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Ethics approval and consent to participate
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The use of extracted teeth was approved by the Instituti...
PMC10386604
Consent for publication
Not applicable.
PMC10386604
Competing interests
The authors declare no competing interests.
PMC10386604
References
PMC10386604
ABSTRACT
PMC9839988
Background
chronic kidney disease
The kidney has the highest level of selenium (Se) in the body, but the role of plasma Se in chronic kidney disease is uncertain.
PMC9839988
Objective
hypertension
HYPERTENSION
We aimed to investigate the longitudinal association between baseline plasma Se and renal function decline in adults with hypertension and to explore possible effect modifiers.
PMC9839988
Methods
decline in renal function, hypertension, Stroke
HYPERTENSION, STROKE
This was a post hoc analysis of 935 men and women with hypertension aged 40 to 75 years from a folic-acid intervention trial (the China Stroke Primary Prevention Trial) in China. The baseline plasma Se was analyzed both as a continuous variable and as tertiles. The primary outcome was a rapid decline in renal function,...
PMC9839988
Results
decline in renal function
The median follow-up duration from baseline to outcome was 4.4 years. After multivariate adjustment, there was an inverse association between plasma Se and a rapid decline in renal function (per 10-unit increment; OR: 0.85; 95% CI: 0.73, 0.99). When the baseline plasma Se was assessed as tertiles, compared to the lowes...
PMC9839988
Conclusions
Stroke
HYPERTENSION, STROKE
In this sample of Chinese adults with hypertension, baseline plasma Se concentrations were inversely associated with the risk of renal function decline. The China Stroke Primary Prevention Trial was registered at clinicaltrials.gov as NCT00794885.
PMC9839988
Introduction
CKD
HYPERTENSION, CHRONIC KIDNEY DISEASE (CKD)
Chronic kidney disease (CKD) is a major public health problem worldwide (Selenium (Se) is an essential trace element that is incorporated into selenoproteins. Selenocysteine is the key component of several selenoproteins, which have potent antioxidant, antiapoptotic, and anti-inflammatory effects (To address the above ...
PMC9839988
Methods
PMC9839988
Study participants and design
stroke, CKD, hypertensive, Stroke
STROKE, STROKE
This was a post hoc analysis of 935 hypertensive adults from the China Stroke Primary Prevention Trial (CSPPT), a folic acid intervention trial to prevent stroke. The study design and major results of the CSPPT (registered at clinicaltrials.gov as NCT00794885) (A total of 20,702 eligible participants were randomly assi...
PMC9839988
Laboratory assays
BLOOD
Blood and spot-urine samples were collected from the participants at both the baseline and the exit visits. Methylenetetrahydrofolate reductase (
PMC9839988
Study outcomes
decline in renal function, CKD
SECONDARY
The primary outcome was a rapid decline in renal function, defined as a mean decline in eGFR of 5 mL/(min × 1.73 mThe secondary outcome was the development or progression of CKD, defined as any of the following:
PMC9839988
Other definitions
BMI was calculated as weight divided by height squared (kg/m
PMC9839988
Statistical analyses
±, decline in renal function, CKD, diabetes
REGRESSION, DIABETES
Of the 935 participants, there were missing data on serum folate (Participant characteristics were presented as means ± SDs for continuous variables and proportions for categorical variables, according to the tertiles of baseline plasma Se. Differences in baseline characteristics by tertiles of plasma Se were compared ...
PMC9839988
Results
PMC9839988
Characteristics of the study participants
±, CKD, chronic kidney disease
As illustrated in Characteristics of participants by tertiles of plasma seleniumFor continuous variables, values are presented as means ± SDs. CKD, chronic kidney disease; DBP, diastolic blood pressure; eGFR, estimated glomerular filtration rate; In addition, during the treatment period, the frequencies in use of conco...
PMC9839988
Association between plasma Se and renal outcomes
decline in renal function, CKD, chronic kidney disease, hypertensive
During the median treatment duration of 4.4 years (IQR: 4.2–4.6 years), a rapid decline in renal function and the development or progression of CKD occurred in 72 (7.7%) and 33 (3.5%) participants, respectively.As shown in The frequency distribution of baseline plasma selenium in 935 participants by outcome status: (A)...
PMC9839988
Exploratory subgroup analyses
decline in renal function, hypertensive
Stratified analyses were performed to assess the association between plasma Se (per 10-unit increment) and the rapid decline in renal function in various subgroups (Forest plot of subgroup analyses on the association between plasma selenium (per 10-unit increment) and the risk of rapid decline in renal function in hype...
