bluuebunny/crossref_metadata_2025 huggingface dataset:
S05 National Implementation Programmes to promote Active Ageing: Points of Success and Challenges
Authors: Borodulin Katja
Published: September 2024

After retirement, nowadays, we can expect to live from 20 to 40 years of time. For such a long time window, plenty of opportunities should be offered to support active aging. It is surprising how few countries have developed national physical activity programs for older people, particularly knowing the benefits of physical activity for maintenance of functional capacity, prevention of non-communicable diseases and postponing of care and services. Physical activity promotion among older persons has great potential, while it requires more public discussion and sharing the existing good practices.

In this symposium we share three examples of national physical activity programs for older persons. We present their aims, target groups, and main activities. All programs rely on research-based evidence in their implementation, collect results and regularly evaluate their activities. They present action that has increased physical activity, promoted knowledge and education, and improved co-operation. Country examples include issues on scaling-up, sustainability, and communications. Furthermore, challenges and potential solutions in each case are shared and discussed. We discuss and share the take-home-messages and ask the audience to share their views for improved action towards the future.

Presentations in the symposium include

Katja Borodulin (chair and discussant, Age Institute, Helsinki, Finland).
S06-1: Collaborating across diverse clinical areas and locations to tackle deconditioning in the acute healthcare setting #ActiveWards
Authors: Harvey Juliet
Published: September 2024

Purpose

To provide opportunity to reduce deconditioning in the clinical in-patient environment by using person-centred practice development methods to empower staff to be agents of change in their local specialty area.

Project Description

In the acute hospital setting deconditioning is a major risk factor with around 90% of the day spent sitting/lying. In this setting we have the opportunity to promote physical activity and reduce sedentary behaviour. As experts in activity and movement, Physiotherapists and Occupational Therapists routinely assess function/activity of patients and provide support from brief intervention through to complex rehabilitation, behaviour change interventions and lifestyle prescription, as well as signposting or referring on to other services. The therapists work in multi-disciplinary teams to provide person-centred care to the patient in the treatment of injury, illness, or disability. To scope the situation a survey was conducted resulting in the formation of a Special Interest Group (SIG). The purpose of the group was to provide peer-support and act as a platform for sharing resources and ideas relating to patient activity. Group members (N = 23) were from across NHS Greater Glasgow and Clyde including Older Peoples Services, Stroke, Medical, Surgical, Orthopaedics, Oncology, Critical Care, Neurology and Physical Disability Teams.

The SIG provided a collaborative hub where staff networked, supported each other, conducted projects, and shared their findings and challenges. Members worked with staff groups, patients, carers, health improvement, medical illustrations, digital, patient experience, equality and diversity teams, volunteer services, third sector organisations and international consensus groups. The outputs from the group were shared widely (#ActiveWards) and included development of resources, audit tools and training material. The group formed Active Wards Principles, which are now included in board-wide guidelines and standards.

Conclusion

Tackling deconditioning in the clinical environment requires complex interventions that are tailored to the patient, teams, and local circumstance. The work demonstrates what can be achieved when staff are provided with a little time and given ownership of change processes. There are now >50 members in the group. The work has had a ripple effect across our health board and to other organisations.
S08-3: Goals and realities in local goverments’ involvement in PA promotion for diverse populations subgroups – a comparative analysis of municipalities from 5 countries
Authors: Sandu Petru , Gelius Peter , Messing Sven , Noel-Racine Antoine , Oguma Yuko , Onatsu Tanja , Papiu Antonia Paula , Saito Yoshinobu , Takeda Noriko , Tuunanen Katariina , Vuillemin Anne , Chereches Razvan Mircea
Published: September 2024

Although cross-sectoral cooperation is important at all levels, in practice it often remains at a declarative level. Different sectoral policies and the resulting measures to promote HEPA are usually disconnected, uncoordinated and without the necessary synergies. This pertains especially to local environments with less financial and expert support, such as small rural communities, where people have few HEPA options that are suitable and attractive for vulnerable groups: children and adolescents, elderly and people with disabilities.

“Development of indicators for the assessment of the provision of settlements with green spaces for outdoor physical activity” is a research project co-funded by the Slovenian Research and Innovation Agency, the Ministry of Health and the Ministry of Natural Resources and Spatial Planning and implemented at the Urban Planning Institute of the Republic of Slovenia. The aim of the project is to define indicator(s) for the provision of green spaces for PA and active lifestyles in settlements, which could be used at local level to assess, improve, and monitor the situation. We took a medium-sized city and a small rural community as pilot projects, the latter often being a disadvantaged environment in terms of HEPA in spatial planning compared to larger cities. On the pilots, our objectives have been to establish cooperation at the local level between at least three different sectors and to test methodology and indicators developed in the project to assess the provision of green spaces to promote PA in selected environments, thus enabling more equitable and inclusive spatial conditions for HEPA at the local level.

