Research connections最新文献

{"title":"Community-based interventions to improve hepatitis C linkage to care among people with substance use disorders in Southwest Virginia: a pragmatic sequential cohort study.","authors":"Mariana Gomez de la Espriella, Merly Konathapally, Sarah Henrickson Parker, Cynthia Morrow, Marrieth Rubio, Tara P Menon, Cara Ravagli, Anthony Baffoe-Bonnie","doi":"10.1093/rescon/vmag171","DOIUrl":"https://doi.org/10.1093/rescon/vmag171","url":null,"abstract":"<p><p>In 2024, the reported hepatitis C virus (HCV) case rate in Roanoke City was nearly three times the rate of the state of Virginia, reflecting the disproportionate impact of the opioid epidemic in the region. Despite highly effective direct-acting antiviral therapies, substantial barriers to linkage to care (LTC) persist among individuals with substance use disorders (SUDs). While prior studies suggest that patient navigation and financial support may improve LTC, evidence from rural and underserved settings remains limited. This study aims to evaluate community-based interventions designed to improve HCV LTC among individuals with SUD in Southwest Virginia. We conducted a pragmatic, non-randomized, sequential cohort pilot study to evaluate the impact of iteratively refined community-based interventions on LTC. A total of 60 adults with detectable HCV RNA and SUD were enrolled sequentially into four cohorts (control and three intervention groups). All participants received peer support; intervention components were modified across cohorts to address observed barriers to care. The primary outcome was attendance at an outpatient HCV visit within 180 days of enrolment. LTC was 3/15 (20%) in both the control group and Intervention 1, increasing to 6/15 (40%) in Intervention 2 and 11/15 (73%) in Intervention 3. Exploratory analyses demonstrated significantly higher attendance in Intervention 3 than in the control group (73% vs. 20%, <i>P</i> = .009). Telehealth utilization and provision of prepaid phones were incorporated in the final cohort, which demonstrated the highest LTC rate. Multicomponent community-based interventions were associated with improved LTC among individuals with SUD. Although the non-randomized sequential design limits causal attribution, the progressive improvement across cohorts provides preliminary support for a potential benefit. Interventions incorporating community navigation, telehealth access, and communication support may help address barriers to HCV treatment engagement in underserved communities.</p>","PeriodicalId":521376,"journal":{"name":"Research connections","volume":"1 4","pages":"vmag171"},"PeriodicalIF":0.0,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective cohort study measuring the disparities in post-COVID conditions among persons with disabilities: findings from primary care settings, 2019-22.","authors":"Esther E Velasquez, Robert L Phillips, JoAnn M Thierry, Sharon Saydah, Emilia H Koumans, Ilia Rochlin, Linda Geng, David Rehkopf, Neil Kamdar","doi":"10.1093/rescon/vmag125","DOIUrl":"https://doi.org/10.1093/rescon/vmag125","url":null,"abstract":"<p><strong>Background and aims: </strong>This study compared the incidence of post-COVID conditions by pre-pandemic disability status within primary care.</p><p><strong>Methods: </strong>This retrospective observational study used electronic health record data to identify primary care patients with ≥1 visit during January 2018-December 2019 and ≥1 visit during May 2020-December 2022. Disability status was identified using diagnostic codes from January 2018 to December 2019. COVID-19 diagnosis was captured during April 2020-December 2022. Accelerated Failure Time models were used to assess time to incident circulatory, endocrine, neurological, and respiratory diagnoses at least 28 days post COVID-19.</p><p><strong>Results: </strong>Among patients aged ≥50 years, those with disabilities and COVID-19 had higher incidence and earlier onset of newly diagnosed circulatory [time ratio (TR) 0.70, 95% confidence interval (CI) 0.64-0.77], endocrine (TR 0.91, 95% CI 0.84-0.99), and neurological (TR 0.52, 95% CI 0.44-0.62), but not respiratory conditions during the post-COVID period as compared to patients with COVID-19 without disability. No associations were found among patients aged <50 years.</p><p><strong>Conclusion: </strong>Primary care patients with pre-existing disability experienced a higher incidence and earlier onset of post-COVID conditions than patients without disability.