PMC9839988
Discussion
hypertensive
Our study demonstrated a significant, inverse association between plasma Se and the subsequent risk of renal function decline in hypertensive patients. Furthermore, folate was a significant modifier for the relation of plasma Se and renal function. The inverse association was more pronounced in participants receiving f...
PMC9839988
Previous longitudinal studies on the association between Se and renal function
leukemias and lymphomas
SOLID TUMORS
The association between Se and renal function remains uncertain. Farhadnejad et al. (In support of our findings, a randomized, double-blind, placebo-controlled, phase-II, crossover study of 74 patients with leukemias and lymphomas (LL) and solid tumors (ST) reported that although there was no statistically significant ...
PMC9839988
The potential mechanisms on the association between Se and renal function
alleviating renal function, kidney injuries
Whilst the exact mechanisms underlying the inverse association of Se and renal function declines remains uncertain, it has been found that selenium exerts antioxidation, anti-inflammatory, and antiapoptotic functions, thus reducing kidney injuries and alleviating renal function declines, in animals (
PMC9839988
Strengths of our study
declines in renal functions, CKD
HYPERTENSION, ENDOTHELIAL DYSFUNCTION
Our study has made new contributions to the field. First, to our knowledge, this is the first study of its kind in Chinese adults with hypertension, a high-risk population for developing CKD. It showed an inverse association between plasma Se and the risk of declines in renal functions. If further confirmed, these find...
PMC9839988
Limitations of our study
hypertensive
REGRESSION
Our study also has several limitations. First, as an observational study, although a number of covariates have been adjusted for in the regression models, we cannot exclude the possibility of residual confounding from other unmeasured or unknown factors, such as detailed information on antioxidant dietary intakes, diet...
PMC9839988
Conclusions
HYPERTENSION
Our study showed an inverse association of baseline plasma Se levels with the risk of renal function decline in adults with hypertension, especially among those receiving folic acid treatment or with higher baseline folate levels, suggesting a synergistic effect of Se and folate in preserving renal function. Our findin...
PMC9839988
Supplementary Material
Click here for additional data file.
PMC9839988
Acknowledgements
The authors’ responsibilities were as follows – YL, YS, LL, ZZ, ZW, XX, JL: conducted the research; YL, XW, JL: analyzed the data and wrote the manuscript; JL: had primary responsibility for the final content of the manuscript; and all authors: designed the research and read and approved the final manuscript.
PMC9839988
Data Availability
Data described in the manuscript, code book, and analytic code will be made available from the corresponding author on request, after the request is submitted and formally reviewed and approved by the Ethics Committee of the Institute of Biomedicine, Anhui Medical University, and the Ethics Committee of Nanfang Hospita...
PMC9839988
Notes
lymphomas, CKD, chronic kidney disease, Stroke
LEUKEMIAS, MYOCARDIAL INFARCTION, STROKE, SOLID TUMORS, LYMPHOMAS
This work was supported by the National Natural Science Foundation of China (82000691); the Science and Technology Planning Project of Guangzhou, China (202102021155); and the Outstanding Youths Development Scheme of Nanfang Hospital, Southern Medical University (2019J004).Author disclosures: Dr. Youbao Li reports gran...
PMC9839988
References
PMC9839988
Keywords
schizophrenia, schizophrenia-spectrum disorders
VIRUS
In the United States, the health and economic consequences of the COVID-19 pandemic have disproportionately affected the Latinx community. Within the Latinx community, people with schizophrenia-spectrum disorders are more susceptible to exposure to the virus. Given their increased risk of contracting and getting sick f...
PMC9898851
Introduction
PMC9898851
Background
cognitive impairment, schizophrenia, memory deficits, schizophrenia-spectrum disorders
VIRUS
The health and economic consequences of the COVID-19 pandemic have disproportionately affected the Latinx community. Across many states, their rates of contracting the virus are twice their population proportion [Within the Latinx community, those with schizophrenia-spectrum disorders may be more susceptible to virus e...
PMC9898851
Conceptual Framework
A commonly used form of visual narrative is the We developed a 12 min, Spanish-language, digitally animated audio-visual
PMC9898851
Methods
PMC9898851
Participants
schizophrenia-spectrum disorder, schizophrenia-spectrum disorders
The participants were 100 Spanish-speaking adults with schizophrenia-spectrum disorders receiving mental health services at the San Fernando Mental Health Center, a community mental health center operated by the Los Angeles County Department of Mental Health. The inclusion criteria were the participant self-identified ...