The presentation will present the approach, results and overall experiences with the work implemented in the pilot project of a rural community. It will highlight the benefits of cross-sectoral cooperation for more effective local level HEPA policies to ensure the inclusive and equitable access to green spaces in settlements.

Funding source

Slovenian Research and Innovation Agency, grant no. V5-2232
S09-2: Physical activity in the Irish vision impaired and blind population
Authors: Flynn Lisa
Published: September 2024

Purpose

Physical activity (PA) is known to improve physical and mental health. Research suggests that adults and children who are vision impaired (VI) have reduced levels of PA compared to their sighted peers. In the Irish context, census data suggests that up to 40% of people with VI struggle to participate in leisure and social activities. This project aims to understand PA levels, and the barriers/motivators to participation, in the Irish VI population.

Methods

Questionnaires were used to assess self-reported PA, sports participation, perceived barriers to participation and mental health/well-being levels using validated and reliable tools (CSPPA, Kidscreen-10, HSBC survey) ​(Booth et al., 2001; Woods CB et al., 2018)​. Fundamental movement skills (FMS) and VO2 max were assessed in VI children using the TGMD-3 and the Queen’s College Step ​(Maciej Serda et al., 2018)​.

Results

The children’s results (n = 61, mean 12.2 years (range 6-16 years)) showed just 12.7% were active more than 30 mins daily each week. Barriers in this cohort included fear of injury (82%) and a lack of confidence (63%). Further analysis (n = 59, age 12.34 ± 2.40) indicate that just 52.2% of females and 68.6% of males were in the healthy fitness zone according to their VO2 max. Worst performed FMS included two-hand strike, kick and throw with 30.5%, 22% and 30.5% achieving mastery/near-mastery respectively.

The adult population (n = 258, f = 138, m = 173, non-binary = 16, mean = 25 years (range 17-78)) showed the most popular forms of PA included gym classes (18.49%), walking (15.96%) and running (9.80%). Lack of transport (25.8%) and lack of accessible facilities (15.2%) were the most commonly cited barriers to PA.

Conclusion

PA levels were low in both the youth and adult VI populations when compared to the general population. Future research should focus on further exploring the barriers to participation.

Support/Funding Source

Vision Sport Ireland, Institute of Education, Dublin City University, Sport Ireland.
S10 How can HEPA research contribute to shifting modes of transport towards active mobility?
Authors: Tcymbal Antonia , Abi-Omar Karim
Published: September 2024

Active mobility represents a win-win for individual and planetary health. With this in mind, the question on how to shift modes of transport towards walking and biking becomes an increasingly urgent one for HEPA research. The symposium presents different approaches on how to foster active transport: the use of GIS data to identify bikeable neighborhoods for adolescent; the HEAT – a widely used tool that enables to calculate the economic value of active mobility; a science-based project on the determinants of biking among children; and an interdisciplinary collaboration to explore how the transition towards active mobility can be accelerated.

By integrating science- and practice-based presentations, the symposium will provide attendees with an excellent opportunity to reflect on the complexity of fostering active mobility. It will also enhance participants’ understanding on how active mobility is linked to planetary health and how research-driven approaches can address transport choices.
S12 Optimising health enhancing physical activity by using a human rights-based approach
Authors: Messing Sven
Published: September 2024

The World Health Organization calls to employ a human rights-based approach for the implementation of the Global Action Plan on Physical Activity. However, research on physical activity promotion does usually not adopt a human rights perspective, even though there are overlaps with established fields of research such as health equity. The symposium is based on theoretical considerations on the potential status of physical activity as a human right, and aims to discuss how a human rights-based approach could be utilized to further develop physical activity promotion for vulnerable target groups.

Presentation 1 describes a framework that supports the use of a human rights-based approach to promote physical activity for vulnerable groups. The framework is based on four criteria (availability, accessibility, acceptability, and quality) which are discussed in the other presentations of the symposium. Presentation 2 focuses on the rights of persons with disabilities and investigates the perceptions of disability rights groups on the #Wethe15 campaign after the 2021 Paralympic Games. Presentation 3 systematically analyses a physical activity program for women in difficult life situations using a human rights-based approach based on semi-structured interviews.

Interaction with the audience will be stimulated by an interactive discussion on how a human rights-based approach could be integrated into PA promotion research, and whether this would be an added value from a political and scientific perspective.
S12-1: Can a human rights-based approach help to promote physical activity for vulnerable groups?
Authors: Messing Sven , Abu-Omar Karim , Gelius Peter
Published: September 2024

Purpose

As physical activity was limited in some countries during the pandemic-related lockdowns, the question whether humans have a right to be active was discussed in public and academia. A recent scientific study has shown how a right to physical activity can be derived from well-established human rights such as the right to health, the right to rest and leisure, the right to education, and the principle of nondiscrimination. However, this is a new perspective for the field of PA promotion, and examples of studies using a human rights-based approach systematically are rare.

This study aimed to develop a framework for utilizing a human rights-based approach in physical activity research.

