bluuebunny/crossref_metadata_2025 huggingface dataset:
New deals ‘The Second After Leaving?’ IO withdrawal and bilateral trade agreements
Authors: Bakaki Zorzeta , Böhmelt Tobias
Published: March 2022

The Brexit campaign was based on the idea that newly gained British sovereignty and flexibility in global trade governance would facilitate the quick negotiation of preferential trade agreements. We explore how long it may take for a state to negotiate bilateral preferential trade agreements to offset potential losses from International Organizations withdrawals. We address the question of ‘timing’, and discuss several mechanisms that delay or speed up the implementation of bilateral trade deals after exiting International Organizations. The empirical findings are based on quantitative data and models accounting for the likely simultaneous relationship between International Organizations exits and preferential trade agreements’ formation. We show that leaving economic organisations significantly lowers the likelihood of subsequent preferential trade agreements ratification. This effect wears out after about 1 year. This research has crucial implications for our understanding of International Organizations, state benefits’ stemming from their membership therein, bilateral trade deals, and international cooperation.
“This would be sweet in VR”: On the discursive newness of virtual reality
Authors: Harley Daniel
Published: March 2022

When virtual reality (VR) entered the consumer market in 2016, it was accompanied by claims of its potential as a “revolutionary” new technology. This article examines these claims of newness by focusing on statements made by industry leaders and other professionals. The findings suggest repetitions of problematic discourse, in which colonialist language of “pioneering” expansion appears to be used to mobilize developers who are dominantly young, White, and male. I argue that recontextualizing the “newness” of VR opens opportunities to contest its depoliticized histories and to question its imagined futures. Situating VR within a much longer history of digital and non-digital technologies not only challenges the notions of newness that are foundational to industry-led VR discourse, but also offers a critical alternative.
The International Law of Energy of Offshore Carbon Capture and Storage: The Rotterdam Nucleus Project case study
Authors: Branco de Almeida Laisa
Published: March 2022

Achieving net-zero emissions by 2050 infers that the total CO2 emissions would need to fall by around 45% from 2010 levels by 2030. The general sustainable development scenario suggests that change in energy demand will uphold an extensive usage of renewable energy and clean energy technologies. This paper focuses on the Rotterdam Nucleus Project and how it can contribute to large-scale CO2 transportation from the Port of Rotterdam to CO2 storage with capacity within 20 km of the Dutch coast. The Project is a model for establishing a European CCS infrastructure in the North Sea, targeting a gateway transferring CO2 from source to sink. It envisions taking part in the subsequent EU CO2 Project of Common Interest (PCI), facilitating financial support from the Connecting Europe Facility (CEF). In the first section, this paper analyses the ad hoc approach governing the implementation of the Rotterdam Nucleus, including the relevant regulatory framework at both national and local levels and its investment arrangements alongside the EU Commission. The following section stresses the Project's foundational approach and how inter-national law assists the global governance of offshore CCS transportation.
Conducting Focus Groups in Multicultural Educational Contexts: Lessons Learned and Methodological Insights
Authors: CohenMiller Anna , Durrani Naureen , Kataeva Zumrad , Makhmetova Zhadyra
Published: March 2022

What happens when focus groups are conducted in challenging situations across languages, cultures, and educational settings? What adjustments might need to be made? How can adaptations be made while still maintaining the integrity of the research? Drawing on a multi-year study of gender and schooling in post-Soviet Kazakhstan, this article brings together researcher data from (1) informal discussion occurring after each focus group between the researchers, (2) reflections and observations from notes written during the research process, and (3) individual reflexivity on the topic of conducting focus groups in multicultural contexts written retrospectively. Using a practical iterative framework, this work adds an important contribution to the qualitative research literature by leading the reader through our processes, considerations, and lessons learned for improving culturally relevant and inclusive focus groups in multicultural educational contexts.
The importance of context for leadership in education
Authors: Lakomski Gabriele , Evers Colin W
Published: March 2022

The doctrine of leader centrism, supported by the concept of methodological individualism, dominates contemporary accounts of leadership in education and is generally applied as the default option that explains how organizations such as schools function. We argue that methodological individualism is not defensible and that as a result, the explanatory value of leadership is an open empirical question, not a default option. Leadership, and especially problem-solving, is always exercised under a set of constraints. Making the study of these constraints the focal point for determining leadership not only requires the resources of sciences not usually employed in leadership research, but leads to a reconceptualizing how leadership ought to be studied. In this paper we identify three broad contexts that help determine the constraint sets that define problems and their solutions. A defensible theory of educational leadership, we argue, must incorporate context as sets of constraints and develop empirical procedures to investigate context. Only after investigation is it possible to determine who or what the unit of leadership was, or whether leadership occurred at all. There are no default options.
An intellectual history of the political in the educational management, administration and leadership field
Authors: Gunter Helen M
Published: March 2022

