bluuebunny/crossref_metadata_2025 huggingface dataset:
Inverse association between Mediterranean diet and risk of multiple sclerosis
Authors: Alfredsson Lars , Olsson Tomas , Hedström Anna Karin
Published: June 2023

Objective:

There is some evidence implicating diet in the development of inflammatory diseases. We aimed to study the influence of dietary habits on the risk of developing multiple sclerosis (MS).

Methods:

We used a population-based case–control study recruiting incident cases of MS (1953 cases, 3557 controls). Subjects with different dietary habits 5 years prior to MS diagnosis were compared regarding MS risk by calculating odds ratios (OR) with 95% confidence intervals (CI) using logistic regression models. Adjustment was made for a large number of environmental and lifestyle habits, including ancestry, smoking, alcohol consumption, body mass index, physical activity, and sun exposure habits.

Results:

Mediterranean diet was associated with lower risk of developing MS (adjusted OR = 0.54, 95% CI: 0.34–0.86, p = 0.009), compared with Western-style diet. There was no significant association between vegetarian/vegan diet and MS risk (adjusted OR = 0.96, 95% CI: 0.75–1.24, p = 0.976), nor between diet with low glycemic index and MS risk (adjusted OR = 0.93, 95% CI: 0.60–1.42, p = 0.518).

Conclusions:

Mediterranean diet may exert a protective influence regarding the risk of subsequently developing MS compared with Western-style diet.
The program-to-campaign linkage: Party organization and ideological inconsistency during election campaigns
Authors: Nasr Mohamed
Published: June 2023

What determines party strategies in the short run during election campaigns? In this paper, I highlight a novel aspect of party behavior pertaining to the connection between election programs and actual campaign statements issued by party elites in the media. I argue that party leaders may feel compelled to fine-tune their rhetoric and stances during campaigns and thus deviate from their party’s election programs. Nonetheless, their ability to conduct ad-hoc adaptations is limited. The theory I propose posits that two features of party organizations will determine if party leaders can engage in short-term inconsistencies. First, membership-dominated parties will be less likely to be inconsistent because their leaders will fear alienating (the strong) party members and getting punished as a result. Second, parties with strong societal integration—those that maintain strong ties with society and an extensive network of local branches—are more likely to indulge in ideological inconsistency because they establish close bonds with voters based on problem-solving rather than broad ideological principles. I test these dynamics in 14 European democracies between 1972 and 2017 and find strong empirical support. The findings show that intricate party organizations and robust connections with normal citizens influence parties’ short-term strategies during election campaigns.
Staff experiences of training and delivery of remote home monitoring services for patients diagnosed with COVID-19 in England: A mixed-methods study
Authors: Sidhu Manbinder , Walton Holly , Crellin Nadia , Ellins Jo , Herlitz Lauren , Litchfield Ian , Massou Efthalia , Tomini Sonila M , Vindrola-Padros Cecilia , Fulop Naomi J
Published: June 2023

Objectives

Remote home monitoring services for patients at risk of rapid deterioration introduced during the COVID-19 pandemic had important implications for the health workforce. This study explored the nature of ‘work’ that health care staff in England undertook to manage patients with COVID-19 remotely, how they were supported to deliver these new services, and the factors that influenced delivery of COVID-19 remote home monitoring services for staff.

Methods

We conducted a rapid mixed-methods evaluation of COVID-19 remote home monitoring services during November 2020 to July 2021 using a cross-sectional survey of a purposive sample of staff involved in delivering the service (clinical leads, frontline delivery staff and those involved in data collection and management) from 28 sites across England. We also conducted interviews with 58 staff in a subsample of 17 sites. Data collection and analysis were carried out in parallel. We used thematic analysis to analyse qualitative data while quantitative survey data were analysed using descriptive statistics.

Results

A total of 292 staff responded to the surveys (39% response rate). We found that prior experience of remote monitoring had some, albeit limited benefit for delivering similar services for patients diagnosed with COVID-19. Staff received a range of locally specific training and clinical oversight along with bespoke materials and resources. Staff reported feeling uncertain about using their own judgement and being reliant on seeking clinical oversight. The experience of transitioning from face-to-face to remote service delivery led some frontline delivery staff to reconsider their professional role, as well as their beliefs around their own capabilities. There was a general perception of staff being able to adapt, acquire new skills and knowledge and they demonstrated a commitment to continuity of care for patients, although there were reports of struggling with the increased accountability and responsibility attached to their adapted roles at times.

Conclusions

Remote home monitoring models can play an important role in managing a large number of patients for COVID-19 and possibly a range of other conditions. Successful delivery of such service models depends on staff competency and the nature of training received to facilitate effective care and patient engagement.
Fanconi syndrome, diabetes insipidus, and acute kidney injury due to tenofovir disoproxil fumarate: A case report
Authors: Zilwa Nthabiseng , Mpejane Onalethata , Mehboob Golam , Gill Sajan , Kalinoski Thomas
Published: June 2023

Background

Tenofovir disoproxil fumarate is widely used in Botswana as part of the first-line antiretroviral regimen in the ‘Treat All’ strategy implemented in 2016 by the Ministry of Health. Its use has been associated with several uncommon adverse renal effects, though rarely all in conjunction or without the combined use of protease inhibitors.

