bluuebunny/crossref_metadata_2025 huggingface dataset:
Chronic illness as cultural disruption: The impact of chronic illness on religious and cultural practice
Authors: Cluley Victoria , Trivedi Adya , Burton James O.
Published: August 2024

The relationship between religion and health tends to be framed positively. Religion has been found to act as a coping mechanism and source of support in times of ill health. In this paper, we focus on the disruptive effect of chronic illness on religious practice and cultural engagement. Drawing on interviews with ethnic minority adults with end‐stage kidney disease, who also identify as religious, we introduce the concept ‘cultural disruption’. While religious practice and belief was found to provide strength and comfort we also found that chronic illness had a disruptive impact on religious and cultural practice that participants attempted to manage. To highlight the potential disruptive effect of chronic illness on religious faith and cultural engagement we identify three elements of cultural disruption—disruption to religious practice, disruption to sense of self and identity and disruption to wellbeing. We conclude by suggesting that understanding and accounting for the potential of cultural disruption when diagnosing, treating and supporting people with chronic illness offers an alternative entry point to the life‐worlds of patients who identify as religious and the things that are important to them.
Parents' and healthcare providers' perceptions, experiences, knowledge of, and attitudes toward kangaroo care of preterm babies in hospital settings: Mixed‐methods systematic review
Authors: Almutairi Amal , Gavine Anna , McFadden Alison
Published: August 2024

Background

Kangaroo care is an effective intervention to increase survival and improve the health and development of preterm infants. Despite this, implementation of kangaroo care globally remains low. The objectives of this review were to: (a) synthesize evidence on parents' and healthcare practitioners' perceptions, experiences, knowledge of, and attitudes toward kangaroo care of preterm babies in hospital settings; and (b) establish parents' satisfaction with kangaroo care.

Methods

Studies of any design were included if they focused on parents' or healthcare practitioners' perceptions, experiences, knowledge of, and attitudes to kangaroo care of preterm babies, or reported parents' satisfaction, and were conducted in hospital settings. The search of seven electronic databases, African Journals Online, World Health Organization regional databases, and a gray literature search was conducted in April/May 2020, and updated in January 2024. Study selection was undertaken by two independent reviewers. Quality assessment using the Mixed Method Appraisal Tool and data extraction were completed by one reviewer with a 10% check by a second reviewer. Data were synthesized narratively using a parallel results convergent integrated design.

Results

Thirty‐seven studies, 19 quantitative, 16 qualitative, and 2 mixed methods, were included. The findings suggested that while healthcare practitioners generally demonstrated knowledge about kangaroo care, there was a notable minority with insufficient understanding among those who received training. Parents' knowledge, particularly among fathers, was limited. Both healthcare practitioners and parents appeared to have positive attitudes to kangaroo care. Little is known about parental satisfaction with kangaroo care.

Conclusions

Most healthcare practitioners were knowledgeable about kangaroo care, but parents had limited knowledge. This review findings suggest a need to enhance parental knowledge of kangaroo care before neonatal unit admission, and training is needed for HCPs to implement kangaroo care consistently.
Labor outcomes in caseload midwifery compared with standard midwifery care: A cohort study
Authors: Hjorth Sarah , Brülle Anne‐Line , Kristensen Helle , Frederiksen Anette , Nohr Ellen Aagard
Published: August 2024

Background

Research has shown caseload midwifery to increase the chance of vaginal birth, but this may not be the case in settings with high vaginal birth rates in standard care. This study investigated the association between caseload midwifery and birth mode, labor interventions, and maternal and neonatal outcomes at a large obstetric unit in Denmark.

Methods

Cohort study including medical records on live, singleton births fr om June 2018 until February 2022. Exposure was caseload midwifery care compared with standard midwifery care. The primary outcome was birth mode, and secondary outcomes were other outcomes of labor. Adjusted risk ratios (aRR) with 95% confidence intervals (CI) were estimated by log‐binomial regression.

Results

Among 16,110 pregnancies, 3162 pregnancies (19.6%) received caseload midwifery care. Caseload midwifery was associated with fewer planned cesareans (aRR 0.63 [95% CI 0.54–0.74]) and emergency cesareans (aRR 0.86 [95% CI 0.75–0.95]). No differences in labor induction, use of epidural analgesia, oxytocin augmentation, or anal sphincter tears were observed. Caseload midwifery performed more amniotomies (aRR 1.14 [95% CI 1.02–1.27]) and tended to perform more episiotomies (aRR 1.19 [95% CI 0.96–1.48]). Postpartum hemorrhage (aRR 0.90 [95% CI 0.82–0.99]) and low Apgar score were less likely (aRR 0.54 [95% CI 0.37–0.77]), and early discharge more likely (aRR 1.22 [95% CI 1.17–1.28]) in caseload midwifery.

