bluuebunny/crossref_metadata_2025 huggingface dataset:
Back pain Knowledge and beliefs Survey (BacKS): development and assessment of measurement properties
Authors: Corrêa Leticia Amaral , Hancock Mark , Mathieson Stephanie , Verhagen Arianne , Darlow Ben , Hodges Paul William , French Simon
Published: September 2024

Objective

To develop and evaluate a new patient-reported outcome measure (PROM) to assess people’s knowledge and beliefs about low back pain.

Methods

This study followed the COnsensus-based Standards for the selection of health Measurement INstruments guidelines. An 18-item preliminary version of the Back pain Knowledge and beliefs Survey (BacKS) was generated based on evidence-based key messages and current clinical guidelines for low back pain. Four items were added following input from three consumers and seven experts. Focus groups (n=9) confirmed content validity. The 22-item version was completed by 258 Australian-based adults (>18 years) with self-reported low back pain. A follow-up survey was sent 1 week later. The following measurement properties were evaluated to produce, and then assess the final version of BacKS: structural validity (exploratory factor analysis); internal consistency (Cronbach’s alpha); test–retest reliability (intraclass correlation coefficient); measurement error (Smallest Detectable Change); construct validity (hypothesis tested: moderate positive Pearson correlation between BacKS and Back Beliefs Questionnaire); plus, interpretability and feasibility.

Results

The final BacKS comprised 20 items with a 2-factor structure (biomedical factor: 9 items, score ranging from 9 to 45, and self-care factor: 11 items, score ranging from 11 to 55). Internal consistency and reliability were adequate (>0.70) for each factor. Smallest detectable change was 4.4 (biomedical factor) and 7.0 (self-care factor). Our construct validity hypothesis was confirmed (Pearson correlation=0.53). No floor or ceiling effects were detected.

Conclusion

The BacKS is a valid, reliable and feasible PROM to measure knowledge and beliefs about low back pain in clinical practice and research settings.
Human resources for health: a framework synthesis to put health workers at the centre of healthcare
Authors: Nwankwo Ogonna N O , Auer Christian , Oyo-Ita Angela , Eyers John , Wyss Kaspar , Fink Günther , Bosch-Capblanch Xavier
Published: September 2024

Background

Human resources are a key determinant for the quality of healthcare and health outcomes. Several human resource management approaches or practices have been proposed and implemented to better understand and address health workers’ challenges with mixed results particularly in low- and middle-income countries (LMICs). The aim of this framework synthesis was to review the human resources frameworks commonly available to address human resources for health issues in LMIC.

Methods

We searched studies in Medline, Embase, CAB Global Health, CINAHL (EBSCO) and WHO global Index Medicus up to 2021. We included studies that provided frameworks to tackle human resources for health issues, especially for LMICs. We synthesised the findings using a framework and thematic synthesis methods.

Results

The search identified 8574 studies, out of which 17 were included in our analysis. The common elements of different frameworks are (in descending order of frequency): (1) functional roles of health workers; (2) health workforce performance outcomes; (3) human resource management practises and levers; (4) health system outcomes; (5) contextual/cross-cutting issues; (6) population health outcomes and (7) the humanness of health workers. All frameworks directly or indirectly considered themes around the functional roles of health workers and on the outcomes of health workforce activities, while themes concerning the humanness of health workers were least represented. We propose a synthesised Human-Centred Health Workforce Framework.

Conclusions

Several frameworks exist providing different recurring thematic areas for addressing human resources for health issues in LMIC. Frameworks have predominantly functional or instrumental dimensions and much less consideration of the humanness of health workers. The paradigms used in policy making, development and funding may compromise the effectiveness of strategies to address human resources challenges in LMIC. We propose a comprehensive human resources for health framework to address these pitfalls.
Neurological manifestations in adult patients with the m.3243A>G variant in mitochondrial DNA
Authors: Majamaa Kari , Kärppä Mikko , Moilanen Jukka S
Published: September 2024

Background

The m.3243A>G variant in mitochondrial DNA (mtDNA) is the most common cause of the MELAS (Mitochondrial encephalopathy, lactic acidosis and stroke-like episodes) syndrome usually commencing in childhood or adolescence. In adults, the variant presents with versatile and mostly neurological phenotypes, but MELAS may not be common.

Objective

To examine the frequency of phenotypes in adults with m.3243A>G in a population-based cohort and in a meta-analysis of reported case series.

Methods

We clinically examined 51 adult patients with m.3243A>G to determine the frequency of phenotypes and to analyse the contribution of variant heteroplasmy, age, sex and mtDNA haplogroup to the phenotypes. The frequencies of neurological features were also assessed in a meta-analysis on 25 published case series reporting 1314 patients.

Results

Sensorineural hearing impairment (HI), cognitive impairment and myopathy were the most common manifestations, whereas stroke-like episodes were infrequent. Variant heteroplasmy and age were only modest predictors of the phenotypes, although heteroplasmy correlated significantly with disability and Kaplan-Meier analysis showed progression of phenotypes with age. Male sex predicted more severe disability, whereas haplogroup UK was associated with no significant disability. Meta-analysis revealed substantial heterogeneity of phenotype frequencies and preferential inclusion of the MELAS phenotype.

