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  • 1
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Circulation Vol. 147, No. Suppl_1 ( 2023-02-28)
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 147, No. Suppl_1 ( 2023-02-28)
    Abstract: Introduction: Although many clinical trials tested the effects of a low sodium diet (LSD) on high blood pressure (HBP) management, adherence to an LSD remains challenging. Considerable barriers to adherence to diet modification have been examined, and heterogenous responses to an LSD evolved. We tested the intra-individual response to an LSD to develop an individualized dietary intervention to optimize HBP management. The purpose of this pilot study was to determine the effectiveness of a personalized low-sodium diet (P-LSD), enhanced by mobile health technology for real-time dietary assessment and at-home BP monitoring in hypertensive adults. Methods: A total of 24 hypertensive patients (60.4±10.7 years) were randomly assigned to either PLSD (n=16) or usual care control groups (n=8). Participants in P-LSD went through individual sessions via video conferencing to discuss LSD regimens, patients’ food choices, and BP tracks on mobile apps. The Control group followed their usual care for HBP management. All participants in both groups monitored diet and BP using mobile apps for 8 weeks. A 24-hour urinary sodium excretion for the estimation of dietary sodium intake, SBP, and DBP were measured at the baseline and at 8 weeks. The preliminary effects of P-LSD were tested by paired t-test and analysis of covariance (ANCOVA). Results: Dietary sodium intake ( t = 3.82), SBP ( t = 3.95), and DBP ( t = 3.54) were significantly declined overtime in the P-LSD group (Ps 〈 0.01) but not in control group (Ps 〉 0.05). There were significant differences between the control and intervention groups in changes of dietary sodium intake (F=18.6, p 〈 0.001) and SBP over time (F=4.84, p 〈 0.05) before and after the intervention. No statistically significant difference was revealed in DBP between the two groups before the intervention (p=0.20). Conclusion: The PLSD appears to be effective on the adherence to an LSD and BP control in hypertensive patients. Future studies with larger sample sizes are warranted to examine the long-term effects of PLSD on outcomes.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 1466401-X
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  • 2
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2021
    In:  BMC Pediatrics Vol. 21, No. 1 ( 2021-12)
    In: BMC Pediatrics, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-12)
    Abstract: In mildly to moderately dehydrated patients with acute gastroenteritis (AGE), oral rehydration therapy (ORT) is the treatment of choice. Though ondansetron is a very effective antiemetics and leads to succeed ORT, there have been reports QT prolongation in patients using it. We investigated the effect of oral ondansetron on QT interval in mildly to moderately dehydrated children with AGE. Methods This retrospective observational study was conducted in a single pediatric emergency department (ED) of a tertiary university hospital. We collected the medical records of patients with a primary diagnosis of AGE who received oral ondansetron and underwent an electrocardiogram between January 2017 and June 2018. A pediatric emergency physician calculated the corrected QT interval (QTc) by Bazett’s method, and the calculations were reviewed by a pediatric cardiologist. QTc values before (preQTc) and after (postQTc) ondansetron administration were analyzed. ΔQTc was calculated as the change from preQTc to postQTc. We also investigated any cardiac complications from oral ondansetron. Results Total 80 patients were included. The mean age of the patients was 53.31 ± 32.42 months, and 45% were male. The mean dose of oral ondansetron was 0.18 ± 0.04 mg/kg. The mean interval from administration of ondansetron to performance of the electrocardiogram was 65 ± 26 min. The mean preQTc was 403.3 ± 24.0 ms, and the mean postQTc was 407.2 ± 26.7 ms. Two patients had a preQTc ≥460 ms, and one patient had a postQTc ≥460 ms. ΔQTc was ≥30 ms in seven patients (8.8%). No ΔQTc was ≥60 ms. No pre- or postQTc was ≥500 ms. No patient had a fatal cardiac arrhythmia after taking ondansetron. Conclusion Oral administration of a single dose of ondansetron in children with AGE did not cause high-risk QTc prolongation or fatal arrhythmia.