PMC9898851
Data Collection
schizophrenia, schizoaffective disorder
Subjects with chart-diagnosed schizophrenia or schizoaffective disorder were recruited through advertisements posted at the community mental health center. Interested subjects contacted a Spanish-speaking research assistant, who obtained informed consent from the subject, administered the baseline measures (demographic...
PMC9898851
Materials
The audio-visual novela, entitled “Examples of images from audio-visual novella. The development of the audio-visual novela was led by one of the co-authors (GM), whose team at the University of Southern California School of Pharmacy has produced numerous audio-visual novelas used throughout the world to improve health...
PMC9898851
Measures
fatigue, fever, pain, infection, dry cough
VIRUS, INFECTION, EVENTS
All data was generated from interviews conducted by a Spanish-speaking research assistant. Demographic variables including age, gender, marital status, educational level, and working status were ascertained. Acculturation level was measured using the 23-item Cuellar acculturation scale [The assessment of COVID-19 Knowl...
PMC9898851
Data Analysis
infection
REGRESSION, INFECTION
SPSS Version 27 was used to carry out the data analysis. We carried out independent t-tests and Pearson Chi-square analyses to assess whether there were significant differences in the background of the participants in the two conditions. The study hypotheses were that subjects exposed to the COVID-19 material would hav...
PMC9898851
Results
PMC9898851
Sample
schizophrenia-spectrum disorder
Of the 137 people screened for eligibility, 23 did not meet inclusion criteria (insufficient Spanish language proficiency = 9; did not meet criteria for a schizophrenia-spectrum disorder = 8, lacked capacity to provide informed consent = 6). Of the 114 people invited to participate, 14 refused because they would not be...
PMC9898851
Participants’ Background by Condition
There were no differences in the two conditions regarding age (p = 0.53), years of schooling (p = 0.37), gender (p = 0.67), employment status (not employed, employed, p = 0.36), marital status (never married, married at some time, p = 0.19) and language preference (Spanish or bilingual, p = 0.51).
PMC9898851
Discussion
infection, schizophrenia-spectrum disorders
INFECTION
The purpose of this study was to test the hypotheses that Spanish-speaking individuals with schizophrenia-spectrum disorders would demonstrate increased knowledge, more realistic attitudes, and engage in safer behaviors after watching a digitally animated audio-visual novela focused on COVID-19. We found partial suppor...
PMC9898851
Limitations
schizophrenia-spectrum disorders, cognitive deficits
These findings are subject to several limitations. The intervention itself was very brief and delivered only once. Given the cognitive deficits often found in people with schizophrenia-spectrum disorders [
PMC9898851
Acknowledgements
The funding for this research was provided by the UCLA David Geffen School of Medicine COVID-19 Research Award Program. This study was reviewed and approved by the UCLA Institutional Review Board and the Human Subjects Research Committee of the Los Angeles County Department of Mental Health. The authors thank the membe...
PMC9898851
References
PMC9898851
Background
Joint first authors.One size does not fit all in assessment and intervention for people with convictions for sexual offences. Crime scene indicators and risk-related variables have been used to identify distinct clusters of people with convictions for sexual offences, but there is a need for more robust typologies that...
PMC10727912
Aims
To use robust modelling techniques to identify latent profiles of people with convictions for sexual offences based on indicators of dynamic risk.
PMC10727912
Method
Adult male participants, who had been convicted for sexual offences and assessed for eligibility for the prison-based Core Sex Offender Treatment Programme delivered by His Majesty's Prison and Probation Service (UK), were randomly allocated to a test (
PMC10727912
Results
low psychological impairment
Five latent profiles were identified in the test and validation data-sets. These were labelled low psychological impairment, impulsive, distorted thinker, rape preoccupied and child fantasist. Profiles varied in individual characteristics, offence histories, victim preferences and level of risk.
PMC10727912
Conclusions
Our findings should be used to guide assessment and intervention practices that are tailored to distinct psychological profiles consistent with principles of risk, need and responsivity.
PMC10727912
Keywords:
familiality
Sexual violence is an international public health concern that entails a substantial cost to society.Given this heterogeneity, it is unsurprising that attempts have been made to categorise people into more homogeneous groups on the basis of offence type (e.g. contact versus online offending), victim age (e.g. prepubesc...
PMC10727912
Method
PMC10727912
Sample
MAY
Participants were part of a data-set of 2394 UK adult males convicted of sexual offences. All participants were assessed between 2003 and 2014 (with 65% of assessments occurring between 2007 and 2011, inclusive) for eligibility for the prison-based version of HMPPS Core Sex Offender Treatment Programme (SOTP). Approxim...
