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Biomedical subjects

Yuelin Li

Publications and source records attributed to Yuelin Li.

18 recordsLinked to original sources

Interventions to Reduce Loneliness in Informal Caregivers of People With Dementia: A Systematic Review.

AIM: To summarize the current evidence on reducing loneliness among informal caregivers of people with dementia, such as family members or friends. DESIGN: A systematic review. METHODS: The methodological quality was evaluated using the revised Cochrane risk-of-bias tool for randomized controlled trials and the revised JBI critical appraisal checklist for quasi-experimental studies. Data were extracted as predefined and synthesized narratively. The Template for Intervention Description and Replication checklist was used to report the intervention characteristics. DATA SOURCES: Six electronic databases (MEDLINE via PubMed, EMBASE, Cochrane Library, PsycINFO, CINAHL Plus, and Web of Science Core Collection) were searched for studies published in peer-reviewed English journals from the inception of each database until 28 January 2024. RESULTS: Eight studies were included in this review, published between 2002 and 2023, with three being randomized controlled trials. All included interventions were psychosocial. Only one study reported significant improvements in loneliness. Five studies utilized remote and online interventions, such as social networking, psychotherapy, and online social support. Interventions varied in their impact on secondary outcomes, including stress, depressive symptoms, anxiety, and caregiver burden. Four studies demonstrated a positive effect on caregiver stress levels. One pilot trial reported a positive impact on depressive symptoms, and another study noted potential improvements in anxiety. One pilot study reported an average improvement in caregiver burden. CONCLUSION: While the evidence is insufficient for conclusive statements, this systematic review suggests potential benefits of interventions to reduce loneliness and improve mental health among these caregivers. It highlights the promise of remote interventions in addressing loneliness among dementia caregivers. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: The findings suggest that tailored interventions, especially those delivered remotely, can enhance the support provided to caregivers, potentially improving their mental health and overall well-being. REPORTING METHOD: This systematic review adhered to the PRISMA statement. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Humans↗

Comprehension of skin cancer genetic risk feedback in primary care patients.

Few studies have examined comprehension and miscomprehension of genetic risk feedback for moderate-risk genes in the general population. We examined the prevalence and nature of accurate and inaccurate genetic risk feedback comprehension among those who received genetic testing for melanocortin-1-receptor (MC1R) gene variants that confer moderate melanoma risk. Participants (N = 145 Albuquerque, NM) were tested as part of a randomized controlled trial. Two weeks after receiving MC1R genetic risk feedback, participants answered open-ended questions regarding their reactions to the MC1R feedback report. Participants' comprehension of their feedback (average-risk or higher-risk for melanoma) was evaluated through qualitative analysis of open-ended responses. Most participants demonstrated comprehension of their feedback results (i.e., 63% of average-risk participants [ARPs]; 51% of higher-risk participants [HRPs]). Miscomprehension was evident in fewer participants (i.e., 16% of ARPs, 11% of HRPs). A few ARPs misunderstood the purpose of testing, whereas a few HRPs reported confusion about the meaning of their risk feedback. Some participants' responses to the open-ended questions were too ambiguous to ascertain comprehension or miscomprehension (i.e., 21% of ARPs, 38% of HRPs). Taken together, these findings suggest that genetic testing feedback for MC1R risk variants is largely comprehensible to general population participants. This study adds to the work examining comprehension and usage of common, moderate risk genetic information in public health contexts. However, to maximize the utility of genetic risk information in the general population, further research is needed to investigate and address areas where common genetic risk feedback misunderstandings occur.

Genetic testing↗

Shortening of a laser pulse with a self-modulated phase at the focus of a lens.

We found that, at the focus of a chromatic lens, a laser pulse with a self-modulated phase can be shortened due to the radial dependence of the group delay imposed by the lens. Normally, this group delay stretches a short pulse into a long pulse by spreading the arrival time of the pulse at the focus. However, for a pulse with a self-modulated phase, it causes the fields with different phases to overlap, thus resulting in destructive interference that shortens the pulse.

Journal Article↗

What postoperative outcomes matter to pediatric patients?