Methods

In an interdisciplinary process, a framework was developed by experts for human rights policy and physical activity promotion. This framework is based on a conceptualization of the United Nation’s Committee on Economic, Social and Cultural Rights which defined – originally for the right to health – four attributes. These attributes were linked systematically to the field of physical activity promotion.

Results

The framework is based on four attributes of PA as a human right: The availability, accessibility, acceptability and quality of PA programmes, facilities and services: (1) Availability includes, for example, the provision of exercise programs for vulnerable groups. (2) Accessibility has four overlapping dimensions: Nondiscrimination, physical accessibility, economic accessibility, and information accessibility. (3) Acceptability can include the sensitivity of a PA program for the culture of participating individuals and/or gender requirements. (4) And the quality of PA programmes, facilities and services, is, among other aspects, related to the pre- and in-service training of professionals.

Conclusions

A framework based on the attributes of PA as a human right can be applied to promote PA among vulnerable groups. The framework can also help to improve physical activity among vulnerable groups such as, for instance, people with disabilities and women in difficult life situations.

Funding

None
S12-2: Perceptions of the #Wethe15 campaign to promote rights of physical activity among people with disabilities
Authors: Ng Kwok , Ng Kwok , Haslett Damian , Noske-Turner Jessica , Pullen Emaa , Legg David
Published: September 2024

Purpose

Since 1948, the Paralympic Games are a platform that gives opportunities to persons with disabilities for competitions akin to the Olympic games. This may be seen as fulfilment of the United Nations Convention on the Rights of Persons with Disabilities . Article 30, where people with disabilities have the to participate in cultural life, recreation, leisure and sport on an equal basis with others. It is less known, how the disability community see the acceptability of these games. A campaign to raise awareness is through the #Wethe15 campaign. This study aimed to investigate the initial perceptions of the #Wethe15 campaign after the 2021 Paralympic Games.

Methods

Interviews and focus groups with representatives of disability rights groups from Canada, Finland, Malawi, Peru and the United Kingdom were carried out to investigate perceptions about the #Wethe15 campaign. The main questions were related to how the disability community could contribute or benefit from the campaign. Data were then translated, then transcribed in English and analysed through thematic analyses mapped against the concepts of availability, accessibility, and acceptability.

Results

In late 2021, 29 representatives (20 with lived experience of disability) took part in five focus groups and interviews. The campaign was deemed as acceptable due to the positive sentiment about the campaign to promote disability rights and sport in society. Yet, as #Wethe15 does not translate well into some non-English languages, more instructions of how to make it culturally appropriate was needed to broaden access to the main message of the campaign.

Conclusions

The campaign brought awareness of disabilities in society, yet the rights of physical activity to people with disabilities was less obvious, particularly regarding availability and accessibility. Partners of the movement need to find ways to fund mechanisms to promote more quality, accessibility and availability, while recognising the health benefits from participation in physical activity.

Funding

The study was commissioned by the IPC. The IPC had no influence the recruitment of the participants or interpretation of the results.
S13-4: Using the socio-ecological model of physical activity to test the efficacy of a social intervention at an active leisure event: the parkwalker initiative
Authors: Gilburn Andre
Published: September 2024

Purpose

The socio-ecological model of participation in physical exercise assumes that individual and environmental components interact to shape patterns of activity. The model proposes that the environmental component can be broadly separated into the physical, social and political environments. The active leisure event organiser parkrun recently introduced a new volunteer role, the parkwalker, to manipulate the social environment at their events to encourage more walkers to attend. The aim of this study was to determine the success of the parkwalker initiative.

Methods

This study builds a socio-ecological model of the finishing times of new parkrun participants in Scotland for a year before and after the introduction of the parkwalker initiative to determine if the intervention has worked. Event locations in Scotland were separated into those that fully adopted, partially adopted and did not adopt the parkwalker role into their events.

Results

The model of finishing times revealed they have slowed after the introduction of parkwalkers and the level of slowing is associated with the level of adoption of the role by events. The parkwalker initiative was particularly effective on the impact of finishing times of older new participants and at larger events. The initiative was also associated with an increase in the proportion of female new participants and a reverse in the recent decline in the age of new participants.

Conclusions

This suggests that parkrun have introduced a successful intervention to their events that has manipulated the social environment to increase both engagement and inclusivity. This has management implications for both parkrun and other active leisure events as the study reveals it is possible to successfully manipulate the social environment of events to increase engagement. The study also highlights how the socio-ecological model can be used to test the efficacy of an intervention and quantify and understand its impact.

Funding

None
S14-2: The association of physical activity referral scheme’ components with physical activity level, scheme uptake and adherence rates: a systematic review, meta-analysis with meta-regression
Authors: Geidl Wolfgang , Brandmeier Anna , Klamroth Sarah , Naber Inga , Weissenfels Anja , Abu-Omar Karim , Pfeifer Klaus , Mino Eriselda , Hanson Coral , McHale Sheona , Schuler Michael , Gelius Peter , Whiting Stephen , Wickramasinghe Kremlin , Galea Gauden
Published: September 2024

Purpose

Physical activity referral schemes (PARS) are complex interventions comprised of multiple components such as screening, brief advice, and written prescription. This study aimed to investigate the relationship between PARS components and physical activity, uptake, and adherence rates. Additionally, the overall effect of PARS is analysed.

