community-driven conversations), Stupid Cancer, an AYA-focused cancer patient advocacy organization, sought to better understand the perceived impact of racism, homophobia, transphobia, and ableism on supportive cancer care among AYAs. Methods: This paper describes how Stupid Cancer developed and implemented its Health Equity Initiative programming (2021-2023) and presents findings from this program. Community-driven conversations comprised of several virtual focus groups, working groups, and town halls conducted via Zoom over the two years. We performed thematic analysis of transcripts from community-driven conversations. Results: Three themes were identified from community-driven conversations across initiative events 1) perception, 2) transition, and 3) representation. Based on these findings and further community discussions, four solutions were codeveloped with community members, which serve as proposed mechanisms for addressing identified health care inequities among AYA cancer survivors. Conclusion: Inclusivity and representation are vital components of AYA cancer care delivery. More research and quality improvement initiatives are needed to identify community-level interventions to mitigate health care disparities, ensuring all AYAs receive access to high-quality cancer care.

Socialist medical mobilities from the Global East: Hungarian women’s access and experiences, 1950s–1960s

ABSTRACT The Second World, and Hungary within it, developed extensive medical assistance and expert mobility programs to improve health care infrastructure and access in many countries of the Global South. While these programs peaked in the years of late socialism, there have been few attempts to trace their genealogies. Yet it is crucial to understand how early socialist medical assistance shaped the structures and processes that underpinned the more robust and better-remembered projects of the 1970s and 1980s. This article helps fill the gap by focusing on the experiences of Hungarian women medical professionals who traveled in the 1950s to North Korea and in 1963 to Algeria, in parallel with the new opportunities opened through Hungary’s reentry into the World Health Organization. It argues for the importance of both initiating systematic periodization and extending the scope of research beyond physicians, including other health care personnel to make class visible within these mobilities. In line with these goals, I offer an account of early Hungarian medical assistance to North Korea and Algeria, primarily through the stories of women doctors, nurses, and operating room assistants.

Access to medicines, care, and services for multiple sclerosis patients in Central and Eastern European countries: a comparative analysis

ABSTRACT Background The study compared access to disease-modifying treatments (DMTs), care, and services for multiple sclerosis (MS) patients across six Central and Eastern European Countries (CEECs). Research design and methods A 2-part questionnaire-based survey was conducted among experts from Bulgaria, Estonia, Poland, Romania, Serbia, and Slovakia over 4 months (1 December 2022 – 1 April 2023). Results The study reveals notable variations in the legal requirements for pricing and reimbursement of MS medications, as well as criteria for health technology assessment (HTA) across countries. Despite these differences, DMTs were fully reimbursed in all countries. Poland exhibited the highest MS expenditures in 2021, totaling 171 million euros. Administrative procedures for prescribing and dispensing MS drugs were similar across countries, but the range of services and support offered to MS patients varied. Assessment of treatment accessibility, based on the number of authorized DMTs listed in Positive Drug Lists (PDLs), shows Bulgaria leading with 84.21% access, followed closely by Poland and Slovakia with comparable rates of 78.95%. Conclusions The study revealed disparities in health care and services for MS patients across the countries surveyed. Addressing these disparities and the need for targeted interventions to ensure equitable access is critical. Further research is needed to find effective solutions.

It "Made a Huge Difference when He had a Dry Bed in the Morning": Impacts of Dementia-Related Incontinence on Unpaid Carers' Sleep, Health, and Quality of Life.