Conclusion

In caseload midwifery care, a higher vaginal birth rate was observed with no increase in adverse outcomes, mainly due to a lower likelihood of planned cesarean. Also, fewer children were born with low Apgar scores.
A technological construction of society: Comparing GPT‐4 and human respondents for occupational evaluation in the UK
Authors: Gmyrek Paweł , Lutz Christoph , Newlands Gemma
Published: August 2024

Despite initial research about the biases and perceptions of large language models (LLMs), we lack evidence on how LLMs evaluate occupations, especially in comparison to human evaluators. In this paper, we present a systematic comparison of occupational evaluations by GPT‐4 with those from an in‐depth, high‐quality and recent human respondents survey in the UK. Covering the full ISCO‐08 occupational landscape, with 580 occupations and two distinct metrics (prestige and social value), our findings indicate that GPT‐4 and human scores are highly correlated across all ISCO‐08 major groups. At the same time, GPT‐4 substantially under‐ or overestimates the occupational prestige and social value of many occupations, particularly for emerging digital and stigmatized or illicit occupations. Our analyses show both the potential and risk of using LLM‐generated data for sociological and occupational research. We also discuss the policy implications of our findings for the integration of LLM tools into the world of work.
Fusobacterium nucleatum, immune responses, and metastatic organ diversity in colorectal cancer liver metastasis
Authors: Shigematsu Yasuyuki , Saito Rumiko , Amori Gulanbar , Kanda Hiroaki , Takahashi Yu , Takeuchi Kengo , Takahashi Shunji , Inamura Kentaro
Published: August 2024

The presence of Fusobacterium nucleatum is associated with an immunosuppressive tumor immune microenvironment (TIM) in primary colorectal cancer (CRC), contributing to tumor progression. Its persistence in CRC liver metastasis tissues raises questions about its role in modulating local and systemic immune responses and influencing recurrence patterns. This retrospective cohort study of 218 patients with CRC liver metastasis investigated the association of F. nucleatum in CRC liver metastasis tissues with systemic inflammation, TIM alterations, and the number of metastatic organs involved in recurrence. Two‐step polymerase chain reaction (PCR), including digital PCR, detected F. nucleatum in 42% (92/218) of fresh‐frozen specimens of CRC liver metastases. Compared with the F. nucleatum‐none group, the F. nucleatum‐high group showed higher C‐reactive protein levels (0.82 vs. 0.22 mg/dL; Ptrend = 0.02), lower numbers of CD8+ cells (33.2 vs. 65.3 cells/mm2; Ptrend = 0.04) and FOXP3+ cells (11.3 vs. 21.7 cells/mm2; Ptrend = 0.01) in the TIM, and a greater number of metastatic organs involved in recurrence (1.6 vs. 1.1; p < 0.001). The presence of F. nucleatum in CRC liver metastasis tissues was associated with increased systemic inflammation, TIM alterations, and a greater number of metastatic organs involved in recurrence. These findings suggest a potential contribution of F. nucleatum to the metastatic propensity of CRC cells and could inform future research to enhance understanding of the interaction between tumor, host, and microbes in the metastatic process.
Daily versus fortnightly oral vitamin D3 in treatment of symptomatic vitamin D deficiency in children aged 1−10 years: An open labelled randomized controlled trial
Authors: Mondal Kumar Arghya Prasanna , Singh Preeti , Singh Ritu , Malhotra Rajeev Kumar , Seth Anju
Published: August 2024

Objective

Compare the efficacy and safety of daily versus fortnightly oral vitamin D3 in treating symptomatic vitamin D deficiency in children aged 1−10 years.

Design

Open labelled randomized controlled trial.

Patients

Eighty children with symptomatic vitamin D deficiency were randomized into group daily (D) and group bolus (B) [40 in each group] to receive oral vitamin D3, 4000 IU daily or 60,000 IU fortnightly for 12 weeks respectively. Both groups received daily oral calcium of 500 mg/day.

Measurements

Serum calcium (Ca), phosphate (P), alkaline phosphatase (ALP), 25‐hydroxy cholecalciferol (25(OH)D), parathyroid hormone (PTH) levels, urine calcium: creatinine ratio and radiological score were assessed at baseline, 4 weeks and 12 weeks. At the end of 12 weeks, 74 children were available for evaluation of the efficacy and safety of both regimens.

Results

Both regimens led to a significant increase in Ca and P levels and a fall in ALP and PTH levels from baseline to 4 and 12 weeks of therapy, with no intergroup difference. At 4‐ and 12‐week assessments, all children in both treatment arms achieved 25(OH)D level in sufficiency range, with no significant difference in their geometric mean.

Both regimens were associated with asymptomatic transient hypercalcemia [group D—51.4% vs. group B—34.3%; p −0.14] and hypercalciuria (5.7%) in group D that resolved spontaneously on follow‐up.

Conclusions

Daily and fortnightly oral vitamin D3 in similar cumulative doses are efficacious for treating symptomatic vitamin D deficiency in children (1−10 years). Treated children should be monitored for serum 25(OH)D, Ca and urinary calcium creatinine ratio.
Role of the circRNA_34414/miR‐6960a‐5p/SIRT3 axis in postoperative delirium via CA1 Vglut1+ neurons in older mice
Authors: Wang Hai‐Bi , Liu Qiang , Liu Yan‐Ping , Dong Wei , Wan Jie , Jiao Xin‐Hao , Wu Yu‐Qing , Li Tian‐Zuo , Miao Hui‐Hui
Published: August 2024

Aims

Postoperative delirium (POD) is a common neurological complication in elderly patients after anesthesia/surgery. The main purpose of this study is to explore the effect of circRNA‐targeted miRNA regulating SIRT3 on mitochondrial function through ceRNA mechanism under the surgical model of tibial fracture and to further explore the potential mechanism of postoperative delirium mediated by circRNA, so as to provide new ideas for clinical diagnosis and prevention of POD.

Methods

The surgical model of tibial fracture under sevoflurane anesthesia caused acute delirium‐like behavior in elderly mice. We observed that the decrease of SIRT3 and mitochondrial dysfunction was related to POD, and miRNA and circRNA (circRNA_34414) related to SIRT3 were further studied. Through luciferase and RAP, we observed that circRNA_34414, as a miRNA sponge, was involved in the regulation of SIRT3 expression.