Case presentation

A 49-year-old woman living with HIV whose viral load is suppressed on tenofovir disoproxil fumarate, lamivudine, and dolutegravir presented with 1 day of generalized weakness and myalgia causing an inability to ambulate. This was associated with nausea and vomiting and profound fatigue. She was found to have an acute kidney injury, non-anion-gap metabolic acidosis, hypernatremia, hypokalemia, and hypophosphatemia. Urinalysis revealed pyuria with white blood cell casts, glucosuria, and proteinuria. The diagnosis was made of tenofovir-induced nephrotoxicity. The tenofovir was discontinued, and the patient was initiated on intravenous fluids and electrolyte and bicarbonate supplementation with improvement in her symptoms and laboratory values.

Conclusions

This report suggests the possibility of severe tenofovir-induced nephrotoxicity with combined acute kidney injury, Fanconi syndrome, and nephrogenic diabetes insipidus in the absence of other provoking factors such as use with protease inhibitors or advanced HIV disease, chronic kidney disease, and age. With its wide use in Botswana and other countries, health-care providers should have a high index of suspicion for tenofovir-induced nephrotoxicity for HIV patients on tenofovir with deranged renal function tests and electrolytes.
The effects of a cognitive linguistic approach on college students’ learning English tenses in Taiwan
Authors: Yang Li-Chin
Published: June 2023

This study investigated the effectiveness of cognitive linguistics-based instruction (CLI), as compared to that of traditional instruction (TI), in classrooms where English present and past tenses were taught to Chinese learners of English as a foreign language (EFL). Seventy-nine non-English major freshmen at CEFR B1 level from a Taiwan university were divided into two groups: the CLI group ( N = 41) and the TI group ( N = 38). In CLI, the cognitive notion of immediacy/non-immediacy for the present/past tenses and how prototypical and peripheral senses of the English tenses are tackled in cognitive linguistics were introduced, and then interpretation tasks were given for familiarizing learners with the previously learned information. In TI, language facts were explained through grammatical taxonomies, such as generics encoded with simple present, and past events encoded with simple past, followed by interpretation tasks. To measure learning outcomes, a pretest, a posttest, and a delayed posttest were conducted one week before, one week after, and five weeks after the teaching intervention. A questionnaire was also given to explore learners’ learning awareness about English tense teaching. Results revealed that CLI could be a more efficient teaching method for tense selection than TI in both short- and long-term learning outcomes. In addition, learners receiving CLI, provided with tools for prospective autonomous learning, may make consistent progress, construct an ability to observe pragmatic contexts, and build better cross-linguistic awareness. These findings suggest positive implications for EFL teachers and researchers in integrating cognitive linguistics with grammar teaching.
Understanding violence on British university campuses through the lens of the deviant leisure perspective
Authors: Miles Liam
Published: June 2023

This paper examines how the deviant leisure perspective plays a role in explaining encounters of violence across British University Campuses within which a university campus in the Midlands Region will be applied as case study. The deviant leisure framework will be broken down into its ultra-realist, cultural criminological, and zemiological underpinnings, through which violence will be contextualised under the backdrop of neoliberal capitalism. Through primary-based qualitative semi-structured interviews and surveys, two key arguments are made. Firstly, British university campuses are brand-driven spaces whereby under neoliberal capitalism, success is predicated upon excessive acts of consumption, that are capable of transcending into expressive and acquisitive modes of violence to achieve ‘success’. Secondly, consumer holidays are precipitators of violence rather than dark nights. It is argued that whilst dark nights serve as a catalyst for violence, it is instead the surge of consumer holidays including the Black Friday Sales and Christmas that drives violence. This research offers a fresh approach to understanding the correlation between violence and consumer culture. Forward-thinking, it is urged that the harmful subjectivities that are cultivated under liberal capitalism are considered when contesting violence within education settings for future practice.
Advancing basic psychological needs theory in marketing research
Authors: Gilal Faheem Gul , Paul Justin , Gilal Rukhsana Gul , Gilal Naeem Gul
Published: June 2023