Discussion

In adult patients with m.3243A>G sensorineural HI, cognitive impairment and myopathy are common manifestations with lifetime prevalences approaching unity. Stroke-like episodes are rare. Variant heteroplasmy, age, sex and mtDNA haplogroup contribute to the severity of the disease. Meta-analysis provided a solid estimate of the various neurological symptoms in adults with m.3243A>G.
Environmental degradation, climate change and health from the perspective of Brazilian Indigenous stakeholders: a qualitative study
Authors: Grande Antonio José , Dias Ieda M A V , Jardim Paulo T C , Aparecida Vieira Machado Alessandra , Soratto Jacks , da Rosa Maria Inês , Ceretta Luciane Bisognin , Zourntos Xanthi , Suares Regeane Oliveira , Harding Seeromanie
Published: September 2024

Background

The WHO identifies climate change as the most significant threat to global health systems. Indigenous peoples, whose lives are deeply intertwined with nature, are particularly vulnerable to the impacts of these changes.

Objective

This study aimed to understand the perspectives of Indigenous stakeholders and public services managers on the interconnectedness of climate change and Indigenous health.

Design

A qualitative study with 22 Indigenous stakeholders and public service managers on climate change and perceived impact on Indigenous health.

Setting and participants

Indigenous stakeholders and public service managers on climate change and perceived impact on Indigenous health from Brazil. Data was collected through interviews incorporating two vignette videos depicting environmental and health scenarios. Thematic content analysis was used to analyse the data.

Results

The analytical process yielded six subcategories that were further grouped into three overarching thematic macro-categories: environmental degradation and climate change in the context of Indigenous peoples; environment, vulnerability and impact on Indigenous mental health; and actions and public health policies for Indigenous peoples.

Conclusion

The perspectives of Indigenous stakeholders and public service managers on the interconnectedness of climate change and Indigenous health were deeply entrenched in their lived experiences of loss of their lands from deforestation and environmental degradation. They argued strongly for the strengthening of public health policies aimed at the Indigenous peoples, to face many challenges, especially suicide, and to have a voice in decision-making. A sensitive approach that values Indigenous peoples' connections with nature is fundamental to promote their health and well-being.
Improve Mental Health (Improve-MH) in refugee families using a culturally adapted, general practitioner-delivered psychotherapeutic intervention combined with Triple P Online parenting programme: study protocol of a multicentre randomised controlled trial
Authors: Zagha Karim , Konietzny Kerstin , Brettschneider Christian , Chehadi Omar , Chehadi-Köster Angela , Chikhradze Nino , Dababneh Nesreen , Hegerath Flora-Marie , Heller Lisa , Dehnen Alessia , Hessbruegge Martina , in der Schmitten Jürgen , König Hans-Helmut , Krasko Julia , Kumsta Robert , Luhmann Maike , Lukaschek Karoline , Margraf Juergen , Pflug Verena , Roesgen David , Sönnichsen Andreas , Vollmar Horst Christian , Gensichen Jochen , Schneider Silvia
Published: September 2024

Introduction

Germany and the European Union have experienced successive waves of refugees since 2014, resulting in over 1.6 million arrivals, including families with young children. These vulnerable populations often face xenophobia, discrimination, substandard living conditions and limited healthcare access, contributing to a high prevalence of mental health problems (MHP). Our primary goal is to proactively address MHP in refugee parents and prevent its potential impact on their children through effective early interventions. Using a low-threshold, primary care-based approach, we aim to enhance parenting skills and address parental psychopathology, creating a supportive environment for parents and children.

Methods and analysis

In this randomised controlled trial, 188 refugee parents of 6-year-old children or younger who meet the clinical cut-off on the MHP scale will participate. They are randomly assigned to either the experimental psychotherapeutic intervention, delivered by general practitioners (10-week Improve intervention), or treatment as usual, in a ratio of 1:1. The randomisation will be masked only for outcome assessors. Improve includes face-to-face sessions with general practitioners, an interactive online parenting programme (Triple P Online) and regular protocol-based telephone calls by psychologists. Primary outcomes will assess the intervention’s effects on parental and child MHP and parenting skills, with secondary outcomes including psychosocial and physical health indicators. Outcomes will be assessed at pre, post and at 3-month and 6-month follow-ups. The study is scheduled to run from February 2019 to July 2025.

Ethics and dissemination

The project Improve-MH (application number 602) was approved by the local ethics committee of Ruhr-University of Bochum and is being conducted in accordance with the Declaration of Helsinki. The study is also conducted in full accordance with the German Data Protection Act, and the Good Clinical Practice guideline (GCP) and is sensitive to specific ethical considerations. Results will be disseminated at scientific conferences, published in peer-reviewed journals and provided to consumers of healthcare.

Trial registration number

The trial was prospectively registered at the German Clinical Trials Register (Deutsches Register Klinischer Studien, DRKS-ID: DRKS00019072) on 16 March 2020.
How well does the academic performance of Ethiopian anaesthetists predict their National Licensing Examination scores: a cross-sectional study
Authors: Asemu Yohannes Molla , Yigzaw Tegbar , Ayalew Firew , Scheele Fedde , van den Akker Thomas
Published: September 2024

Objectives

This study assessed the relationship between academic performance and National Licensing Examination (NLE) scores of Ethiopian anaesthetists and proposed academic performance thresholds that predict failing the NLE.