Research and practice regarding politics within and for the educational management administration and leadership community are well established. The 50th anniversary issue of the journal educational management, administration and leadership is an opportunity to examine knowledge production where I have developed a new conceptual framework based on three approaches to ontology and epistemology in the social sciences. This framework presents positivist, interpretive and critical approaches to political relationality, and I deploy this conceptualisation in order to read and analyse field outputs. I present an account of each of these three approaches where I show the main authors, projects and knowledge claims that have raised awareness and established a conceptual and empirical database. I identify the resilience and dominance of positivist politics, but recognise the ongoing validity of interpretive and critical politics.
Indigenous secularism and the secular-colonial
Authors: Carr Ryan
Published: March 2022

Many non-Indigenous people assume that secularism—the belief that religion and politics are and should be different spheres of life—is foreign to Native American experience. This partly explains why the topic of Native conversions in early New England has always been so controversial, since conversion implies the differentiation of religion from politics. Be that as it may, history shows that Indigenous peoples are well acquainted with secularism and have been debating it within their communities for centuries. This essay demonstrates proof of concept for a history of Indigenous secularism via a case study of Samson Occom, whose vision of Indigenous self-determination was informed by secularist ideas about sovereignty and conversion. It also offers a critique of scholarly romanticizations of Indigenous peoples' primordially “holistic” a-secularism. This romanticization is the product of a secular-colonial ideology which presupposes the otherness of Indigenous peoples when it comes to differentiating between religion and politics.
Teachers’ Base Salary and Districts’ Academic Performance: Evidence From National Data
Authors: García Emma , Han Eunice S.
Published: March 2022

This paper examines the relationship between teacher pay and students’ academic achievement, using nationally representative, district-level linked data between districts’ performance on standardized tests and average teacher base salary. By employing state fixed effects and multilevel mixed effects models, we find that both mathematics and English test scores are significantly higher in districts that offer higher base salaries to teachers, compared with those in districts with a lower teacher base salary. We also find that higher teacher base salaries reduce achievement gap between white and black students, as well as between white and Hispanic students, by raising test scores more for those minority students.
RaGA and Tala of Research Productivity: A Study of Leading Business School in India
Authors: Ramkumar S.
Published: March 2022

Research productivity at business schools is of interest to academicians, policy-makers, and other stakeholders. This study attempts to understand stratification in research productivity in a business school and explores the individual (rank, gender) and departmental (area of discipline) characteristics (RaGA), covering a dataset of 4,013 research outputs spanning the research themes (themes) of academic, practice-oriented, and pedagogic and (a la carte) (Tala) from 2011 to 2020. Theme-wise, the quantum and direction of research indicated that academic research > practice-oriented research > pedagogic development during 2010–2015 and 2015–2020. The major findings include: professors had higher per-capita productivity (PCP) across the themes, followed by assistant professors. In terms of a la carte, professors had higher PCP in scientific presentations/invited talks, books, chapters in books, articles in periodicals/dailies, and teaching cases. Assistant professors participated more in working papers and research projects. Associate professors had higher PCP in articles in academic journals and doctoral students advising. Female faculty fared well in academic research and male faculty in pedagogic development. Mixed trend was seen in practice-oriented research. Economic and social sciences outperformed other disciplinary areas in academic (working papers and scientific presentations) and practice-oriented research (research projects, books, chapters in books, and articles in dailies). Marketing, decision sciences, strategy, production, and operations management were better in pedagogic development. The higher production in articles in academic journals came from organization behavior, public policy, and production and operations management. This study has takeaways for policy-makers and emphasizes having a clear research agenda that can combine academic rigor with practice.
Growth and Pubertal Development Among HIV Infected and Uninfected Adolescent Girls in Lagos, Nigeria: A Comparative Cross-Sectional Study
Authors: Agatha David , Titilola Gbaja-biamila , Abideen Salako , Oluwatosin Odubela , Agatha Wapmuk , Sabdat Ekama , Tomilola Musari-Martins , Priscilla Ezemelue , Ebiere Herbertson , Oliver Ezechi
Published: March 2022