This paper presents a rigorous and in-depth systematic review of the literature on Basic Psychological Needs Theory (BPNT) and its applications in marketing research. Despite the widespread use of conventional models and theories in marketing research, motivational theories, such as BPNT, which have demonstrated significant effectiveness in driving motivation, have been relatively neglected. BPNT proposes that fulfilling basic psychological needs for autonomy, competence, and relatedness (ACR) leads to intrinsic motivation, emotional stability, and strong attachment. Our systematic review identifies how the constructs underpinned by BPNT have been utilized, as well as what research designs, contexts, and methodologies have been applied in marketing research. By integrating BPNT into marketing research, the authors aim to provide researchers with much-needed directions for future research and advocate for its continued growth. Specifically, the review notes tensions in terms of contradictory findings, identifies major gaps, and operationalizes BPNT in marketing research by establishing a set of marketing priorities (provided in the form of testable propositions) in seven major domains under the lens of BPNT. As the first systematic literature review of its kind, this theoretical study serves as an essential reference and valuable resource for scholars and practitioners aiming to explore and integrate BPNT into their research and practice.
Some implications of the neoliberal massification of Colombian HE for achieving the sustainable development goals
Authors: Mackenzie Lee
Published: June 2023

This article draws on existing research, including publicly available data, to identify changes in Colombian HE which have led to its progressive massification and neoliberalisation. These include the introduction of standardised testing; endogenous and exogenous privatisation (Ball and Youdell, 2007); the expansion of the country’s non-income contingent loan scheme; cost-cutting and cost-sharing; and the Government of Colombia’s prioritisation of technical and technological (T&T) education. The article then explores some implications of this neoliberal massification of Colombian HE for the achievement of the UN’s sustainable development goals in general and more specifically Sustainable Development Target 4.3, which is the only target to explicitly reference inclusion in HE. The analysis suggests that although some neoliberal policies may have broadened access to HE for some Colombians from low-income and rural backgrounds, they are not consistent with a sustainable development agenda. Reasons for this include the large number of student loans recipients who are in arrears; the use of public money to finance students’ courses in private higher education institutions (HEIs); the prioritisation of T&T education which leaves limited room in Colombian HE for the ‘full development of the human personality’ (OHCHR, 2022: article 13.1); and the country’s overreliance on non-renewable resources for its economic prosperity. The paper ends with some proposals for disrupting the ongoing neoliberalisation of higher learning in Colombia such as the replacement of the country’s non-contingent loan scheme with an income-contingent model; improving the efficiency and accountability of state-run T&T programmes; the granting of student loans only for courses at accredited HEIs; the provision of loans to accredited private HEIs only in cases where no public alternative exists; the abolition of tuition fees in public HEIs for the poorest students; the introduction of stipend-supported internships; and the promotion of Civic Education.
Evaluation of a Mandatory Professional Development on Supporting Transgender, Nonbinary, and Gender-Nonconforming Students in Chicago Public Schools
Authors: Jarpe-Ratner Elizabeth , Bloedel A. , Little D. , DiPaolo M. , Belcher K. , Mangiaracina M. , Marshall B.
Published: June 2023

To address the reality that LGBTQ+ (lesbian, gay, bisexual, transgender, queer, intersex, asexual, and others) students remain more likely to experience harm, harassment, and violence at school as well as miss school due to feeling unsafe and the fact that students identifying as transgender, nonbinary, and gender-nonconforming (TNBGNC) are at even greater risk of bullying, harassment, and significant mental health concerns, Chicago Public Schools’ (CPS) Office of Student Health and Wellness (OSHW) created a novel professional development (PD) requirement in 2019, entitled “Supporting Transgender, Nonbinary, and Gender Nonconforming Students.” The PD, a recorded webinar encouraging independent time for reflection and planning, takes an intersectional approach and is required of all CPS staff members across the entire district. A pre- and postevaluation of the PD, guided by the Kirkpatrick model, was completed by 19,503 staff members. The findings from this evaluation show that staff members significantly increased their knowledge, showed statistically significant gain in self-reported skills, and articulated key actions they could take toward sustaining an environment that fosters skill implementation and culture change more broadly. Findings reveal that a culture that supports staff members in learning from their mistakes can help to encourage staff members to employ gender-inclusive behaviors such as asking individuals for their pronouns and using gender-neutral pronouns. This districtwide mandatory PD approach shows value in influencing staff members’ thinking and behaviors known to be supportive of TNBGNC students and may serve as a model for other school districts looking to build capacity to support TNBGNC students.
Plasma Thioredoxin Reductase as a Potential Biomarker for Gynecologic Cancer
Authors: Zhu Yinxing , Hu Yixuan , Shi Junfeng , Wei Xiaowei , Song Yaqi , Tang Cuiju , Zhang Wenwen
Published: June 2023

Background

According to previous literatures, plasma thioredoxin reductase (TrxR) level was significantly elevated in various malignant tumors and serve as a potential biomarker for diagnosis and prognostic prediction. However, there is little awareness of the clinical value of plasma TrxR in gynecologic malignancies. In the present study, we aim to evaluate the diagnostic accuracy of plasma TrxR in gynecologic cancer and explore its role in treatment surveillance.

Methods

We retrospectively enrolled 134 patients with gynecologic cancer and 79 patients with benign gynecologic disease. The difference of plasma TrxR activity and tumor markers level between two groups was compared using Mann-Whitney U test. By detecting pretreatment and post-treatment level of TrxR and conventional tumor markers, we further assessed the change trend of them with the Wilcoxon signed-ranks test.