Design

A retrospective cross-sectional study.

Setting

Academic performance measures were collected from eight universities and matched to total and subdomain NLE scores for anaesthetists. Four universities were first generation (oldest), three were second generation and one was third generation (newest).

Participants

524 anaesthetists.

Measures

Selected course grades, yearly (Y1–Y4) and cumulative grade point averages (GPAs) and in-school exit exam status were correlated with NLE scores. Linear regression was used to identify predictors of NLE score. Receiver operating characteristic curves were plotted to estimate GPA thresholds that predict failing the NLE.

Results

Total and general surgery anaesthesia subdomain NLE scores showed moderate to strong linear relationships with most academic performance indicators. However, correlations between the rest of the subdomain NLE scores and composite course scores were either small or negligible (r<0.5). For every 1-point increase in a 4-point cumulative GPA and composite senior year practicum course score, the first-attempt NLE score increased by 12.61 (95% CI 10.03 to 15.19; p<0.0001) and 3.98 (95% CI 1.77 to 6.19; p=0.001) percentage points, respectively. Those entering university directly from high school and those attending a third-generation university would, on average, score 2.79 (95% CI 0.23 to 5.35; p=0.033) and 4.34 (95% CI 1.42 to 7.26; p=0.004) higher NLE scores compared with nurse entrants and first-generation university graduates, respectively. On a 4-point grading system, the thresholds for failing the NLE were below 2.68 for year-1 GPA, 2.62 for year-2 GPA, 2.72 for year-3 GPA, 3.04 for year-4 GPA and 2.87 for cumulative GPA.

Conclusions

The Ethiopian anaesthetist’s NLE score modestly correlated with most academic performance indicators. Based on pass/fail thresholds, the NLE could assist training programmes in improving NLE pass rates.
What is known about nurse retention in peri-COVID-19 and post-COVID-19 work environments: protocol for a scoping review of factors, strategies and interventions
Authors: Buckley Laura , McGillis Hall Linda , Price Sheri , Visekruna Sanja , McTavish Candice
Published: September 2024

Introduction

The pandemic has highlighted a worsening of nurses’ working conditions and a global nursing shortage. Little is known about the factors, strategies and interventions that improve nurse retention in the peri-COVID and post-COVID time period. An improved understanding of approaches implemented to support and retain nurses will provide a blueprint for sustaining the nursing workforce. The objectives of this scoping review are to investigate and describe the following: (a) factors associated with nurse retention; (b) strategies suggested to support nurse retention and (c) interventions trialled to support nurse retention, during and after the COVID-19 pandemic.

Methods and analysis

Medline, Embase, CINAHL and Scopus will be searched. The included studies will be qualitative, quantitative, mixed methods and grey literature studies of nurses including factors, strategies and/or interventions to support nurse retention in the peri-COVID and post-COVID time period (2019 to present) that are in English or can be translated into English. The excluded studies will be those that focus on nurse managers, educators, students or those in advanced practice roles and studies where the population cannot be segmented to identify which data came from nurses. Systematic, scoping reviews and meta-syntheses will be excluded, but their reference lists will be hand-screened for suitable studies. Data will be evaluated for quality and synthesised qualitatively to map the current evidence available. The relevant studies will be reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.

Ethics and dissemination

Approval for the broader research study, including this scoping review, has been obtained from the university health sciences research board (protocol #00042510). All data for this scoping review will be collected from published literature, and findings will be published in a peer-reviewed journal and presented at relevant conferences.

Trial registration number

The protocol was registered on Open Science Framework (4 April 2024)https://doi.org/10.17605/OSF.IO/XWH45.
Role of mixed healthcare providers networks in strengthening primary care systems: a case study of a rural primary care site
Authors: Tan-Lim Carol Stephanie Chua , Marfori Jose Rafael A , Sanchez Josephine T , Galingana Cara Lois T , Rey Mia P , De Mesa Regine Ynez H , Dans Leonila F , Dans Antonio L
Published: September 2024

Introduction

Service delivery networks, also called healthcare providers networks (HCPNs) have been used to address health inequities and promote universal healthcare (UHC). This study described the effect of instituting a mixed HCPN (partnership of public health facilities with a private pharmacy) on the provision of medications in the rural primary care pilot site of the Philippine Primary Care Studies (PPCS).

Methods

This is a case study of the mixed HCPN in the PPCS rural site. A mixed HCPN involving one private pharmacy was instituted to increase the supply of drugs. The total number of medications prescribed per month from April 2019 to October 2021, and the number of medications dispensed from the public sector (rural health unit or RHU) and from the partner private pharmacy in the same time period were obtained.

Results

Of the 101 031 medications prescribed in the first year (April 2019 to March 2020), 21.7% were dispensed at the RHU and 66.7% were dispensed in the partner private pharmacy. The remaining 11.5% were unrendered or dispensed in other private pharmacies. Of the 35 408 medications prescribed in the second year (April 2020 to March 2021), 5.6% were dispensed at the RHU and 32.2% were dispensed at the partner private pharmacy. Majority (62.1%) were unrendered or dispensed in other private pharmacies. From April to October 2021, of the 6448 medications prescribed, 2.3% were dispensed at the RHU, and 47.3% were dispensed at the partner private pharmacy. Majority (50.3%) were unrendered or dispensed in other private pharmacies.

