bluuebunny/crossref_metadata_2025 huggingface dataset:
The influence of perceived teacher and peer supports and barriers in female Spanish engineering undergraduates through their own voices
Authors: Inda‐Caro Mercedes , Viñuela‐Hernández María‐Paulina , Martínez‐García María‐Lindsay , García‐Pérez Omar
Published: September 2022

The goal of the study was to analyze the influence of perceived teacher/peer supports and barriers on career development in female engineering undergraduates based on Social Cognitive Career Theory. Thirteen students studying various engineering degrees participated. The results of a qualitative methodology, life stories, and focus groups, showed that the students perceived more teacher and peer supports than barriers from primary school to university. Students' perceptions of teacher support increased due to the climate they promoted in the classrooms, and the delivery of challenging lessons, mainly in subjects such as mathematics, technology, and computing. Peer influence became stronger at university, and was one of the most important factors in students achieving their goals. The main barriers they perceived were being discouraged from choosing Science, Technology, Engineering, and Math‐Information Technology, Electrical Engineering (STEM‐ITEE), feeling isolated when beginning ITEE courses, and negative comments.
Pax McDonaldica before the storm: From geopolitical fault‐line to urbicide in Mariupol, Ukraine
Authors: Gentile Michael
Published: September 2022

Until 24 February 2022, when Russia launched its full‐scale attack on Ukraine, Mariupol, like many other Ukrainian government‐controlled cities in the country's eastern regions, was trying to reinvent and rebrand itself as a modern European city. But it was missing something: the golden arches, that ubiquitous symbol of globalisation that can be found in almost any medium‐sized city in Europe. Because McDonald's restaurants are perceived as powerful symbols of global capitalism and of Western or American culture, the establishment of new McDonald's restaurants has sometimes been challenged – even violently – by nationalist or anti‐globalist forces. In Mariupol, which lost its status as a ‘McDonald's city’ at the beginning of the Donbas war in 2014, this was not the case. In this intervention, I describe how the restaurant was a symbolic centrepiece of local debates taking place in this geopolitical fault‐line city, where deep divisions surrounding foreign policy and geopolitical preferences carried the potential for volatile and unpredictable urban conflict, trumping most frictions related to the city's diverse ethno‐national structure. In its role as globally signifying flagship, McDonald's had generated an area of popular and political consensus – a Pax McDonaldica – while also acting as a (welcome?) distraction from a low‐intensity war that had already lasted for eight years. This all came to an end when Russia attacked Ukraine, destroying much of the city, killing man thousands, forcefully displacing or deporting hundreds of thousands, and terrorising those left behind.
Geographic expeditions through the Brazilian Sertão (1941–1948): Origins of another epistemological style of geography
Authors: de Lira Larissa Alves
Published: September 2022

This paper seeks to validate the hypothesis that in Brazil, between 1941 and 1948, when the first geographical expeditions to the sertão (backcountry) of Brazil took place, there was a transition in the epistemological style practiced by geographers between the historicist and ecological approach and a positivistic planning approach. Added to both is the need to restructure the colonial legacy of the country's territory, a perspective marked by social geography with a Marxist bias. This transition process is, simultaneously, the construction of another hybrid geographical style and an epistemological point of view of its own. This form of epistemology reflects the configuration of space, i.e., the continuity of the economic and political life of the coast without major modifications. However, the projected planning perspectives for the future occupation of the sertão, seen by the actors of the time as an empty territory, with resources and in which its occupation could gradually reverse Brazil's colonial legacy. Brazilian scientific space is observed as a circulation of knowledge, which is subject to tensions. Conceptual developments occurred in discussions in National Council of Geography (CNG) and Brazilian Institute of Geography and Statistics (IBGE) institutional settings and were called ‘geographical talks/gatherings’, which were published in the Boletim Geográfico and the Revista Brasileira de Geografia. Based on these discussions and controversies, it was possible to differentiate the styles of geography mobilised by actors, as well as to create a general interpretation based on the material analysed. Development geography and a geographical reason are understood as the result of this construction, based on two main factors: the influences of foreign geographies and the nature of the country. The methodology adopted was a geo‐history of knowledge, associated with aspects of Bruno Latour's actor‐network theory. Finally, the paper seeks to contribute to the validation of the epistemological and heuristic virtues typical of the southern hemisphere.
Whose ethics of care? The geographies of live‐in elder care in China
Authors: Yu Jie , Rosenberg Mark W.
Published: September 2022