Results

Compared with benign control [5.7 (5, 6.6) U/mL], statistically significant increase of TrxR activity was observed in gynecologic cancer group [8.4 (7.25, 9.825) U/mL] ( P < .0001), regardless of age and stage. On the basis of receiver operating characteristic (ROC) curves, we found plasma TrxR shows the highest diagnostic efficacy for distinguishing malignancy with benign disease, with an area under the curve (AUC) of 0.823 (95% confidence interval [CI] = 0.767-0.878), in the whole cohort. Besides, patients receiving treatment previously [8 (6.5, 9) U/mL] had a decreased TrxR level relative to treatment-native patients [9.9 (8.6, 10.85) U/mL]. Furthermore, follow-up data showed that plasma TrxR level would be evidently decreased after two courses of antitumor therapy ( P < .0001), which is consistent with the downward trend of conventional tumor markers.

Conclusion

Collectively, all these results demonstrated plasma TrxR is an effective parameter for gynecologic cancer diagnosis and concurrently acts as a promising biomarker for treatment response assessment.
Prognostic Factors for Survival in Multiple Primary Lung Adenocarcinomas: A Retrospective Analysis of 283 Patients
Authors: Zheng Yuting , Han Xiaoyu , Wu Ying , Jia Xi , Zhang Kailu , Fan Jun , Shi Heshui
Published: June 2023

Purpose: In recent years, a rising number of multiple primary lung cancers have been detected with the advancement of imaging technology. No detailed study has assessed the prognosis of multiple primary lung adenocarcinomas based on computed tomography characteristics. The present study aimed to analyze outcomes and determine valuable factors for predicting the prognosis of multiple primary lung adenocarcinoma. Methods: This single-center retrospective study was performed from January 2013 to October 2021. All patients were divided into 3 groups based on tumor density as follows: multi-pure ground-glass nodules, at least one part-solid nodule without solid nodules, and at least one solid nodule. Clinicopathologic features, computed tomography signs, and survival outcomes were compared between these groups. The Kaplan-Meier method was used for survival analysis. The multivariable Cox proportional hazards regression model was used to identify independent predictors for recurrence-free survival and overall survival. Results: The sample included 283 patients with 623 lesions who met the inclusion criteria for multiple primary lung adenocarcinoma. Of these patients, 71 (25.1%) presented with multi-pure ground-glass nodules, 100 (35.3%) with at least one part-solid nodule without solid nodule, and 112 (39.6%) with at least one solid nodule. The 3 groups had distinguished clinicopathologic and radiological features of age, adjuvant therapy, types of tumor resection, TNM stage, pathological subtypes, pleural indentation, spicule, and vacuole (all P < .001). Multivariate analysis found that lesion number was an independent predictor for both recurrence-free survival (hazard ratio 2.41; 95% confidence interval 1.12-5.19; P = .025) and overall survival (hazard ratio 4.78; 95% confidence interval 1.88-12.18; P = .001), and the at least one solid nodule was an independent predictor for overall survival (hazard ratio 5.307; 95% confidence interval 1.16-24.31; P = .032). Stage III (hazard ratio 5.71; 95% confidence interval 1.94-16.81; P = .002) and adjuvant therapy (hazard ratio 2.52; 95% confidence interval 1.24-5.13; P = .011) influenced the recurrence-free survival. Conclusions: Survival of multiple primary lung adenocarcinoma patients is strongly correlated with the lesion number and the at least one solid nodule tumors in radiological. This information may be useful for predicting survival and making clinical decisions in future studies.
Narratives of Actionable Medical Leadership From Senior Leaders for Aspiring Leaders in Academic Medicine
Authors: Mancuso Carol A. , Robbins Laura
Published: June 2023

Background:

Physicians understand that certain personal attributes are essential in medical leaders, but they often do not know what actions are expected of them as leaders or what they should do to be more effective leaders.

Purpose:

We sought to compile, through interviews with senior leaders at an academic institution, real leadership scenarios for a series of case-based examples to be used during group mentoring sessions for aspiring medical leaders.

Methods:

We conducted one-to-one interviews using open-ended questions with 11 current and emeritus chairpersons or chiefs of major departments or divisions at our academic medical center. Questions were designed to elicit anecdotes and examples of actions that demonstrate effective and ineffective leadership. Responses were analyzed with qualitative techniques to generate topics of leadership behaviors, which then were compiled into a collection of illustrative examples.

Results:

The leaders interviewed discussed challenges they encountered in daily routines and described how they addressed certain dilemmas. Topics included making decisions without complete information, winning over reluctant administrators, building alliances with peers, involving subordinates in initiatives, and using knowledge to defend one’s position. Actions requiring interpersonal skills also were discussed, including varying modes of communication, avoiding adversity, displaying gratitude toward subordinates, and safeguarding one’s professional image. The leaders’ insights and recommendations were compiled into a themed collection of topics to be used during group mentoring sessions to enhance leadership skills.