PMC10727912
Measure selection
The clinical data-set contained pre- and post-programme test scores on 92 scales from 17 psychological measures (see Supplementary Material A for descriptions), along with demographic, intervention and offence characteristics. Only pre-programme test scores were considered for inclusion. One scale was removed because o...
PMC10727912
Socially desirable responding
Given concerns about the tendency towards socially desirable responding, we used the Balanced Inventory of Desirable Responding (BIDR)
PMC10727912
Latent profile analysis
Model-based clustering is based on the theory that data are derived from a mixture of underlying probability distributions.It is recommended that a range of criteria are used for identifying the correct number of profiles.
PMC10727912
Validity of latent profiles
REGRESSION
The replicability of the final profile solution was validated using the validation data-set (30% of the total sample). To establish criterion-related evidence, a series of linear regression models and tests of association were used to examine whether profile allocation was associated with theoretically plausible crimin...
PMC10727912
Results
PMC10727912
Socially desirable responding
Scores on the BIDR subscales in the test sample (Self-Deceptive Enhancement: mean 5.9, s.d. = 3.4; Impression Management: mean 6.3, s.d. = 4.0) showed that the extent of socially desirable responding was small and within the range of normative values reported in the BIDR manual (Self-Deceptive Enhancement: mean 7.5, s....
PMC10727912
Latent profile analysis
Seventy-two cases were removed owing to missingness, and 1505 cases were included in the LPA. BIC and SABIC indicated that Model 3 generated a better relative fit than Model 1 and showed a plateau at five latent profiles (Supplementary Fig. 2, Supplementary Material A). For Model 3, ICL and BLRT were also highest at fi...
PMC10727912
Solution validation
Our validation data-set generated a very similar five-profile solution. Nineteen cases were removed owing to missingness, and 649 cases were included in the validation LPA. For Model 3, BIC and SABIC plateaued at five profiles, ICL and BLRT were also high at five profiles, and both entropy and minimum probability steep...
PMC10727912
Exploratory analyses
In a
PMC10727912
Discussion
heightened impulsive, antisocial, high-functioning
In a pre-treatment sample of people convicted for sexual offences in the UK, we used psychological test measures, indexing three of the four SARN domains of dynamic risk,The second profile was termed impulsive and accounted for approximately 8.4% of the test sample. These individuals were characterised by heightened im...
PMC10727912
Clinical implications
Our findings have clear implications for assessment and treatment, and can be considered in the context of SARN domains of dynamic risk, and principles of risk, need and responsivity.
PMC10727912
Strengths and limitations
Our work has several strengths, including a large, heterogeneous sample, data on intelligence, the number and type of previous convictions, and information about level of risk and index offence codes. However, our results are nonetheless subject to some limitations. First, factor analyses revealed that the psychologica...
PMC10727912
Future research
Future work should aim to authenticate the five identified latent profiles within and outside the UK and examine differences between profiles in responsivity to different interventions (including pharmacological interventions where indicated).
PMC10727912
Supporting information
PMC10727912
Gillespie and Elliott supplementary material 1
Gillespie and Elliott supplementary material
PMC10727912
Gillespie and Elliott supplementary material 2
Gillespie and Elliott supplementary material
PMC10727912
Supplementary material
Supplementary material is available online at
PMC10727912
Data availability
The data that support the findings of this study are available from Ministry of Justice, UK. Restrictions apply to the availability of these data, which were used under licence for this study.
PMC10727912
Author contributions
S.M.G. formulated the research question. S.M.G. and I.A.E. designed the study and wrote the article. I.A.E. analysed the data.
PMC10727912
Funding
This research was funded in whole, or in part, by a grant from the Economic and Social Research Council (ES/T002824/1), awarded to S.M.G.
PMC10727912
Declaration of interest
S.M.G. has provided paid consultancy for Ministry of Justice, UK. I.A.E. is an employee of Ministry of Justice, UK.
PMC10727912
References
PMC10727912
Background
Overtreatment poses a challenge to healthcare systems due to harmful consequences of avoidable side-effects and costs. This study presents the first account for examining the feasibility of placebo use for reducing overtreatment in primary care, including whether public attitudes support the use of different placebo ty...
PMC10510165
Methods
We used a multi-study, mixed-methods design, including patient and public (PPI) consultations, focus groups (Study 1) and two pre-registered online experiments (Studies 2 and 3).