Reflecting on different theoretical premises within geographies of care, this paper develops their connections and responds to the normativity and universalism in care literature through conceptualising live‐in elder care (LEC). Considering the relationality of differential contributions to care, we propose a conceptualisation of multiple interrelated approaches by: (1) extending the critical frameworks of care to understand the broader frames of institution, market, and morality in mediating interpersonal connectedness of elder care; (2) thinking care relationally, we challenge the dominant conceptualisation of care and power as unidirectional flows and elder care relationships as a receiver–giver dyad; (3) emplacing care, we focus on the actual conditions of care through which ethics are assembled in their geo‐historical context; (4) treating care as grounded, we centre voices from both older people and LEC workers and how ethics of care are comprehended in the everyday rather than prescribed for commodified care. Our thematic analysis starts with a commodification process where LEC is negotiated in tensions; yet moving beyond arguments around systems of dominance and ideal ethics of care, findings show LEC also creates a space of care where LEC workers and older people constantly negotiate norms, boundaries, and care as a relational process. Conceptually, this paper recognises the role of power in shaping the market and intimate relationships of elder care by elaborating on the inequities of age, gender, and place (not just gender). Moving beyond critiques, this paper emphasises the entangled and relational nature of care as grounded in a series of everyday concerns and resistance, where ethics of difference are negotiated and a cultural‐historical configuration of care still perpetuates in its locale. Finally, this paper speaks to the active yet overlooked role of age and ageing in constructing an ethics of care.
Stochastic Buckling of Geometrically Imperfect Beams on Elastic Foundation
Authors: Baizhikova Zheren , Le Jia-Liang , Ballarini Roberto
Published: September 2022

Geometrical imperfections are ubiquitous in load-bearing structures, including beams, columns, and shells. Fabrication processes of structural members most often create geometrical imperfections of random size and shape, which lead to non-deterministic load-carrying capacity. This study investigates the statistics of the buckling load of a beam with a random initial imperfection profile that rests on a nonlinear elastic foundation. The geometrical imperfection is represented by a zero-mean Gaussian random field, generated using the Karhunen–Loève expansion. The spatial distribution of the random imperfection is characterized by the probability distribution of the local imperfection magnitude and a spatial autocorrelation function. A finite-difference scheme is used to solve the governing equilibrium equation for a given initial imperfection profile, from which the buckling load is determined. Through a set of Monte Carlo simulations, the mean and variance of the buckling load are determined. The simulations reveal the influence of different length scales on the statistics of the buckling load, including the beam length and the autocorrelation length of the geometrical imperfection. The size effects predicted with the simplified model have implications for reliability-based structural design.
Evolution of Turbulence and Its Modification by Axial Casing Grooves in a Multi-Stage Axial Compressor
Authors: Koley Subhra Shankha , Saraswat Ayush , Katz Joseph
Published: September 2022

This experimental study examines the evolution of turbulence across an axial compressor and its modification by semicircular axial casing grooves (ACGs) at the pre-stall and near the best efficiency (BEP) flowrates. The turbulence is highly anisotropic and spatially inhomogeneous, with each normal Reynolds stress component evolving differently. Most of the observed trends can be explained by examining the dominant production rate terms. At the pre-stall flowrate, the turbulence increases significantly upon entering the rotor with peak RMS values of axial velocity fluctuations reaching as high as 71% of the mean axial velocity. The region with elevated turbulent kinetic energy (TKE) covers 30% of the outer span near the rotor leading edge, expanding to 50% near the trailing edge. While the TKE in the outer span decays rapidly in the stator, the local turbulence production persists in the stator blade boundary layer. By stabilizing and homogenizing the flow, the ACGs reduce the turbulence production, hence the TKE, in the rotor and the stator. The only exception is an increase in turbulence in the region dominated by groove–passage flow interactions. Near BEP, the TKE is much lower everywhere, except for the region influenced by the outflow from grooves. Downstream of the rotor and the stator, the turbulence level with or without ACGs are similar. The large variations in the magnitude and even the sign of the measured eddy viscosity highlight the extreme non-equilibrium conditions over the entire machine, questioning the fundamental assumptions of local equilibrium in eddy viscosity-based Reynolds stress models.
Neurorobotic approaches to emulate human motor control with the integration of artificial synapse
Authors: Kim Seonkwon , Kim Seongchan , Ho Dong Hae , Roe Dong Gue , Choi Young Jin , Kim Min Je , Kim Ui Jin , Le Manh Linh , Kim Juyoung , Kim Se Hyun , Cho Jeong Ho
Published: September 2022

The advancement of electronic devices has enabled researchers to successfully emulate human synapses, thereby promoting the development of the research field of artificial synapse integrated soft robots. This paper proposes an artificial reciprocal inhibition system that can successfully emulate the human motor control mechanism through the integration of artificial synapses. The proposed system is composed of artificial synapses, load transistors, voltage/current amplifiers, and a soft actuator to demonstrate the muscle movement. The speed, range, and direction of the soft actuator movement can be precisely controlled via the preset input voltages with different amplitudes, numbers, and signs (positive or negative). The artificial reciprocal inhibition system can impart lifelike motion to soft robots and is a promising tool to enable the successful integration of soft robots or prostheses in a living body.
Sex-specific epigenetic development in the mouse hypothalamic arcuate nucleus pinpoints human genomic regions associated with body mass index
Authors: MacKay Harry , Gunasekara Chathura J. , Yam Kit-Yi , Srisai Dollada , Yalamanchili Hari Krishna , Li Yumei , Chen Rui , Coarfa Cristian , Waterland Robert A.
Published: September 2022