Results

Postoperative delirium in elderly mice showed decreased expression of hippocampal circRNA_34414, increased expression of miR‐6960‐5p, decreased expression of SIRT3, and impaired mitochondrial membrane potential. Overexpression of circRNA_34414, or knockdown of miR‐6960‐5p, or overexpression of SIRT3 in hippocampal CA1 glutamatergic neurons significantly upregulated hippocampal SIRT3 expression, increased mitochondrial membrane potential levels, and significantly ameliorated postoperative delirium in aged mice; CircRNA_34414 ameliorates postoperative delirium in mice, possibly by targeting miR‐6960‐5p to upregulate SIRT3.

Conclusions

CircRNA_34414 is involved in the improvement of postoperative delirium induced by anesthesia/surgery by upregulating SIRT3 via sponging miR‐6960‐5p.
Screening and early intervention for substance use during pregnancy: A retrospective case note review of antenatal care records
Authors: Stevens Matthew W. R. , Cooper Megan , Cusack Lynette , Ali Robert L. , Holmwood Chris , Briley Annette L.
Published: August 2024

Introduction

Screening for substance use during pregnancy is critical for enhancing maternal health and perinatal outcomes. However, disparities persist in screening and intervention rates within maternity services. This retrospective case note review explored contemporaneous practices around screening and interventions for substance use among pregnant women during routine antenatal care.

Methods

A random sample of 100 sets of maternity records were reviewed. Eligible cases included any woman attending initial pregnancy assessments at one of two South Australian metropolitan Hospital‐based antenatal clinics, from July 2019–September 2020. Screening rates for past and current alcohol, tobacco and other substance use were identified and compared with data from a subset of a nationally representative survey. Intervention details and referral pathways were also assessed.

Results

The final sample of eligible cases (n = 93) demonstrated prioritisation of screening for current use, over past use, across all substances (p < 0.001). Screening was most likely for tobacco and least likely for e‐cigarettes (p < 0.001). Significant underreporting of past use compared with the benchmark was identified for all substances (except tobacco, p = 0.224). Interventions typically involved written resources, which were usually declined by clients.

Discussion and Conclusions

Despite longstanding recommendations, screening and intervention practices for substance use appear inconsistent. With the recent emergence of vaping, no evidence of updated approaches to identifying e‐cigarette consumption in pregnant women was found. Several opportunities for enhancing routine screening and intervention practices within antenatal clinics were identified, and will inform the development of policy directives, targeted training modules, and other resources for health professionals working in these services.
Barriers to early diagnosis of chronic kidney disease and use of sodium‐glucose cotransporter‐2 inhibitors for renal protection: A comprehensive review and call to action
Authors: Czupryniak Leszek , Mosenzon Ofri , Rychlík Ivan , Clodi Martin , Ebrahimi Fahim , Janez Andrej , Kempler Peter , Małecki Maciej , Moshkovich Evgeny , Prázný Martin , Sourij Harald , Tankova Tsvetalina , Timar Bogdan
Published: August 2024

Chronic kidney disease (CKD) affects approximately 13% of people globally, including 20%–48% with type 2 diabetes (T2D), resulting in significant morbidity, mortality, and healthcare costs. There is an urgent need to increase early screening and intervention for CKD. We are experts in diabetology and nephrology in Central Europe and Israel. Herein, we review evidence supporting the use of sodium‐glucose cotransporter‐2 (SGLT2) inhibitors for kidney protection and discuss barriers to early CKD diagnosis and treatment, including in our respective countries. SGLT2 inhibitors exert cardiorenal protective effects, demonstrated in the renal outcomes trials (EMPA‐KIDNEY, DAPA‐CKD, CREDENCE) of empagliflozin, dapagliflozin, and canagliflozin in patients with CKD. EMPA‐KIDNEY demonstrated cardiorenal efficacy across the broadest renal range, regardless of T2D status. Renoprotective evidence also comes from large real‐world studies. International guidelines recommend first‐line SGLT2 inhibitors for patients with T2D and estimated glomerular filtration rate (eGFR) ≥20 mL/min/1.73 m2, and that glucagon‐like peptide‐1 receptor agonists may also be administered if required for additional glucose control. Although these guidelines recommend at least annual eGFR and urine albumin‐to‐creatinine ratio screening for patients with T2D, observational studies suggest that only half are screened. Diagnosis is hampered by asymptomatic early CKD and under‐recognition among patients with T2D and clinicians, including limited knowledge/use of guidelines and resources. Based on our experience and on the literature, we recommend robust screening programmes, potentially with albuminuria self‐testing, and SGLT2 inhibitor reimbursement at general practitioner (GP) and specialist levels. High‐tech tools (artificial intelligence, smartphone apps, etc.) are providing exciting opportunities to identify high‐risk individuals, self‐screen, detect abnormalities in images, and assist with prescribing and treatment adherence. Better education is also needed, alongside provision of concise guidelines, enabling GPs to identify who would benefit from early initiation of renoprotective therapy; although, regardless of current renal function, cardiorenal protection is provided by SGLT2 inhibitor therapy.
Exploring the therapeutic potential of Modafinil in mitigating renal ischemia–reperfusion injury in rats
Authors: Asli Fatemeh , Poshtdar Sepideh , Dehpour Ahmad Reza , Mohammad Jafari Razieh
Published: August 2024

Background

Renal ischemia reperfusion injury (IRI) is a post‐ischemic event, which can lead to subsequent acute kidney injury (AKI), transplant failure, renal dysfunction and fibrosis via heightened oxidative stress and production of inflammatory cytokines and chemokines.