Children are often excluded from making decisions related to their medical treatment, and parents' proxy reports are often used. This approach fails to consider that parents and children may differ in their perception of the child's health. In this study, we assessed children's decision-making processes related to postoperative pain management. Forty-five children who underwent an anterior cruciate ligament repair or Nuss procedure for pectus excavatum repair were studied. A standard gamble technique was used to assess children's perceptions of the utility of a hypothetical treatment that would provide them with perfect pain control, with respect to different rates of risk for vomiting during the postoperative period. The maximum risk of vomiting that the overall study population was willing to accept to decrease the pain level to zero was 32% +/- 24%. Girls were willing to take a significantly higher risk (41% +/- 24%) compared to boys (25% +/- 22%) (P = 0.02). Children who actually experienced vomiting before they were questioned were willing to take a higher risk (46% +/- 26%) compared to those who did not (23% +/- 17%) (P = 0.035). Children can express opinions about preferred postoperative outcomes and provide useful input about their care. Girls, more than boys, seem to perceive vomiting as less important than improved pain control in the postoperative period.

Adolescent↗

Using the open-source statistical language R to analyze the dichotomous Rasch model.

R, an open-source statistical language and data analysis tool, is gaining popularity among psychologists currently teaching statistics. R is especially suitable for teaching advanced topics, such as fitting the dichotomous Rasch model--a topic that involves transforming complicated mathematical formulas into statistical computations. This article describes R's use as a teaching tool and a data analysis software program in the analysis of the Rasch model in item response theory. It also explains thetheory behind, as well as an educator's goals for, fitting the Rasch model with joint maximum likelihood estimation. This article also summarizes the R syntax for parameter estimation and the calculation of fit statistics. The results produced by R is compared with the results obtained from MINISTEP and the output of a conditional logit model. The use of R is encouraged because it is free, supported by a network of peer researchers, and covers both basic and advanced topics in statistics frequently used by psychologists.

Algorithms↗

Predictors of primary care follow-up after a pediatric emergency visit for asthma.

OBJECTIVE: Prior studies have reported low rates of follow-up with a primary care provider (PCP) after emergency department (ED) treatment for asthma. We sought to identify predictors associated with PCP follow-up. METHODS: As part of a randomized trial we surveyed parents of children aged 2-18 years being discharged after ED asthma treatment. Parents described their child's asthma history and perceived benefits and barriers to making a PCP follow-up visit. Bivariate tests and multivariable logistic regression were used to determine association with completion of a follow-up visit within 4 weeks of the ED visit. RESULTS: A total of 278 subjects (N = 278) were enrolled; 55% saw their PCP within 4 weeks of the ED visit. Baseline factors that were associated with an increased likelihood of follow-up included a recent hospitalization, more than one ED visit for asthma in the past year, the parent's assessment that the child has "very severe" asthma, and current daily use of a controller medication. Parental beliefs that taking daily asthma medications and finding out about the causes of asthma attacks were very important and were also associated with increased PCP follow-up. Parents were less likely to follow up if they reported a lack of convenient appointments or prolonged waits in the PCP office. A multivariable model including clinical factors, parental beliefs, and the study intervention predicted the likelihood of follow-up. CONCLUSIONS: Parental beliefs about asthma severity, the benefits of controlling asthma, and organizational barriers to seeing a PCP were associated with follow-up after a pediatric ED visit for asthma.

Adolescent↗

Men's values-based factors on prostate cancer risk genetic testing: a telephone survey.

BACKGROUND: While a definitive genetic test for Hereditary Prostate Cancer (HPC) is not yet available, future HPC risk testing may become available. Past survey data have shown high interest in HPC testing, but without an in-depth analysis of its underlying rationale to those considering it. METHODS: Telephone computer-assisted interviews of 400 men were conducted in a large metropolitan East-coast city, with subsequent development of psychometric scales and their correlation with intention to receive testing. RESULTS: Approximately 82% of men interviewed expressed that they "probably" or "definitely" would get genetic testing for prostate cancer risk if offered now. Factor analysis revealed four distinct, meaningful factors for intention to receive genetic testing for prostate cancer risk. These factors reflected attitudes toward testing and were labeled "motivation to get testing," "consequences and actions after knowing the test result," "psychological distress," and "beliefs of favorable outcomes if tested" (alpha = 0.89, 0.73, 0.73, and 0.60, respectively). These factors accounted for 70% of the total variability. The domains of motivation (directly), consequences (inversely), distress (inversely), and positive expectations (directly) all correlated with intention to receive genetic testing (p < 0.001). CONCLUSIONS: Men have strong attitudes favoring genetic testing for prostate cancer risk. The factors most associated with testing intention include those noted in past cancer genetics studies, and also highlights the relevance in considering one's motivation and perception of positive outcomes in genetic decision-making.

