RECENT RESEARCH
Lin Y-J , Chang H-T , Chen R-Y , Chen P-J , Lin W-Y , Hsieh J-G , … Hwang S-J . Terminally ill patients ’ and their relatives ’ experiences and behaviors regarding complementary and alternative medicine utilization in hospice palliative inpatient care units : a cross-sectional , multicenter survey . BMC Complementary Medicine and Therapies . 2023 , 23 , Article number : 31 .
Background : Terminally ill patients often experience exacerbations of diseases that render mainstream medicine ineffective in relieving symptoms , prompting attempts at complementary and alternative medicine ( CAM ). This study collected data from terminally ill patients and their relatives to determine differences between CAM use , behavioral patterns , and perceptions of health information about CAM .
Methods : A cross-sectional design using a self-administered questionnaire was adopted . Eight medical institutions in Taiwan with inpatient hospice palliative care units were chosen . Ninety-two terminally ill patients and 267 relatives met the inclusion criteria . The questions concerned the experience of CAM use , the kinds of products / services CAM provided , the purpose of CAM use , the source of CAM information , and the perceptions and attitudes toward CAM .
Results : Both terminally ill patients and their relatives have a high proportion of lifetime and one-year prevalence of CAM use ( 88.0 % vs . 88.4 %; p = 0.929 ). CAM use for musculoskeletal and neurological discomfort is higher among terminally ill patients than among their relatives . Relatives / friends are the most frequent sources of information on CAM ( 53.3 % vs . 62.2 %; p = 0.133 ). The percentage of terminally ill patients who discontinued mainstream medical treatment because of CAM use was higher than that of their relatives ( 18.5 % vs . 9.3 %; p = 0.026 ). More than half the terminally ill patients and their relatives had never been asked about CAM by medical staff ( 64.1 % vs . 66.7 %), nor had they informed medical professionals about the use of CAM products and services ( 63 % vs . 66.9 %). Random inquiries by medical professionals may be associated with increased disclosure of CAM use ( terminally ill patients : odds ratio , 9.75 ; 95 % confidence interval , 1.97 – 48.35 vs . relatives : odds ratio , 5.61 ; 95 % confidence interval , 2.66 – 11.83 ).
Conclusions : The high prevalence and concealment of CAM use in terminally ill patients should be considered . Medical professionals should establish a friendly and barrier-free communication model , encourage patients to share CAM experiences , and provide evidence-based information on the use of CAM products and services , to reduce the potential damage caused by harmful use .
COVID-19 studies
Sinha S , Konetzka RT . Association of COVID-19 Vaccination Rates of Staff and COVID-19 Illness and Death Among Residents and Staff in US Nursing Homes . JAMA Netw Open . 2022 ; 5 ( 12 ): e2249002 . doi : 10.1001 / jamanetworkopen . 2022.49002
Importance : It is important to understand the association between staff vaccination rates and adverse COVID-19 outcomes in nursing homes .
Objective : To assess the extent to which staff vaccination was associated with preventing COVID-19 cases and deaths among residents and staff in nursing homes .
Design , Setting , and Participants : This longitudinal cohort study used data on COVID-19 outcomes in Medicare- and Medicaid-certified nursing homes in the US between May 30 , 2021 , and January 30 , 2022 . Participants included the residents of 15 042 US nursing homes that reported COVID-19 data to the Centers for Disease Control and Prevention and passed Centers for Medicare & Medicaid Services data quality checks in the National Healthcare Safety Network .
Exposures : Weekly staff vaccination rates .
Main Outcomes and Measures : Main outcomes are weekly COVID-19 cases and deaths among residents and weekly COVID-19 cases among staff . The treatment variable is the primary 2-dose staff vaccination rate in each facility each week .
Results : In the primary analysis of 15 042 nursing homes before the Omicron variant wave ( May 30 to December 5 , 2021 ) using fixed effects of facility and week , increasing weekly staff vaccination rates by 10 percentage points was associated with 0.13 ( 95 % CI , −0.20 to −0.10 ) fewer weekly COVID-19 cases per 1000 residents , 0.02 ( 95 % CI , −0.03 to −0.01 ) fewer weekly COVID-19 deaths per 1000 residents , and 0.03 ( 95 % CI , −0.04 to −0.02 ) fewer weekly COVID-19 staff cases . In the secondary analysis of the Omicron wave ( December 5 , 2021 , to January 30 , 2022 ), increasing staff vaccination rates were not associated with lower rates of adverse COVID-19 outcomes in nursing homes .
Conclusions and Relevance : The findings of this cohort study suggest that before the Omicron variant wave , increasing staff vaccination rates was associated with lower incidence of COVID-19 cases and deaths among residents and staff in US nursing homes . However , as newer , more infectious and transmissible variants of the virus emerged , the original 2-dose regimen of the COVID-19 vaccine as recommended in December 2020 was no longer associated with lower rates of adverse COVID-19 outcomes in nursing homes . Policy makers may want to consider longer-term policy options to increase the uptake of booster doses among staff in nursing homes .
Smith ER , Oakley E , Grandner GW , Ferguson K , Farooq F , Afshar Y , … Tielsch JM . Adverse maternal , fetal , and newborn outcomes among pregnant women with SARS-CoV-2 infection : an individual participant data meta-analysis . BMJ Global Health . 2023 , 8 ( 1 ).
Introduction : Despite a growing body of research on the risks of SARS-CoV-2 infection during pregnancy , there is continued controversy given heterogeneity in the quality and design of published studies .
Methods : We screened ongoing studies in our sequential , prospective meta-analysis . We pooled individual participant data to estimate the absolute and relative risk ( RR ) of adverse outcomes among pregnant women with SARS-CoV-2 infection , compared with confirmed negative
44 | vol29 | no1 | JATMS