Objective

This study aims to assess the effect of Modafinil, a wake‐promoting agent with previously proven anti‐inflammatory and anti‐oxidative properties, on ameliorating renal IRI.

Methods

A total of 30 male Wistar rats were divided into five groups: Sham‐operated group, ischemia reperfusion (I/R) control group and Modafinil pre‐treated groups (at different doses of 50, 100 and 150 mg/kg). IRI was induced by means of bilaterally clamping the renal arteries for 45 min, followed by 24 h of reperfusion.

Results

Tissue pathological assessments demonstrated a reduction of glomerular, vascular and interstitial injury at doses of 50 and 100 mg/kg of Modafinil. The biochemical studies showed a significant decrease in tissue pro‐inflammatory factors, including tumor necrosis factor alpha (TNF‐α), Interleukin‐18 (IL‐18) and lactate dehydrogenase (LDH). Moreover, an elevation was observed in levels of super oxide dismutase (SOD) and catalase, indicating the reduction of oxidative stress. Furthermore, the levels of creatinine (Cr), urea and neutrophil gelatinase‐associated lipocalin (NGAL) were declined, indicating the improvement in renal function at effective doses of Modafinil (50 and 100 mg/kg) compared to the I/R control group without Modafinil pre‐treatment.

Conclusion

Our findings suggest that Modafinil holds promise as an effective therapeutic agent to address the clinical challenges associated with kidney IRI reducing the need for hospitalization and potentially alleviating related morbidities.
Reconstruction of artificial nuclei with nuclear import activity in living mouse oocytes
Authors: Yonezawa Nao , Shindo Tomoko , Oda Haruka , Kimura Hiroshi , Hiraoka Yasushi , Haraguchi Tokuko , Yamagata Kazuo
Published: August 2024

In eukaryotes, DNA is housed within the cell nucleus. Molecules required for the formation of a nucleus have been identified using in vitro systems with frog egg extracts and in vivo imaging of somatic cells. However, little is known about the physicochemical factors and conditions required for nuclear formation in mouse oocytes. In this study, using a reconstitution approach with purified DNA, we aimed to determine factors, such as the amount and timing of DNA introduction, required for the formation of nuclei with nuclear transport activity in mouse oocytes. T4 phage DNA (~166 kbp) was microinjected into strontium‐activated oocytes to evaluate the conditions appropriate for nuclear formation. Microinjection of 100–500 ng/μL of T4 DNA, but not 20 ng/μL, was sufficient for the formation of nucleus‐like structures. Furthermore, microinjection of DNA during metaphase II to telophase II, but not during interphase, was sufficient. Electron and fluorescence microscopy showed that T4 DNA‐induced nucleus‐like structures had nuclear lamina and nuclear pore complex structures similar to those of natural nuclei, as well as nuclear import activity. These results suggest that exogenous DNA can form artificial nuclei with nuclear transport functions in mouse oocytes, regardless of the sequence or source of the DNA.
Zinc transporter ZnT5 is associated with epithelial mesenchymal transition via SMAD1 in breast cancer
Authors: Iwabuchi Erina , Miki Yasuhiro , Xu Junyao , Kanai Ayako , Ishida Takanori , Sasano Hironobu , Suzuki Takashi
Published: August 2024

Zinc levels in breast cancer tissues have been reported to be higher than those in normal tissues. In addition, the expression levels of zinc transporters, including ZnT5 and ZnT6, are reportedly higher in breast cancer than in normal breast tissues. ZnT5 and ZnT6 also contribute to heterodimer formation and are involved in several biological functions. However, the functions of ZnT5 and ZnT6 heterodimers in breast cancer remain unknown. Therefore, we first investigated the immunolocalization of ZnT5 and ZnT6 in pathological breast cancer specimens and in MCF‐7 and T‐47D breast cancer cells. Next, we used small interfering RNA to assess cell viability and migration in ZnT5 knockdown MCF‐7 and T‐47D cells. Immunohistochemical analysis showed that the number of ZnT5‐positive breast cancer cells was inversely correlated with the pathologic N factor status. ZnT5 knockdown had no effect on cell viability in the presence of 100 μM ZnCl2 in MCF‐7 and T‐47D cells. In a wound healing assay, 100 μM ZnCl2 treatment inhibited cell migration of MCF‐7 and T‐47D cells, whereas ZnT5 knockdown promoted cell migration, decreased E‐cadherin expression and increased vimentin, slug and matrix metalloproteinase 9 expression. Antibody arrays showed that ZnT5 knockdown increased the expression of SMAD1, and that dorsomorphin treatment inhibited the promotion of migratory ability induced by ZnT5 knockdown. The results of this study revealed that both ZnT5 may be involved in less aggressive breast cancer subtypes, possibly through inhibition of cell migration.
Factors that influence the clinical supervision implementation for nurses: A scoping review
Authors: Ryu Hosu , Buus Niels , Naccarella Lucio , Zarb Lauren , Hamilton Bridget
Published: August 2024

Aims

The aim of this review is to identify and map the evidence available on the factors that influence the implementation of clinical supervision for nurses.

Design

The scoping review was conducted and reported following the JBI methodology for scoping reviews.