Adult↗

Parental decision-making in considering cochlear implant technology for a deaf child.

OBJECTIVES: Advances in cochlear implant (CI) technology have increased the complexity of treating childhood deafness. We compare parental decision-making, values, beliefs, and preferences between parents of eligible and ineligible children in considering cochlear implants. METHODS: Surveys were obtained from 83 hearing parents of deaf children. A subset of 50 parents also underwent semi-structured interviews. Nine hypothetical outcomes, ranging from mainstream success to poor mainstream outcome were created to measure parents' overall preferences and preference for specific outcomes for their child who is deaf. RESULTS: Among parents of eligible children (n = 50), approximately 2/3 considered implantation (n = 33). The other 1/3 did not consider implantation. Parents who were eligible but did not consider implantation placed significantly lower priority on mainstream success over bilingual success (P < 0.03), and on the child's ability to speak versus sign (P < 0.02). They also showed significantly higher concerns on the cost of services in general and on the availability of resources offered at the local school district (both P > 0.05). Parents of ineligible children (n = 30) rarely considered implantation, even if they showed similar aspirations in mainstream outcomes (P = 0.003). Semi-structured interview data supported these findings. CONCLUSIONS: The decision to consider cochlear implantation is strongly influenced by the eligibility and by professionals' recommendations. However, for some parents, the decision goes beyond eligibility and is determined by parental preferences, goals, values, and beliefs. This highlights the importance of careful audiologic evaluation and professionals' awareness of and sensitivity to parental goals, values, and beliefs in evaluating the child's candidacy.

Adolescent↗

Attitudes and beliefs concerning prostate cancer genetic screening.

This quantitative study determines the values, beliefs, and attitudes influencing the intention of men to undergo or defer genetic testing for prostate cancer risk using a model based on components of the Theory of Reasoned Action and Health Belief Model. Telephone interviews of a community sample of 400 men in a large, East Coast metropolitan area of diverse educational, ethnic, and age backgrounds were conducted to rank key values and beliefs about genetic testing for prostate cancer risk in anticipation of its future availability. Descriptive statistics, univariate analyses, and logistic regression were used in data analysis. The factors of values attached to consequences, motivation from self, beliefs in benefits, and a motivation to comply with others (borderline) were statistically significant for testing intention. Of all demographics, only increased education was associated with diminished interest in testing. Desire to be tested varied widely across groups of men. Based on these identified values, health professionals can better understand men's values and beliefs on the risks and benefits of testing. The relationship of men to others, family and society, require further investigation in this and other aspects of genetic testing.

Adult↗

Community asthma education program for parents of urban asthmatic children.

OBJECTIVES: To demonstrate the effectiveness of community asthma education provided by peers in the urban community. METHOD: A convenience sample of 267 self-referred, primarily African-American parents or primary caregivers of asthmatic children aged 18 months to 16 years completed a five-session education program. Program efficacy was evaluated at baseline, immediately postinstruction, and at three-, six-, and 12 months retention. Outcomes included three questionnaires measuring asthma self-management knowledge, control and quality of life. RESULTS: Immediately following program completion, participants demonstrated improvements in asthma knowledge (13% increased proportion correct, p < 0.01), ability to control their child's asthma 16% increased score, p < 0.01), and asthma quality of life (7% increased score, p < 0.01). Retention of knowledge with steady improvement of control and quality of life was observed up to one year postinstruction, as compared with immediate postprogram scores (p = 0.09 and 0.05, respectively). CONCLUSIONS: A community-based asthma educational program for caregivers should be an important component of childhood asthma management. The complexities of asthma management are best taught in educational programs that are easily accessible, provide a comfortable environment for participants, and are taught by peers.

Adolescent↗

Characterization of a chaotic optical field using a high-gain, self-amplified free-electron laser.

We report on a characterization of the chaotic optical field from a high-gain, self-amplified spontaneous-emission (SASE) free-electron laser. The temporal structure of the amplitude and phase are measured in a single-shot mode, with a resolution well below the coherence length, and the statistics over multiple pulses is determined. The measurement is in excellent quantitative agreement with the prediction based on analysis of random noise, and further verifies the chaotic nature of the SASE optical field.

