Background: Homestay accommodations aim to support a smoother transition for refugees; yet, the intricate nature of relationships between refugees and their hosting families can make this process complex, which, in turn, can affect their health and well-being. It is crucial to grasp the experiences of both refugees and their host families in order to foster effective settlement, integration, and well-being.
Objective: The purpose of this scoping review is to explore the dynamics of homestay or hosting with a focus on understanding the experiences of both refugees and their hosting families to identify gaps in the literature and propose directions for future research.
Methods: We used the Joanna Briggs Institute methodology and followed the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist to guide this scoping review. Searches were conducted in MEDLINE via EBSCO, Scopus via OVID, CINAHL, SOCIndex, Web of Science Core Collection, ProQuest Dissertations and Theses, the SciELO Citation Index, and APA PsycInfo. Literature written in English and published from 2011 to 2024 that focused on homestay hosting contexts for refugees was included.
Results: The results of this review illuminate the multifaceted and dynamic nature of homestay hosting for refugees. The findings include motivations and barriers for homestay hosting, factors influencing host-refugee relations, and psychological and social outcomes of homestay hosting.
Conclusions: The results of this scoping review demonstrated the need for tailored support for refugees to improve homestay programs for the benefit of both refugees and host families and highlighted the need of more inclusive, supportive, and effective strategies for the hosting, resettlement, and integration of refugees.
International registered report identifier (irrid): RR2-10.2196/56242.
Background: Chronically elevated inflammation is implicated in many conditions, including obesity, metabolic syndrome, and cardiovascular disease, and has been associated with increased mortality risk. Whole-body cryotherapy (W-BC) is a promising modality to treat inflammation with demonstrated benefits for clinical subpopulations including those with arthritis, obesity, and type 2 diabetes. However, it is unclear whether the benefit from W-BC extends to healthy individuals prior to chronic disease-related inflammation. In addition, the long-term durability of W-BC effect is unknown.
Objective: This study investigates the inflammatory response to W-BC in healthy adults with a biomarker of inflammation, high-sensitivity C-reactive protein (hsCRP), and clinical biomarkers of metabolism including fasting glucose, hemoglobin A1c (HbA1c), low-density lipoprotein (LDL) and high-density lipoprotein (HDL), and triglycerides.
Methods: Fifteen individuals (n=9 female) participated in frequent recreational W-BC (3 minutes of cold exposure at -110 ℃) over approximately 9 months and had blood draws at baseline plus follow-up visits. Biomarkers were modeled as linear functions of W-BC sessions received in the month prior to blood draw.
Results: The mean amount of W-BC received was 6.78 (SD 4.26) times per month with the cumulative total ranging from 13 to 157 W-BC sessions over the course of the study. On average, participants completed 1-2 sessions per week throughout the intervention. The number of W-BC sessions were associated with decreased hsCRP (-0.14 mg/L in hsCRP per W-BC session; P<.01) and with durability of up to 9 months. Increased W-BC was also associated with a downward trend in fasting glucose. This trend failed to reach significance at 1 month (-0.73 mg/dL in fasting glucose per W-BC session; P<.10) but was significant for 2- and 3-month windows (P<.05). HbA1c was increased significantly after 9 months (P<.01); however, the change occurred within normal ranges (difference=0.13% and <5.7%) and was not clinically significant. There was no association between W-BC and LDL cholesterol, HDL cholesterol, or triglycerides (P>.10), although LDL trended lower over the time period examined (P=.07).
Conclusions: These results suggest that W-BC beneficially impacts systemic inflammation by lowering hsCRP levels in healthy individuals and may also have some modulating effect on fasting glucose.
Background: Nations of considerable wealth and sophisticated health care infrastructures have experienced high rates of illness and death from COVID-19. Others with limited economic means and less developed health systems have achieved much lower burdens. To build a full understanding, an appraisal of the contribution of social relationships is necessary. Social cohesion represents a promising conceptual tool.