Data Sources

Searches were conducted on MEDLINE, PsycINFO, and CINAHL databases on 28 March 2023.

Review Methods

A total of 1398 studies were imported into Covidence for screening. Researchers screened the papers according to the inclusion criteria. Empirical studies in English focusing on the implementation of clinical supervision for nurses were included, without year restrictions. Data from 16 studies were extracted and organized according to the constructs within the Consolidated Framework for Implementation Research (CFIR) domains: intervention characteristics, outer setting, inner setting, characteristics of individuals, and process.

Results

When compared with the CFIR constructs, it was found that the influence of the outer setting on implementation was less explored in the literature. Most of the reviewed data highlighted recurring factors, particularly logistical challenges of nursing work such as shift work and lack of control over work time. Organizational culture and managerial support were also identified as significant factors in the implementation. Another significant challenge in implementation was the variety in clinical supervision's design, purpose, and application, despite sharing the same label, leading to questions about whether studies are implementing the same practice.

Conclusion

Policy documents should clearly define both the design and purpose of clinical supervision, beyond just its conceptual definition. Greater emphasis on equitable implementation of clinical supervision is necessary to prevent perpetuating existing inequalities. We conclude that implementation of such complex interventions is not linear, and the implementation strategies need to align with expected implementation challenges.

Impact

The advantage of using the implementation framework lies not only in observing what exists as a form of evidence but also in identifying what is underdeveloped. Healthcare services and policy developers can utilize our review to recognize and address potential challenges in introducing, modifying, scaling up, or sustaining their clinical supervision implementation.

Patient or Public Contribution

No patient or public contribution.
Navigating the Uncertainties of Post‐disruption Dynamics in Discourse: A Case Study of the EU–UK Security Relationship After Brexit
Authors: Brusenbauch Meislová Monika
Published: August 2024

The article presents a model that conceptualizes the discursive construction of post‐disruption dynamics endorsed and reproduced by the affected parties and its potential to (not) contribute to future co‐operation. Conceiving of Brexit as a prime case of a broader phenomenon of post‐disruption contexts, this paper applies this model to the empirical case of the post‐Brexit European Union (EU)–United Kingdom (UK) security co‐operation in order to reveal how considerations on Brexit‐related re‐engagement and de‐engagement in the context of the EU–UK security relationship were discursively articulated by the UK government and the European Commission in the 2016–2023 period. The findings show that despite the lack of tangible actions and a seemingly continuous string of missed opportunities, the institutional discourse production has largely fulfilled an enabling function vis‐à‐vis potential future co‐operation. At the same time, this article highlights the lingering effects of Brexit‐triggered discord.
Impact of a clinical decision support system on identifying drug‐related problems and making recommendations to providers during community pharmacist‐led medication reviews in Ontario, Canada: A pilot study
Authors: Riley Karen , Yap Katherine , Foley Gaelan , Lambe John , Lund Sean
Published: August 2024

Objective

To evaluate the impact of a clinical decision support system (CDSS) to identify drug‐related problems (DRPs) during community pharmacist medication reviews.

Design

Pilot 3‐phase (group), open‐label study.

Setting and Participants

Two community pharmacies in Sarnia, Ontario, with pharmacists providing medication reviews to patients.

Study Procedures

Five pharmacists participated in three phases (groups). During Phase 1, pharmacists conducted medication reviews in 25 adult patients using the usual approaches. In Phase 2, pharmacists were trained to use a CDSS to identify DRPs, and then conducted medication reviews using the tool in a different group of 25 adult patients. In Phase 3, pharmacists conducted medication reviews without the aid of the CDSS in 25 additional adult patients.

Main Outcome Measures

The primary outcome was recommendation to the primary care physician to alter pharmacotherapy based on medication review, assessed using mean number and frequency (yes/no) of recommendations by patient. Secondary outcomes included number of potential DRPs, actual DRPs, medication review duration time, pharmacist's perceptions of the CDSS and patient satisfaction with medication review.

Results

The mean number of recommendations to primary care physicians to alter pharmacotherapy per patient in Phases 1, 2 and 3 did not differ: 1.0 (SD = I.2) versus 1.5 (1.0) versus 1.5 (1.0), respectively; p = 0.223. The percentage of patients with a pharmacy recommendation sent to physicians across the phases, however, differed: 52% versus 80% versus 88%, respectively; p = 0.010, with more in Phases 2 and 3 compared to 1. There were more potential DRPs in group 2 compared to other groups. There were no differences in actual DRPs and medication review time. Pharmacists had positive attitudes about the CDSS. Patients were generally satisfied with their medication review.

Conclusions

This small pilot study provides some preliminary evidence for performance and feasibility of a CDSS to identify DRPs that pharmacists will act on. Future research is recommended to validate these findings in a larger sample.
Health‐related quality of life and its association with disease activity/functional status in rheumatoid arthritis: A cross‐sectional study from South India
Authors: Haridoss Madhumitha , Bagepally Bhavani Shankara , Venkataraman Krishnamurthy , Purushothaman Sudha Rani
Published: August 2024

Background

Rheumatoid arthritis (RA) is an autoimmune disease with chronic pain that gradually becomes incapacitating and negatively influences the health‐related quality of life (HRQoL). This study estimates HRQoL in RA using the EuroQol five dimensions (EQ‐5D) tool and its association with functional status and disease activity.

