Publications by authors named "Merchant R"
Background And Methods: Colorectal cancer (CRC) treatment can influence health-related quality of life (HRQOL). This study examined HRQOL among older adults undergoing CRC treatment, and the conditional effects of race, ethnicity, and primary language. We conducted a retrospective cohort study of Medicare Advantage enrollees ≥ 65 years old who completed the Medicare Health Outcomes Survey (MHOS) (2016-2020).
View Article and Find Full Text PDFIntroduction: Timely detection of dementia enables early access to dementia-specific care services and interventions. Various stakeholders brought together to refine Singapore's dementia care strategy identified a lack of a standardised cognitive screening tool and the absence of a comparative review of existing tools. We hence conducted a rapid review to evaluate the diagnostic performance of brief cognitive screening tools in identifying possible dementia among community-dwelling older adults in Singapore.
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- Aging leads to physiological changes and increased disease vulnerability, culminating in higher mortality rates as individuals get older.
- Regular physical activity (PA) and exercise can counteract aging effects, improve health span, and reduce the risk of chronic diseases such as heart disease and cancer.
- Personalized exercise plans, including various forms of training like aerobic and resistance exercises, are essential for maintaining health and functionality in older adults, particularly those with age-related issues.
An expert consensus statement on biomarkers of ageing for use in intervention studies.
J Gerontol A Biol Sci Med Sci
December 2024
Biomarkers of ageing serve as important outcome measures in longevity-promoting interventions. However, there is limited consensus on which specific biomarkers are most appropriate for human intervention studies. This work aimed to address this need by establishing an expert consensus on biomarkers of ageing for use in intervention studies via the Delphi method.
View Article and Find Full Text PDFBackground: Therapists and their patients increasingly discuss digital data from social media, smartphone sensors, and other online engagements within the context of psychotherapy.
Objective: We examined patients' and mental health therapists' experiences and perceptions following a randomized controlled trial in which they both received regular summaries of patients' digital data (eg, dashboard) to review and discuss in session. The dashboard included data that patients consented to share from their social media posts, phone usage, and online searches.
Background: Chronic pain following traumatic stress exposure (TSE) is common. Increasing evidence suggests inflammatory/immune mechanisms are induced by TSE, play a key role in the recovery process versus development of post-TSE chronic pain, and are sex specific. In this study, we tested the hypothesis that the inflammatory marker C-reactive protein (CRP) is associated with chronic pain after TSE in a sex-specific manner.
View Article and Find Full Text PDFSocial Buffering of PTSD: Longitudinal Effects and Neural Mediators.
Biol Psychiatry Cogn Neurosci Neuroimaging
November 2024
Article Synopsis
- This study investigates how early social support after trauma affects PTSD symptoms over time and explores specific brain regions involved in this process, such as the amygdala and ventromedial prefrontal cortex.
- Using data from 315 participants in the AURORA study, researchers measured PTSD symptoms and perceived emotional support at multiple time points, while also conducting neuroimaging two weeks post-trauma.
- The results show that early emotional support is linked to changes in white matter connectivity between key brain areas, but it also highlighted unexpected increased threat reactivity in the default mode network, suggesting complex neural pathways in response to social threats.
Article Synopsis
- This study examines the connection between frailty and mortality in elderly individuals, particularly focusing on those aged 90 and older.
- It found that frail adults generally have a significantly lower overall survival rate compared to non-frail individuals, especially in those under 90 years old.
- However, results were less conclusive for participants over 90, indicating that frailty's impact on mortality may vary by age and sex, with notable differences among older males.
Importance: Online review platforms offer valuable insights into patient satisfaction and the quality of health care services, capturing content and trends that traditional metrics might miss. The COVID-19 pandemic has disrupted health care services, influencing patient experiences.
Objective: To examine health care facility numerical ratings and patient experience reported on an online platform by facility type and area demographic characteristics after the COVID-19 pandemic (ie, post-COVID).
Article Synopsis
- Emergency department visits for substance use among youth (ages 12-21) rose from 2.8% to 3.4% of all visits between 2018 and 2023, particularly among 18-21-year-olds, but also in younger groups.
- Female visits for substance use increased significantly, from 43.4% to 52.4% during this period.
- Cannabis-related visits saw a substantial rise from 17.9% to 35.3%, while alcohol remained the most common substance involved, accounting for 53.1% of visits.
Objective: To investigate whether direct admission to geriatric inpatient care from the emergency department (EMD) was associated with lower length of stay (LOS) and cost compared to patients admitted through an acute medical unit (AMU).
Methods: Retrospective single-centre cohort study conducted using hospital database on older patients ≥ 75 years discharged from geriatric inpatient service in a tertiary academic centre from March 2021 to September 2021 who were admitted through AMU or direct from EMD.
