Introduction:Physical activity, strength training, and sleep are important determinants of mental health. The authors of this study examined the associations of these lifestyle behaviors with emotional health outcomes among U.S. adults. Methods:Authors conducted a cross-sectional analysis of data from the 2024 Health Information National Trends Survey® 7, a nationally representative survey of U.S. adults aged ≥18 years (N = 7278). Outcomes included depression (PHQ-2), anxiety (GAD-2), overall loneliness (PROMIS Social Isolation Short Form), social loneliness, and emotional loneliness. Predictors included moderate-intensity physical activity (≥150 min/week), strength training (≥2 days/week), and weekday and weekend sleep duration. Survey-weighted logistic and multinomial logistic regression analyses were performed, adjusting for sociodemographic and health-related covariates. Results:Most respondents screened negative for depression (79.4%) and anxiety (78.4%), and 61.6% reported low loneliness. Most respondents did not meet the recommended levels of moderate-intensity physical activity (56.6%) or strength training (55.4%). In adjusted analyses, meeting strength-training guidelines was associated with lower odds of depression (adjusted odds ratio [aOR], 0.71; 95% confidence interval [CI], 0.53-0.95) and loneliness (aOR, 0.65; 95% CI, 0.43-0.98). Moderate-intensity physical activity was not independently associated with emotional health outcomes. Obtaining the recommended 7-9 hours of weekend sleep was associated with lower odds of depression, anxiety, and loneliness, whereas obtaining the recommended weekday sleep duration was associated with lower social and emotional loneliness. Conclusions:Strength training and adequate sleep were independently associated with better emotional health among U.S. adults. These findings support muscle-strengthening activities and healthy sleep habits as potential targets for mental health promotion.
Introduction:Lean type 2 diabetes mellitus (T2DM) is a form of diabetes that develops in persons with normal Body Mass Index (BMI) and considerable metabolic impairment. High levels of Fibroblast Growth Factor-21 (FGF21) can indicate disrupted metabolic signaling in this group. The study aimed to assess circulating FGF21 levels in lean T2DM and to examine their association with insulin resistance and hepatic steatosis, both biomarkers of metabolic dysregulation. Methods:This cross-sectional study included 425 lean adults (body mass index 18.5-22.9 kg/m2), comprising 200 lean T2DM patients and 225 non-diabetic controls. An enzyme-linked immunosorbent assay (ELISA) was used to measure serum FGF21 levels. Insulin resistance was assessed using the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), and ultrasonography was used to evaluate hepatic steatosis. Results:Lean T2DM patients had significantly higher levels of glycated hemoglobin (HbA1c), homeostatic model assessment of insulin resistance (HOMA-IR), fasting glucose, fasting insulin, low-density lipoprotein (LDL) cholesterol, aspartate aminotransferase (AST), and total cholesterol, while high-density lipoprotein (HDL) cholesterol was lower than non-diabetic controls (all p <0.001). In multivariable analyses of the lean T2DM cohort, serum FGF21 was independently associated with HOMA-IR (β = 0.775, p <0.001) and hepatic steatosis (OR, 1.02; 95% CI, 1.01-1.03). Conclusions:Circulating FGF21 levels are elevated in lean T2DM and may reflect compensatory upregulation or altered FGF21 signaling rather than confirmed tissue-level resistance. FGF21 was an independent predictor of insulin resistance and hepatic steatosis, suggesting its potential as a biomarker of metabolic dysfunction in the normal-BMI group.
Introduction:Unsafe sleep practices are a leading cause of infant mortality in the United States. Authors of this qualitative study examined parental perceptions and reported practices related to infant safe sleep among families who received a free portable crib after their infant's birth. Specifically, authors explored whether families used the portable crib to provide a safe sleep environment for their infants. Methods:Parents of infants aged 2 to 11 months who received a free portable crib were invited to participate in a structured 11-question interview assessing safe sleep perceptions and practices, including crib use. Eleven families participated in the study. Results:Six themes emerged from the interviews: (1) parents recalled receiving safe sleep counseling, often in considerable detail; (2) many parents initially planned to bed-share before receiving the crib; (3) reported sleep practices frequently differed from established safe sleep recommendations; (4) parents described multiple reasons for not consistently following recommendations; (5) participants supported the continued provision of free cribs and safe sleep counseling; and (6) parents generally found the crib helpful, although it often was used alongside other sleep arrangements. Conclusion:Although parents recalled receiving safe sleep counseling, reported sleep practices frequently did not align with recommended guidelines. Further research is needed to better understand this gap and to identify strategies that improve adherence to safe sleep recommendations.