PMC10510165
Results
Study 1 (
PMC10510165
Conclusions
Findings from PPI and three studies indicate general support for combatting overprescribing in primary care through clinical placebo use. This is an indicator for wider UK public support for a novel, behavioural strategy to target a long-standing healthcare challenge. General acceptability appears to be highest for the...
PMC10510165
Supplementary Information
The online version contains supplementary material available at 10.1186/s12916-023-03074-4.
PMC10510165
Keywords
PMC10510165
Background
This article presents the first comprehensive evidence around public acceptability of clinical placebo use as a behavioural strategy to reduce overtreatment in “primary care”, defined by the World Health Organisation as “a model of care that supports first-contact, accessible, continuous, comprehensive and coordinated ...
PMC10510165
Placebo use in primary care
Placebos are “inert” substances that have no therapeutic effects but can alleviate symptoms through patients’ participation in the therapeutic encounter and the associated, measurable effects on neurobiological mechanisms [Placebo types can be categorised based on the amount of information provided upon administration....
PMC10510165
Public acceptability of placebo use
DISEASE
The present research aims to test clinical placebo use as a substitution strategy to reduce the overuse of unnecessary medicines in UK primary care. Based on decision theory and empirical results pertaining to placebo effectiveness, we predict the benefits of placebos to be twofold. Firstly, they offer a behavioural so...
PMC10510165
Framing effects
Evidence from the decision sciences shows that the specific way information is worded or “framed” can influence the way information is processed, perceived and subsequently acted upon. For example, a classic study suggested that framing the same treatment outcomes either in terms of losses (number of patients lost) or ...
PMC10510165
Individual differences
anxiety
A 2020 systematic review suggests that personality variables may affect the strength of patients’ placebo responses, with optimism leading to higher effectiveness of placebos and health anxiety leading patients to experience more negative side effects (“nocebo effects”) when taking placebos [
PMC10510165
Study 1: focus groups
RESPIRATORY INFECTIONS
The first study consisted of an in-depth qualitative exploration of public attitudes around placebos. Focus groups were employed to generate discussion between different participants. At the same time, this initial qualitative study served to test the wording and general appropriateness of the patient scenario for late...
PMC10510165
Methods
PMC10510165
Participants
Using advertisements on social media (Twitter, Facebook), we recruited an opportunity sample of 16 adult members of the general public living in the UK. The sample included 9 males and 7 females with a mean age of 26.56 (
PMC10510165
Materials and procedure
The project idea and research plans including draft focus group materials were presented at two separate PPI (Patient and Public Involvement) group meetings of the “Leicester, Leicestershire and Rutland Ageing Patient and Public Involvement Forum” and the “Ethnic Minority Research Inclusion (EMRI) Hub (South Yorkshire)...
PMC10510165
Data analysis
Focus group recordings were transcribed verbatim and imported into NVivo 12 for coding. In accordance with a Grounded Theory approach [
PMC10510165
Results
The responses from the focus groups fell into three primary categories: ethical considerations around placebo usage, perceptual and conceptual understandings of placebos by the respondents, and practicalities of using placebos within healthcare provision. A detailed overview of individual codes as well as exemplary par...
PMC10510165
Theme 1: ethical considerations
pain
MINOR, BLIND
Trust within the patient-clinician relationship was viewed as foundational to the use of placebos in appropriate conditions and contexts. Primarily, trusting that a clinician would be using the placebo for an appropriate condition—i.e. one that would not be worsened by substituting a placebo—and in a context that was b...
PMC10510165
Theme 2: perceptions and conceptions of placebos
The discussions also revealed how participants perceived placebos as a “non-real” form of treatment, with descriptors such as “pseudo-medication”, “does nothing”, and “not a real treatment” being used. Nevertheless, the placebo effect itself was largely accepted and spoken about as a real phenomenon. Participants sugge...
PMC10510165
Theme 3: practicalities of placebo usage in healthcare
infection
INFECTION
Participants debated whether placebos should be priced as regular medication, with most believing that as a tangible good or service received from a healthcare provider, a placebo should be treated monetarily similar to any other medication. However, others viewed charging for placebos as either unethical or unfair to ...
PMC10510165
Brief discussion
CHRONIC PAIN
Our study aligns with previous research indicating trust in doctor-patient relationships as crucial for placebo utilisation [The participants’ identification of mental health contexts as suitable for placebo use suggests a promising avenue for further research; especially when this is contrasted with their view of plac...
PMC10510165