Recent genome-wide association studies corroborate classical research on developmental programming indicating that obesity is primarily a neurodevelopmental disease strongly influenced by nutrition during critical ontogenic windows. Epigenetic mechanisms regulate neurodevelopment; however, little is known about their role in establishing and maintaining the brain’s energy balance circuitry. We generated neuron and glia methylomes and transcriptomes from male and female mouse hypothalamic arcuate nucleus, a key site for energy balance regulation, at time points spanning the closure of an established critical window for developmental programming of obesity risk. We find that postnatal epigenetic maturation is markedly cell type and sex specific and occurs in genomic regions enriched for heritability of body mass index in humans. Our results offer a potential explanation for both the limited ontogenic windows for and sex differences in sensitivity to developmental programming of obesity and provide a rich resource for epigenetic analyses of developmental programming of energy balance.
Postglacial species arrival and diversity buildup of northern ecosystems took millennia
Authors: Alsos Inger Greve , Rijal Dilli Prasad , Ehrich Dorothee , Karger Dirk Nikolaus , Yoccoz Nigel Gilles , Heintzman Peter D. , Brown Antony G. , Lammers Youri , Pellissier Loïc , Alm Torbjørn , Bråthen Kari Anne , Coissac Eric , Merkel Marie Kristine Føreid , Alberti Adriana , Denoeud France , Bakke Jostein ,   PhyloNorway Consortium
Published: September 2022

What drives ecosystem buildup, diversity, and stability? We assess species arrival and ecosystem changes across 16 millennia by combining regional-scale plant sedimentary ancient DNA from Fennoscandia with near-complete DNA and trait databases. We show that postglacial arrival time varies within and between plant growth forms. Further, arrival times were mainly predicted by adaptation to temperature, disturbance, and light. Major break points in ecological trait diversity were seen between 13.9 and 10.8 calibrated thousand years before the present (cal ka BP), as well as break point in functional diversity at 12.0 cal ka BP, shifting from a state of ecosystem buildup to a state where most habitat types and biotic ecosystem components were in place. Trait and functional diversity stabilized around 8 cal ka BP, after which both remained stable, although changes in climate took place and species inflow continued. Our ecosystem reconstruction indicates a millennial-scale time phase of formation to reach stable and resilient levels of diversity and functioning.
Cryo-EM reveals a mechanism of USP1 inhibition through a cryptic binding site
Authors: Rennie Martin L. , Arkinson Connor , Chaugule Viduth K. , Walden Helen
Published: September 2022

Repair of DNA damage is critical to genomic integrity and frequently disrupted in cancers. Ubiquitin-specific protease 1 (USP1), a nucleus-localized deubiquitinase, lies at the interface of multiple DNA repair pathways and is a promising drug target for certain cancers. Although multiple inhibitors of this enzyme, including one in phase 1 clinical trials, have been established, their binding mode is unknown. Here, we use cryo–electron microscopy to study an assembled enzyme-substrate-inhibitor complex of USP1 and the well-established inhibitor, ML323. Achieving 2.5-Å resolution, with and without ML323, we find an unusual binding mode in which the inhibitor disrupts part of the hydrophobic core of USP1. The consequent conformational changes in the secondary structure lead to subtle rearrangements in the active site that underlie the mechanism of inhibition. These structures provide a platform for structure-based drug design targeting USP1.
The Response of a Plasma Magnetospheric Maser to Atmospheric Perturbations
Authors: Savina O. N. , Bespalov P. A.
Published: September 2022

The effect of weak external influences associated with infrasonic waves in the ionosphere on the operation of a plasma magnetospheric maser (PMM) is considered. It is shown that if the frequency of infrasonic waves is close to the eigen frequency oscillations of the PMM, then quasi-periodic (QP) electromagnetic VLF emissions with repetition periods of spectral forms of 10–300 s can be excited in radiation belts. It has been found that one of the possible reasons for this phenomenon may be the Q-switching of the magnetospheric resonator due to a change in the coefficient of reflection of whistler waves from the ionosphere from above by atmospheric infrasonic waves. For natural atmospheric sources of infrasonic disturbances with horizontal scales of approximately 100 km, model calculations of the depth of modulation of the energy density of electromagnetic waves in a magnetic field tube were carried out. It has been found that in the morning and daytime subauroral magnetosphere, even weak external influences lead to the appearance of signals with a sufficiently large modulation depth (tens of percent).
Use of xylometazoline in hospitalised infants: is it safe? A retrospective cohort study
Authors: van Stralen Karlijn J , van Tol Joyce E , de Wildt Saskia N , Becker Matthijs L , van Houten Marlies A
Published: September 2022

Objective

When infants suffer from nasal congestion, xylometazoline spray or drops can be effective to facilitate breathing and drinking. However, case reports on side effects have resulted in international warnings regarding use of xylometazoline in infants. Nevertheless, the incidence of these side effects in hospitalised infants is unknown.

Design

Retrospective cohort study.

Setting

Teaching hospital between 2017 and 2021.