Conclusion

Creation of a mixed HCPN in a rural primary care site augmented access to essential medications. The mixed HCPN model in the study showed potential in strengthening access to consultations and medications in a rural community. Improving essential primary care services can facilitate implementation of UHC in the Philippines.
Machine learning to evaluate the relationship between social determinants and diabetes prevalence in New York City
Authors: Tanner Darren , Zhang Yongkang , Chang Ji Eun , Speyer Peter , Adamson Elizabeth , Aerts Ann , Lavista Ferres Juan M , Weeks William B
Published: September 2024

Introduction

Diabetes is a leading contributor to cardiovascular disease and mortality; social determinants of health (SDOH) are associated with disparities in diabetes risk. Quantifying the cumulative impact of SDOH and identifying the SDOH most associated with diabetes prevalence at the neighbourhood level can help policy-makers design and target local interventions to mitigate these disparities. Machine learning (ML) methods can provide novel insights and help inform public health intervention strategies in a place-based manner.

Methods

In a cross-sectional study, we used gradient boosting ML models to estimate the cumulative contribution of a set of SDOH variables to diabetes prevalence (%) at the census tract level within New York City (NYC); Shapley Additive Explanations were used to assess the magnitude and shape of relationships between our SDOH variables and model-predicted NYC diabetes prevalence. SDOH measures included socioeconomic position, educational attainment, food access, air quality, neighbourhood environment, housing conditions and insurance coverage.

Results

Across 2096 NYC census tracts (population 8 170 505), mean diabetes prevalence was 11.5% (SD 3.7%; range 1.9%–42.8%). A set of 16 SDOH variables representing a framework of 16 distinct SDOH concepts accounted for 67% of the between-tract variance in model-derived NYC diabetes prevalence estimates (95% CI 66% to 68%); a set of 81 variables representing these 16 concepts accounted for 80% of variance (95% CI 78% to 81%). Models showed excellent across-location generalisation. The most important variables driving model predictions within NYC were measures of low educational attainment and poverty.

Conclusions

SDOH accounted for a substantial proportion of neighbourhood-level variation in diabetes prevalence within NYC, independent of the demographics and health behaviours associated with those SDOH. Our place-based findings suggest that, within NYC, where approximately one million residents have diabetes and there are legislative requirements to reduce the impacts from diabetes, policies reducing socioeconomic and educational inequality could have the greatest potential to equitably achieve this.
Reducing strain on primary healthcare systems through innovative models of care: the impact of direct access physiotherapy for musculoskeletal conditions—an interrupted time series analysis
Authors: Zouch James Henry , Berg Bjørnar , Pripp Are Hugo , Storheim Kjersti , Ashton-James Claire E , Ferreira Manuela L , Grotle Margreth , Ferreira Paulo H
Published: September 2024

Objectives

To evaluate the longitudinal impact of introducing a national, direct access physiotherapy model of care on the rates of primary and secondary care consultations for musculoskeletal (MSK) conditions.

Design

Interrupted time series analysis using segmented linear regression.

Setting

Norway primary care

Participants

A cohort of 82 072 participants was derived from 3 population-based health surveys conducted across separate geographical regions in Norway. All participants surveyed were eligible for inclusion as a national representative sample of the Norwegian population. Registered MSK consultations were linked to the Norwegian Control and Payment of Health Reimbursement database and the Norwegian Patient Register using the International Classification of Primary Care diagnostic medical codes L-chapter for MSK conditions and spine related International Classification of Diseases, 10th Revision, codes.

Intervention

Direct access to physiotherapy model of care introduced nationally in Norway in 2018. This model allowed Norwegians to consult directly with qualified physiotherapists for MSK conditions (eg, back pain, knee osteoarthritis) without the need for a medical referral in order to claim a social security reimbursement.

Main outcomes measured

Rates of primary care consultations per 10 000 population (general practitioner (GP) and physiotherapist consultations) and secondary care (specialist consultations and surgical procedures) measured from 2014 to 2021.

Results

The introduction of the direct access physiotherapy model was associated with an immediate stepped reduction of 391 general practice consultations per 10 000 population, (95% CI: −564 to −216), without an associated change in physiotherapy consultations. Subgroup analyses suggested there was an associated reduction in physiotherapy consultations for those in the lowest education group of 150 consultations per quarter (95% CI:−203 to −97), 70 consultations per quarter in the intermediate education group (95% CI:−115 to −27) and a stepped reduction of 2 spinal surgical procedures per 10 000 population, for those aged between 40 and 60 years (95% CI: −3 to −1) following the introduction of the direct access physiotherapy model.

