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Supplemental material, sj-docx-1-jtt-10.1177_1357633X231166031 for Perceptions of telehealth among older U.S. adults during the COVID-19 pandemic: A national survey by Kathleen Y Li, Liz B Marquis, Preeti N Malani, Erica Solway, Matthias Kirch, Dianne Singer, Jeffrey T Kullgren, Melissa A Plegue and Lorraine R Buis in Journal of Telemedicine and Telecare

Supplemental material, sj-docx-1-jtt-10.1177_1357633X231166031 for Perceptions of telehealth among older U.S. adults during the COVID-19 pandemic: A national survey by Kathleen Y Li, Liz B Marquis, Preeti N Malani, Erica Solway, Matthias Kirch, Dianne Singer, Jeffrey T Kullgren, Melissa A Plegue and Lorraine R Buis in Journal of Telemedicine and Telecare

Qi Chen,1 Siqing Lian,2 Melissa A Plegue,3 Michael D Fetters3,41School of Health Humanities, Peking University Health Science Center, Beijing, People’s Republic of China; 2Peking University First Hospital, Beijing, People’s Republic of China; 3Mixed Methods Program, Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA; 4Peking University Health Science Center, Beijing, People’s Republic of ChinaIntroduction: Chinese policy increasingly emphasizes growth of general practice (GP). The purpose of this research was to understand attitudes toward GP among first-year Chinese and international medical students studying in China.Methods: Based on a cross-sectional survey using a 5-point Likert scale of medical students at Peking University Health Science Center regarding attitudes toward specialty choice, practice setting, care of patient age groups, care types, and GP, we compared responses of Chinese and international medical students.Results: In total, 258 national and 77 international students participated. International students ranked equally or more highly as favorable practice settings associated with GP, eg, outpatient (P=0.05) and home care (P

Supplemental material, Supple for Family physicians’ knowledge, attitudes, and behaviors regarding the weight effects of added sugar by Christian Mackey, Melissa Plegue, Marian Deames, Matthew Kittle, Kendrin Sonneville and Tammy Chang in SAGE Open Medicine

Pharmacogenomic (PGx) testing can improve treatment of depression and ADHD by identifying altered metabolizers of specific therapeutic treatments. Despite the lack of widespread clinical uptake, use of commercial PGx tests for depression and ADHD medications is growing. We sought to document how PGx tests are used in clinical practice among early adopters for patients with depression and/or ADHD. Phone survey with providers who had previously ordered an Informed PGx (Progenity, Inc.) test, identified from customer records. Phone survey designed to assess prescriber usage of PGx testing and perceptions of use within eight different clinical scenarios. This study received approval from the University of Michigan IRB.

Sleep disruption is increasingly recognized in hospitalized patients. Impaired sleep is associated with measureable alterations in neurodevelopment. The neonatal intensive care unit (NICU) environment has the potential to affect sleep quality and quantity. We aimed: (i) to determine the frequency and duration of hands-on care, and its impact on sleep, for NICU patients; and (ii) to assess the incidence of respiratory events associated with handling for a cohort of sick neonates.Term and near-term neonates admitted to the NICU and at risk for cerebral dysfunction due to severity of illness or clinical suspicion for seizures underwent attended, bedside polysomnography. Continuous polysomnogram segments were analyzed and data on handling, infant behavioral state, and associated respiratory events were recorded.Video and polysomnography data were evaluated for 25 infants (gestational age 39.4 ± 1.6 weeks). The maximum duration between handling episodes for each infant was 50.9 ± 26.2 min, with a median of 2.3 min between contacts. Handling occurred across all behavioral states (active sleep 29.5%; quiet sleep 23.1%; awake 29.9%; indeterminate 17.4%; P = 0.99). Arousals or awakenings occurred in 57% of contacts with a sleeping infant. Hypopnea, apnea, and oxygen desaturation occurred with 16%, 8%, and 19.5% of contacts, respectively. Hypopnea was most likely to occur following contact with infants in active sleep (28%; P 0.001).Infants in the NICU experience frequent hands-on care, associated with disturbances of sleep and respiration. The potential health and developmental impact of these disturbances merits study, as strategies to monitor sleep and minimize sleep-disordered breathing might then improve NICU outcomes. Pediatr Pulmonol. 2017;52:84-90 © 2016 Wiley Periodicals, Inc.