Methods

6 databases were searched for studies published between 1990-2023; included PARS with participants ≥16 years old; and reported either physical activity, uptake or adherence outcomes. GRADE was used to assess quality of evidence. Separate random-effects meta-analysis by comparison group were conducted for physical activity. Uptake and adherence rates were pooled using proportional meta-analysis. The PARS components were analyzed via univariate meta-regression.

Results

We included 52 studies from which 50 targeted people with, or at risk of, non-communicable diseases. PARS were compared with usual care (11 RCTs, Hedges’ g = 0.18, 95%CI 0.12 to 0.25), physical activity advice (5 RCTs, Hedges’ g=-0.6, 95%CI -0.21 to 0.10), or enhanced PARS (9 RCTs, Hedges’ g = 0.07, 95%CI -0.03 to 0.18). The pooled uptake rate was 87% (95%CI 77% to 94%) among 14 RCTs and 68% (95%CI 51% to 83%) among 14 non-experimental studies. The adherence rate across 16 RCTs and 18 non-experimental studies was 68% (95%CI 55% to 80%) and 53% (95%CI 42% to 63%) respectively.

The meta-regression showed that PARS incorporating a person-centered approach, screening, and brief advice had higher adherence rates. In contrast, PARS offering physical activity sessions had lower adherence rates. No other component-outcome relationship reached statistical significance.

Conclusion

High certainty of evidence confirms a small effect of PARS in increasing physical activity compared to usual care. The evidence comparing PARS with advice and enhance scheme versions is inconclusive and comes from low certainty of evidence. Four out of the 19 PARS components may predict adherence.

Practical implications

The results improve our understanding of effective PARS components in relation to physical activity promotion, scheme uptake and adherence and thus support the future development of optimal PARS.

Funding

The study was conducted within the project BewegtVersorgt, which is funded by the Federal Ministry of Health based on a resolution of the German ‘Bundestag’ by the federal government.
S15-4: Health Promoting Sports Coaches' skills: a systematic mapping review
Authors: Barros Kevin , Lemmonier Fabienne , Rostan Florence , Tezier Benjamin , Van Hoye Aurélie , Vuillemin Anne
Published: September 2024

Purpose

Coaches play a key role on the physical, mental, and social well-being of sports participants, and can foster health through sport’s informal educational nature. Nevertheless, sports coaches feel unequipped in regard to health promotion (HP). The objectives of this systematic encompass the identification of coaches' HP skills, as well as barriers and leverages in their acquisition.

Methods

This systematic review is based on PRISMA-P guidelines. The search was run on 6 databases with following keywords: ((“sport* coach*” OR “sport trainer*” OR “sport* volunteer*”) AND (“skill*” OR “training” OR “behavior” OR “behaviour” OR “education”)) AND (“health”). Double blind analyze was used for selection and exclusion criteria were: not focused on grassroots sport coaches’ skills regarding health; no original English peer-review research article.

Results

On the 2485 studies screened, 56 were included. Ten key skills of coaches in HP empowerment including athletes’ management, support health, education, appraisal, motivation, cooperation, prevention, communication, role model and self-management were identified. Numerous barriers, notably related to perceived constraints within their role, the pressure to sustain athletes' engagement in the activity, and their conceptualization of sport, leading to a concentration on performance-oriented practices rather than holistic sport development, such as HP were reported in the analysed studies. However, certain leverages, such as psychological factors, educational background, experiential learning, knowledge base, and adherence to guidelines have been found to support skills acquisition.

Conclusions

Coaches skillset enables them to engage in athletes' health through motivational strategies, climate management, health support, and self-management techniques. Sports organization should therefore consider coaches as a health multiplier based on their support in regard to these skills acquisition.

Funding

A partnership between Santé Publique France, Université de Lorraine and Université Côte d’Azur allowed and supported this work and by the Région Grand Est and Pole Biologie Medecine Santé of the Université de Lorraine.
S16-2 National Physical Activity Strategies in Ireland
Authors: Veress Réka
Published: September 2024

Purpose

The benefits of physical activity are well recognised across the world. They encapsulate individual physical and mental wellbeing and broader social, economic and environmental benefits to broader society. Ireland has adopted a cross-sectoral approaches to promoting physical activity, driven by the National Physical Activity Plan in 2016 and built on through the National Physical Activity Framework and Action Plan in Q2 2024. The objective of this intervention is to give the audience an outline of the factors which informed the development of national strategies, an overview of their governance and objectives, and where possible, an indication of the impacts such strategies have had on national physical activity levels.