This study aimed to compare growth and pubertal developmental parameters among HIV-infected and uninfected adolescent girls (11-19 years) in Lagos using a cross-sectional approach. Height, weight, BMI Z-scores, sexual maturity rating by Tanner stages and age at menarche, were compared in the 2 groups. The mean age was similar in both groups (13.2 [±2.3] years and 13.6 [±1.6] years for HIV positive and negative respectively [ P = .13]). Majority (66.2%) were in Junior Secondary classes and the mean socioeconomic class was 2.5 (±0.9). HIV-infected girls had significantly lower height, weight, and BMI Z scores compared to their uninfected counterparts. The proportion that had attained Tanner stages 3 to 5 were significantly lower among the HIV-positive participants. The study identified lower growth parameters and pubertal delay among HIV-infected adolescent females compared to HIV uninfected girls. Growth and sexual maturation assessment should form part of routine care of adolescents living with HIV.
Clinical and Apoptotic Factors Defining and Predicting Steroid Resistance in Nephrotic Syndrome in Children
Authors: Burlaka Ievgeniia , Mityuryayeva Inga , Bagdasarova Ingretta
Published: March 2022

Introduction. Nephrotic syndrome (NS) is a kidney disease characterized by albuminuria, hyperlipidemia, edema, and hypoalbuminemia. Above 20 % of nephrotic children do not show response to steroid treatment. Molecular markers controlling apoptosis have not been studied as a predictors of steroid resistant NS (SRNS) and steroid sensitive NS (SSNS) in children. Aim of the Study. To identify clinical and molecular markers which define and predict the steroid-resistance phenomenon in children with NS. Methods. Fifty-six clinical cases of children hospitalized in Pediatric Hospital No. 7 (Kyiv, Ukraine) with NS (26 SSNS and 30 SRNS) studied. Stepwise logistic regression models used to analyze data. Data processed using GraphPad Prism 9.0 Software for Windows (USA, San Diego, CA). Results. Arterial hypertension, WBC and RBC count, serum creatinine, serum urea, serum cholesterol found to be factors defining and predicting SRNS. Apoptosis regulating BcL-xL, Bax but not caspase-8 found to be those defining SRNS. Among transcriptional factors HIF-1alfa selected as a factor predicting steroid resistance phenomenon. For SSNS group significant negative correlation observed between BcL-xL and Bax, BcL-xL and caspase-3, significant positive correlation observed between marker of cellular hypoxia HIF-1alfa and proapoptotic factor caspase-3. For SRNS group significant negative correlation observed between BcL-xL and Bax, BcL-xL and caspase-3 level, significant positive correlation observed between HIF-1alfa and proapoptotic factor caspase-3. Conclusions. Arterial hypertension, serum creatinine level, serum urea level, serum cholesterol level, WBC and RBC count, BcL-xL, Bax, caspase-3, and HIF-1alfa identified as candidate biomarkers to predict and define SRNS in pediatric NS.
Change in contrast sensitivity and OCT parameters in idiopathic intracranial hypertension
Authors: Rehman Obaidur , Ichhpujani Parul , Singla Ekta , Negi Reetika , Kumar Suresh
Published: March 2022

Background:

Deterioration in peripheral contrast sensitivity (CS) can be an indicator to detect progressive deterioration of visual function in patients with idiopathic intracranial hypertension (IIH).

Objectives:

The aim of this study was to evaluate the changes in central and peripheral CS and optical coherence tomography (OCT) parameters and in patients with IIH.

Design and Methods:

In this pilot observational study, data of 20 eyes of 10 ‘treatment-naïve’ IIH patients were analyzed. Detailed ocular examination was performed including CS assessment using both Pelli–Robson (PR) test and Spaeth–Richman Contrast Sensitivity Test (SPARCS) along with the OCT for macular and optic nerve head (ONH) parameters. A comparative analysis was done for CS and OCT parameters from baseline to a follow-up visit > 12 months (range: 18–24 months).

Results:

The study population had a female preponderance (80%, n = 8), and mean age at diagnosis was 31.9 ± 10.3 years. Mean follow-up period was 21.2 months (range: 15–24 months). At presentation, 6/6 visual acuity was noted in 75% eyes ( n = 15) while all eyes had 6/6 vision at the last follow-up. Average PR score increased from 1.96 ± 0.36 to 2.30 at the last visit (Wilcoxon test: V = 0.0, p ⩽ 0.001) while average SPARCS score (total) increased from 71.85 ± 9.10 to 77.55 ± 6.20 (Paired t-test: t = −2.3, p = 0.035). Change in SPARCS score was significant in average total score ( p = 0.035), and quadrant-wise score in superonasal ( p = 0.014), inferonasal ( p = 0.001), and inferotemporal ( p = 0.021) quadrants. Same trend in SPARCS scores was observed when eyes with and without recurrence were analyzed. Statistically significant difference in retinal nerve fiber layer (RNFL) thickness ( p = 0.007) and macular thickness (MT) in nasal quadrant ( p = 0.006) was seen between the eyes with recurrence and without recurrence.