Incontinence is a common consequence of dementia. Incidence is more likely at night, having repercussions for sleep quality and the exacerbation of waking symptoms of dementia as well as negative carer affect. However, the person-centred experience is underrepresented. A thematic analysis was conducted on continence-related comments from a pool of 94 carers participating in a postal sleep survey. Then, a narrative analysis was used on interview transcripts from 13 participants who took part in follow-up interviews after their care recipient had transitioned into aged residential care. Themes illustrate how promoting continence or managing incontinence impacts unpaid caregivers in terms of sleep disruptions and subsequent wellbeing. These are presented alongside overarching narratives of sleep, continence, and caregiving. Including the physical nature of continence-related support and its impact on sleep practices, as well as the emotional impact of balancing sleep needs alongside caregiving responsibilities and overall wellbeing with ageing. Toilet use and (in)continence needs can have profound impacts on sleep and wellbeing within dementia care, having the potential to jeopardise the overall home care situation. Findings will inform future research in the field of sleep and ageing as well as strategies for supporting families affected by dementia. In particular, the results will inform the production of a core outcome set comprising appropriate quality indicators for people living with dementia, their caregivers, and family so that adequate continence care can be assessed and supported in future interventions.

Vocational Rehabilitation Services for Person with Disabilities in Bangladesh: Identifying Service Gap and Scopes for Improvement

Background Vocational rehabilitation is a systematic process aimed at enabling persons with disabilities by providing essential skills and resources to obtain and sustain meaningful work. Objective This research seeks to provide a concise overview of the vocational rehabilitation system in Bangladesh and evaluate the existing vocational rehabilitation services for persons with disabilities. Method This scoping review documented the existing vocational rehabilitation services for people with disabilities in Bangladesh from various electronic databases and policy reports. Results Many groups, including government agencies, non-governmental organizations (NGOs), and international organizations provide vocational rehabilitation programs for individuals with impairments. These programs aim to empower individuals with disabilities by equipping them with vital skills and information for workforce participation and autonomous life. Nevertheless, numerous organizations offering these services remain deficient in suitable facilities. Conclusion Bangladesh is facing multiple challenges in delivering vocational rehabilitation programs for persons with disabilities. The traditional health care delivery system excludes rehabilitation and neglects health policy and vocational rehabilitation. To improve vocational rehabilitation service delivery, the nation should integrate and elevate vocational rehabilitation within the healthcare system.

Fatal coinfection with Hepatozoon canis, Babesia vogeli, Ehrlichia canis, and Bartonella clarridgeiae in a dog from Argentina.

Vector-borne diseases represent a growing global threat, exposing new populations to previously unknown infectious agents, and posing diagnostic challenges for veterinarians. The aim of this article is to present a clinical case of coinfection with different hemoparasites in a canine with severe ectoparasite infestation and clinical signs of shock. Blood smears and complete necropsy were performed. Samples of different organs were obtained for histopathological and molecular biology studies. Examination of the blood smears showed azurophilic intracytoplasmic structures, compatible with the morphology of Ehrlichia canis, monocytes with the presence of gametocytes inside neutrophils, compatible with infection with Hepatozoon canis, and pyriform intraerythrocyte structures compatible with large piroplasms. Acridine orange staining, performed on different histological sections, allowed visualizing textures on fluorescent microscopy analysis, which were morphologically compatible with Bartonella sp. Molecular tests were positive for Ehrlichia spp., Hepatozoon spp., Babesia spp. and Bartonella spp. Control of vector-borne diseases would improve the health and well-being of animals and humans, especially in developing countries in the tropics, where the risk of contracting these diseases is high and access to health care is poor. Vector-borne diseases should always be suspected and included in the differential diagnosis, especially in areas with the presence of ticks and fleas.

Development of a Smart Health Care Service Using Metaverse and Chatbot Technologies for Adolescents, Parents, and School Health Teachers: User-Centered Design Approach.