Policy or policy description

Ireland’s first National Physical Activity Plan was published in 2016, and represented the first joined-up approach across relevant sectors in the State, including Government, NGO, research and practitioner participation. It highlighted the range of benefits accruing from a physically active lifestyle and brought about a number of positive outcomes, chiefly in the areas of cross-sectoral collaboration and the targeting of specific population cohorts. Work on the development of its successor was commenced in 2023, which will be based on the approach of a framework to 2040 which will ensure coherence of approach across the relevant policyholders, and a series of action plans which will drive the achievement of its objectives.

Ireland is not alone in adopting such an approach to the coordination and promotion of physical activity initiatives. This session will inform participants from across the WHO European Region with similar approaches, to inform both policymakers and actors in the physical activity arena on how these linkages operate in Ireland at the HEPA Conference.

Conclusion

The promotion of physical activity is of benefit to a large number of sectors, but a coherent approach requires buy-in and ongoing engagement across a range of policyholders. Developing a national strategy to promote physical activity requires a tailored approach, recognising particular challenges at national and regional level and across population cohorts. An outline by HEPA coordinators of the approaches taken and the learnings arising will be of significant interest to the HEPA audience.
S16-3 Hungarian Sporting Nation Programme
Authors: Jurak Gregor
Published: September 2024

Purpose

The purpose of the Sporting Nation Programme is to ensure access to everyday physical activity and exercise for the Hungarian population. It is an important goal, that parallel with being a successful nation in professional sports, the Hungarian nation should be also a sporting nation at community and grassroots level. The mission is to make physical activity and sport a lifelong regular routine.

Project or policy description

The Sporting Nation Programme had been launched in September 2023, as an overarching initiative of the Hungarian sport governance. The State Secretariat for Sport has initiated the programme and the National Sport Agency is in charge of implementing it. The focus is on ensuring opportunities and provide the necessary conditions for people to access daily physical activity and sporting services. The programme has the following elements:

 - cooperation with sport federations, clubs, coaches: aiming to open sport clubs for the wider public, not only providing sporting opportunity for the professional athletes but also for everyday people

 - Sporting Nation Club: a club offering discounts to different sport services. Members of the Sporting Nation Club have a membership card, that enables the card holders to receive discounts from entry fees to sport facilities maintained by the state and to different sport events.

 - physical activity on the spot of major sport events: in the framework of the programme, top sport events will be accompanied with recreational sport opportunities for fans, spectators and club members.

Dissemination of the programme is continuously happening under the coordination of the National Sport Agency. More and more clubs, venues and events become part of the programme. There is also thematic planning, in 2024 the public street workout parks and gyms will be promoted within the programme with the support of the QR code system that offers a tailored training program for users.

Conclusions

The State Secretariat for Sport together with the National Sport Agency are continuously developing and monitoring the programme with the aim to find the best offers that successfully engage citizens. The programme coordinators look for partnerships to strengthen the reach-out capacity of the programme, thus in 2024 the period of the European Week of Sport will be important.
254 What is the cost of family-based physical activity interventions? A scoping review
Authors: O’Kane S Maria , Williamson Chloë , Murphy Marie H , Gallagher Alison M , Carlin Angela
Published: September 2024

Introduction

Globally, 81% of children fail to meet physical activity (PA) guidelines and the causes of such inactivity are complex and multifactorial. Parents can influence the PA levels of their children through modelling, co-participation, encouragement and family support. A meta-analysis by Brown et al (2016) showed family-based PA interventions to be effective. However, there are many perceived barriers to family PA and it is accepted that there is a persistent socioeconomic gap in PA. Socioeconomic status is an important determinant of health and can influence attitudes, experiences, behaviours, and exposure to health risk factors. PA is positively associated with socioeconomic status and recent research indicates that children from the least affluent families are less likely to meet PA guidelines in comparison to children from the most affluent families (44% vs 55% meeting PA guidelines respectively). To support families to address these inequalities and improve population health, an understanding of the costs associated with family-based PA interventions is required. Therefore, the aim of this scoping review is to provide a comprehensive overview of health economic evaluations of family-based PA interventions.

Methods

This scoping review protocol will be registered with the Open Science Framework and will be conducted according to the Arksey and O’Malley framework for scoping reviews. Electronic databases (Ovid MEDLINE, Embase, Web of Science, PubMed, Cochrane Library, and Scopus) will be searched from inception. Reference lists of eligible studies and relevant systematic reviews will be searched for potentially eligible studies. Included studies will be those that recruited a family unit, delivered an intervention that included a component of PA (e.g. exercise, sport, play), examined the effect on PA and reported on the economic costs. The titles and abstracts of potentially relevant articles will be screened independently by two reviewers and data from eligible studies extracted using Covidence software. Data will be charted and the results summarised.