Conclusions:

This qualitative study suggests that the wisdom and experience of senior leaders may be gleaned for a collection of case-based topics that could complement other formal training programs for aspiring medical leaders.
Optimisation of transmission towers under multiple load cases and constraint conditions with the KSM-GA method
Authors: Li Yinqi , Liang Songfeng , Li Peng , Xu Yuanzhi
Published: June 2023

Transmission towers operate in complex engineering environments, such as gravity, strong winds, ice and snow, wire breaking and unbalanced loads. Owing to complicated structural parameters, multiple load cases and multiple constraint conditions, the optimal design plan of the structure is difficult to acquire. Popular intelligent algorithms (Genetic Algorithm, GA; Particle Swarm Optimisation, PSO; and others) need to spend time in structural mechanical computation and search processes. To solve this problem, the commercial FE software ABAQUS was used to build the full parametric analytical and computational sub-procedures (general static, linear buckling and cost computation) for the transmission tower under multiple load cases and constraint conditions. Then, the main algorithm procedure, KSM-GA, was developed based on the GA optimiser and Kriging Surrogate Model (KSM). The KSM-GA could import the design variables (such as cross-section properties and structural dimensions) of the transmission tower into the FE computational sub-procedures and read the results (including stresses, displacements, buckling load and weight). The results show that the KSM-GA can reduce the search time more than 30% compared with the GA, PSO and BO-GP( Bayesian Optimisation with Gaussian Process) while the training precision of the KSM is above 99% accuracy of the FE results.
How Do Expectations Modulate Pain? A Motivational Perspective
Authors: Liu Tao , Yu Cui-ping
Published: June 2023

Expectations can profoundly modulate pain experience, during which the periaqueductal gray (PAG) plays a pivotal role. In this article, we focus on motivationally evoked neural activations in cortical and brainstem regions both before and during stimulus administration, as has been demonstrated by experimental studies on pain-modulatory effects of expectations, in the hope of unraveling how the PAG is involved in descending and ascending nociceptive processes. This motivational perspective on expectancy effects on the perception of noxious stimuli sheds new light on psychological and neuronal substrates of pain and its modulation, thus having important research and clinical implications.
“Caring for the Uncared for”: A Novel Initiative of Madras Medical College
Authors: Ethirajan Theranirajan , Senthilkumar Priya , Gnanasambandam Usha , Jacob Susan , Natarajan Gopalakrishnan , Rajendran Karthick
Published: June 2023

Background:

Every society has persons with illness who do not have any family support. Taking care of such uncared-for patients requires a well-structured system providing medical, psychological, emotional, and rehabilitory support. The first ever rehabilitation ward among government hospitals in Tamil Nadu was created at Rajiv Gandhi Government General Hospital (RGGGH), Chennai with the motto of “Caring for the uncared for.” This paper highlights the organizational structure, functionality, profile of patients admitted, challenges faced, and the outcome of patients admitted in the rehabilitation ward.

Methods:

A retrospective study was done on the “untended” patients, who were admitted in the rehabilitation ward at Rajiv Gandhi Government General Hospital (RGGGH), Chennai, Tamil Nadu, India from December 2020 to June 2022. Sociodemographic and clinical characteristics and outcome of the patients were analyzed.

Results:

A total of 201 adults with physical disabilities or mixed physical and psychiatric disabilities were admitted for intensive rehabilitation. Common medical illnesses included orthopedic disorders in 80 (39.8%), followed by neurological illness in 43 (21.4%) patients. The median length of stay was 50 (24.5-103.5) days with longest stay of 447 days. Of those patients who recovered, 54 patients (26.9%) reunited with family and returned home and 125 (62.2%) patients were sent to old age homes/asylums.

Conclusion:

A dedicated ward for untended patients is the first of its kind in the state of Tamil Nadu, India. Such a venture has proved to be of benefit, considering the positive outcome in a significant proportion of the beneficiaries.
Looking for Dr B. R. Ambedkar in The Times of India, December 1956–April 1990
Authors: Ankit Rakesh
Published: June 2023