Intervention: Traditional AMU run by internists followed by geriatrician led-care compared with geriatrician led-care.
Article Synopsis
- - The study explored the use of wrist-wearable devices to track heart rate variability (HRV) as potential biomarkers for recovery from adverse neuropsychiatric effects following traumatic events, specifically in a socioeconomically disadvantaged group.
- - Researchers monitored participants within 72 hours of a traumatic event and over a course of 6 months, validating HRV characteristics linked to various posttraumatic symptoms, such as pain, re-experiencing, and anxiety.
- - The findings indicate that changes in HRV could effectively predict improvements or worsening in symptoms, suggesting that these wearable technologies could serve as useful screening tools for identifying posttraumatic stress in high-risk populations.
Article Synopsis
- - The study investigates sex/gender differences in PTSD by examining 16 risk factors and their impact on PTSD severity in a group of 2,924 acutely traumatized individuals.
- - It finds that six risk factors are more prevalent in women, while none are more pronounced in men, highlighting unique pathways contributing to PTSD severity based on sex assigned at birth.
- - The results indicate different risk mechanisms for men and women, suggesting that understanding these differences can help develop targeted mental health interventions and inform future research on other mental disorders.
Objective: Our primary objective was to determine the frequency and type of substance use in youth presenting to our pediatric ED (PED). Our secondary objective was to identify characteristics associated with higher-risk substance use.
Methods: We conducted a tablet-based, anonymous, self-administered screening for substance use using a modified version of the Screening to Brief Intervention (S2BI) tool among a convenience sample of 383 patients 12-21 years presenting to an urban, academic PED from February to July 2023.
Reward Neurocircuitry Predicts Longitudinal Changes in Alcohol Use Following Trauma Exposure.
Biol Psychiatry Cogn Neurosci Neuroimaging
October 2024
Article Synopsis
- Trauma can increase the risk of unhealthy alcohol use, and this study investigates how brain reward systems change after trauma exposure in humans.
- The research involved 286 participants who were assessed for changes in alcohol use and brain activity through fMRI shortly after experiencing trauma.
- Findings suggest that heightened brain activity in specific regions (like the VTA) and altered connections between brain areas may lead to increased alcohol consumption following traumatic events, indicating potential targets for early intervention.
Background: Aging is a risk factor for falls, frailty, and disability. The utility of wearables to screen for physical performance and frailty at the population level is an emerging research area. To date, there is a limited number of devices that can measure frailty and physical performance simultaneously.
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- HCW anxiety and depression increased during the pandemic, leading to the rise of digital mental health platforms like Cobalt that provide online assessments and access to resources.
- This study analyzed the use of Cobalt within a large health system to see if there was any connection between platform usage and COVID-19 impact over three years.
- The findings showed a high volume of anonymous user sessions and assessments on Cobalt, but no significant link was found between COVID-19 case numbers and the platform's use or assessment results.
Article Synopsis
- Motoric cognitive risk syndrome (MCR) is identified by slow walking speed and subjective memory complaints in older adults, and it may serve as an early warning sign for cognitive decline and dementia.
- A systematic review of 20 studies, involving over 1.2 million participants, found that those with MCR had more than double the risk of developing cognitive impairment and dementia compared to those without MCR.
- The findings suggest that MCR could be a valuable predictor of long-term cognitive issues, emphasizing the need for further research to confirm these associations.
Background: Adolescent substance use is a growing public health concern, particularly given rising mortality rates from drug overdose deaths. The emergency department (ED) provides a unique opportunity to screen adolescents for substance use and provide brief interventions and linkage to care.
Objective Of The Review: This article provides a narrative review of the current evidence for ED screening and brief interventions for adolescents with substance use and identifies important opportunities, challenges, and areas for future research.
Importance: In US emergency departments (EDs), empiric antibiotic treatment for gonorrhea (GC) and chlamydia (CT) is common due to the unavailability of immediate test results. Evidence suggests sex-based disparities in treatment practices, with females potentially receiving less empiric treatment than males.
Objective: To investigate sex differences in empiric antibiotic treatment for GC and CT in EDs, comparing practices to subsequent laboratory-confirmed results.
Technology plays a role in nearly every aspect of healthcare delivery. Health systems must continually invest in new and existing technology and analytics platforms to scale initiatives, enable innovation, and achieve interoperability to meet the needs and expectations of patients and clinicians while remaining focused on the organization's mission and strategic priorities. In this process, decision-makers must determine how to allocate technological resources to platforms that meet clinical and administrative needs while reducing the need for frequent replacement or reconfiguration.
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