Conclusions

This scoping review will provide an understanding of the costs associated with family-based PA interventions, information that will be important for the development of evidence-based interventions and for future policy and commissioning.
How are US hospitals adopting artificial intelligence? Early evidence from 2022
Authors: Bin Abdul Baten Redwan
Published: September 2024

US hospitals are rapidly adopting artificial intelligence (AI), but there is a lack of knowledge about AI-adopting hospitals' characteristics, trends, and spread. This study aims to fill this gap by analyzing the 2022 American Hospital Association (AHA) data. The novel Hospital AI Adoption Model (HAIAM) is developed to categorize hospitals based on their AI adoption characteristics in the fields of (1) predicting patient demand, (2) optimizing workflow, (3) automating routine tasks, (4) staff scheduling, and (5) predicting staffing needs. Nearly one-fifth of US hospitals (1107 or 18.70%) have adopted some form of AI by 2022. The HAIAM shows that only 3.82% of hospitals are high adopters, followed by 6.22% moderate and 8.67% low adopters. Artificial intelligence adoption rates are highest in optimizing workflow (12.91%), while staff scheduling (9.53%) has the lowest growth rate. Hospitals with large bed sizes and outpatient surgical departments, private not-for-profit ownership, teaching status, and part of health systems are more likely to adopt different forms of AI. New Jersey (48.94%) is the leading hospital AI-adopting state, whereas New Mexico (0%) is the most lagging. These data can help policymakers better understand variations in AI adoption by hospitals and inform potential policy responses.
Prevalence of chondrocalcinosis and calcium pyrophosphate deposition disease in a cohort of adult patients with low alkaline phosphatase levels and a positive versus negative genetic ALPL study
Authors: Tornero Carolina , de Miguel Eugenio , Navarro-Compán Victoria , Balsa Alejandro , Aguado Pilar
Published: September 2024

Objectives

To estimate the prevalence of chondrocalcinosis and calcium pyrophosphate dihydrate deposition disease (CPPD) in patients with low alkaline phosphatase (ALP) levels and a positive ALPL genetic study (+GT) for hypophosphatasia (HPP) compared to those with the same biochemical abnormality and a negative genetic test (−GT). As a secondary objective, to analyze the biochemical factors associated with its presence in subjects with ALPL variants.

Methods

Seventy-eight subjects with persistently low ALP levels and ALPL genetic test were included. Baseline and 24-mo knee ultrasounds were performed in 42 + GT and 36 −GT subjects, in whom the fibrocartilage, hyaline cartilage of menisci, tendons, and synovial fluid were scanned to detect calcium pyrophosphate deposits. A MyLabTwice ultrasound machine (Esaote) with a multifrequency linear array transducer (4–13 MHz) was used.

Results

A higher percentage of chondrocalcinosis was observed in the +GT group [9/42 (21.4%)] compared to the −GT group [2/36 (5.6%), p=.045)]. Two patients (4.76%), both in the +GT group, had arthritis secondary to CPPD. No new cases were identified at the 24-mo control. When comparing +GT patients with and without chondrocalcinosis, ALP levels were lower, and pyridoxal-5′-phosphate (PLP) and phosphate levels were higher in the former group (p<.05). Logistic regression analysis revealed that higher PLP levels are associated with the presence of chondrocalcinosis (OR: 1.1; 95% confidence interval, CI, 1.001–1.012).

Conclusions

Chondrocalcinosis was a frequent ultrasonographic finding in HPP. Arthritis secondary to calcium pyrophosphate deposits, however, proved less prevalent. Genetic causes, such as HPP, should be considered when evaluating patients with chondrocalcinosis in clinical practice.
A conditional adversarial operator network prediction method for current fields in armature-rail contact surface
Authors: Jin Liang , Guo Shaonan , Su Haozhan , Song Juheng , Jia Yufang
Published: September 2024

Linear propulsion electromagnetic energy equipment can convert electromagnetic energy to kinetic energy instantaneously and has many advantages, such as high kinetic energy, efficiency, precision, and strong controllability. It surpasses traditional mechanical and chemical energy methods, significantly impacting various fields. Aiming at the numerical simulation method, which has problems with large computation volume and a long time of physical field simulation, the current field prediction method of linear propulsion electromagnetic energy equipment based on a Deep Generation Adversarial Operator Network is proposed. Firstly, deep operator network is combined with conditional generative adversarial network to obtain the knowledge-embedded conditional adversarial operator network (CGAONet) model. Then, Res-Transformer-Unet (RTUnet) is used as a branch network of CGAONet to establish the RTUnet-CGAONet model, and the current field method using a deep adversarial operator network is proposed. Finally, the finite element simulation model of the US public linear propulsion electromagnetic energy equipment calculation example is established to construct the simulation dataset from 1D excitation current value and time data to a 2D current field. The trained RTUnet-CGAONet model predicts the mean absolute percentage error of 2.94% in the 2D current field, and the model is minimally affected by the number of samples in the dataset. The results of this paper can achieve the second-level calculation of the current field under different excitation currents, which provides a new way of thinking for the analysis of dynamic characteristics of linear propulsion electromagnetic energy equipment.
Heat shock factor ZmHsf17 positively regulates phosphatidic acid phosphohydrolase ZmPAH1 and enhances maize thermotolerance
Authors: Zhang Huaning , Meng Xiangzhao , Liu Ran , Li Ran , Wang Yantao , Ma Zhenyu , Liu Zihui , Duan Shuonan , Li Guoliang , Guo Xiulin
Published: September 2024