Patients

Infants under 2 years of age.

Exposure

Receiving either saline-only (unlimited frequency, concentration 0.9%) or in combination with xylometazoline (maximum three times daily, concentration 0.025%).

Main outcome measures

Predefined potential side effects (events), including among others apnoea, nausea, bradycardia, cyanosis and nosebleeds, were extracted from patient records, and the probability to be caused by saline only or xylometazoline–saline was determined using the ADR Probability Scale.

Results

We included 898 admitted children during 1285 treatment episodes who received saline with or without xylometazoline. 26 events occurred in the saline-only group (incidence 20.0/100 treatment episodes), and 117 events occurred in the xylometazoline saline group (incidence of 10.5/100 treatment episodes), which was significantly lower (OR 0.47 95% CI 0.29 to 0.75, p=0.002). No definite linked or life-threatening events were found. Three nosebleeds had a probable link to the use of xylometazoline–saline, and all other events could only possibly be linked to saline-only or xylometazoline saline use. The incidence of all events was higher in the saline-only group as compared with the xylometazoline saline group, except nausea, which had a similar occurrence (p=0.65). Results were very similar across (gestational) age groups, gender and reasons for admission.

Conclusion

The use of low-dose xylometazoline seems to be safe in hospitalised infants.
Long-term quality of life, work limitation, physical activity, economic cost and disease burden following ACL and meniscal injury: a systematic review and meta-analysis for the OPTIKNEE consensus
Authors: Filbay Stephanie Rose , Skou Søren T , Bullock Garrett S , Le Christina Y , Räisänen Anu M , Toomey Clodagh , Ezzat Allison M , Hayden Alix , Culvenor Adam G , Whittaker Jackie L , Roos Ewa M , Crossley Kay M , Juhl Carsten Bogh , Emery Carolyn
Published: September 2022

Objective

Determine the long-term health-related quality-of-life (HRQoL), work limitation, physical activity, health/economic cost and disease burden of traumatic ACL and/or meniscal injury. Findings will inform OPTIKNEE evidence-based consensus recommendations.

Design

Random-effects meta-analysis evaluated HRQoL (SF-36/SF-12/VR-12 Physical Component Scores (PCS) and Mental Component Scores (MCS), EuroQol-5D (EQ-5D)) stratified by time postinjury, and pooled mean differences (95% CI) between ACL-injured and uninjured controls. Other outcomes were synthesised descriptively. Risk-of-bias (RoB) and certainty of evidence (Grading of Recommendations Assessment, Development and Evaluation) were assessed.

Data sources

MEDLINE, EMBASE, CENTRAL, SPORTDiscus, CINAHL searched inception: 22 November 2021.

Eligibility

Studies reporting HRQoL, work limitations, physical activity levels, health/economic costs or disease burden, ≥2 years post-ACL and/or meniscal injury.

Results

Fifty studies were included (10 high-RoB, 28 susceptible-to-some-bias and 12 low-RoB). Meta-analysis (27 studies, very low certainty of evidence) estimated a pooled mean (95% CI) PCS of 52.4 (51.4 to 53.4) and MCS of 54.0 (53.0 to 55.0) 2–14 years post-ACL injury. Pooled PCS scores were worse >10 years (50.8 (48.7 to 52.9)) compared with 2–5 years (53.9 (53.1 to 54.7)) postinjury. Excluding high-RoB studies, PCS scores were worse in ACL-injured compared with uninjured controls (−1.5 (−2.9 to –0.1)). Six studies (low certainty of evidence) informed a pooled EQ-5D score of 0.83 (0.81 to 0.84). Some individuals experienced prolonged work absenteeism and modified activities ≥2 years post-ACL injury. ACL injury was associated with significant direct and indirect costs, and early ACL reconstruction may be less cost-effective than rehabilitation. Only three studies evaluated meniscal injury outcomes (all evaluated HRQoL).

Conclusion

There is a very-low certainty of evidence that PCS scores ≥2 years post-ACL injury are worse than uninjured controls and decline over time, whereas MCS scores remain high. ACL injury can result in prolonged work absenteeism and high health/economic costs. Further studies are needed to determine the long-term burden of traumatic meniscal injury.
Trends in adherence to recommended physical activity and its effects on cardiometabolic markers in US adults with pre-diabetes
Authors: Qu Xiaolin , Chen Kun , Chen Jigang , Zhang Junhui
Published: September 2022

Introduction

This study aimed to examine the trends in adherence to Physical Activity Guidelines for Americans (PAG) as well as the association between them and cardiometabolic risk factors among US adults with pre-diabetes.

Research design and methods

This study included 6734 participants who were diagnosed with pre-diabetes from the National Health and Nutrition Examination Survey 2007–2008 to 2017–2018. The logistic regression model and linear regression model were used to test the trends in adherence to PAG. The multivariable linear regression model was used to examine the association between adherence to PAG and cardiometabolic risk factors.

