Online Health Information Seeking Behaviors and Infant Feeding Practices: A Social Cognitive Theory Perspective

Breastfeeding benefits infants, but support is often needed to meet breastfeeding goals. Social media may help disseminate infant feeding information to caregivers. The relationship between parents’ health information-seeking behaviors (HISB) on social media and infant feeding practices remains understudied. Based on social cognitive theory (SCT), parents’ self-efficacy and outcome expectations are two potential factors for improving online HISB. We aimed to use SCT to describe associations between outcome expectations, self-efficacy (eHealth literacy), and online HISB across infant feeding groups among a nationally representative sample of U.S. parents. Eligible participants (N = 580) completed a cross-sectional online survey assessing infant feeding practices (never breastfed, only pumped, only fed-at-the-breast, and both pumped and fed-at-the-breast), self-efficacy (using eHealth literacy as a proxy), outcome expectations in online HISB, parents’ online HISB on social media, and demographic information. Survey weighted linear and logistic regression models were constructed. No online activities differed by infant feeding practices. Parents who pumped only had significantly lower eHealth literacy than parents who never breastfed (adjusted β = -2.63, 95% CI: -4.73, -0.53). Parents who used both methods had 1.78 times greater odds of considering online tools useful for making health-related decisions (95% CI: 0.96, 3.28) and 1.49 times greater odds of considering online tools important for accessing health information (95% Cl: 0.70, 3.15) than parents who never breastfed, though neither association was statistically significant. Understanding these associations between infant feeding practices and online HISB, as well as the two potential factors of parents’ self-efficacy and outcome expectations, may offer implications for tailoring online social media resources to promote breastfeeding outcomes

'Keeping busy' as agency in early desistance

Agency in desistance research has often been understood as deliberate action undertaken in pursuit of a desisting identity. Through a micro-longitudinal approach, this research focuses on the early desistance experiences of a number of mainly white British female participants. Agency was exhibited not with a new identity in mind, but instead through 'keeping busy'. The surprising lack of identity concerns may be due to the early stages of the participants' desistance experiences, with new identities emerging later in the process. Alternatively, it may indicate a fundamental difference to the classic desistance narrative, linked to the differences between this sample and the frequently researched, Western, male, high-frequency offender. Finally, important aspects of the cultures surrounding desistance research may have shaped the narratives of desisters and the biases of researchers towards finding a concern for identity when this is not necessarily experienced in the everyday lives of desisters

A computerized scheme for lung nodule detection in multiprojection chest radiography: Lung nodule detection in multiprojection chest radiography

Purpose: Our previous study indicated that multiprojection chest radiography could significantly improve radiologists’ performance for lung nodule detection in clinical practice. In this study, the authors further verify that multiprojection chest radiography can greatly improve the performance of a computer-aided diagnostic (CAD) scheme

Preliminary Evaluation of Biplane Correlation (BCI) Stereographic Imaging for Lung Nodule Detection

A biplane correlation (BCI) imaging system obtains images that can be viewed in stereo, thereby minimizing overlapping structures. This study investigated whether using stereoscopic visualization provides superior lung nodule detection compared to standard postero-anterior (PA) image display. Images were acquired at two oblique views of ±3° as well as at a standard PA position from 60 patients. Images were processed using optimal parameters and displayed on a stereoscopic display. The PA image was viewed in the standard format, while the oblique views were paired to provide a stereoscopic view of the subject. A preliminary observer study was performed with four radiologists who viewed and scored the PA image then viewed and scored the BCI stereoscopic image. The BCI stereoscopic viewing of lung nodules resulted in 71 % sensitivity and 0.31 positive predictive value (PPV) index compared to PA results of 86 % sensitivity and 0.26 PPV index. The sensitivity for lung nodule detection with the BCI stereoscopic system was reduced by 15 %; however, the total number of false positives reported was reduced by 35 % resulting in an improved PPV index of 20 %. The preliminary results indicate observer dependency in terms of relative advantage of either system in the detection of lung nodules, but overall equivalency of the two methods with promising potential for BCI as an adjunct diagnostic technique

Preterm birth: inflammation, fetal injury and treatment strategies

Preterm birth (PTB) is the leading cause of childhood mortality in children under 5 and accounts for approximately 11% of births worldwide. Premature babies are at risk of a number of health complications, notably cerebral palsy, but also respiratory and gastrointestinal disorders. Preterm deliveries can be medically indicated/elective procedures or they can occur spontaneously. Spontaneous PTB is commonly associated with intrauterine infection/inflammation. The presence of inflammatory mediators in utero has been associated with fetal injury, particularly affecting the fetal lungs and brain. This review will outline (i) the role of inflammation in term and PTB, (ii) the effect infection/inflammation has on fetal development and (iii) recent strategies to target PTB. Further research is urgently required to develop effective methods for the prevention and treatment of PTB and above all, to reduce fetal injury

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

“How Did that Make You Feel?”: Influences of Gender and Parental Personality on Family Emotion Talk

Parent–child conversations about shared events may facilitate important aspects of psychosocial development through the family’s references to emotions. Although past research has begun examining features of speakers and topics that predict emotion talk in these conversations, the potential contribution of personality traits has been overlooked. The current study investigated whether parental personality and participant gender were related to emotion talk during conversations between parents and their 5-year-old children. Results revealed discussion differences as a function of gender and discussion topic. Moreover, higher levels of trait Social Closeness in mothers corresponded to their richer emotional talk during discussions, particularly when conversing with daughters

“How Did that Make You Feel?”: Influences of Gender and Parental Personality on Family Emotion Talk

Parent–child conversations about shared events may facilitate important aspects of psychosocial development through the family’s references to emotions. Although past research has begun examining features of speakers and topics that predict emotion talk in these conversations, the potential contribution of personality traits has been overlooked. The current study investigated whether parental personality and participant gender were related to emotion talk during conversations between parents and their 5-year-old children. Results revealed discussion differences as a function of gender and discussion topic. Moreover, higher levels of trait Social Closeness in mothers corresponded to their richer emotional talk during discussions, particularly when conversing with daughters

Psychosocial Factors that Inform the Decision to Have Metabolic and Bariatric Surgery Utilization in Ethnically Diverse Patients

Metabolic and bariatric surgery (MBS) is currently the only clinically proven method of weight loss that is effective in treating severe obesity and its related comorbidities. However, only about 36% of MBS-eligible patients complete MBS. This qualitative study used the psychosocial framework to identify barriers and facilitators to MBS utilization among patients who had been referred to, or were considering MBS, but had not completed it. A combination of focus groups and in-depth interviews were utilized (Spring 2019) among ethnically diverse patients (N = 29, 82% female, 62% non-Hispanic Black, 10% Hispanic) who were considering MBS. All data was audio recorded, transcribed, and coded. Interview questions were grouped by the four psychosocial model domains (intrapersonal, interpersonal, organization/clinical interaction, societal/environmental) within the context of why patients would/would not follow through with MBS. The analysis included a combination of deductive and inductive approaches to generate the final codebook. Then, each code was input into Dedoose to identify overarching themes and sub-themes. A total of 9 themes and 17 subthemes were found. Two major intrapersonal themes and four subthemes were identified as facilitators to MBS utilization and included a desire for improvement in existing comorbidities, mobility, and anticipated changes in physical appearance. Primary barriers to MBS completion included concerns about potential change in dietary behaviors post-MBS and safety of procedure. Providing educational materials to address MBS common fears and misconceptions may increase utilization rates. Providing community-based pre- and post-support groups for this patient population may also increase MBS completion rates