Journal Article↗

Parental decision making and the choice of communication modality for the child who is deaf.

BACKGROUND: Early intervention decisions for a deaf or hard of hearing child are difficult to make, partly because of the lack of definitive proof of the superiority of any particular communication approach. OBJECTIVE: To compare the relative importance of the child's hearing loss and parental attitudes, beliefs, values, and aspirations in the decision process. METHODS: Eighty-three parents were surveyed about decision factors that may have affected their choice of communication modality, including resource availability, attitudes and beliefs about hearing loss, values, trade-offs, and goals. Parental preference ratings on hypothetical outcomes were also collected in 4 domains: communication, academic performance, social functioning, and emotional well-being. RESULTS: The child's extent of hearing loss was the most influential decision factor (P<.001). Beyond the extent of hearing loss, logistic regression further showed that parental cognitive-attitudinal factors were important in the inclination to favor an oral approach-if they believed that deafness can and should be corrected and if they desired the child to be able to speak (P =.03 and.04, respectively). Technology that aims at improving the child's ability to speak (eg, cochlear implants) had no significant impact on the decision to choose oral only training. CONCLUSIONS: Professionals who work with deaf children and their parents should recognize the presence of many relevant issues beyond the extent of the child's hearing loss. Interventions may be most effective if aimed at balancing parental beliefs and aspirations and audiologic considerations.

Adolescent↗

Decisions Hispanic families make after the identification of deafness.

This study examines the decision-making process for Hispanic families living in the United States who have a child with a hearing loss. Twenty-nine families in four geographical areas shared their experiences in searching for appropriate interventions and making choices regarding communication and education. We explored the impact of language, culture, minority status, and access to information and services on the decision-making process. The results indicate that the deliberations of Hispanic parents are often complicated by language and cultural barriers and by limited access to information, resources, and a full range of options. The communication method chosen tended to be the one recommended by professionals, usually a combination of spoken English and sign language. Parents frequently expressed the hope that their child would learn Spanish as well. These subjects displayed a higher degree of assertiveness in obtaining services for their children than other studies have suggested.

Journal Article↗

Scheduled follow-up after a pediatric emergency department visit for asthma: a randomized trial.

OBJECTIVES: Follow-up with a primary care provider (PCP) is recommended after an emergency department (ED) visit for asthma to assess clinical status and develop a management plan to improve future care. However, previous ED-based studies of urban children with asthma have reported low follow-up rates. The objective of this study was to determine whether scheduling an appointment at the time of an ED visit improves PCP follow-up for urban children. A secondary goal was to assess the effect of this intervention on short-term health outcomes and the use of recommended preventive controller medications. METHODS: This randomized trial enrolled a convenience sample of children who were 2 to 18 years old and discharged after treatment for acute asthma in an urban children's hospital ED. Both intervention and control subjects were instructed to follow up with their PCP within 3 to 5 days. Study staff assisted intervention subjects to call their PCP from the ED and schedule an appointment. When follow-up could not be scheduled, assistance continued after ED discharge by telephone until an appointment date was confirmed. Study outcomes included PCP visits, asthma-related morbidity, and daily use of preventive medication 4 weeks after the ED visit. Outcomes were assessed by telephone interview and confirmed by PCP record review. RESULTS: A total of 278 eligible subjects were enrolled over 8 months; intervention and control groups were similar by demographic variables and PCP type as well as by asthma history, symptoms, and previous medication use. Only 38% of subjects reported using a daily controller medication, although 70% described persistent asthma symptoms for which these are recommended. For the intervention group, follow-up appointments were successfully obtained during the ED visit for 24% of subjects; when unsuccessful, a median of 3 telephone calls (range: 1-14) were needed to confirm that an appointment had been scheduled. During the 4 weeks after the ED visit, intervention subjects were more likely than controls to follow up with their PCP (64% vs 46%; relative probability for follow-up: 1.4; 95% confidence interval: 1.1-1.7). Study groups did not differ in return ED visits, missed school or work, or the percentage reporting daily use of a controller medication (58% vs 54%) 4 weeks after the ED visit. The median time to the next PCP visit was shorter among intervention subjects (13 vs 54 days). CONCLUSIONS: Scheduling an appointment after an ED visit increased the likelihood that urban children with asthma would follow up with a PCP. An appointment could not be obtained during the ED visit for most children. Other interventions are needed to improve linkage between ED and primary care for asthma and to improve the use of controller medications.