Conclusion:

Peripheral CS showed significant difference in all eyes over time. It showed significant change in eyes with recurrence, even in the presence of intact visual acuity and preserved central CS. Changes in RNFL thickness and nasal MT could differentiate eyes which developed recurrence from normal eyes.
Obacunone alleviates ferroptosis during lipopolysaccharide-induced acute lung injury by upregulating Nrf2-dependent antioxidant responses
Authors: Li Jin , Deng Shi-hua , Li Jing , Li Li , Zhang Feng , Zou Ye , Wu Dong-ming , Xu Ying
Published: March 2022

Background

Acute lung injury (ALI) has received considerable attention in the field of intensive care as it is associated with a high mortality rate. Obacunone (OB), widely found in citrus fruits, is a natural bioactive compound with anti-inflammatory and antioxidant activities. However, it is not clear whether OB protects against lipopolysaccharide (LPS)-induced ALI. Therefore, in this study, we aimed to evaluate the protective effects of OB and the potential mechanisms against LPS-induced ALI and BEAS-2B cell injury.

Methods

We established a model of BEAS-2B cell injury and a mouse model of ALI by treating with LPS. Samples of in vitro model were subjected to cell death, Cell Counting Kit-8, and lactate dehydrogenase (LDH) release assays. The total number of cells and neutrophils, protein content, and levels of IL-6, TNF-α, and IL-1β were determined in bronchoalveolar lavage fluid (BALF). Glutathione, reactive oxygen species, and malondialdehyde levels were determined in lung tissue. Additionally, immunohistochemical analysis, immunofluorescence, western blot, quantitative real-time PCR, and enzyme-linked immunosorbent assay were conducted to examine the effects of OB. Furthermore, mice were treated with an Nrf2 inhibitor (ML385) to verify its role in ferroptosis. Data were analyzed using one-way analysis of variance or paired t-tests.

Results

Compared with the LPS group, OB effectively alleviated LPS-induced ALI by decreasing lung wet/dry weight ratio, reactive oxygen species and malondialdehyde production, and superoxide dismutase and glutathione consumption in vivo. In addition, OB significantly alleviated lung histopathological injury, reduced inflammatory cytokine secretion and Fe2+ and 4-HNE levels, and upregulated GPX4, SLC7A11, and Nrf2 expression. Mechanistically, OB activated Nrf2 by inhibiting Nrf2 ubiquitinated proteasome degradation. ML385 reversed the protective effects of OB against LPS-induced ALI.

Conclusion

Overall, OB alleviates LPS-induced ALI, making it a potential novel protective agent against LPS-induced ALI.
mRNA expression analysis of the hippocampus in a vervet monkey model of fetal alcohol spectrum disorder
Authors: Gillis Rob F. , Palmour Roberta M.
Published: March 2022

Background

Fetal alcohol spectrum disorders (FASD) are common, yet preventable developmental disorders that stem from prenatal exposure to alcohol. This exposure leads to a wide array of behavioural and physical problems with a complex and poorly defined biological basis.

Molecular investigations to date predominantly use rodent animal models, but because of genetic, developmental and social behavioral similarity, primate models are more relevant. We previously reported reduced cortical and hippocampal neuron levels in an Old World monkey (Chlorocebus sabaeus) model with ethanol exposure targeted to the period of rapid synaptogenesis and report here an initial molecular study of this model. The goal of this study was to evaluate mRNA expression of the hippocampus at two different behavioural stages (5 months, 2 years) corresponding to human infancy and early childhood.

Methods

Offspring of alcohol-preferring or control dams drank a maximum of 3.5 g ethanol per kg body weight or calorically matched sucrose solution 4 days per week during the last 2 months of gestation. Total mRNA expression was measured with the Affymetrix GeneChip Rhesus Macaque Genome Array in a 2 × 2 study design that interrogated two independent variables, age at sacrifice, and alcohol consumption during gestation.