This article searches for Dr B. R. Ambedkar (India’s first Law Minister) in the pages of The Times of India ( TOI; India’s largest-selling English-language newspaper) from December 1956 to April 1990, that is, from Ambedkar’s death to his receiving the Bharat Ratna. A lone soldier for his social and political causes, during his life and after his death, Ambedkar’s afterlife has recently seen a total transformation in contemporary India. This article looks for Ambedkar before this turn by going through the pages of TOI over a period of thirty-four years, to trace both his representation in and resistance to it, before the current appropriation, on four key themes of religion (neo-Buddhism), region (Bombay/Maharashtra), caste (scheduled/backward) and class (lower-middle/political). Drawing upon 200+ items, the article presents the newspaper’s expanding coverage of Ambedkar in Indian politics in a framework of continuum that reconciles its changes, by focussing on the regularity of these reports and analysing their periodicity. Taken together, these details allow us to see the slow switch in the status quo on Ambedkar’s iconography, long before the present idolisation, and fill a political vacuum before his present veneration.
Meeting the Needs of Older Adults with Mental Ill-Health in Non-Psychiatric Care Settings: Self-Rated Confidence in Helping and its Co-Variates within a Multiprofessional Study Sample
Authors: Häger Magdalena , Boman Erika , Forsman Anna K.
Published: June 2023

In this paper we sought to explore health and social care professionals’ self-rated confidence in helping older adults with mental ill-health in non-psychiatric care settings. A cross-sectional survey study was performed exploring the participants’ ( n = 480) confidence in helping. Confidence in helping was analyzed together with background characteristics and selected explanatory variables, such as the workplace and work experience of the participants, their personal experiences of and attitudes to mental ill-health, as well as their knowledge in mental ill-health among older adults, by means of descriptive statistics and logistic regression analysis. We found that approximately half (55%) of the participants were confident in helping older adults with mental ill-health. The odds ratios for being confident in helping were significantly associated to the workplace of the professionals, professionals’ attitude to and experience of mental ill-health, and knowledge of mental health among older adults. To increase confidence in helping older adults with mental ill-health, we recommend confidence-building interventions, for example, educational programs, through which knowledge of mental health among older adults is increased and negative attitudes are challenged, especially within the context of specialist somatic healthcare.
Perspectives of researchers with lived experience in implementation science research: Opportunities to close the research-to-practice gap in substance use systems of care
Authors: Cioffi Camille C. , Hibbard Patrick F. , Hagaman Angela , Tillson Martha , Vest Noel
Published: June 2023

Background

The field of implementation science acknowledges the importance of diversity within research teams including members from diverse disciplines and with lived expertise in practical implementation (e.g., administrators, front-line workers, patients/clients). Gaps remain in the successful implementation of proven substance use treatment interventions.

Methods

This paper will outline the rationale for the purposeful inclusion of researchers with lived experience (RLE) related to substance use disorder (SUD) within implementation science research studies focused on improving SUD services.

Results

We posit that researchers with such experience can help address research-to-practice gaps by (1) building strong community partnerships, (2) engaging in conversations around effective interventions through knowledge translation, (3) providing community-congruent approaches to evaluation, and (4) aiding in dissemination and sustainability efforts.

Conclusions

We end by offering recommendations for researchers without lived experience as they intentionally collaborate with RLE.
Involvement of cell cycle and ion transferring in the salt stress responses of alfalfa varieties at different development stages
Authors: Yin YanLing , Fan ShuGao , Li Shuang , Amombo Erick , Fu JinMin
Published: June 2023

Background

Alfalfa (Medicago sativa) is the worldwide major feed crop for livestock. However, forage quality and productivity are reduced by salt stress, which is a common issue in alfalfa-growing regions. The relative salt tolerance is changed during plant life cycle. This research aimed to investigate the relative salt tolerance and the underlying mechanisms of two alfalfa varieties at different developmental stages.

Results

Two alfalfa varieties, "Zhongmu No.1 (ZM1)" and "D4V", with varying salt tolerance, were subjected to salt stress (0, 100, 150 mM NaCl). When the germinated seeds were exposed to salt stress, D4V exhibited enhanced primary root growth compared to ZM1 due to the maintenance of meristem size, sustained or increased expression of cell cycle-related genes, greater activity of antioxidant enzymes and higher level of IAA. These findings indicated that D4V was more tolerant than ZM1 at early developmental stage. However, when young seedlings were exposed to salt stress, ZM1 displayed a lighter wilted phenotype and leaf cell death, higher biomass and nutritional quality, lower relative electrolytic leakage (EL) and malondialdehyde (MDA) concentration. In addition, ZM1 obtained a greater antioxidant capacity in leaves, indicated by less accumulation of hydrogen peroxide (H2O2) and higher activity of antioxidant enzymes. Further ionic tissue-distribution analysis identified that ZM1 accumulated less Na+ and more K+ in leaves and stems, resulting in lower Na+/K+ ratio, because of possessing higher expression of ion transporters and sensitivity of stomata closure. Therefore, the relative salt tolerance of ZM1 and D4V was reversed at young seedling stages, with the young seedlings of the former being more salt-tolerant.