</p>","PeriodicalId":521376,"journal":{"name":"Research connections","volume":"1 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13693701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149281083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Higher steps per day and better diet quality associated with lower symptom burden in adults with HIV: results from the PROSPER-HIV study.","authors":"Allison Webel, Stephanie Ruderman, Christine Horvat Davey, Vitor H F Oliveira, Heidi M Crane, Thomas W Buford, Barbara M Gripshover, Greer A Burkholder, Julia G Fleming, Josepha A Delaney, Michael S Saag, Amanda L Willig","doi":"10.1093/rescon/vmag109","DOIUrl":"10.1093/rescon/vmag109","url":null,"abstract":"<p><strong>Background and aims: </strong>People with HIV (PWH) experience a persistent symptom burden that negatively affects quality of life and daily functioning. Evidence examining modifiable lifestyle behaviors that may mitigate symptoms is limited. We examined longitudinal associations between objectively measured physical activity, diet quality, and symptom burden in PWH.</p><p><strong>Methods: </strong>PROSPER-HIV enrolled adults with well-controlled HIV receiving care at four Centers for AIDS Research Network of Integrated Clinical Systems sites in the United States. Participants completed annual assessments, including physical activity levels using actigraphy, dietary intake measured with three 24-h recalls generating the Healthy Eating Index-2015 (HEI-2015), and symptom burden with the <i>HIV Symptom Index</i>. Linear mixed models evaluated associations adjusting for age, sex at birth, race/ethnicity, and site.</p><p><strong>Results: </strong>Among 704 participants (mean age, 52.7 years; 78% male; 52% non-Hispanic Black), symptom burden remained stable over follow-up. Participants averaged 5426 ± 3149 steps/day, 164 (IQR, 67-311) minutes/week of moderate-to-vigorous physical activity (MVPA), and an HEI-2015 score of 48.1 ± 14.6. The most prevalent bothersome symptoms were muscle aches/joint pain, fatigue, sleep disturbance, anxiety, and trouble remembering. More steps/day were associated with fewer bothersome symptoms (<i>β</i> = -0.59 steps; <i>P </i>< .01), whereas more sedentary time was associated with higher symptom burden (<i>β</i> = 0.64; <i>P </i>< .01). Higher diet quality was associated with lower symptom burden (<i>β</i> = -0.20; <i>P </i>= .01). Duration of MVPA and light physical activity were not associated with symptom burden.</p><p><strong>Conclusions: </strong>Among adults with well-controlled HIV, a higher daily step count, less sedentary time, and better diet quality were associated with lower symptom burden, highlighting critical lifestyle behaviors to support symptom management in HIV care.</p><p><strong>Learning points: </strong>Among adults with well - controlled HIV, objectively measured higher daily steps and better diet quality, but not weekly moderate - to - vigorous physical activity, were associated with lower symptom burden over three years. Achievable targets to improve persistent, clinically meaningful symptoms in HIV care were identified.</p><p><strong>Clinical trial registration number: </strong>ClinicalTrials.gov [NCT03790501].</p>","PeriodicalId":521376,"journal":{"name":"Research connections","volume":"1 3","pages":"vmag109"},"PeriodicalIF":0.0,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preventing and reducing burnout globally: a six continent thematic assessment.","authors":"Mark Linzer, Erin E Sullivan, Trung A Nguyen, Jacqueline Hoare, Fiona Herco, Jennifer Holmes, Paula Gabriela Ponce de León Lovatón, Michaella Alexandrou, Jaskanwal D S Sara, Elizabeth Goelz, Vallire Hooper, Jordan McWilliams, Sara Poplau, Emily O'Brien, Carolyn M Porta, Victor M Montori","doi":"10.1093/rescon/vmag064","DOIUrl":"10.1093/rescon/vmag064","url":null,"abstract":"<p><strong>Background and aims: </strong>Burnout affects millions of healthcare workers worldwide, from food service and nurses to physicians and leaders, impairing worklives and threatening health system stability.</p><p><strong>Methods: </strong>An international collaborative, PREVAIL, was created to reduce burnout globally. Leaders from six continents shared structured insights into the local state of wellness and burnout contributors and mitigators, which were then subjected to a formal thematic (qualitative) analysis to identify common and region-specific themes.</p><p><strong>Results: </strong>Across continents, findings showed the global state of well-being was in danger, though threats varied by region: long shifts in Africa, heavy workloads in Asia, austerity-prone environments in Europe and financially driven care in North America. Vulnerable worker groups included women, nurses, and primary care. Mitigators included workload and schedule adjustments (Africa), shift policies with fair pay (Asia), leader support and regular well-being assessments (Australia), improved psychosocial services (Europe), organizational wellness support and career development (North America), and trainee support (South America).</p><p><strong>Conclusions: </strong>A proposed \"common pathway\" framework explains shared drivers of poor workforce well-being and provides actionable steps for promoting compassionate, supportive environments worldwide.</p><p><strong>Implications/learning points: </strong>Adopting a coordinated international approach may prevent devastating workforce shortages over the comingdecades. Burnout assessment and reduction in the global workforce is a high priority.