Methods

RA patients (n = 320) aged above 18 years, visiting outpatient clinic at a tertiary care multispecialty hospital in south India were the study participants. Sociodemographic, clinical, and laboratory data were collected from them. EQ‐5D‐5L questionnaire and the EQ Global Health Visual Analogue Scale (EQ‐VAS) were used to measure HRQoL. Disease activity was measured using Disease Activity Score‐28 (DAS‐28), and the Health Assessment Questionnaire (HAQ) was used to assess functional status. Pearson's correlation and multiple linear regression were used to measure association, and statistical significance was considered at p < 0.05.

Results

The EQ‐5D utility score was 0.54 ± 0.36, pain and anxiety were the most affected domains, and the mean EQ‐VAS was 63.05 ± 18.54%. A moderate to high disease activity was present in 85% (DAS‐28 > 3.2), and a severe functional disability in 32.8% (HAQ > 1.5) of study participants. The mean EQ‐5D scores for RA patients were 0.78 (0.65–0.90) for no disease activity, 0.73 (0.65–0.80) for mild, 0.53 (0.32–0.74) for moderate and 0.47 (0.32–0.62) for high disease activity. In multiple linear regression analysis, HAQ and age independently predicted EQ‐5D.

Conclusion

RA significantly impacts HRQoL, and interventions focussing on pain and anxiety management are essential. The study's EQ‐5D values could help estimate Quality Adjusted Life Years (QALY) while conducting economic evaluation studies in RA within an Indian context.
Quality of care and patient satisfaction: Future trends and economic implications for the healthcare system
Authors: Perals Paula Ortega , Rambaud Salvador Cruz , García Javier Sánchez
Published: August 2024

The healthcare system is a fundamental pillar for the economy of any country. One of its main goals is to reach an adequate effectiveness of medical care so that certain levels of well‐being are achieved. In recent years, healthcare has experienced important changes to take into account quality of care and patient satisfaction as the drivers of effectiveness and financial performance. In this sense, it is specifically important to bring together in a single document all aspects that participate in the quality of care and patient satisfaction relationship. The purpose of this paper is to analyze, organize, and synthesize all the theories, methodologies, factors, and variables that conform to this relationship. To achieve that, a systematic literature review of 90 articles is performed. The main contributions of this paper are to reveal all factors and aspects relevant for the quality of care and patient satisfaction binomial, and the classification of impactful articles, methodological and theoretical approaches, leading journals, and variables of interest that exist in quality of care and patient satisfaction research. Eventually, important research gaps and further research lines are highlighted.
Transitional challenges: Psychotropic medication and residential setting among young adults with intellectual disabilities
Authors: Houseworth James , Tichá Renáta , Pettingell Sandra L. , Stancliffe Roger J. , Bershadsky Julie
Published: August 2024

As youth with intellectual and developmental disabilities (IDD) are transitioning from the school systems and special education supports, many of them are moving into the adult service system (e.g., Vocational Rehabilitation, Home and Community‐Based Services). Thus, in addition to adolescence being a source of many psychological and behavioral needs, the change in service systems often leads to uncertainty and anxiety. Psychotropic medications tend to be used to treat challenging behavior and psychological conditions (e.g., depression, anxiety, psychosis). This study used National Core Indicators‐In‐Person Survey 2020–2021 data to explore the prevalence of psychotropic medication use among two groups of people with IDD: disability service users of transition age (18–25 years) and disability service users of adult age (26–45 years) and the role of residential settings (where one lives) as related to psychotropic medication use. The results indicated that adults (aged 26–45 years) are more likely to be prescribed psychotropic medications. This appears to be driven by the larger number of transition‐aged adults who still live with family, where prescription rates are much lower. Psychotropic drug use is an important issue due to its potential to lead to unintended negative consequences that affect health, social inclusion, and self‐determination if not carefully and effectively administered.
Morphological analysis and lipid composition of the stable fly Stomoxys calcitrans salivary glands reinforce important features of feeding behaviour
Authors: Florencio Melissa , Oilveira Magalhães Francisco Romulo , Araujo Zuma Aline , Lima Oliveira Lugathe Cinara , Rosa Dayana , Riguete Karina , Machado Motta Maria Cristina , Alves do Nascimento Aparecida , Reis dos Santos Mallet Jacenir , Correa Atella Georgia , Fampa Patrícia
Published: August 2024

Stomoxys calcitrans L. (Diptera: Muscidae), the stable fly, is a hematophagous insect of great veterinary importance, because it is a mechanical vector of diverse pathogens in livestock. The saliva of blood‐feeding insects presents important pharmacologically active molecules that impair blood clotting, promote vasodilation and modulate the host immune system response, crucial processes for successful feeding. These properties also enable pathogens' transmission. In the present work, we describe an efficient protocol to dissect S. calcitrans salivary glands, their morphological characteristics and lipid profile. The mean length of the tubular gland is 3.23 mm with a bulbous posterior end and a narrow anterior end. Histological analysis revealed a monolayer of large polygonal epithelial cells with voluminous nuclei and high lipid content in their cytoplasm. Ultrastructural analysis showed that the epithelium is rich in mitochondria, free ribosomes, Golgi complex cisternae, presenting a great extension of rough endoplasmic reticulum that contains an electron‐dense material. Lipid analysis by thin‐layer chromatography showed that neutral fatty acids and phosphatidylcholine are predominant in the fly salivary glands. Lysophosphatidylcholine, an important signalling biomolecule involved in different metabolic processes, including host's immunomodulation and pathogens proliferation and differentiation, is also present.
Global, regional, and national burden of fungal skin diseases in 204 countries and territories from 1990 to 2021: An analysis of the global burden of disease study 2021
Authors: Qin Qinglian , Su Jinming , Liu Jie , Chen Rongfeng , Wei Wudi , Yuan Zongxiang , Lai Shiyi , Duan Ran , Lai Jingzhen , Ye Li , Liang Hao , Jiang Junjun
Published: August 2024

Background

Fungal skin diseases are common skin diseases with a heterogeneous distribution worldwide.