Results

The rate of adherence to the PAG for aerobic physical activity was not significantly changed (64.1% in 2007–2008 to 66.4% in 2017–2018, p=0.599). The sedentary time changed significantly (5.6, 6.8, and 6.0 hours in 2007–2008, 2013–2014, and 2017–2018, respectively; p<0.001). Adherence to the PAG was significantly associated with levels of waist circumference, body mass index (BMI), high-density lipoprotein cholesterol (HDL-C), triglycerides, insulin, 2-hour postload plasma glucose, and measurements of insulin resistance (homeostatic model assessment for insulin resistance (HOMA-IR)) and β-cell function (homeostasis model assessment of β-cell function (HOMA-β)). There was a significant relationship between sedentary time and levels of waist circumference, BMI, HDL-C, insulin, 2-hour postload glucose, HOMA-IR, and HOMA-β. The associations of adherence to the PAG and sedentary time with the levels of systolic and diastolic blood pressures and hemoglobin A1c were not significant.

Conclusions

Adherence to PAG for aerobic activity did not change significantly among US adults with pre-diabetes. The time spent on sedentary behavior peaked in 2013–2014 and then decreased afterward. Adhering to the PAG for aerobic activity and reducing sedentary time significantly improved cardiometabolic health among adults with pre-diabetes.
Burden and treatment of chronic obstructive pulmonary disease among people using illicit opioids: matched cohort study in England
Authors: Lewer Dan , Cox Sharon , Hurst John R , Padmanathan Prianka , Petersen Irene , Quint Jennifer K
Published: September 2022

Objective

To understand the burden of chronic obstructive pulmonary disease among people who use illicit opioids such as heroin, and evaluate inequalities in treatment.

Design

Cohort study.

Setting

Patients registered at primary care practices in England.

Participants

106 789 patients in the Clinical Practice Research Datalink with illicit opioid use recorded between 2001 and 2018, and a subcohort of 3903 patients with a diagnosis of chronic obstructive pulmonary disease. For both cohorts, the study sampled a comparison group with no history of illicit opioids that was matched by age, sex, and general practice.

Main outcome measures

In the base cohort: diagnosis of chronic obstructive pulmonary disease and death due to the disease. In the subcohort: five treatments (influenza vaccine, pneumococcal vaccine, pulmonary rehabilitation, bronchodilators or corticosteroids, and smoking cessation support) and exacerbations requiring hospital admission.

Results

680 of 106 789 participants died due to chronic obstructive pulmonary disease, representing 5.1% of all cause deaths. Illicit opioid use was associated with 14.59 times (95% confidence interval 12.28 to 17.33) the risk of death related to chronic obstructive pulmonary disease, and 5.89 times (5.62 to 6.18) the risk of a diagnosis of the disease. Among patients with a new diagnosis, comorbid illicit opioid use was associated with current smoking, underweight, worse lung function, and more severe breathlessness. After adjusting for these differences, illicit opioids were associated with 1.96 times (1.82 to 2.12) times the risk of exacerbations requiring hospital admission, but not associated with a substantially different probability of the five treatments.

Conclusions

Death due to chronic obstructive pulmonary disease is about 15 times more common among people who use illicit opioids than the general population. This inequality does not appear to be explained by differences in treatment, but late diagnosis of the disease among people who use illicit opioids might contribute.
Patient and public involvement in the development of clinical practice guidelines: a scoping review
Authors: Bryant Elizabeth Ann , Scott Anna Mae , Greenwood Hannah , Thomas Rae
Published: September 2022

Objectives

Organisations that develop clinical practice guidelines (CPGs) encourage involvement of patients and the publics in their development, however, there are no standard methodologies for doing so. To examine how CPGs report patient and public involvement (PPI), we conducted a scoping review of the evidence addressing the following four questions: (1) who are the patients and publics involved in developing the CPG?; (2) from where and how are the patients and publics recruited?; (3) at what stage in the CPG development process are the patients and publics involved? and (4) how do the patients and publics contribute their views? We also extracted data on the use of PPI reporting checklists by the included studies.

Design

We used the methodology developed by Arksey and O’Malley and refined by the Joanna Briggs Institute. We searched PubMed, Embase, CINAHL and PsycINFO, websites of national guideline bodies from the UK, Canada, Australia and the USA, and conducted a forward citation search. No language, date or participant demographics restrictions were applied. Data were synthesised narratively.

Results

We included 47 studies addressing 1 or more of the 4 questions. All included studies reported who the patient and publics involved (PPI members) were, and several studies reported PPI members from different groups. Patients were reported in 43/47 studies, advocates were reported in 22/47 studies, patients and advocates reported in 17/47 studies, and general public reported in 2/47 studies. Thirty-four studies reported from where the patients and publics were recruited, with patient groups being the most common (20/34). Stage of involvement was reported by 42/47 studies, most commonly at question identification (26/42) and draft review (18/42) stages. Forty-two studies reported how the patients contributed, most commonly via group meetings (18/42) or individual interviews. Ten studies cited or used a reporting checklist to report findings.