</p>","PeriodicalId":521376,"journal":{"name":"Research connections","volume":"1 2","pages":"vmag064"},"PeriodicalIF":0.0,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148335702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and acceptability of an electronic decision aid for genetic testing in ovarian and pancreatic cancer patients.","authors":"Danielle A Lynch, Sarah Wiser, Devanshi Patel, Kajal Patel, Ava Siegel, Mackenzie Wooters, Linda Rodgers-Fouche, Sara Bouberhan, Colin Weekes, Nana Addo-Tabiri, Kimberly Zayhowski, Elizabeth Pottier, Karen R Sepucha, Yuchiao Chang, Kristen M Shannon, Daniel C Chung","doi":"10.1093/rescon/vmag026","DOIUrl":"10.1093/rescon/vmag026","url":null,"abstract":"<p><strong>Background and aims: </strong>Germline genetic testing is recommended for all patients with ovarian or pancreatic cancer, and alternative service delivery models are needed to meet this demand. We evaluated an electronic decision aid (DA) that can be administered during a visit with an oncology provider. The DA centered around the decision to pursue genetic testing and selection of a specific multi-gene panel.</p><p><strong>Methods: </strong>An electronic DA had previously been developed by a multi-disciplinary team. Patients were enrolled at two academic medical centers. We surveyed participants with ovarian or pancreatic cancer who completed the DA about their experience and knowledge gained. Oncology providers were also surveyed.</p><p><strong>Results: </strong>Ninety-two patients were enrolled. The DA took 13.7 min to complete. There was a 20% increase in knowledge scores after using the DA. Ninety-five percent opted to pursue genetic testing; 20% chose the smallest cancer-specific gene panel, 31% chose the mid-size multi-cancer panel, and 49% chose the largest panel that included limited evidence genes. Nearly all participants (93%) indicated the DA helped their decision-making, and 95% would recommend the DA to friends interested in genetic testing. Ninety-one percent of providers felt patients were well-informed about genetic testing options and 93% indicated the DA did not extend appointment times.</p><p><strong>Conclusions: </strong>Use of a DA for genetic testing is feasible and acceptable. Patients and providers expressed high levels of satisfaction. The wide range of multi-gene panels selected highlights the importance of offering choice. Studies to formally compare the performance of the DA with traditional genetic counseling are warranted.</p>","PeriodicalId":521376,"journal":{"name":"Research connections","volume":"1 2","pages":"vmag026"},"PeriodicalIF":0.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13123761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The need for whole-person care in managing community dwelling older stroke survivors.","authors":"Hawa O Abu, Annie Ferris, Betty Ferrell, Ann Berger","doi":"10.1093/rescon/vmag032","DOIUrl":"10.1093/rescon/vmag032","url":null,"abstract":"<p><p>Stroke remains a leading cause of disability and mortality worldwide, disproportionately affecting older adults. Advances in acute stroke management have reduced mortality but led to a growing population of survivors living with long-term disability. The burden and impact of stroke extend beyond neurological impairment. Physically, older survivors experience functional decline, loss of independence in activities of daily living, and heightened need for environmental or institutional support. Psychologically and socially, stroke survivors face high rates of depression, anxiety, apathy, and fatigue, compounded by social isolation and caregiver burden. Spiritual distress is common yet often overlooked, particularly among those previously active in their faith communities who struggle with meaning, guilt, and disengagement after disability. Current care models require a more structured approach to whole-person care in stroke recovery that recognizes and addresses the physical, psychological, social, and spiritual/existential dimensions of well-being. Multidimensional validated assessment tools are needed to assess and promptly identify challenges to holistic recovery for stroke survivors. Multidisciplinary teams including physicians, nurses, rehabilitation specialists, psychologists, social workers, chaplains, and palliative care providers are essential to address the full range of patient and caregiver needs while potentially addressing long-term disability, enhancing quality of life, and preserving dignity for stroke survivors and their caregivers. By implementing such approaches, healthcare systems can more effectively meet the complex needs of this vulnerable population.</p>","PeriodicalId":521376,"journal":{"name":"Research connections","volume":"1 2","pages":"vmag032"},"PeriodicalIF":0.0,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13131110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147826373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}