Objectives

This study aimed to analyse the spatiotemporal trends in the burden of fungal skin diseases at global, regional, and national levels from 1990 to 2021.

Methods

Based on the data obtained from the Global Burden of Disease Study (GBD) 2021, we described the incident cases, prevalent cases, number of disability‐adjusted life years (DALYs), and corresponding age‐standardised rates (ASRs) for fungal skin diseases in 1990 and 2021 by sex, age, socio‐demographic index (SDI), 21 GBD regions, and 204 countries and territories. We used Joinpoint regression analysis to assess the temporal trends in burden of fungal skin diseases during 1990 to 2021. Spearman's rank test was used to analyse the relationship between disease burden and potential factors.

Results

From 1990 to 2021, the incident cases, prevalent cases, and DALYs for fungal skin diseases worldwide increased by 67.93%, 67.73%, and 66.77%, respectively. Globally, the age‐standardised incidence rate (ASIR), age‐standardised prevalence rate (ASPR), and age‐standardised DALYs rate (ASDR) for fungal skin diseases in 2021 were 21668.40 per 100,000 population (95% UI: 19601.19–23729.17), 7789.55 per 100,000 population (95% UI: 7059.28–8583.54), and 43.39 per 100,000 population (95% UI: 17.79–89.10), respectively. Between 1990 and 2021, the ASIR, ASPR, and ASDR for fungal skin diseases have modestly increased, with AAPC of 11.71% (95% confidence interval [CI]: 11.03%–12.39%), 19.24% (95% CI: 18.12%–20.36%), and 20.25% (95% CI: 19.33%–21.18%), respectively. Males experienced a higher burden of fungal skin diseases than females. The incident cases, prevalent cases, and DALYs for fungal skin diseases were highest at the age of 5–9, while the ASRs were highest among the elderly. At national level, the highest ASRs were observed in Nigeria, Ethiopia, and Mali. Overall, SDI was negatively correlated with the ASRs, whereas Global Land‐Ocean Temperature Index (GLOTI) was remarkably positively correlated with the burden of fungal skin diseases.

Conclusions

Between 1990 and 2021, the global burden of fungal skin diseases has increased, causing a high disease burden worldwide, particularly in underdeveloped regions and among vulnerable population such as children and the elderly. With global warming and aging of the population, the burden of fungal skin diseases may continue to increase in the future. Targeted and specific measures should be taken to address these disparities and the ongoing burden of fungal skin diseases.
The relationship between dietary sugar consumption and anxiety disorders: A systematic review
Authors: Wang Xin , Wong Agassi Chun Wai , Sheng Ziyue , Wong Samuel Yeung‐Shan , Yang Xue
Published: August 2024

High‐sugar intake is a risk factor for chronic diseases such as cardiovascular disease and type 2 diabetes, but less is known about its role in anxiety disorders. This systematic review aimed to systematically synthesise and assess the existing evidence regarding the association between dietary sugars intake and anxiety disorders. Following PRISMA guidelines, a systematic search of PubMed, MEDLINE, Embase, APA PsycArticles and APA PsycINFO was conducted up to 19th August 2022. Study quality was assessed by the Newcastle‐Ottawa scale (NOS) and the Cochrane risk of bias tool. Eleven studies (10 cross‐sectional and 1 randomised controlled trial [RCT]) were included. Seven cross‐sectional studies had very good quality or good quality, and the quality of the RCT was at low risk of bias. These studies examined sugar‐sweetened beverages (n = 7), sugar‐sweetened foods (n = 4) and/or added sugar (n = 5). The findings suggest a possible positive relationship of added sugar consumption with anxiety disorders, with age as a potential moderator in such association. No conclusions can be drawn on the associations between sugar‐sweetened beverages, sugar‐sweetened foods consumption and anxiety disorders. Due to the included studies being mostly cross‐sectional, the conclusions drawn from the existing evidence should be interpreted with caution. The longitudinal design is warranted to investigate any causal relationship and the potential mechanisms underlying these heterogeneous results. The potential difference in effect at different ages observed in this review should be further examined.
Building a Pluriverse of Nursologies: A paradigm for decolonial theory and knowledge development in nursing
Authors: Cleofas Jerome Visperas
Published: August 2024

The imperative to decolonise health disciplines underscores the need for a critical examination of the coloniality of nursing knowledge development. Decolonising nursing requires epistemic resistance aimed at exposing and dismantling epistemological hierarchies that marginalise indigenous knowledges. This paper introduces the ‘Pluriverse of Nursologies’ as paradigm to guide decolonial theorising in nursing. Through a four‐part exploration, I first elucidate the coloniality embedded in mainstream nursing knowledge. Next, I offer a decolonial critique of Fawcett's nursing metaparadigm as an exemplar of pyramidal epistemology. I then discuss pluriversality as an approach to decolonising nursing knowledge. Finally, I introduce the Pluriverse of Nursologies (PoN) as a meta‐theoretical paradigm for theory and knowledge development that decentres and dismantles the pyramidal epistemology of colonial/modern nursing, and relinks diverse nursologies from marginalised communities to the centre of intellectual nursing discourse, thereby revitalising the theoretical landscape of the discipline.
Trusting others in a divided country: The determinants of social trust in South Africa
Authors: Dorrington Georgia , Schulz‐Herzenberg Collette
Published: August 2024

