Notes

Improvement along with validation of the pregnancy idea design according to ultrasonographic characteristics in connection with endometrial receptors.
Neighborhood-level social determinants are increasingly recognized as factors shaping mental health in adults. Data-driven informatics methods and geographic information systems (GIS) offer innovative approaches for quantifying neighborhood attributes and studying their influence on mental health. Guided by a modification of Andersen's Behavioral Model of Health Service Use framework, this cross-sectional study examined associations of neighborhood resource groups with psychological distress and depressive symptoms in 1,528 U.S. Veterans. Data came from the Veteran Affairs (VA) Health Services Research and Development Proactive Mental Health trial and publicly available sources. Hierarchical clustering based on the proportions of neighborhood resources within walkable distance was used to identify neighborhood resource groups and generalized estimating equations analyzed the association of identified neighborhood resource groups with mental health outcomes. Few resources were found in walkable areas except alcohol and/or tobacco outlets. In clustering analysis, four meaningful neighborhood groups were identified characterized by alcohol and tobacco outlets. Living in an alcohol-permissive and tobacco-restrictive neighborhood was associated with increased psychological distress but not depressive symptoms. Living in urban or rural areas and access to VA care facilities were not associated with either outcome. These findings can be used in developing community-based mental health-promoting interventions and public health policies such as zoning policies to regulate alcohol outlets in neighborhoods. Augmenting community-based services with Veteran-specialized services in neighborhoods where Veterans live provides opportunities for improving their mental health.The number of hospitalizations with an obesity diagnosis have increased among youth in the past two decades, yet remain understudied, particularly among racial/ethnic minority groups. The purpose of this study was to characterize obesity prevalence among children, adolescents, and young adults receiving inpatient care in Hawai'i acute care hospitals during 2015-2016. This study analyzed statewide administrative data from a racially and ethnically diverse population. Participants (N = 7,751) included Hawai'i residents aged 5-29 years receiving inpatient care, excluding those hospitalized due to pregnancy. Recorded height and weight were used to calculate body mass index (BMI) and classify obesity. Primary or secondary diagnoses for obesity were assessed. A multivariable logistic regression model was used to determine characteristics associated with obesity, including race/ethnicity-sex interaction, age group, insurance payer, and county of residence. Based on BMI, 28.4% (2,202/7,751) of patients had obesity. However, an obesity diagnosis was present only in 40.4% (889/2,202) of patients with obesity based on BMI (11.9% of all patients). In the multivariable model, compared to whites, the odds of having obesity were highest among Pacific Islanders [adjusted odds ratio (aOR) = 4.07, 95% CI(3.16-5.23)] and Native Hawaiians [aOR = 2.16, 95% CI(1.75-2.67)] for females, and among Pacific Islanders [aOR = 5.39, 95% CI(4.27-6.81)], Native Hawaiians [aOR = 2.36, 95% CI(1.91-2.91)], and Filipinos [aOR = 2.08, 95% CI(1.64-2.64)] for males. Obesity was also associated with age group, but not insurance payer type or county of residence. These findings support the need for greater attention to obesity in the inpatient setting and equity-focused interventions to reduce obesity among younger hospitalized patients.Tobacco use disproportionately affects low-income communities. Prevalence among patients in Federally Qualified Health Centers (FQHCs) is higher (29.3%) than the general population (20%). Little is known about the rates of referrals to cessation services and cessation pharmacotherapy practices in FQHCs. This study will examine referral and prescribing patterns based on patient characteristics at a large FQHC in Southern California. We conducted a retrospective analysis of EHR data from 2019. Patients who were ≥ 18 years old and had "tobacco use" as an active problem were included in analyses. We characterized the proportion of 1) those who were referred to California Smokers' Helpline (CSH), 2) referred to smoking cessation counseling (SCC) at the FQHC clinic, or 3) received pharmacotherapy. Associations of demographic characteristics and comorbidities with referral types and uptake of services were evaluated using mixed-effects multinomial and logistic regressions. Of the 20,119 tobacco users identified, 87% had some cessation intervention 66% were advised to quit and given information to contact CSH, while 21% were referred to SCC. Patients were least likely to get referred to cessation services if they had more medical, psychiatric, or substance use comorbidities, were in the lowest income group, were uninsured or were Hispanic. Although EHR systems have enhanced the ease of screening, most patients do not receive more than brief advice to quit during a PCP visit. Most (70%) low-income smokers see their PCPs at least once a year, making FQHCs excellent settings to promote smoking cessation initiatives in low-income populations.American Indians (AI) face significant disparities in smoking-related diseases. In addition, smoking prevalence increases exponentially between ages 11 and 18. Smoking prevention and cessation efforts aimed at AI youth therefore are important. In order to strengthen understanding of evidence-based message strategies for smoking prevention and cessation among AI youth. The objective of this study was to test whether a message that was tailored to AI cultural values associated with the sacredness of traditional tobacco can change variables that behavioral theories