Conclusion

The national introduction of a direct access to physiotherapy model of care was associated with a reduction in the workload of GPs for the management of MSK conditions. The use of physiotherapists in direct contact roles is a potential strategic model to reduce the burden on the GP workforce in primary care worldwide.
Neurofilament light chain levels as an early predictive biomarker of neurotoxicity after CAR T-cell therapy
Authors: Larue Marion , Bouvier Amélie , Maillard Alexis , Cuffel Alexis , Allain Vincent , Ursu Renata , Carpentier Antoine F , Azoulay Elie , Thieblemont Catherine , Di Blasi Roberta , Caillat-Zucman Sophie
Published: September 2024

Immune effector cell-associated neurotoxicity syndrome (ICANS) remains a significant cause of morbidity associated with CD19-targeted chimeric antigen receptor (CAR) T-cell therapy. Early prediction of patients who will develop ICANS would be crucial to better guide individualized management of high-risk patients, but specific predictive markers are still missing. Serum neurofilament light chain (NfL) levels are a sensitive indicator of neuroaxonal injury in neurological diseases. Elevated NfL levels at the time of CAR T-cell infusion have been associated with the severity of ICANS, but their utility for earlier identification of patients with subclinical neurological damage has not been evaluated.

We studied all consecutive adult patients who received commercial CAR T cells for relapsed/refractory B-cell lymphomas at Saint-Louis Hospital between January 2019 and February 2023. Patients with pre-existing or current neurological disease were excluded. NfL levels were quantified in frozen serum collected at the time of the decision to treat (ie, the day of leukapheresis) and at the time of treatment (ie, the day of infusion).

Of the 150 study patients, 28% developed ICANS of any grade, including 15.3% of grade 2–4. Receiving a CAR construct with a CD28 domain (58% of patients) was the strongest predictor of grade 2–4 ICANS. Serum NfL levels were significantly higher in patients with grade 2–4 ICANS than in those with grade 0–1 ICANS, both at the time of leukapheresis and infusion. In multivariate models, NfL above the cut-off value was independently associated with grade 2–4 ICANS at leukapheresis (NfL>75 pg/mL, OR 4.2, 95% CI 1.2 to 14.2, p=0.022) and infusion (NfL>58 pg/mL, OR 4.3, 95% CI 1.3 to 13.7, p=0.015).

In conclusion, high NfL levels at the time of the decision to proceed with CAR T-cell manufacturing may represent an early surrogate of underlying loss of neuroaxonal integrity that increases the risk of subsequent neurotoxicity. Incorporating NfL levels into the decision-making process based on each patient’s risk profile could help determine the appropriate CAR product when possible, and guide the prophylactic or therapeutic management of ICANS.
Metabolic reprogramming of hypoxic tumor-associated macrophages through CSF-1R targeting favors treatment efficiency in colorectal cancers
Authors: Gharzeddine Khaldoun , Gonzalez Prieto Cristina , Malier Marie , Hennot Clara , Grespan Renata , Yamaryo-Botté Yoshiki , Botté Cyrille Y , Thomas Fabienne , Laverriere Marie-Hélène , Girard Edouard , Roth Gael , Millet Arnaud
Published: September 2024

Background

Tumor-associated macrophages participate in the complex network of support that favors tumor growth. Among the various strategies that have been developed to target these cells, the blockade of the colony-stimulating factor 1 receptor (CSF-1R) receptor is one of the most promising ones. Here, we characterize the resulting state of human macrophages exposed to a CSF-1R kinase inhibitor.

Methods

Using RNA sequencing and metabolomics approach, we characterize the reprogramming of human monocyte-derived macrophages under CSF-1R targeting.

Results

We find that CSF-1R receptor inhibition in human macrophages is able to impair cholesterol synthesis, fatty acid metabolism and hypoxia-driven expression of dihydropyrimidine dehydrogenase, an enzyme responsible for the 5-fluorouracil macrophage-mediated chemoresistance. We show that this inhibition of the CSF-1R receptor leads to a downregulation of the expression of sterol regulatory element-binding protein 2, a transcription factor that controls cholesterol and fatty acid synthesis. We also show that the inhibition of extracellular signal-regulated kinase 1/2 phosphorylation resulting from targeting the CSF-1R receptor destabilizes the expression of hypoxic induced factor 2 alpha in hypoxia resulting in the downregulation of dihydropyrimidine dehydrogenase expression restoring the sensitivity to 5-fluorouracil in colorectal cancer.

Conclusions

These results reveal the unexpected metabolic rewiring resulting from the CSF-1R receptor targeting of human macrophages and its potential to reverse macrophage-mediated chemoresistance in colorectal tumors.
Development of home-based care educational programme for the family caregivers of activity limited older people: an educational programme model for community nurses
Authors: Wijesiri H S Maliga S K
Published: September 2024

Background/aim

A home-based care educational programme for family caregivers of activity-limited older people was developed and implemented to provide caregiver education and to teach basic caregiving techniques. The purpose of the home-based care educational programme was to improve the caregivers’ knowledge, skills and attitudes necessary to perform the caregiving tasks with reduced physical strain.

Methods

The educational programme model comprises the knowledge and skills necessary to carry out the caretaking responsibilities of older people, especially those with limited activities. It was conducted as an interventional study recruiting two groups (n=72) as intervention (n=36) and control group (n=36), and the knowledge of the caregivers was evaluated. The teaching sessions were planned considering the adult educational learning theories and guided by a developed educational handbook.