This study investigates three key determinants of social trust to explain South Africa's social trust deficit: income inequality, confidence in institutions, and racial diversity. Despite the country's racially heterogenous society and segregated history, racial diversity arguments overlook alternative theories on the determinants of low social trust. We instead argue that the decline in social trust in South Africa can be explained by worsening levels of income inequality and declines in institutional trust in recent decades. Using the 2019 South African Reconciliation Barometer citizen survey data, the empirical analysis confirms that South Africans' confidence in institutions and their subjective perceptions of income distribution (or income inequality) have the strongest influence on social trust levels while racial diversity has a negligible effect. This is encouraging for a country with South Africa's racial diversity and troubled history. Instead, efforts to address South Africa's social trust deficit should focus on increasing citizens' confidence in institutions and addressing the high levels of income inequality. However, given the dire state of institutional confidence and income inequality in the country, it remains unlikely that these conditions will improve in the short term.
Appraising Anssi Paasi's ‘Bounded Spaces in the Mobile World’: Introducing the Forum while Riding the Pendulum of Fixity and Mobility
Authors: van Liempt Ilse , van Meeteren Michiel
Published: August 2024

The 2024 TESG Forum revisits Anssi Paasi's 2001 article Bounded Spaces in the Mobile World: Deconstructing ‘Regional Identity’. This work expanded Paasi's ideas on the institutionalisation of regions by highlighting the interplay between the social construction of regions and the changing regional identities of individuals and communities in the context of Europeanisation.  The article places Paasi's theoretical work on how regions emerge as bounded spaces in the whirlwind of a rapidly globalising world. In exploring the relation between regions and identity, Bounded Spaces in the Mobile World reveals tensions between fixity and mobility. Revisiting this important paper 20 years later makes us realise how the world around us has changed. The tension between mobility and fixity remains but in different imaginaries and power constellations.
Digital Infrastructure – The Need to Overcome Digital Divide and Inequality in Higher Education
Authors: Savio Dominic , Rachel S.
Published: August 2024

Coronavirus affected millions of people worldwide. India was no exception with huge loss of lives. Life was not normal for everyone. The absence of requisite learning skills in around 825 million children and gaps in access to education were further highlighted by pandemic (World Economic Forum, 2021). When Covid hit, academics had no clue of how to manage education. While educational institutions in Chennai were getting ready for online education, this qualitative study was undertaken to identify the availability of Digital Infrastructure among students for Education. Purposive sampling method was adopted for the study. A survey questionnaire was used for data collection from students online and 681 samples were collected for the study. Data analysis on the availability of infrastructure with the students for online academics revealed that the majority of the students (60) reported that they used smart phones for online education. More than half of the students (51%) had only average and poor broadband or internet connectivity. Nearly fifty percent of the students (48.9%) reported to have affordability for only 1 GB internet data per day. Findings revealed the digital divide and inequality in higher education.
Somatostatin modulation of initial fusion pores in Ca2+‐triggered exocytosis from mouse chromaffin cells
Authors: Cheng Jinbo , Jackson Meyer B.
Published: August 2024

Somatostatin, a peptide hormone that activates G‐protein‐coupled receptors, inhibits the secretion of many hormones. This study investigated the mechanisms of this inhibition using amperometry recording of Ca2+‐triggered catecholamine secretion from mouse chromaffin cells. Two distinct stimulation protocols, high‐KCl depolarization and caffeine, were used to trigger exocytosis, and confocal fluorescence imaging was used to monitor the rise in intracellular free Ca2+. Analysis of single‐vesicle fusion events (spikes) resolved the action of somatostatin on fusion pores at different stages. Somatostatin reduced spike frequency, and this reduction was accompanied by prolongation of pre‐spike feet and slowing of spike rise times. This indicates that somatostatin stabilizes initial fusion pores and slows their expansion. This action on the initial fusion pore impacted the release mode to favour kiss‐and‐run over full‐fusion. During a spike the permeability of a fusion pore peaks, declines and then settles into a plateau. Somatostatin had no effect on the plateau, suggesting no influence on late‐stage fusion pores. These actions of somatostatin were indistinguishable between exocytosis triggered by high‐KCl and caffeine, and fluorescence imaging showed that somatostatin had no effect on stimulus‐induced rises in cytosolic Ca2+. Our findings thus demonstrate that the signalling cascades activated by somatostatin target the exocytotic machinery that controls the initial and expanding stages of fusion pores, while having no effect on late‐stage fusion pores. As a result of its stronger inhibition of full‐fusion compared to kiss‐and‐run, somatostatin will preferentially inhibit the secretion of large peptides over the secretion of small catecholamines.

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Key points

Somatostatin inhibits the secretion of various hormones by activating G‐protein‐coupled receptors.

In this study, we used amperometry to investigate the mechanism by which somatostatin inhibits catecholamine release from mouse chromaffin cells.

Somatostatin increased pre‐spike foot lifetime and slowed fusion pore expansion.

Somatostatin inhibited full‐fusion more strongly than kiss‐and‐run.

Our results suggest that the initial fusion pore is the target of somatostatin‐mediated regulation of hormone release.

The stronger inhibition of full‐fusion by somatostatin will result in preferential inhibition of peptide release.