Objective: This study aimed to examine scholarship on social cohesion during the COVID-19 pandemic: specifically, the constructions of social cohesion being deployed, the variables chosen for representation, and the effects of and on social cohesion being reported.
Methods: The PubMed, Scopus, and JSTOR databases were searched for relevant journal articles and gray literature. A total of 100 studies met the inclusion criteria. Data were extracted and analyzed from these using spreadsheet software.
Results: Several constructions of social cohesion were found. These concerned interpersonal relationships, sameness and difference, collective action, perceptions or emotions of group members, structures and institutions of governance, locally or culturally specific versions, and hybrid or multidimensional models. Social cohesion was reported to be influential on health outcomes, health behaviors, resilience, and emotional well-being, but there was some potential for it to drive undesirable outcomes. Scholarship reported increases or decreases in quantitative measures of social cohesion, a temporary "rally round the flag" effect early in the pandemic, the variable impacts of policy on social cohesion, and changing interpersonal relationships due to the pandemic conditions. There are numerous issues with the literature that reflect the well-documented limitations of popular versions of the concept.
Conclusions: Social cohesion has been used to express a range of different aspects of relationships during the pandemic. It is claimed to promote better health outcomes, more engagement with positive health behaviors, and greater resilience and emotional well-being. The literature presents a range of ways in which it has been altered by the pandemic conditions. There are significant weaknesses to this body of knowledge that greatly impede its overall quality.
Background: Long-term care hospitals have been considered an efficient response to the health care needs of an increasingly aging population. These centers are expected to contribute to better hospital bed management and more personalized care for patients needing continuous care. The evaluation of their outcomes is necessary after a sufficient period to assess their impact. Hospitals for Acute and Chronic Long-Term Extended Stay (HACLES) emerged in Spain in the late 20th century as a response to the aging population and the increase in chronic diseases.
Objective: This study aimed to analyze the profile of patients treated in a HACLES, particularly analyzing gender differences, and evaluate the cost savings associated with using these centers.
Methods: A retrospective study was conducted based on data from patients 65 years old or older admitted to a HACLES between 2022 and 2023. Gender, age, household cohabitation data, diagnosis and comorbidity, daily medication intake, and degree of dependency were obtained to describe the profile of patients who attended the HACLES. Data coded in SIA-Abucasis (version 37.00.03; Consellería Sanitat, Generalitat Valenciana; a digital medical record system used in the Valencian region) were reviewed, and descriptive statistics and comparison tests were used. The direct cost savings of HACLES admissions were calculated by comparing the daily cost of a general hospital bed with that of a HACLES bed.
Results: Data from 123 patients with a mean age of 77 years were analyzed. Most (n=81, 65.9%) had a cohabiting family member as their primary caregiver. Palliative care was the most frequent reason for admission (n=75, 61%). The mortality rate (odds ratio [OR] 61.8, 95% CI 53.2-70.5) was similar between men and women (OR 54.1, 95% CI 47.8-71.5 vs OR 59.7, 95% CI 42.2-66.0; P=.23). The cognitive assessment, using the Pfeiffer scale, improved at discharge (mean 3.2, SD 3.2 vs mean 2.5, SD 3.1; P=.003). The length of stay was significantly larger for patients who returned home compared with patients discharged to other facilities (mean 89.8, SD 58.2 versus mean 33.1, SD 43.1 days; P<.001). The direct cost savings were estimated at US $42,614,846 per 1000 admissions.
Conclusions: Patients typically treated in HACLES are older, with a high level of cognitive impairment and physical dependency, and a significant proportion are in palliative care, highlighting the importance of adapting care to the individual needs of the admitted patients. The HACLES model contributes to the sustainability of the public health system.
Background: The integration of artificial intelligence (AI) into health care has the potential to transform the industry, but it also raises ethical, regulatory, and safety concerns. This review paper provides an in-depth examination of the benefits and risks associated with AI in health care, with a focus on issues like biases, transparency, data privacy, and safety.