Results

The pre and post mean±SD knowledge scores of the intervention group (43.78±12.41; 89.78±5.61) showed a significant difference (p<0.001), whereas the pre and post knowledge mean±SD scores of the control group (50.69±17.90; 51.43±17.79) showed no significant improvement (p>0.05). The difference between the pre-test and post-test between the two groups was significant (p<0.0001).

Conclusions

At the end of the educational programme, participants valued the opportunity that they received, and the assessment of knowledge before and after the programme showed an improvement in caregivers’ knowledge. The study suggests conducting home-based or community-based health education programmes for caregivers of older people with limited activities, with the involvement of responsible healthcare professionals and leaders.
Digital health for cancer symptom management in palliative medicine: systematic review
Authors: Hamdoune Meryem , Jounaidi Khaoula , Ammari Nada , Gantare Abdellah
Published: September 2024

Background

Digital health technologies (DHTs) play a crucial role in symptom management, particularly in palliative care, by providing patients with accessible tools to monitor and manage their symptoms effectively. The aim of this systematic review was to examine and synthesise the scientific literature on DHTs for symptom management in palliative oncology care.

Methods

A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews and meta-analyses from 2 June to 20 June 2024. Databases including Scopus, Web of Science, ScienceDirect, PubMed and the Cochrane Library were searched. Data were extracted using a standardised form based on the PICOTT (Population, Intervention, Comparison, Outcome, Type and Technology) framework. The quality of the included studies was assessed using the Appraisal of Guidelines for Research & Evaluation (AGREE) II tool during the selection process.

Results

The systematic review included seven articles describing six DHTs from five countries: the UK, Kenya, Tanzania, the Netherlands and the USA. The findings of this comprehensive literature review elucidate four principal themes: the specific types of DHTs used for symptom management in palliative cancer care, their roles and advantages, as well as the factors that limit or promote their adoption by patients and healthcare professionals.

Conclusion

The findings of this review give valuable insights into the ongoing discourse on integrating digital health solutions into palliative care practices, highlighting its potential role in enhancing symptom management within palliative cancer care and showcasing its possible benefits while also identifying key factors influencing their adoption among patients and healthcare professionals.
Groundwater vulnerability in the Athabasca and Cold Lake oil sands regions: gaps, opportunties, and challenges
Authors: Birks S.J. , Gibson J.J. , Fennell J.W. , McClain C.N. , Sayanda D. , Bickerton G. , Yi Y. , Castrillon-Munoz F.
Published: September 2024

Oil sands development in the Athabasca and Cold Lake oil sands regions of Alberta has raised concerns about potential impacts to groundwater and groundwater dependent ecosystems. This review summarizes the current state of understanding as to how oil sands mining and in situ activities can affect groundwater systems using a stressor-mechanism-response framework. Specific oil sands activities and practices are reviewed, and where possible, described in terms of how they can impact hydraulic head, the hydraulic properties of aquifers, recharge and transport of constituents of concern and linked to observed or potential impacts to groundwater quantity and quality. Groundwater is an important component of the water balance in boreal ecosystems, and specific vulnerabilities related to development are reviewed, including water use, landscape disturbance, groundwater withdrawals, tailings pond seepage, deep well disposal and thermal impacts. Knowledge gaps include lack of baseline data and monitoring of the quantity and quality of groundwater discharge to rivers, lakes and wetlands. One key monitoring challenge is attribution of hydrogeologic responses to specific oil sands stressors given the range of other natural and anthropogenic factors contributing to their variability. Quantitative groundwater exchange mapping, regional-scale isotope mass balance assessment, and broader incorporation of isotopic and geochemical tracers for fingerprinting water sources and incorporation of Indigenous Knowledge appear promising for improved effectiveness of monitoring.
A WAVELET MODELING OF CORRELATED NOISE IN SMART HEALTH MULTI-SENSORS DATA MONITORING
Authors: MABROUK ANOUAR BEN , BASSFAR ZAID , ALSHAMMARI FEHAID S. , BASSFAR SARAH , ALANAZI ABDULAZIZ
Published: September 2024

This paper concerns the modeling of smart health sensors for data monitoring, where the data are eventually noisy, with correlated noise. In this work, we applied Clifford-based wavelets/multiwavelets for correlated noise in multi-sensors health data monitoring by estimating the set of sensor nodes minimizing an eventual error computed by the signal values at the selected nodes mostly caused by the correlated noise. Instead of directly minimizing the estimation error, we focused on evaluating a multi-level scheme based on multiwavelets for the estimation of the error between the parameter vector and its sub-vector of those nodes. Numerical simulations are provided with a comparison to some recent existing works. This model showed a performance and a fast time execution compared to those existing works. This model exceeds these models by the non-necessity to assume a priory structure of the data. Wavelets are capable to detect, localize, and eliminate the noise, even correlated, efficiently via the independent uncorrelated multiwavelets’ components.
FROM PIXELS TO PREDICTIONS: ROLE OF BOOSTED DEEP LEARNING-ENABLED OBJECT DETECTION FOR AUTONOMOUS VEHICLES ON LARGE SCALE CONSUMER ELECTRONICS ENVIRONMENT
Authors: ALKHONAINI MIMOUNA ABDULLAH , MENGASH HANAN ABDULLAH , NEMRI NADHEM , EBAD SHOUKI A. , ALOTAIBI FAIZ ABDULLAH , ALJABRI JAWHARA , ALZAHRANI YAZEED , ALNFIAI MRIM M.
Published: September 2024