have identified as predictors of smoking (i.e., instrumental and experiential attitudes, injunctive and descriptive norms, perceived capacity and autonomy, and intention with respect to smoking). We conducted a randomized field experiment among 300 never-smoking and ever-smoking urban AI youth in Minneapolis-Saint Paul between May 18 and July 27, 2019. We used a 3 (message condition cultural benefits of not smoking cigarettes, health benefits of not smoking cigarettes, comparison message about benefits of healthy eating) × 2 (smoking status ever-smoked, never-smoked) between-subjects design. Multivariate analysis of variance showed that for ever-smokers, the cultural consequences of smoking message significantly lowered instrumental attitude (partial eta2 = 0.029), experiential attitude (partial eta2 = 0.041), perceived capacity (partial eta2 = 0.051), and smoking intention (partial eta2 = 0.035) compared to the healthy eating comparison message and the health consequences of smoking message. This was not observed among never-smokers, who already had very negative smoking perceptions. We conclude that messages that tailor to AI culture may be effective tools for discouraging smoking among AI youth.Recreational physical activity (PA) facilities have the potential to deliver health benefits for surrounding communities, however little is known about the impact of marketing strategies to encourage their use. This study aimed to assess the effectiveness of two low intensity interventions aimed at promoting usage of a new multipurpose recreation facility. A community-based randomized controlled trial with a 24-month follow up period was conducted with 1320 inactive adult residents of the City of Frankston, Victoria, Australia. Participants were randomized to a control, intervention 1 (information and attendance incentive) or intervention 2 (information, attendance incentives, personalized support) group. Primary outcomes were recreation facility attendance, purchase of facility membership and PA participation. Eight hundred and fifty-four (65%) participants completed 24-months follow up. Provision of incentives with personalized support was associated with greater attendance at the facility, as well as higher rates of membership. Those receiving incentives without additional support reported increases in stage of readiness to attend the facility. The interventions did not contribute to higher levels of PA, however those who became regular users of the facility were more likely to improve PA and meet the target of ≥150 min per week. Increased frequency and duration of promotion led to more regular attendance at the recreation facility, while those who attended regularly showed significant increases in PA. Incorporating recreation facilities within broader PA strategies, by engaging community members in a way that promotes more regular use of recreation facilities, will contribute to improvements in PA at a population level.The objective of this initiative was to conduct a comprehensive opioid overdose vulnerability assessment in Indiana and evaluate spatial accessibility to opioid use disorder treatment, harm reduction services, and opioid response programs. We compiled 2017 county-level (n = 92) data on opioid-related and socioeconomic indicators from publicly available state and federal sources. First, we assessed the spatial distribution of opioid-related indicators in a geographic information system (GIS). Next, we used a novel regression-weighted ranking approach with mean standardized covariates and an opioid-involved overdose mortality outcome to calculate county-level vulnerability scores. Finally, we examined accessibility to opioid use disorder treatment services and opioid response programs at the census tract-level (n = 1511) using two-step floating catchment area analysis. Opioid-related emergency department visit rate, opioid-related arrest rate, chronic hepatitis C virus infection rate, opioid prescription rate, unemployment rate, and percent of female-led households were independently and positively associated with opioid-involved overdose mortality (p less then 0.05). We identified high-risk counties across the rural-urban continuum and primarily in east central Indiana. We found that only one of the 19 most vulnerable counties was in the top quintile for treatment services and had naloxone provider accessibility in all of its census tracts. selleck chemicals Findings from our vulnerability assessment provide local-level context and evidence to support and inform future public health policies and targeted interventions in Indiana in areas with high opioid overdose vulnerability and low service accessibility. Our approach can be replicated in other state and local public health jurisdictions to assess opioid-involved public health vulnerabilities.Accurate and effective local data collection systems are needed to inform community change on youth health behaviors such as physical activity (PA). Systematic methods are particularly important for understanding PA behaviors that may be influenced by individual, interpersonal, organizational, and regional factors. The purpose of this study was to describe a protocol for coordinating community stakeholders to implement an online youth PA surveillance instrument. The research team collaborated with local health departments (LHDs) from two rural communities to coordinate schools in implementing school-wide youth PA surveillance. A data sharing agreement was established between all partners. School administrators and teachers attended in-person training sessions for an online PA survey and how to use the data. Following the training, students were provided individualized logins to complete the survey once a semester over a two-year academic period. Across both communities, 23 teachers and administrators attended the training sessions that were facilitated by the LHDs and research team.
Website: https://www.selleckchem.com/products/merbarone.html