Conclusions

Our scoping review has revealed knowledge gaps to inform future research in several ways: replication, terminology and inclusion. First, no standard approach to PPI in CPG development could be inferred from the research. Second, inconsistent terminology to describe patients and publics reduces clarity around which patients and publics have been involved in developing CPGs. Finally, the under-representation of research describing PPI in the development of screening, as opposed to treatment, CPGs warrants further attention.
Medical service utilisation and direct medical cost of depression: a cross-sectional analysis of urban medical claims data from China
Authors: Ding Ruoxi , Zhu Dawei , Wang Yanshang , Yong Ma , Shi Xuefeng , He Ping
Published: September 2022

Objectives

Depression is becoming a growing cause of disability, suicides and disease burden. It incurred substantial costs to societies all over the world. Estimating the medical costs of depression will provide implications for related policies and interventions. However, there is scarce of evidence on the economic costs of depression in China. The aim of this study is to assess depression-related medical service utilisation, the direct medical costs of depression and potential associated factors.

Settings

This study used data that comprised 5% random sample of claims data from China’s Urban Basic Medical Insurance between January 2013 and December 2016. Beneficiaries’ demographic information, diagnoses and cost of outpatient and inpatient services were recorded in the data set.

Participants

26 123 patients with depression were identified as the study population in this study.

Primary and secondary outcome measures

The information on health service utilisation and cost was extracted based on the condition that depression was claimed as the index disease.

Results

From 2013 to 2016, weighted average annual total medical cost of depression in urban China was RMB2706.92, and the annual out-of-pocket cost was RMB786.4. The annual total medical cost of depression among urban residents in China was estimated to be 4.4 billion RMB (95% CI 4.15 to 4.67) (US$ 0.70, 95% CI 0.66 to 0.74). Nearly 65% of medical costs (RMB 1795.7 or US$ 285.0) were accounted by inpatient expenditure, and tertiary hospitals were the main provider of depression treatment. Depression-related medical care utilisation and direct costs were associated with gender, age, insurance status, severity of depression and diagnosis. Medication costs and medical service contributed to 41.7% and 56.6% of the average depression-related medical costs.

Conclusion

Depression poses a considerable burden on both the health system and the individual in urban China. Specific policies to strengthen the mental health resources in primary and secondary hospitals are in urgent need, and effective treatment strategies are important to prevent a progression and recurrence of depression, as well as an increase in medical cost.
Development, implementation and validation of resource-stratified guidelines in low-income and middle-income countries: a scoping review protocol
Authors: Griswold Dylan , Venturini Sara , Carney Nancy , Rubiano Andres M , Hutchinson Peter John , Kolias Angelos G
Published: September 2022

Introduction

Nearly every field of medicine has some form of clinical practice guidelines. However, only within the past 5–10 years has the medical community acknowledged the need for well-developed guidelines tailored to the local healthcare needs and the resources available. In most low-income and middle-income countries (LMICs), healthcare workers depend on guidelines developed in high-income countries (HICs), yet many interventions validated in a HIC are ineffective when implemented in an LMIC. The variation in infrastructure, medical personnel, technology and environmental conditions exhibited in LMICs relative to HICs necessitates a careful appraisal of the evidence base used in clinical guideline recommendations. This review aims to map the use of resource-stratified guidelines across all fields of medicine. The review seeks to answer three questions for the identified guidelines: (1) what was the method of development, (2) have they been implemented and, if so, (3) have they been validated.

Methods

The search strategy will aim to locate studies from inception to November 2021. An initial limited search of PubMed and Scopus was undertaken to identify articles on the topic. The text words contained in the titles and abstracts of relevant articles, and the index terms used to describe the articles were used to develop a full search strategy for PubMed and Scopus. This scoping review will be conducted in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews. Data to be extracted from each study will include population characteristics of both developers and intended implementation population, medical specialty, validation status, method of guideline development, whether the study is consensus or evidence-based in addition to a summary of recommendations for practice.

Ethics and dissemination

Ethical approval is not required for this review. The plan for dissemination is to publish review findings in a peer-reviewed journal.
Psychiatric treatment conducted via telemedicine versus in-person consultations in mood, anxiety and personality disorders: a protocol for a systematic review and meta-analysis
Authors: Shaker Ali Abbas , Austin Stephen F , Sørensen John Aasted , Storebø Ole Jakob , Simonsen Erik
Published: September 2022

Introduction

Major advancements in technology have led to considerations how telemedicine (TM) and other technology platforms can be meaningfully integrated in treatment for psychiatric disorders. The COVID-19 pandemic has placed a further focus on use of TM in psychiatry. Despite the widespread use of TM, little is known about its effect compared with traditional in-person (IP) consultation. The objective of this systematic review is to examine if individual psychiatric outpatient interventions for adults using TM are comparable to IP in terms of (1) psychopathology outcomes, (2) levels of patient satisfaction, (3) working alliance and (4) dropout from treatment.