Adolescent↗

[Relationship between soil enzyme activities and trace element contents in Eucalyptus plantation soil].

Canonical correlation analysis on soil enzyme activities and trace element contents in Eucalyptus plantation soil showed that among the test elements, only Zn and Mn affected enzyme activity. Both Zn and Mn increased soil proteinase activity. Zn decreased the activities of soil urease and peroxidase, while Mn promoted them. "Integral soil enzyme factor" could be used as an index of soil fertility. Together with other growth factors, this index should be considered when evaluating soil fertility of Eucalyptus forest sites. It also had a definite significance on the division of Eucalyptus soil families.

Endopeptidases↗

Time-resolved phase measurement of a self-amplified free-electron laser.

We report on the first time-resolved phase measurement on self-amplified spontaneous emission (SASE) free-electron laser (FEL) pulses. We observed that the spikes in the output of such free-electron laser pulses have an intrinsic positive chirp. We also observed that the energy chirp in the electron bunch mapped directly into the FEL output. Under certain conditions, the two chirps cancel each other. The experimental result was compared with simulations and interpreted with SASE theory.

Journal Article↗

Fear of litigation may increase resuscitation of infants born near the limits of viability.

OBJECTIVES: To explore how fear of litigation influences neonatal treatment decisions. STUDY DESIGN: In a mailed survey, we presented a hypothetical vignette of a premature infant to 1000 neonatologists. We asked them to estimate prognosis, indicate appropriate intervention, and respond to parental treatment requests. Subjects were randomly assigned to receive one of two questionnaires, "litigious" or "nonlitigious," which differed only in the description of the infant's parents. RESULTS: The response rate was 63.0%. The vast majority of respondents deferred to parental requests rather than adhering to their best judgment. They deferred whether or not parents requested treatment and whether or not parents were described as litigious (P <.0001). Among those respondents who shifted their resuscitation opinion after parental introduction, respondents to the nonlitigious version were more likely to shift their opinion from "treat" to "do not treat" after parental requests to "use your best judgment" (P <.042). The influence of parental litigiousness was primarily seen among neonatologists who thought that the infant's prognosis was dismal (P <.044). CONCLUSIONS: There is a strong disposition among neonatologists toward respecting parental wishes. This disposition is stronger when neonatologists are given additional reason to be concerned about litigation.

Adult↗

Looming threat-processing style in a cancer cohort.

OBJECTIVE: Looming threat-processing style, where threats are perceived to be progressing (looming) at a frightening velocity, is implicated in anxiety vulnerability. This study aims to validate a new measure of looming, the looming cancer, and explore its clinical correlates in a chronic lymphocytic leukemia (CLL) cohort. METHODS: In a cross-sectional design, 105 CLL patients completed the Looming Cancer Scale, Looming Cognitive Style Questionnaire (LCSQ), SF-36, Beck Anxiety Inventory (BAI) and Beck Depression Inventory II (BDI-II). RESULTS: Exploratory factor analysis reduced the 20-item Looming Cancer Scale to a 10-item version, which demonstrated good psychometric properties (Cronbach's alpha=.926). Convergent validity was demonstrated by Pearson correlation with the LCSQ (0.418), BAI (0.380), BDI-II (0.336) and the mental component score of the SF-36 (-0.434) (all P<.001). Divergent validity was demonstrated by a lack of correlation with the SF-36 physical component score and cross tabulation frequencies of high and low loomers. High vs. low loomers showed significantly more anxiety (31% vs. 13%), depression (23% vs. 2%) and mixed anxiety-depression (18% vs. 2%). An area under the receiver operating characteristic curve analysis revealed high sensitivity (82%) and specificity (69%) in detecting mixed anxiety-depression using a cutoff score of >/=20/30. CONCLUSIONS: The Looming Cancer Scale is a valid measurement of looming cognitive style and is the first time that the looming construct has been studied in a cancer cohort. The importance of this research lies in its potential to identify populations vulnerable to developing anxiety, depression and mixed anxiety-depression symptoms.

Adult↗