Consumer electronics (CE) companies have the potential to significantly contribute to the advancement of autonomous vehicles and their accompanying technology by providing security, connectivity, and efficiency. The Consumer Autonomous Vehicles market is set for significant growth, driven by growing awareness and implementation of sustainable practices using computing technologies for traffic flow optimization in smart cities. Businesses are concentrating more on eco-friendly solutions, using AI, communication networks, and sensors for autonomous city navigation, giving safer and more efficient mobility solutions in response to growing environmental concerns. Object detection is a crucial element of autonomous vehicles and complex systems, which enables them to observe and react to their surroundings in real-time. Multiple autonomous vehicles employ deep learning (DL) for detection and deploy specific sensor arrays custom-made to their use case or environment. DL processes sensory data for autonomous vehicles, enabling data-driven decisions on environmental reactions and obstacle recognition. This paper projects a Galactical Swarm Fractals Optimizer with DL-Enabled Object Detection for Autonomous Vehicles (GSODL-OOAV) model in Smart Cities. The presented GSODL-OOAV model enables the object identification for autonomous vehicles properly. To accomplish this, the GSODL-OOAV model initially employs a RetinaNet object detector to detect the objects effectively. Besides, the long short-term memory ensemble (BLSTME) technique was exploited to allot proper classes to the detected objects. A hyperparameter tuning procedure utilizing the GSO model is employed to enhance the classification efficiency of the BLSTME approach. The experimentation validation of the GSODL-OOAV technique is verified using the BDD100K database. The comparative study of the GSODL-OOAV approach illustrated a superior accuracy outcome of 99.06% over present innovative approaches.
EXPLOITING OPTIMAL SELF-ATTENTION DEEP LEARNING-BASED RECOGNITION OF TEXTUAL EMOTIONS FOR DISABLED PERSONS
Authors: ALSHAHRANI HAYA MESFER , YASEEN ISHFAQ , DRAR SUHANDA
Published: September 2024

A disability is a significant issue that has posed and continues to pose a challenge. Disability is a basis of frustration because it can be observed as a mental, constraint, cognitive, and physical handicap that inhibits the individual’s growth and involvement. Consequently, significant effort has been put into removing these kinds of restrictions. These initiatives address the trouble that disabled people encounter. People with disabilities often need to rely on others to meet their requirements. Machine learning (ML) is excelling in producing smart cities and offering a secure environment for disabled individuals. Emotional detection is an important research domain that can expose many appreciated inputs. Emotion is expressed differently through speech and facial expressions, gestures, and written text. Emotion detection in a text document is fundamentally a content-based classification task, utilizing models from deep learning (DL), complex systems and natural language processing (NLP). This paper presents an Optimal Self-Attention DL-based Recognition of Textual Emotions (OSADL-RTE) technique for Disabled Persons. The presented OSADL-RTE technique focuses on identifying distinct types of emotions in the textual data. As a primary preprocessing step, the OSADL-RTE technique comprises different phases to transform the input in a useful way. For word embedding, the bag of words (BoWs) approach is exploited. The OSADL-RTE technique derives self-attention long short-term memory (SA-LSTM) approach to identify emotions. Lastly, the arithmetic fractals optimization algorithm (AOA) approach correctly tunes the hyperparameter selection of the SA-LSTM approach. The experimental study of the OSADL-RTE approach occurs on the emotion database. The investigational outcome of the OSADL-RTE approach portrayed a superior accuracy outcome of 99.59% over existing methods.
Enhanced mechanical properties of Ni3Al composites reinforced with single-walled and multi-walled carbon nanotubes: An atomistic modeling study
Authors: Yankovskaya Ustina I. , Starostenkov Mikhail D. , Markidonov Artem V. , Kazakov Arseny M. , Korznikova Elena A. , Zakharov Pavel V.
Published: September 2024

In this study, the mechanical properties of a Ni3Al matrix composite reinforced with single-walled carbon nanotubes (SWCNTs) and multi-walled carbon nanotubes (MWCNTs) were investigated using atomistic modeling. The analysis focused on the behavior of the composite under uniaxial tensile strain across a range of temperatures (100–900[Formula: see text]K). The results demonstrated that the incorporation of any type of carbon nanotubes (CNTs) significantly enhanced Young’s modulus, yield strength, and tensile strength of the Ni3Al matrix. Notably, the reinforcement with MWCNTs resulted in superior mechanical properties compared to SWCNTs. Additionally, an increase in temperature led to a reduction in Young’s modulus for all composite samples. Among the tested configurations, the composite reinforced with MWCNTs exhibited the highest tensile modulus and yield strength, outperforming both the SWCNT-reinforced composite and the unreinforced Ni3Al crystal. These findings underscore the potential of MWCNTs as effective reinforcements in improving the mechanical performance of Ni3Al-based composites, especially at elevated temperatures.
Incidence of Natural Conception in Fertility Couples Delayed Treatment in the COVID-19 Shutdown in Australia
Authors: Cutting Elizabeth , Ebinger Emma , Edelstein Sascha , Mol Ben W.
Published: September 2024

Background: In vitro fertilization (IVF) is the most widely applied fertility treatment. While the indication for IVF is not disputed in couples where natural conception chances are close to zero (blocked fallopian tubes or severe male infertility), it is less clear when IVF should be started in other couples. Natural conception occurs frequently and has been reported in patients pre- and post-IVF treatment. The outbreak of COVID-19 in the early months of 2020, resulted in Australian fertility clinics stopping treatment. This enabled the opportunity for fertility patients to try and conceive naturally.