Conclusion

Our data revealed the changes of relative order of salt tolerance between alfalfa varieties as they develop. Meristem activity in primary root tips and ion transferring at young seedling stages were underlying mechanisms that resulted in differences in salt tolerance at different developmental stages.
“I felt like I had been put on the shelf and forgotten about” – lasting lessons about the impact of COVID-19 on people affected by rarer dementias
Authors: Harding Emma , Rossi-Harries Sam , Gerritzen Esther Vera , Zimmerman Nikki , Hoare Zoe , Proctor Danielle , Brotherhood Emilie , Crutch Sebastian , Suárez-González Aida
Published: June 2023

Background

The public health measures imposed in many countries to contain the spread of COVID-19 resulted in significant suspensions in the provision of support and care for people with dementia. The negative effects of these measures have been extensively reported. However, little is known about the specific impact on people with young onset, non-memory-led and inherited dementias. This group may have experienced different challenges compared to those with late onset dementia given their non-memory phenotypes and younger age. We explored the impact of the first COVID-19 lockdown on people living with familial Alzheimer’s disease, behavioural variant frontotemporal dementia, familial frontotemporal dementia, dementia with Lewy bodies, posterior cortical atrophy and primary progressive aphasia and their carers in the UK and their self-reported strategies for coping.

Methods

This was a mixed methods study. An online survey was administered to people with dementia and family carers recruited via Rare Dementia Support. Free-text responses were analysed using framework analysis to identify key issues and themes.

Results

184 carers and 24 people with dementia completed the survey. Overall, people with dementia experienced worsening of cognitive symptoms (70%), ability to do things (62%), well-being (57%) and changes to medication (26%) during lockdown. Carers reported a reduction in the support they received (55%) which impacted their own mental health negatively. Qualitative analysis of free-text responses shed light on how the disruption to routines, changes to roles and responsibilities, and widespread disconnection from friends, family and health and social care support varied according to phenotype. These impacts were exacerbated by a more general sense that precious time was being lost, given the progressive nature of dementia. Despite significant challenges, respondents demonstrated resilience and resourcefulness in reporting unexpected positives and strategies for adapting to confinement.

Conclusions

This study has highlighted the specific impacts of the COVID-19 restrictions on people with young onset, non-memory-led and inherited dementias, including behavioural variant frontotemporal dementia, primary progressive aphasia and posterior cortical atrophy, and their carers. The specific challenges faced according to diagnosis and the self-reported strategies speak to the importance of – and may inform the development of – tailored support for these underrepresented groups more generally.

Visual abstract
Two rare cases of myelin oligodendrocyte glycoprotein antibody-associated disorder in children with leukodystrophy-like imaging findings
Authors: Wang Xin , Zhao Ruibin , Yang Huafang , Liu Chong , Zhao Qing
Published: June 2023

Background

Children with acquired demyelinating syndromes (ADS) whose sera are positive for myelin oligodendrocyte glycoprotein (MOG) immunoglobulin (IgG) can be diagnosed with MOG-IgG associated disorder (MOGAD). Cases with leukodystrophy-like imaging findings with recurrent MOGAD have rarely been reported.

Case presentation

Two children with MOGAD, whose onset age was 6 months and 3 years, respectively, were admitted to the hospital due to fever and altered consciousness. In both children, MOG-IgG was detected in the serum using live cell-based assay. Brain magnetic resonance imaging (MRI) revealed leukodystrophy-like lesions with diffuse bilateral white matter. Cerebrospinal fluid (CSF) analysis showed mild pleocytosis with normal or slightly increased protein levels and no oligoclonal bands. Metabolic and inflammatory blood/CSF markers were all negative. Full exon gene testing revealed normal results, and nuclear and mitochondrial DNA were normal. Despite regular immunotherapy and reduction of lesions based on brain MRI results, the patients repeatedly relapsed and had residual neurological dysfunction at 3–4 years of follow-up.

Conclusions

Although MOGAD is a monophasic and benign condition, certain MOGAD patients can experience multiple relapses and residual neurologic deficits. The spectrum of clinical manifestations in MOGAD is wider in children than in previously reported cases, including cases with leukodystrophy-like imaging findings. Such imaging findings along with MOG-IgG may occur recurrently and result in severe neurological prognosis. Patients with extensive and confluent white matter lesions should undergo early testing of MOG-IgG to ensure early therapy. In refractory cases, MOGAD treatment may need to be escalated beyond the current therapy, which means second-line immunotherapy should be performed as early as possible and hormone levels should not be rapidly reduced. Early diagnosis and appropriate treatment may improve the prognosis of children with MOGAD.
Implementation of a workplace protection system and its correlation with experiences of workplace violence: a cross-sectional study
Authors: Baek Eun-Mi , Lee BoKim
Published: June 2023

Background

While customer interactions are inherent and essential aspects of the service industry, instances of violence against service workers have brought social attention to the need for a system to ensure their protection. In South Korea, a protection system for the health of service workers has been implemented to prevent this type of violence and its negative consequences. This study conducted a comparative analysis to clarify the impacts of this protection system across a sample of service workers. We collected data on their general characteristics, occupational characteristics, and experiences with the service protection system to determine how those factors were related to workplace violence, with a focus on whether the system has reduced such occurrences.