    Type of Medium: Online Resource
    ISSN: 1471-2431
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2041342-7
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  • 3
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2018
    In:  Journal of Immigrant and Minority Health Vol. 20, No. 3 ( 2018-6), p. 641-650
    In: Journal of Immigrant and Minority Health, Springer Science and Business Media LLC, Vol. 20, No. 3 ( 2018-6), p. 641-650
    Type of Medium: Online Resource
    ISSN: 1557-1912 , 1557-1920
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2018
    detail.hit.zdb_id: 2220162-2
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  • 4
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Nursing Research Vol. 70, No. 4 ( 2021-7), p. 317-322
    In: Nursing Research, Ovid Technologies (Wolters Kluwer Health), Vol. 70, No. 4 ( 2021-7), p. 317-322
    Abstract: Metabolomics profiling is an objective assessment of metabolic responses to intricate dietary patterns. However, few studies have investigated the potential benefits associated with personalized behavioral nutrition (PBN) interventions incorporating the metabolomics approach for improving diabetes outcomes for older Asian Americans with Type 2 diabetes. Objective This article describes the protocol for a pilot study testing self-management of a nutrition intervention-provided personalized dietary advice incorporating metabolites phenotypic feedback and digital self-monitoring of diet and blood glucose. Methods A total of 60 older Asian Americans will be randomized into two groups: a PBN group and a control group. Participants in the PBN group will receive personalized dietary advice based on dietary and phenotypic feedback-used metabolic profiles. This study aims to examine the feasibility and preliminary effects of the PBN on diabetes outcomes. Results The study began in September 2020, with estimated complete data collection by late 2021. Discussion Findings from this pilot study will inform future research for developing personalized nutrition interventions for people with Type 2 diabetes.
    Type of Medium: Online Resource
    ISSN: 1538-9847 , 0029-6562
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 1480527-3
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  • 5
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Nursing Research Vol. 69, No. 3 ( 2020-5), p. 210-218
    In: Nursing Research, Ovid Technologies (Wolters Kluwer Health), Vol. 69, No. 3 ( 2020-5), p. 210-218
    Abstract: Although scientific reports increasingly document the negative impact of inadequate health literacy on health-seeking behaviors, health literacy’s effect on health outcomes in patients with diabetes is not entirely clear, owing to insufficient empirical studies, mixed findings, and insufficient longitudinal research. Objective The aim of this study was to empirically examine underlying mechanisms of health literacy’s role in diabetes management among a group of Korean Americans with Type 2 diabetes mellitus. Methods Data from a randomized clinical trial of a health literacy-focused Type 2 diabetes self-management intervention conducted during 2012–2016 in the Korean American community were collected at baseline and at 3, 6, 9, and 12 months. A total of 250 Korean Americans with Type 2 diabetes participated (intervention, 120; control, 130). Participants were first-generation Korean American immigrants. Health literacy knowledge was measured with the original Rapid Estimate of Adult Literacy in Medicine and the diabetes mellitus-specific Rapid Estimate of Adult Literacy in Medicine. Functional health literacy was measured with the numeracy subscale of the Test of Functional Health Literacy in Adults and the Newest Vital Sign screening instrument, which also uses numeracy. Primary outcomes included glucose control and diabetes quality of life. Multivariate analyses included latent variable modeling. Results A series of path analyses identified self-efficacy and self-care skills as significant mediators between health literacy and glucose control and quality of life. Education and acculturation were the most significant correlates of health literacy. Discussion Despite inconsistent findings in the literature, this study indicates that health literacy may indirectly influence health outcomes through mediators such as self-care skills and self-efficacy. The study highlights the importance of health literacy, as well as underlying mechanisms with which health literacy influences processes and outcomes of diabetes self-management.
    Type of Medium: Online Resource
    ISSN: 1538-9847 , 0029-6562
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 1480527-3
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  • 6
    Online Resource
    Online Resource
    Project MUSE ; 2018
    In:  Journal of Health Care for the Poor and Underserved Vol. 29, No. 4 ( 2018), p. 1455-1471
    In: Journal of Health Care for the Poor and Underserved, Project MUSE, Vol. 29, No. 4 ( 2018), p. 1455-1471
    Type of Medium: Online Resource
    ISSN: 1548-6869
    Language: English
    Publisher: Project MUSE
    Publication Date: 2018
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  • 7
    Online Resource
    Online Resource
    SAGE Publications ; 2019
    In:  Journal of Transcultural Nursing Vol. 30, No. 2 ( 2019-03), p. 154-162
    In: Journal of Transcultural Nursing, SAGE Publications, Vol. 30, No. 2 ( 2019-03), p. 154-162
    Abstract: Introduction: Excess sodium intake can increase the risk of high blood pressure and cardiovascular disease, common comorbidities for those with type 2 diabetes mellitus (T2DM). The purpose of this study is to describe sodium intake and high sodium food sources among Korean Americans (KAs) with T2DM. Method: This study, a descriptive, secondary analysis of baseline data from a clinical trial for diabetes, recruited KAs with T2DM ( n = 232) from the community. Results: Average dietary sodium intake was 3,433 mg. Major sources of dietary sodium were from bicultural diets: noodles and dumplings, Korean-style soups, kimchi, breads and snacks, and boiled or seasoned vegetables. Participants who consumed excessive sodium were more likely to consume more calories and be male, married, and more recently diagnosed with T2DM. Discussion: High consumption of sodium among KAs with T2DM supports the need to develop effective, tailored interventions addressing dietary sodium that incorporates the individual’s culture.