Methods: We studied couples who were scheduled to start IVF in March 2020 but who faced delayed treatment due to COVID-19 shutdowns. Outcomes were recorded as couples returned for treatment or were contacted via phone and asked why they did not return. We collected baseline characteristics including maternal age, day of next Day 1, and type of infertility, as well as the pregnancy outcome or reason for not returning.

Results: We studied 533 couples who were delayed IVF treatment for a total of 1,204 observation months. From the initial cohort of 533 couples delayed treatment, 16 couples achieved pregnancy (3%) with 12 resulting in live birth (2.3%). When analyzed by indication, patients with ovulatory disorders (4 of 55 [7.2%]) or reduced ovarian reserve (7 of 141 [5%]) proved to have higher rates of natural conception compared to other diagnostic categories. There were 39 couples who did not return to treatment and did not achieve natural conception.

Conclusion: There is a significant emotional toll that patients experience when undergoing fertility treatment. Natural conception is evident within cohorts scheduled for IVF treatment, and this study indicates that the chance per cycle of live birth in couples waiting to undergo medically assisted reproduction during the COVID pandemic was 2.3%.
Feel the Rhythm: A Blind-Accessible Rhythm Game Showcasing a Novel Approach to Accessibility
Authors: Mrazik Matthew , Khatib Firas
Published: September 2024

Over the past few decades, video games have grown from a novelty of entertainment into one of the largest media industries in the world. For blind players or players with significant visual impairment, gaming is an activity which is largely out of reach, particularly for certain genres of game. The focus of this paper is one specific problem in games accessibility, which is the challenge of providing visually impaired players with access to the rhythm game genre. This paper presents a new game, titled Feel the Rhythm, in the rhythm genre developed with accessibility as a core design goal in order to implement novel blind-accessible features. The game serves as proof of concept for implementing solutions to this specific accessibility problem and presents the potential to allow visually impaired players access to a generally unavailable genre of games.
Agent-based Mediation on Smartphone Usage among Co-located Couples
Authors: Khatra Karanmeet , Sin Jaisie , Kuzminykh Anastasia , Hasan Khalad
Published: September 2024

Smartphone overuse around family and friends has been shown to be increasing over the past years and often leads to limited one-to-one interaction between co-located individuals. Smartphone-based virtual agents have been shown to be effective for behavior intervention and mediation, such as promoting physical activity. Little is known about leveraging smartphone-based agents to play a role in communication and facilitate conversation between co-located individuals. In this paper, we explore strengthening conversations between co-located couples by introducing a smartphone-based agent that acts as a conversation facilitator between them. We contrast the results with a text-based alternative. Our findings suggest that virtual agents serve as a valuable social entity mediating support in couples' communication and relationship dynamics. Through this, we suggest design considerations for this context that leverage the unique qualities of virtual agents.
Body-Based Augmented Reality Feedback During Conversations
Authors: Pohl Henning
Published: September 2024

Engaging with our devices as we engage with each other is problematic as it distracts us and diminishes our social interactions. Subtle interactions have been presented as an approach to reconcile personal and computing interactions, through less disrupting technology. Along those lines, we investigate showing information right on and next to the people we are engaging with. Body-based data visualization allows us to maintain our attention with others, but to also receive information at the same time. We explore potential designs of such body-based and especially on-face visualizations and create a set of five prototype visualizations in a Snapchat lens. We use these prototypes in a video call study with 16 participants to evaluate how body-based visualizations affect actual conversations.
Experience from Designing Augmented Reality Browsing Interfaces for Real-world Walking Scenarios
Authors: Chang Yu-Cheng , Wang Yen-Pu , Chang Chiao-Ju , Tan Wei Tian Mireille , Hsu Yu Lun , Chen Yu , Chen Mike Y.
Published: September 2024

Mobile phones have enabled users to browse information in varying mobility contexts. For high-mobility settings such as walking, however, phones pose several usability challenges, particularly safety and limited screen sizes. While Augmented Reality (AR) has been proposed to address these issues, prior work has yet to investigate AR interface design in real-world walking conditions beyond text readability and notification design. This paper presents the first exploration of AR browsing interface design and extended usage while walking in the wild. We first conducted design sessions with 12 UI designers while walking in varied environments to design the window size, distance, opacity, anchor type, and placement for three categories of apps: text, video, and mixed content. Results show that traffic level significantly affects the designed window size, whereas content type significantly affects window size, distance, opacity, and vertical placement. To gain further insights from real-world usage, we conducted a multi-day observational study with 5 participants and observed that participants on average switched among window layouts every 3.3 minutes, for reasons such as safety and the level of extended visual attention.