Results and discussion

Statistical analysis identified a preferential downregulation of expression when interrogating the factor ‘alcohol’ with a balanced effect of upregulation vs. downregulation for the independent variable ‘age’. Functional exploration of both independent variables shows that the alcohol consumption factor generates broad functional annotation clusters that likely implicate a role for epigenetics in the observed differential expression, while the variable age reliably produced functional annotation clusters predominantly related to development. Furthermore, our data reveals a novel connection betweenEFNB1and the FASDs; this is highly plausible both due to the role of EFNB1 in neuronal development as well as its central role in craniofrontal nasal syndrome (CFNS). Fold changes for key genes were subsequently confirmed viaqRT-PCR.

Conclusion

Prenatal alcohol exposure leads to global downregulation in mRNA expression. The cellular interference model ofEFNB1provides a potential clue regarding how genetically susceptible individuals may develop the phenotypic triad generally associated with classic fetal alcohol syndrome.
Impact of cardiopulmonary resuscitation duration on the neurological outcomes of out-of-hospital cardiac arrest
Authors: Albinali Hissah , Alumran Arwa , Alrayes Saja
Published: March 2022

Background

Patients experiencing cardiac arrest outside medical facilities are at greater risk of death and might have negative neurological outcomes. Cardiopulmonary resuscitation duration affects neurological outcomes of such patients, which suggests that duration of CPR may be vital to patient outcomes.

Objectives

The study aims to evaluate the impact of cardiopulmonary resuscitation duration on neurological outcome of patients who have suffered out-of-hospital cardiac arrest.

Methods

This is a quantitate cross-sectional study where data is collected from emergency cases handled by a secondary hospital in industrial Jubail, Saudi Arabia, between January 2015 and December 2020. There were 257 out-of-hospital cardiac arrest cases, 236 of which resulted in death. The outcome is the survival of OHCA or death, and the neurological outcome by the cerebral performance category (CPC) score for survivors. A score of 1 or 2 defined as good CPC outcome and 3, 4, and 5 as poor outcome.

Results

The mean for the duration of emergency CPR procedures in surviving patients is 26.5 ± 7.20 min, whereas in patients who died after the procedure it is 29.6 ± 9.15 min. Bivariate analysis showed no significant association between duration of CPR and Cerebral Performance Category (CPC) outcome but could be significant if the sample size is large. Age, however, is significantly related to the survivorship of OHCA and to a better CPC outcome. Younger patients are more likely to have better CPC outcome. A good CPC outcome was reported with a limited duration of 8.1 min of CPR, whereas, poor CPC outcomes were associated with prolonged periods of CPR, 13.2 min.

Conclusion

Cardiopulmonary Resuscitation Duration out-of-hospital cardiac arrest does not significantly influence the patient neurological outcome in the current study hospital. Variables such as the patient population's uniqueness, underlying medical conditions, or the specific study conditions may explain this variance between the bivariate analysis and the study conclusion. Therefore, a more comprehensive study is recommended in future.
Symbiont-conferred immunity interacts with effects of parasitoid genotype and intraguild predation to affect aphid immunity in a clone-specific fashion
Authors: Purkiss Samuel Alexander , Khudr Mouhammad Shadi , Aguinaga Oscar Enrique , Hager Reinmar
Published: March 2022

Background

Host-parasite interactions represent complex co-evolving systems in which genetic and associated phenotypic variation within a species can significantly affect selective pressures on traits, such as host immunity, in the other. While often modelled as a two-species interaction between host and parasite, some systems are more complex due to effects of host enemies, intraguild predation, and endosymbionts, all of which affect host immunity. However, it remains unclear how these factors, combined with genetic variation in the host and the parasitoid, affect host immunity. We address this question in an important agricultural pest system, the pea aphidAcyrthosiphon pisum, which shows significant intraspecific variability in immunity to the parasitoid waspAphidius ervi. In a complex experiment, we use a quantitative genetic design in the parasitoid, two ecologically different aphid lineages and the aphid lionChrysoperla carneaas an intraguild predator to unravel the complex interdependencies.

Results

We demonstrate that aphid immunity as a key trait of this complex host-parasite system is affected by intraspecific genetic variation in the parasitoid and the aphid, the interaction of intraspecific genetic variation with intraguild predation, and differences in defensive endosymbionts between aphid lineages. Further, aphid lineages differ in their altruistic behaviour whereby infested aphids move away from the clonal colony to facilitate predation.