    Type of Medium: Online Resource
    ISSN: 1043-6596 , 1552-7832
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2069642-5
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  • 8
    Online Resource
    Online Resource
    Cambridge University Press (CUP) ; 2022
    In:  Journal of Clinical and Translational Science Vol. 6, No. s1 ( 2022-04), p. 51-52
    In: Journal of Clinical and Translational Science, Cambridge University Press (CUP), Vol. 6, No. s1 ( 2022-04), p. 51-52
    Abstract: OBJECTIVES/GOALS: Despite the large body of evidence concerning the effects of dietary interventions on blood pressure, trials have often reported poor adherence to sodium restriction. We implemented the Sodium Watcher Program-Hypertension (SWPH) program using digital self-monitoring. The purpose of this study was to determine the feasibility of the SWPH program. METHODS/STUDY POPULATION: The SWPH is a pilot two-arm, 2-month randomized controlled trial that enrolls adults with hypertension. The intervention group received personalized feedback on dietary sodium intake and BP and the control group participants received usual care for hypertension. Both groups participated in digital self-monitoring of daily diet and BP over 8 weeks. The primary outcomes were adherence to dietary sodium intake as captured by 24-hour urinary sodium excretion and BP at baseline and at the 2-month follow-up. Feasibility assessment included adherence to dietary sodium intake monitoring and in-home BP monitoring measured by the percentage of days that participant logged their food intake and in-home BP. The preliminary effect on the outcome variables was tested by using a repeated-measures analysis of variance. RESULTS/ANTICIPATED RESULTS: In this feasibility study, we included data from 12 participants (n=9 SWPH, n=3 control) who completed all phases of the study. The patients median age was 56.5 years and 70% were female. The mean baseline BP was 142.7/87.5 mmHg. The mean 24-hour urine sodium of 4853.0 mg (SD=1639.9 mg) with 80% having 24-hour urine sodium 〉 2300 mg at baseline. SWPH group had lower systolic (baseline 142.4 mmHg vs follow-up 124.1 mmHg, p 〈 0.001), diastolic (baseline 87.1 mmHg vs follow-up 77.5 mmHg, p 〈 0.05) BP, and 24-hour urine sodium (baseline 3790.4 mg vs 2609.7 mg, p 〈 0.05) compared with control group. Compared with the control group, the SWPH group had significantly more eligible days of digital food log usage (control 80.0% vs intervention 98.2%, p 〈 0.01) and in-home BP monitor usage (control 77.6% vs intervention 94.6%, p 〈 0.01). DISCUSSION/SIGNIFICANCE: Millions of Americans remain in need of effective interventions to manage their hypertension. Innovative and accessible strategies to sustain a low sodium diet intervention are needed for the majority of individuals not following the low sodium diet. By leveraging digital self-monitoring, a low sodium diet program was feasible and in reducing BP.