BackgroundHypertension (HTN) is an important problem in the United States, with an estimated 78 million Americans aged 20 years and older suffering from this condition. Health disparities related to HTN are common in the United States, with African Americans suffering from greater prevalence of the condition than whites, as well as greater severity, earlier onset, and more complications. Medication adherence is an important component of HTN management, but adherence is often poor, and simply forgetting to take medications is often cited as a reason. Mobile health (mHealth) strategies have the potential to be a low-cost and effective method for improving medication adherence that also has broad reach. ObjectiveOur goal was to determine the feasibility, acceptability, and preliminary clinical effectiveness of BPMED, an intervention designed to improve medication adherence among African Americans with uncontrolled HTN, through fully automated text messaging support. MethodsWe conducted two parallel, unblinded randomized controlled pilot trials with African-American patients who had uncontrolled HTN, recruited from primary care and emergency department (ED) settings. In each trial, participants were randomized to receive either usual care or the BPMED intervention for one month. Data were collected in-person at baseline and one-month follow-up, assessing the effect on medication adherence, systolic and diastolic blood pressure (SBP and DBP), medication adherence self-efficacy, and participant satisfaction. Data for both randomized controlled pilot trials were analyzed separately and combined. ResultsA total of 58 primary care and 65 ED participants were recruited with retention rates of 91% (53/58) and 88% (57/65), respectively. BPMED participants consistently showed numerically greater, yet nonsignificant, improvements in measures of medication adherence (mean change 0.9, SD 2.0 vs mean change 0.5, SD 1.5, P=.26), SBP (mean change –12.6, SD 24.0 vs mean change –11.3, SD 25.5 mm Hg, P=.78), and DBP (mean change –4.9, SD 13.1 mm Hg vs mean change –3.3, SD 14.3 mm Hg, P=.54). Control and BPMED participants had slight improvements to medication adherence self-efficacy (mean change 0.8, SD 9.8 vs mean change 0.7, SD 7.0) with no significant differences found between groups (P=.92). On linear regression analysis, baseline SBP was the only predictor of SBP change; participants with higher SBP at enrollment exhibited significantly greater improvements at one-month follow-up (β=–0.63, P

Susceptibility to rheumatoid arthritis (RA) is associated with HLA-DRB1 alleles coding a 5-amino acid sequence motif called the shared epitope (SE). To explore the potential mechanisms that lead to RA susceptibility, we analyze the in vitro effect of peptides bearing different HLA-DR4 sequences on human peripheral blood-derived cells. Three 15-mer peptides were used: 65-79*0401 (an HLA-DRB1*04:01-coded sequence carrying the SE motif, QKRAA); 65-79*0402 (an HLA-DRB1*04:02-coded sequence carrying a SE-negative motif, DERAA); 65-79*0403 (an HLA-DRB1*04:03-coded sequence carrying a SE-negative motif, QRRAE). We found that CD4 TH17 cells are regulated by peptide treatment with gender bias. In male-derived T cells, all peptide treatments significantly reduced TH17 cell differentiation in vitro when compared to no peptide treatment, and to female samples. TH17 differentiation in samples not treated with peptides, either in the presence or absence of TH17-polarizing cytokines, was higher in males than in females; however, in unfractionated PBMC after treatment with TH17 polarizing cytokines, IL-17A positive cells were more abundant in females than in males. In addition, SE-positive females showed a significantly higher percentage of IL-17A-positive cells compared to SE-negative females. In conclusion, donor’s SE status and gender may both influence TH17 immune polarization.