Methods

We collected self-reported survey data over 28 days (March 2 to March 30, 2020), resulting in 1,349 (99.3%) responses for our final analysis. We conducted a chi-square test and logistic regression analysis to investigate the general and occupational characteristics, experiences of violence, and experiences with the worker protection system.

Results

We found workplace violence is more observed among males, older workers, electronic equipment repairers, irregular workers, and those who worked for extended periods. On the other hand, we found a reduction in the occurrence of workplace violence in businesses that provided service workers with regular counseling from professional counselors, had designated persons responsible for grievance procedures, and/or had grievance procedure committees. We found the lowest likelihood of workplace violence in businesses that operated stress relaxation programs (all p < 0.01).

Conclusions

This study identified a correlation between the adoption of the protection system for service workers and the prevalence of workplace violence. We also clarified the effects of the service protection system and developed a plan for its expansion.

Key points

This study clarified the correlation between the adoption of the protection system for service workers and the occurrence of workplace violence. Along with our investigation of the protection system’s effects, these findings provide a basis for expanding Korea’s existing worker protection system.
Using group based trajectory modeling for assessing medication adherence to nintedanib among idiopathic pulmonary fibrosis patients
Authors: Nili Mona , Epstein Andrew J. , Nunag Dominic , Olson Amy , Borah Bijan
Published: June 2023

Background and objective

Adherence to antifibrotic medications has been evaluated in a few studies using annual proportion of days covered (PDC), a common adherence metric. However, PDC alone cannot identify and distinguish between different patterns of adherence over time, which can be accomplished using group-based trajectory models (GBTM) of monthly PDC. The objective is to assess nintedanib adherence trajectories using GBTM and identify characteristics of patients within each trajectory group.

Methods

Individuals with idiopathic pulmonary fibrosis (IPF) who initiated nintedanib during 10/1/2014–12/31/2018 were identified in 100% Medicare claims and enrollment data. The sample consisted of community-dwelling older adults (≥ 66 years) with continuous coverage in Medicare Parts A, B and D for one year before (baseline) and after (follow-up) initiating nintedanib. A series of GBTMs of adherence was estimated to identify the best-fitting specification. Patients were then grouped based on their estimated adherence trajectories. Associations between baseline patient characteristics, including demographics, comorbidities, and health care use, and group membership probabilities were quantified as odds ratios using fractional multinomial logit modeling.

Results

Among the 1,798 patients initiating nintedanib, mean age was 75.4 years, 61.1% were male, and 91.1% were non-Hispanic white. The best-fitting GBTM had five adherence trajectory groups: high adherence (43.1%), moderate adherence (11.9%), high-then-poor adherence (10.4%), delayed-poor adherence (13.2%), and early-poor adherence (21.5%). The principal factors associated with higher odds of being in at least one of the poor-adherence groups were older age, female sex, race and ethnicity other than non-Hispanic white, and number of medications during baseline.

Conclusions

GBTM identified distinct patterns of nintedanib adherence for the IPF patient cohort. Identifying adherence trajectory groups and understanding the characteristics of their members provide more actionable information to personalize interventions than conventional metrics of medication adherence.
Nehiyawak (Cree) women’s strategies for aging well: community-based participatory research in Maskwacîs, Alberta, Canada, by the Sohkitehew (Strong Heart) group
Authors: Listener Luwana , Ross Sue , Oster Richard , Graham Bonny , Heckman Seth , Voyageur Cora
Published: June 2023

Background

The Sohkitehew (Strong Heart) Research Group, which included an Elders Advisory Committee of seven Nehiyawak (Cree) women, set out to bring Maskwacîs community members together to understand Nehiyawak women’s experiences of “aging well”. The goals of this research were to generate information honouring Indigenous ways of knowing, and gather strengths-based knowledge about aging well, to help Maskwacîs, women maintain wellness as they age.

Methods

We facilitated qualitative Sharing Circles in three different settings in Maskwacîs. Discussions were prompted using the four aspects of the self, guided by Medicine Wheel teachings: Physical, Mental, Emotional, Spiritual. Detailed notes were recorded on flip charts during the discussions of each Sharing Circle. Data were analysed using descriptive content analysis to identify practical strategies for aging well.

Results

Thirty-six community members attended one or more Sharing Circle. Strategies included: Physical—keeping active to remain well; Mental—learning new skills to nourish your mind; Emotional—laughing, crying, and being happy; Spiritual—practicing Nehiyawak traditional ways. Participants commented that balancing these four aspects of the self is necessary to achieve wellness. Following the analysis of the Sharing Circle comments, three community feedback sessions were held to discuss the results in the wider community. These strategies were formatted into a draft booklet which incorporated Cree language, and archive photographs of Maskwacîs women and families.

Conclusions

The Nehiyawak Sharing Circles identified practical strategies that help women to remain well as they age. This positive approach to aging could be adopted in other Indigenous and non-Indigenous communities.