Heat stress adversely impacts plant growth, development, and grain yield. Heat shock factors (Hsf), especially the HsfA2 subclass, play a pivotal role in the transcriptional regulation of genes in response to heat stress. In this study, the coding sequence of maize ZmHsf17 was cloned. ZmHsf17 contained conserved domains including a DNA binding domain, oligomerization domain, and transcriptional activation domain. The protein was nuclear localized and had transcription activation activity. Yeast two-hybrid and split luciferase complementation assays confirmed the interaction of ZmHsf17 with members of the maize HsfA2 subclass. Overexpression of ZmHsf17 in maize significantly increased chlorophyll content and net photosynthetic rate, and enhanced the stability of cellular membranes. Through integrative analysis of ChIP-seq and RNA-seq datasets, ZmPAH1, encoding phosphatidic acid phosphohydrolase of lipid metabolic pathways, was identified as a target gene of ZmHsf17. The promoter fragment of ZmPAH1 was bound by ZmHsf17 in protein–DNA interaction experiments in vivo and in vitro. Lipidomic data also indicated that the overexpression of ZmHsf17 increased levels of some critical membrane lipid components of maize leaves under heat stress. This research provides new insights into the role of the ZmHsf17–ZmPAH1 module in regulating thermotolerance in maize.
Psychiatry and the Critical Landscape
Authors: Aftab Awais
Published: September 2024

‘Psychiatry and the Critical Landscape’ presents an overview of psychiatry’s relationship with critique and offers a synthesis of themes encountered in critical and philosophical discussions around psychiatry. Awais Aftab advocates for an integrative and critical pluralism as the preferred mode of critical engagement, contrasting it with the views of the Critical Psychiatry Network in the UK. Mental health problems are complex, value-laden, and multidimensional, Aftab claims, and require a pluralistic approach that takes into account their dimensional, developmental, and idiographic aspects. Nonetheless, they can be categorized in pragmatic ways that have clinical utility and scientific validity. Aftab argues that in order for integrative critical psychiatry to meaningfully embrace the critical tradition, it cannot forego the sociopolitical dimensions of madness and must tackle the social and epistemic marginalization of individuals with psychiatric disabilities. The implications of integrative, critical pluralism and standpoint epistemology for diagnosis, explanation, treatment, and coercion are further explored.
Introduction and Overview
Authors: Hilsabeck Robin C. , Ayers Gayle Y.
Published: September 2024

The purpose of this book is to provide trainees and early career professionals, particularly in psychiatry, psychology, neurology, geriatrics, family medicine, and internal medicine, with the information necessary to care for the often complex clinical presentations of older adults with mild cognitive impairment and dementia. The book is organized into three sections: Section I, Core Concepts; Section II, Dementia Syndromes; and Section III, Disease Management.
Diagnostic Interviewing and Cognitive Screening
Authors: Martin Phillip K. , Surineni Kamalakar , Schroeder Ryan W.
Published: September 2024

The diagnostic interview is an essential component in the evaluation of neurocognitive disorders of older adults. This chapter describes approaches and important considerations for interviewing older adults suspected of neurocognitive disorder. Standard components of the interview are outlined, and specific lines of inquiry for successful differential diagnosis are discussed. Techniques are provided for effectively eliciting both content- and process-based information, adapting the interview approach and managing interactions when working with patients with difficult behavioral and cognitive presentations, and navigating interviews in which both patients and collateral informants are present. The chapter concludes with an up-to-date review of common brief cognitive screening measures and their associated research given the common utilization of these measures alongside the diagnostic interview.
Mild Cognitive Impairment
Authors: Neale Alec , Axelrod Jenna , Geary Elizabeth , Guidotti Breting Leslie M.
Published: September 2024

Mild cognitive impairment (MCI), also known as mild neurocognitive disorder (MiND), is a prevalent condition in older adults characterized by a measurable decline in cognitive function surpassing expected age-related changes. However, functioning in complex daily activities (e.g., driving and financial management) is not significantly impaired. MCI can represent an intermediate stage between normal aging and dementia, although not all individuals with MCI progress to dementia (major neurocognitive disorder). Diagnosis involves assessing cognitive decline through subjective and objective methods, while also ensuring functional independence and ruling out other causes, such as psychiatric conditions or delirium. Various factors can underlie MCI, including cerebrovascular disease, neurodegenerative conditions, and traumatic brain injury. Thus, early detection can be crucial for prompt treatment and the potential to delay dementia progression. The MCI construct gained traction within the past several decades but has become widely recognized in the research community and is an established clinical diagnosis globally.
Safety Considerations
Authors: Asper Joseph J. , Smith Alyssa C. , Polsinelli Angelina J. , Wang Sophia
Published: September 2024