Methods and analysis

This review will only include randomised controlled trials for adult participants with mood disorders, anxiety or personality disorders. The primary outcome is psychopathology, and secondary outcomes include patient satisfaction, treatment alliance and dropout rate. Systematic searches were conducted in MEDLINE, APA PsycINFO, Embase, Web of Science and CINAHL. The inverse-variance method will be used to conduct the meta-analysis. Effect sizes will be calculated as standardised mean difference (Hedges’ g) for the primary outcome, mean difference for patient satisfaction and working alliance, and risk ratio for the dropout rate. Effect sizes will be supplemented with 95% CI. We will calculate the I² statistic to quantify heterogeneity and Chi-square statistic (χ²) to test for heterogeneity for the primary outcome. Potential clinical and methodological heterogeneity moderators will be assessed in subgroup and sensitivity analysis. The risk of bias will be assessed by Cochrane Risk of Bias Tool V.2, and confidence in cumulative evidence will be assessed by Grading of Recommendations Assessment, Development and Evaluation.

Ethics and dissemination

No ethical approval is required for this systematic review protocol. Data sets will be deposited in the Zenodo repository. The findings of this study will be published in a peer-review scientific journal.

PROSPERO registration number

CRD42021256357.
National priority setting partnership using a Delphi consensus process to develop neonatal research questions suitable for practice-changing randomised trials in the United Kingdom
Authors: Evans Katie , Battersby Cheryl , Boardman James P , Boyle Elaine M , Carroll William D , Dinwiddy Kate , Dorling Jon , Gallagher Katie , Hardy Pollyanna , Johnston Emma , Mactier Helen , Marcroft Claire , Webbe James , Gale Chris
Published: September 2022

Introduction

Methodologically robust clinical trials are required to improve neonatal care and reduce unwanted variations in practice. Previous neonatal research prioritisation processes have identified important research themes rather than specific research questions amenable to clinical trials. Practice-changing trials require well-defined research questions, commonly organised using the Population, Intervention, Comparison, Outcome (PICO) structure. By narrowing the scope of research priorities to those which can be answered in clinical trials and by involving a wide range of different stakeholders, we aim to provide a robust and transparent process to identify and prioritise research questions answerable within the National Healthcare System to inform future practice-changing clinical trials.

Methods and analysis

A steering group comprising parents, doctors, nurses, allied health professionals, researchers and representatives from key organisations (Neonatal Society, British Association of Perinatal Medicine, Neonatal Nurses Association and Royal College of Paediatrics and Child Health) was identified to oversee this project. We will invite submissions of research questions formatted using the PICO structure from the following stakeholder groups using an online questionnaire: parents, patients, healthcare professionals and academic researchers. Unanswered, non-duplicate research questions will be entered into a three-round eDelphi survey of all stakeholder groups. Research questions will be ranked by mean aggregate scores.

Ethics and dissemination

The final list of prioritised research questions will be disseminated through traditional academic channels, directly to key stakeholder groups through representative organisations and on social media. The outcome of the project will be shared with key research organisations such as the National Institute for Health Research. Research ethics committee approval is not required.
How do care environments shape healthcare? A synthesis of qualitative studies among healthcare workers during the COVID-19 pandemic
Authors: Harrison Mia , Rhodes Tim , Lancaster Kari
Published: September 2022

Objective

To investigate how care is shaped through the material practices and spaces of healthcare environments during the COVID-19 pandemic.

Design

Critical interpretive synthesis (CIS) of qualitative research.

Participants

Studies included qualitative research investigating the experiences of healthcare workers involved in the care of individuals during the COVID-19 pandemic.

Results

134 articles were identified in the initial sampling frame with 38 studies involving 2507 participants included in the final synthesis. Three themes were identified in the analysis: (1) the hospital transformed, (2) virtual care spaces and (3) objects of care. Through the generation of these themes, a synthesising argument was developed to demonstrate how material spaces and practices of healthcare shape care delivery and to provide insights to support healthcare providers in creating enabling and resilient care environments.

Conclusions

The findings of this study demonstrate how healthcare environments enable and constrain modes of care. Practices of care are shaped through the materiality of spaces and objects, including how these change in the face of pandemic disruption. The implication is that the healthcare environment needs to be viewed as a critical adaptive element in the optimisation of care. The study also develops a versatile and coherent approach to CIS methods that can be taken up in future research.
Common procedures of remote measurement-based care in an integrated behavioural health context: protocol for a scoping review
Authors: Richardson Eric , Hogan Timothy P , Shimada Stephanie L , Sliwinski Samantha K , Kim Bo
Published: September 2022

Introduction

Integrated behavioural health, a model of care that embeds mental health services in primary care, can potentially increase access to mental healthcare. With the increase in health information technologies, remote measurement-based care (RMBC) presents an opportunity to improve support of integrated care. This scoping review will comprehensively examine what common procedures are followed when RMBC for mental health is tested in integrated care settings.