Adolescent health issues, particularly obesity, have become increasingly serious, highlighting the need for health management strategies tailored to the unique life cycle characteristics of adolescents. This study aimed to develop a smart health care service for adolescents, their parents, and school health teachers to enhance their health. The service leverages a mobile app, a web platform, wearable devices, the metaverse, and chatbots. The development process included a needs assessment, core user interface (UI) design, and service model creation. The needs assessment involved a literature review of 65 studies, a web survey of 96 participants, and 30 interviews. A usability evaluation of the core UI, shaped by the insights from the needs assessment, was conducted with 76 participants. The service was conceptualized emphasizing school settings to cater to school-aged users, ensuring that the design is closely aligned with user needs. In addition, it incorporates features to deliver personalized services based on individual health information and uses gamification elements to enhance user engagement. The core UI was developed in response to the needs assessment findings, supported by a user flowchart. Furthermore, we created a use case diagram illustrating the interaction between various users and the services, a flowchart outlining the service algorithm, and a lifelog data collection system. The core UI usability evaluation results revealed that both students and parents considered sleep management important, while school health teachers deemed the measurement of physical activity essential. Students and parents prioritized physical activity measurement, and students particularly favored rewards for activities as the most promising solutions for health management challenges. The outcomes of the core UI usability evaluation indicated that school health teachers rated effectiveness (mean 4.26, SD 0.41), usefulness (mean 4.18, SD 0.54), usability (mean 4.29, SD 0.55), and user control (mean 4.08, SD 0.60) highly, reflecting the highest expectations across all categories. This study demonstrated that a school-based smart health care service can effectively support adolescent health management by integrating personalized health data, gamification, and interactive tools. The usability evaluation revealed that students and parents prioritized sleep and physical activity tracking, while school health teachers emphasized the importance of monitoring physical activity. In addition, reward-based engagement strategies were identified as a promising approach to improve adolescent health behaviors. These findings suggest that leveraging digital health solutions tailored to adolescents' needs can contribute to establishing sustainable health habits from an early age.

From feed to food – Understanding the impact of aflatoxins consumption by Pakistani livestock

Abstract Despite the crucial role of livestock in Pakistan’s economy, this sector remains largely overlooked, particularly concerning animal feed quality. Substandard and contaminated feed, especially with hazardous aflatoxins, poses significant challenges. This review article aims to assess the impact of aflatoxin contamination in livestock feed on animal health, productivity and food safety with a special focus on Pakistan. Aflatoxins, toxic metabolites produced by certain fungi, are frequently found in feed due to poor storage and handling practices. Their presence not only compromises animal health but also leads to their transfer through animal derived products, such as milk, meat and eggs, posing serious public health risks. Therefore, there is an urgent need for Pakistan’s livestock and food industries to recognize the significance of the issue, and to strengthen efforts to understand, monitor and control feed contamination in order to protect public health and food supply chains. This review synthesizes findings from national and international studies, highlighting the prevalence of aflatoxins in livestock feed and their residues in food products. It also discusses the regulatory standards for aflatoxins, identifies major gaps in compliance in Pakistan, and evaluates various control strategies – ranging from pre-harvest interventions and proper storage to the use of mycotoxin binders and regular feed monitoring. The findings underscore that aflatoxin levels in many feed samples often exceed permissible limits, resulting in adverse health effects on both livestock and human health. The principal conclusion emphasizes the urgent need for implementing aflatoxin control strategies in the feed supply chain. Ensuring safe, high-quality, toxin-free feed not only can improve animal health and productivity, but it will also enhance food safety and promote the opportunities for the export of animal-based products. One Health impact statement This article explains how aflatoxins in livestock feed a matter of concern are not just for animal health but also for human health. Aflatoxins in feed also affect the production and health of animal resulting in low- and poor-quality animal products. Chronic exposures of aflatoxins may lead to death of animals. The contaminated feed consumed by the animals is metabolized in the animal’s body and the metabolites are secreted in meat, milk, eggs etc. Human beings consuming these animal-based products become exposed to aflatoxins, which are potent carcinogens, also causing liver damage and immune suppression. Additionally, they cause stunted growth in children as well. The improper storage and handling of aflatoxin contaminated feed contributes to the proliferation of Aspergillus flavus , the aflatoxin-producing fungi, especially in warm and humid climate. This reflects poor agricultural practices and degraded environment which perpetuates the cycle of contamination. Contaminated feed and animal products also have economic implications, like reduced marketability of animal products, trade restrictions on animal products and increased health care cost. By adopting a trans-disciplinary approach, interventions can target the root causes of aflatoxin contamination in livestock feed, promote sustainable agricultural practices and ensure safer food systems for animal and human beings, preserving the environmental integrity.