    Type of Medium: Online Resource
    ISSN: 2059-8661
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2898186-8
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  • 9
    In: JMIR Diabetes, JMIR Publications Inc., Vol. 5, No. 3 ( 2020-7-24), p. e19268-
    Abstract: In the United States, more than one-third of the adult population is obese, and approximately 25.2% of those aged ≥65 years have type 2 diabetes (T2D), which is the seventh leading cause of death. It is important to measure patient-reported outcomes and monitor progress or challenges over time when managing T2D to understand patients’ perception of health and quantify the impact of disease processes or intervention effects. The evaluation of patient-reported outcome measures (PROMs) is especially important among patients with multiple chronic conditions in which clinical measures do not provide a complete picture of health. Objective This study examined the feasibility of collecting Patient-Reported Outcome Measurement Information System (PROMIS) measures, and preliminarily evaluated changes in PROMIS scores and compared the scores with standard scores of the general US population. The parent study is a pilot randomized controlled clinical trial testing three different modes (mobile health [mHealth], paper diary, and control) of self-monitoring in a behavioral lifestyle intervention among overweight or obese patients with T2D. Methods Patients with comorbid overweight or obesity and a diagnosis of T2D for at least 6 months were recruited from a diabetes education program. Participants were randomized to the following three groups: mHealth, paper diary, and control (standard of care) groups. Paper diary and mHealth experimental groups received additional behavioral lifestyle intervention education sessions, as well as tools to self-monitor weight, physical activity, diet, and blood glucose. All participants completed PROMIS-57 and PROMIS-Global Health (GH) version 1.0 questionnaires during visits at baseline, 3 months, and 6 months. The PROMIS-57 includes the following seven domains: anxiety, depression, fatigue, pain interference, physical function, satisfaction with participation in social roles, and sleep disturbance. The PROMIS-GH is composed of the following two domains: global mental health and global physical health. Results A total of 26 patients (mHealth, 11; paper diary, 9; control, 6) were included in our analysis. The study sample was predominantly African American (68%) and female (57%), with a mean age of 54.7 years and a mean BMI of 37.5 kg/m2. All patients completed the PROMIS-57 and PROMIS-GH questionnaires, and we compared the mean scores of the three groups to investigate potential differences. No relevant differences were noted across the groups. However, positive trends were noted in both intervention (mHealth and paper diary) groups in the middle (month 3) and end (month 6) of the study. Conclusions Our pilot study provides evidence for the feasibility of using PROMIS questionnaires to record important components of T2D-related symptoms among overweight or obese individuals. The results from our study support the use of PROMIS questionnaires to provide clinicians and researchers with a benchmark for assessing the overall need for symptom management and determining the success or challenges of an intervention. Trial Registration ClinicalTrials.gov NCT02858648; https://clinicaltrials.gov/ct2/show/NCT02858648
    Type of Medium: Online Resource
    ISSN: 2371-4379
    Language: English
    Publisher: JMIR Publications Inc.
    Publication Date: 2020
    detail.hit.zdb_id: 2955900-5
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  • 10
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Pediatric Emergency Care Vol. 37, No. 12 ( 2021-12), p. e1582-e1588
    In: Pediatric Emergency Care, Ovid Technologies (Wolters Kluwer Health), Vol. 37, No. 12 ( 2021-12), p. e1582-e1588
    Abstract: Children have a larger reserve for traumatic hemorrhagic shock, requiring a score that uses physiologic variables other than hypotension. Recently, the BIG score comprising admission base deficit, international normalized ratio, and the Glasgow Coma Scale has been reported to predict traumatic mortality. We aimed to validate the performance of the BIG score in mortality prediction of normotensive children with trauma. Methods We reviewed 1046 injured children ( 〈 18 years) who visited a Korean academic hospital from 2010 to 2018, excluding those with age-adjusted hypotension. In-hospital mortality, the BIG score and its predicted mortality, Revised Trauma Score, and Pediatric Trauma Score were calculated. We compared areas under the curve (AUCs) for in-hospital mortality of the 3 scores and did in-hospital and BIG-predicted mortalities. Results Of the 1046 children, 554 were enrolled with a 4.9% in-hospital mortality rate. The median BIG score was higher in the nonsurvivors (6.4 [interquartile range, 4.4–9.2] vs 20.1 [16.5–24.8] ; P 〈 0.001). The AUC of the BIG score was 0.94 (95% confidence interval [CI], 0.92–0.96), which was higher than that of Pediatric Trauma Score (0.87 [95% CI, 0.84–0.90] ; P 〈 0.001). The AUC of the BIG score tended to be higher than that of Revised Trauma Score without statistical significance (0.90 [95% CI, 0.87–0.92]; P = 0.130). We noted a parallel between in-hospital and BIG-predicted mortalities. The hemorrhage-related nonsurvivors showed higher median base deficit and BIG score than did the isolated traumatic brain injury-related ones. Conclusions The BIG score can predict mortality with excellent accuracy in normotensive children with trauma.
    Type of Medium: Online Resource
    ISSN: 1535-1815 , 0749-5161
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 2053985-X
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