Methods and analysis

Based on an established six-step framework for conducting scoping reviews, we will search PubMed, Embase, PsycINFO, Cochrane, EBSCOhost and Web of Science with search terms related to ‘integrated care’ and ‘RMBC’. Articles published from 2015 onwards, in English, including an intervention that meets our definition of RMBC, and are conducted in collaboration with primary care or in a primary care setting will be included. After data extraction, we will categorise key findings along the following dimensions: (1) common delivery practices of RMBC; (2) common technologies and instruments used and (3) most common barriers and facilitators when implementing RMBC in an integrated care model.

Ethics and dissemination

Ethics approval is not required for this scoping review. For maximum impact, we will disseminate the findings to the scientific community (via publication in a peer-reviewed journal and at national conferences) and to the broader healthcare community. We will share findings with the broader healthcare community through our research centre’s existing stakeholder communication structures and through guidance from our multidisciplinary research team. These key stakeholder relationships will continue to guide our subsequent RMBC research following the review.
Factors affecting the occurrence of otitis media with effusion in preschool and elementary school children: a comparative cross-sectional study
Authors: Restuti Ratna Dwi , Tamin Susyana , Nugroho Dwi Agustawan , Hutauruk Syahrial Marsinta , Mansyur Muchtaruddin
Published: September 2022

Objective

Identify the risk factors for otitis media with effusion (OME), especially laryngopharyngeal reflux (LPR), adenoid hypertrophy and allergic rhinitis, that could be used to develop prevention strategies in children.

Design

A comparative cross-sectional study was conducted to make sure the adequacy of proportions of OME and non-OME cases in finding the related factors.

Setting

History taking, ear/nose/throat (ENT) examination, and tympanometry were performed in preschool and elementary schools. Flexible fibreoptic nasopharyngolaryngoscopy was performed in a bronchoesophagology outpatient clinic in a tertiary referral hospital in Jakarta, Indonesia.

Participants

Preschool and elementary children in East Jakarta, Indonesia were recruited for this study. A total of 2016 participants underwent history taking, ENT examination and tympanometry. The case group was 46 children with OME, and the control group was 46 children without OME. The number of subjects fulfilled the minimum sample size for two proportions comparison.

Main outcome measures

A type B tympanogram indicated OME. A Reflux Finding Score of more than 7 indicated LPR. Adenoid hypertrophy was diagnosed using flexible fibreoptic nasopharyngolaryngoscopy. Allergic rhinitis was diagnosed using a questionnaire based on the International Study of Asthma and Allergies in Childhood phase III that has been validated for Indonesians.

Results

The proportion of LPR in the OME group was significantly higher than in the non-OME group, at 78.3% and 52.2%. The probability of OME occurrence in patients with LPR was 3.3 times higher than in patients without LPR (OR 3.3; 95% CI 1.33 to 8.189; p=0.01). There was no significant relationship between adenoid hypertrophy and OME (p=0.211; 95% CI 0.71 to 3.97), and also between allergic rhinitis and OME (p=0.463; 95% CI 0.61 to 4.28).

Conclusion

The probability of OME occurrence in patients with LPR was 3.3 times higher than in patients without LPR. LPR should be considered in patients with OME and vice versa.
Early experiences of the Your COVID Recovery®digital programme for individuals with long COVID
Authors: Lloyd-Evans Phoebe H I , Baldwin Molly M , Daynes Enya , Hong Annabel , Mills George , Goddard Amye C N , Chaplin Emma , Gardiner Nikki , Singh Sally J
Published: September 2022

Objectives

To describe the early data from the Your COVID Recovery®digital programme and to explore the data collected from two embedded outcome measures.

Design

Observational.

Setting

Primary and secondary care (England—Online).

Participants

110 individuals completed the programme (68.1% female, 88.1% White British, age: 46.3 (10.8) years, weight: 86.5 (21.1) kg, height: 169.3 (10.0) cm). 47.2% of patients reported comorbidities.

Intervention

Following an assessment by a healthcare professional, individuals with long COVID were offered access to the Your COVID Recovery®digital programme. The programme comprises of four stages for the participants to progress through. Participants are encouraged to record severity of their symptoms and amount of activity they are doing on a symptom and an activity tracker. Resources and interactive material on managing symptoms of long COVID are available throughout each stage.

Primary outcome measures

Questionnaire (EuroQ0l 5-Dimension 5-Level (EQ-5D-5L) and the chronic obstructive pulmonary disease assessment test (CAT)) data were extracted from the site from 11 March 2021 until 9 November 2021.

Results

Participants were on the programme for 8.6 (4.3) weeks. There was a statistically significant increase in EQ-5D-5L visual analogue scale (VAS) score (pre=48.8 (19.5); post=59.9 (22.1); p<0.01). The EQ-5D-5L Index Value preintervention to postintervention did improve but not significantly (pre=0.5 (0.3); post=0.6 (0.3); p=0.09). CAT total score improved significantly preintervention to postintervention (pre=19.8 (7.2); post=15.6 (7.6); p<0.01). All CAT item scores significantly improved preintervention to postintervention (p<0.005), except the phlegm item score (p=0.168).

Discussion

This early data describes the impact of the Your COVID Recovery®digital programme on the first cohort of patients to complete the digital recovery programme. The outcome data are promising and should encourage uptake.