HR practices and the well-being of a marginalized workforce: a review of home health care worker well-being research

Abstract Worker wellbeing is increasingly recognized as a critical factor influencing both organizational and societal outcomes; and is therefore of key interest to the discourse on Common Good Human Resource Management (HRM). This paper presents a systematic review of the literature on HRM practices and worker wellbeing in the context of home health care workers (HHCWs), a workforce characterized by gendered labour, low wages, and limited status. Despite the sector’s growing importance, we find a significant lack of research into how HRM influences wellbeing in marginalized and precarious contexts. Four critical gaps are identified: (1) limited attention to the gendered dimensions of wellbeing, (2) insufficient exploration of the interrelated nature of wellbeing dimensions, (3) a narrow organizational-level focus that overlooks external influences, and (4) a lack of emphasis on worker-centered outcomes. By addressing these gaps, this paper proposes a future research agenda that not only deepens our understanding of HHCWs’ wellbeing but also advances theoretical development of wellbeing in marginalized occupational settings.

Predictors of Discharge Disposition Following Surgical Stabilization of Rib Fractures.

Introduction: Patients are commonly discharged to either home health care (HHC), skilled nursing facility (SNF), or inpatient rehabilitation facility (IRF) following surgical stabilization of rib fractures (SSRF) to assist with recovery. This study explores demographic and surgical factors that may be associated with discharge disposition to a transitional care setting (HHC, SNF, and IRF) relative to routine discharge (self-care) following SSRF. Methods: Patients who underwent SSRF between 2017 and 2021 were included using retrospective data from the National Trauma Data Bank. Patients were stratified by discharge status: routine, HHC, SNF, or IRF. Multinomial logistic regression models were estimated to assess the association between discharge disposition and patient demographic and clinical factors. Results: We abstracted approximately 10,000 SSRF patients between 2017 and 20. Older age, private insurance, and female sex were associated with greater odds of discharge to either HHC, SNF, or IRF than routine discharge. Compared to white patients, black patients were associated with lower odds of discharge to SNF and IRF. Injury severity score, hospital length of stay, time on ventilator, and experiencing a pulmonary embolism were associated with greater odds of discharge to HHC, SNF, and IRF relative to routine. However, the number of ribs fractures and plated were not significantly associated with discharge to HHC or SNF (P > 0.05). Conclusion: This study indicates several patient characteristics and surgical factors to consider when forming a transitional care plan for patients following SSRF, which may help guide patient counseling and improve postoperative outcomes.

Recruiting Asian Americans for Online Studies: Methodological Systematic Review.

Engaging Asian American participants in research studies helps to understand their health needs and health disparities better. However, recruiting Asian Americans for online studies remains challenging. This study aims to synthesize strategies for recruiting Asian Americans to research studies that collected data online and to further explore the characteristics of the recruited participants. A systematic review method was used. Data were searched in the PubMed, CINAHL, and OVID databases using Medical Subject Headings (MeSH) terms and title search strategies. A narrative synthesis was conducted to summarize strategies for recruiting Asian Americans to online research studies. An independent Student t test (2-tailed and unpaired) was performed to compare the characteristics of recruited Asian Americans, using SPSS 29.0 software. The study was reported in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 checklist. After data extraction, 18 studies were included in this review. Results showed that strategies for recruiting Asian Americans to research studies that collected data online included both online and offline methods. Online recruitment methods included online survey market services, social media groups, online advertisements, and email lists. Offline recruitment methods included churches, community organizations, local clinics, health care centers, American Cancer Society local chapters, and cancer registries. Among the online and offline recruitment methods, social media groups and community recruitment were the most frequently used, respectively. The most commonly used online study platform was self-designed project websites. Participants engaged in the online studies tended to be in their middle adulthood and have a high level of education beyond high school. Compared with those recruited offline, participants recruited online tended to be younger and more highly educated. This study suggests that researchers may use mixed recruitment methods, combining both online and offline approaches, to recruit Asian Americans to online studies. When selecting the recruitment venue, researchers should consider project budget, data security, data quality, and credibility. They should also be aware of the distinct characteristics of participants recruited online versus offline.