Safety concerns in individuals with dementia can arise from progressive functional decline, and when present, can result in worsened outcomes. Major concerns include inadequate support systems or oversight of key instrumental activities of daily living (IADLs) and vulnerability to elder abuse (emotional, financial, and physical). This chapter discusses the evaluation and management of behavioral and psychological symptoms of dementia (BSPD) and safety concerns in dementia. These include aggression and agitation, wandering, home safety, driving, assistance with medication and financial management, legal issues, and elder abuse. While outpatient management is typically preferred over inpatient services, the authors discuss when to consider emergency evaluation and inpatient services for these concerns.
The Four Principles
Authors: Bulger Jeffrey W.
Published: September 2024

Abstract: This chapter establishes a structured framework known as the Tripartite Process—Think, Assess, and Conclude—to explore sixty high-yield ethical topics crucial for excelling in national board exams and improving patient care. The Assessment portion of each topic applies the four principles of bioethics: patient autonomy (informed consent), practitioner’s obligations of beneficence (do good), and nonmaleficence (do no harm), along with public policy considerations of justice (be fair). This approach equips healthcare professionals to navigate complex ethical dilemmas adeptly, ensuring patients make informed decisions that align with their best interests and adhere to stringent standards of care. The chapter emphasizes critical thinking, balanced judgment, and ethical integrity, serving as a cornerstone for educational and practical decision-making in healthcare ethics.
Hospice
Authors: Bulger Jeffrey W.
Published: September 2024

Abstract: The first hospice in the United States was established in 1974 in response to the excessive use of technology in mainstream medicine that caused chronic illnesses and lonely hospital deaths. In 1982, federal Medicare started funding hospice care for beneficiaries with less than 6 months of life expectancy, and state Medicaid and private insurance soon followed. Hospice care not only provides relief from pain and symptoms but also includes hospital beds for home use, psychological counseling, family bereavement counseling, and other quality-of-life products and activities. End-of-life discussions with Medicare patients about end-of-life care, living wills, and advanced directives were politicized in 2009 as “death panels” and, as such, hospice care was removed from the 2010 Patient Protection and Affordable Care Act. Hospice’s only requirement is a prognosis of less than 6 months of life. Hospice aims to focus on both the quantity and quality of life.
Impaired Driver
Authors: Bulger Jeffrey W.
Published: September 2024

Abstract: Healthcare practitioners are key players in identifying and evaluating healthcare conditions that could endanger a driver’s ability to operate a vehicle safely. This could range from neurological disorders such as seizures to vision impairment or other health issues directly impacting motor skills or cognitive functioning. Patients must legally self-report certain healthcare conditions, such as seizure disorders, to the department of motor vehicles (DMV). However, the obligation for practitioners to report these conditions varies, being mandatory in some states and voluntary in others. Despite practitioners having no direct authority to suspend or revoke driving privileges, they have a professional responsibility to act in the patient’s best interests and contribute to public safety. In jurisdictions where reporting is not legally mandated, practitioners electing to inform the DMV about a patient’s condition might be sheltered by “good faith” or “Good Samaritan” laws, providing legal protection for the sake of public safety.
Nurses and Allied Health Professionals
Authors: Bulger Jeffrey W.
Published: September 2024

Abstract:This chapter examines the roles and responsibilities of various interprofessional healthcare practitioners in patient care, encompassing a diverse range of types and specialties. Central to the patient–practitioner relationship is the principle of informed consent, where the patient’s best interests and avoidance of harm guide the actions of healthcare professionals. Effective communication within the interprofessional team is essential for providing healthcare, resolving disagreements, and maintaining professionalism in patient management. This includes the responsibility of physicians to support the broader interprofessional healthcare delivery and institutions’ obligations to ensure that all allied health professionals are adequately educated and competent, underscoring the collective responsibility of the healthcare team to maintain professional conduct and the paramount importance of prioritizing patient well-being.
Research on Human Subjects
Authors: Bulger Jeffrey W.
Published: September 2024

The Belmont Report, formalized in 1979, delineates three fundamental ethical principles governing biomedical and behavioral research involving human subjects: respect for persons, beneficence, and justice. Respect for persons emphasizes the requirement of informed consent from research subjects, ensuring their autonomy and freedom to participate. Beneficence embodies the dual obligations of the researchers toward nonmaleficence (do no harm) and beneficence (do good), guiding researchers to act in the participant’s best interests. The principle of justice mandates the fair selection of human subjects and prohibits the undue burdening of one social group for the benefit of another. These principles were codified into federal law through 45 Code of Federal Regulation 46, the Common Rule, and codified institutional review boards. Failure to comply can result in severe penalties, including losing federal funding for the entire institution and denying research publication in academic journals.