Introduction: Endophthalmitis is a serious vision-threatening intraocular infection. Its etiology, microbiologic profile, and antimicrobial resistance patterns vary by region. Understanding local patterns is essential for guiding empiric therapy and improving patient outcomes. Authors of this study aimed to identify the most common etiologies, causative organisms, and resistance patterns of endophthalmitis at a Midwestern tertiary referral center. Methods: Authors conducted a retrospective chart review of patients diagnosed and treated for infectious endophthalmitis at the University of Kansas between 2008 and 2022. Adult patients with infectious endophthalmitis who underwent vitreous biopsy with microbiologic testing were included. Clinical findings, microbiology results, antimicrobial resistance patterns, empiric treatment regimens, and patient characteristics were collected and analyzed. Results: A total of 149 patients met the inclusion criteria, of whom 52 had positive microbiologic cultures, yielding 64 microbial isolates. The most common etiologies were endogenous infection (n = 43), postoperative infection (n = 32), infection secondary to corneal ulcer (n = 19), and trauma (n = 14). Among culture-positive cases, most isolates were bacterial (61/64). Staphylococcus epidermidis and Staphylococcus aureus were the most frequently isolated organisms, accounting for 12 and 8 isolates, respectively. Resistance was most commonly observed to erythromycin (58%) and clindamycin (33%), whereas vancomycin resistance was rare (3%). Conclusions: Endogenous infection was the most common cause of endophthalmitis in this Midwestern cohort. Regional variation in causative organisms and antimicrobial resistance patterns highlights the importance of local surveillance and tailored empiric treatment strategies to optimize patient outcomes.
Introduction. Rural communities face shortages of health care professionals, leading to reduced access to care and increased patient mortality. While prior studies have identified factors that positively influence recruitment and retention, limited research has examined how community characteristics shape these experiences. Authors of this study aimed to better understand the role of community characteristics in recruiting and retaining rural health care professionals in Kansas.Methods. In-depth interviews were conducted with physicians, advanced practice providers (APPs), and nurses working at University of Kansas School of Medicine Summer Training Option in Rural Medicine (STORM) sites. Interviews explored the meaning of community characteristics and their influence on recruitment and retention experiences. Participants were recruited via email. Interviews were digitally recorded, transcribed, and coded inductively. Thematic network analysis was used to develop global themes and inform conclusions.Results. Seventeen rural health care professionals (6 physicians, 5 APPs, and 6 nurses) participated. The average interview length was 18.6 minutes. Five global themes emerged: (1) predisposing factors, (2) community ability to meet basic needs, (3) workplace satisfaction and sense of purpose, (4) fulfillment through social connections and environment, and (5) challenges in rural health care. Although these themes were consistent across professions, each profession described their impact differently.Conclusions. Factors influencing recruitment and retention of rural health care professionals in Kansas were similar across professions; however, their meaning and impact varied by profession. Recognizing these differences is important for developing strategies to improve recruitment and retention in rural communities.
Introduction:Patient portals are designed to improve transparency, engagement, and satisfaction with health care. However, disparities in access and encouragement to use portals persist, and their relationship with perceived care quality is not well understood. Authors of this study examined whether being offered access to a patient portal, and being encouraged to use it, were associated with higher perceived quality of care among United States adults. Methods:The authors analyzed data from the 2024 Health Information National Trends Survey 7 (HINT 7), a nationally representative cross-section of United States adults aged ≥18 years. Weighted analyses assessed associations between portal access offers, encouragement, and self-rated care quality in the past 12 months, adjusting for sociodemographic characteristics. Results:Among 7,278 respondents (mean [SD] age, 49.0 [18.0] years), 78.6% rated their care as good, very good, or excellent. Overall, 73% had portal access and 69.0% were encouraged to use a portal. The number of respondents offered access to patient portal was significantly lower among older adults ≥75 years (10.6%; χ2 8=108.2, p <0.0001), women (27.9%; χ2 4=31.7, p <0.0001), those with lower income (8.3%; χ2 10=158.0, p <0.0001) or education (13.6%; χ2 6=107.9, p <0.0001), and rural residents (10.0%; χ2 2=12.1, p = 0.0024). In adjusted analyses, being offered portal access was associated with higher odds of rating care as excellent (aOR 2.47, 95% CI 1.21-5.07). Conclusions:Being offered portal access independently was associated with higher perceived care quality. Addressing disparities in portal access; especially among older, lower-income, and rural populations; may improve equity in patient experience.