Objective: This study aims to evaluate the advantages and drawbacks of incorporating AI in health care. This assessment centers on the potential biases in AI algorithms, transparency challenges, data privacy issues, and safety risks in health care settings.
Methods: Studies included in this review were selected based on their relevance to AI applications in health care, focusing on ethical, regulatory, and safety considerations. Inclusion criteria encompassed peer-reviewed articles, reviews, and relevant research papers published in English. Exclusion criteria included non-peer-reviewed articles, editorials, and studies not directly related to AI in health care. A comprehensive literature search was conducted across 8 databases: OVID MEDLINE, OVID Embase, OVID PsycINFO, EBSCO CINAHL Plus with Full Text, ProQuest Sociological Abstracts, ProQuest Philosopher's Index, ProQuest Advanced Technologies & Aerospace, and Wiley Cochrane Library. The search was last updated on June 23, 2023. Results were synthesized using qualitative methods to identify key themes and findings related to the benefits and risks of AI in health care.
Results: The literature search yielded 8796 articles. After removing duplicates and applying the inclusion and exclusion criteria, 44 studies were included in the qualitative synthesis. This review highlights the significant promise that AI holds in health care, such as enhancing health care delivery by providing more accurate diagnoses, personalized treatment plans, and efficient resource allocation. However, persistent concerns remain, including biases ingrained in AI algorithms, a lack of transparency in decision-making, potential compromises of patient data privacy, and safety risks associated with AI implementation in clinical settings.
Conclusions: In conclusion, while AI presents the opportunity for a health care revolution, it is imperative to address the ethical, regulatory, and safety challenges linked to its integration. Proactive measures are required to ensure that AI technologies are developed and deployed responsibly, striking a balance between innovation and the safeguarding of patient well-being.
Background: Surveys of internet panels such as Amazon's Mechanical Turk (MTurk) are common in health research. Nonresponse in longitudinal studies can limit inferences about change over time.
Objective: This study aimed to (1) describe the patterns of survey responses and nonresponse among MTurk members with back pain, (2) identify factors associated with survey response over time, (3) assess the impact of nonresponse on sample characteristics, and (4) assess how well inverse probability weighting can account for differences in sample composition.
Methods: We surveyed adult MTurk workers who identified as having back pain. We report participation trends over 3 survey waves and use stepwise logistic regression to identify factors related to survey participation in successive waves.
Results: A total of 1678 adults participated in wave 1. Of those, 983 (59%) participated in wave 2 and 703 (42%) in wave 3. Participants who did not drop out took less time to complete previous surveys (30 min vs 35 min in wave 1, P<.001; 24 min vs 26 min in wave 2, P=.02) and reported having fewer health conditions (5.88 vs 6.6, P<.001). In multivariate models predicting responding at wave 2, lower odds of participation were associated with more time to complete the baseline survey (odds ratio [OR] 0.98, 95% CI 0.97-0.99), being Hispanic (compared with non-Hispanic, OR 0.69, 95% CI 0.49-0.96), having a bachelor's degree as their terminal degree (compared with all other levels of education, OR 0.58, 95% CI 0.46-0.73), having more pain interference and intensity (OR 0.75, 95% CI 0.64-0.89), and having more health conditions. In contrast, older respondents (older than 45 years age compared with 18-24 years age) were more likely to respond to the wave 2 survey (OR 2.63 and 3.79, respectively) and those whose marital status was divorced (OR 1.81) and separated (OR 1.77) were also more likely to respond to the wave 2 survey. Weighted analysis showed slight differences in sample demographics and conditions and larger differences in pain assessments, particularly for those who responded to wave 2.
Conclusions: Longitudinal studies on MTurk have large, differential dropouts between waves. This study provided information about the individuals more likely to drop out over time, which can help researchers prepare for future surveys.
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