Conclusions

Our findings provide new insights into the influence of endosymbiosis and genetic variability in an important host-parasitoid system which is influenced by natural enemies of the parasitoid and the aphid, including its endosymbiont communities. We show that endosymbiosis can mediate or influence the evolutionary arms race between aphids and their natural enemies. The outcome of these complex interactions between species has significant implications for understanding the evolution of multitrophic systems, including eco-agricultural settings.
Prevention Admission into Nursing homes (PAN): study protocol for an explorative, prospective longitudinal pilot study
Authors: Koppitz Andrea L. , Suter-Riederer Susanne , Bieri-Brünig Gabriela , Geschwinder Heike , Senn Anita Keller , Spichiger Frank , Volken Thomas
Published: March 2022

Background

In Switzerland, there is a lack of adequate rehabilitation services, and effective coordination, that take into account the multifactorial health risks of older people. The literature shows that the hospitalisation rate in rehabilitation facilities has increased in recent years and that a gender bias exists. Additionally, there is little or no evidence available on the effect that a post-acute care programme might have over an extended period on functioning, quality of life and the informal network of older people. Therefore, the aim of this trial is to evaluate the sustainability of post-acute care within three nursing homes in Zurich, Canton of Zurich, Switzerland.

Methods

The Prevention Admission into Nursing homes (PAN) study is a explorative, prospective, longitudinal pilot trial based on a convenience sample of three long-term care facilities in the Swiss Canton of Zurich. The proposed pilot study will examine the effects of a post-acute care programme on people aged ≥65 years with a post-acute care potential ≥ three admitted to any of the three post-acute care units (n = 260). Older people of all sexes admitted to one of the post-acute care units and likely to be discharged to home within 8 weeks will be eligible for participation in the study. The primary endpoint is functionality based on the Barthel Index. The secondary endpoints are independency based on delirium, cognition, mobility, falling concerns, frailty, weight/height/body mass index, post-acute care capability, quality of life, and lastly, the informal network. As part of process evaluation, a qualitative evaluation will be conducted based on constructive grounded theory to specifically analyse how the experience of informal caregivers (n = 30) can contribute to a successful daily life 6 months after discharge.

Discussion

We expect to observe improved functional status and independence after the post-acute care programme. The qualitative evaluation conducted with caregivers will complement our description of the transition of older people towards living at home.

Trial registration

This study is registered in the German Clinical Trials Register under DRKS00016647 (registered on 23.05.2019).
Standards and quality of care for older persons in long term care facilities: a scoping review
Authors: Kalideen Letasha , Govender Pragashnie , van Wyk Jacqueline Marina
Published: March 2022

Background

Caring for older persons has become a global necessity to ensure functional ability and healthy ageing. It is of paramount importance that standards of care are monitored, especially for older persons who live in long term care facilities (LTCF). We, therefore, scoped and summarised evidence relating to standards and the quality of care for older persons in LTCFs in gerontological literature globally.

Methods

We conducted a scoping review using Askey and O’Malley’s framework, including Levac et al. recommendations. PubMed, CINAHL, Health Sources, Scopus, Cochrane Library, and Google Scholar were searched with no date limitation up to May 2020 using keywords, Boolean terms, and medical subject headings. We also consulted the World Health Organization website and the reference list of included articles for evidence sources. This review also included peer-reviewed publications and grey literature in English that focused on standards and quality of care for older residents in LTCFs. Two reviewers independently screened the title, abstract, and full-text of evidence sources screening stages and performed the data extraction. Thematic content analysis was used, and a summary of the findings are reported narratively.

Results

Sixteen evidence sources published from 1989 to 2017 met this study’s eligibility criteria out of 73,845 citations obtained from the broader search. The majority of the studies were conducted in the USA 56% (9/16), and others were from Canada, Hong Kong, Ireland, Norway, Israel, Japan, and France. The included studies presented evidence on the effectiveness of prompted voiding intervention for urinary incontinence in LTCFs (37.5%), the efficacy of professional support to LTCF staff (18.8%), and the prevention-effectiveness of a pressure ulcer programme in LTCFs (6.3%). Others presented evidence on regulation and quality of care (12.5%); nursing documentation and quality of care (6.3%); medical, nursing, and psychosocial standards on the quality of care (6.3%); medication safety using the Beer criteria (6.3%); and the quality of morning care provision (6.3%).

Conclusion

This study suggests most studies relating to standards and quality of care in LTCFs focus on effectiveness of interventions, few on people-centredness and safety, and are mainly conducted in European countries and the United States of America. Future studies on people-centerdness, safety, and geographical settings with limited or no evidence are recommended.
Experiences of family caregivers 3-months after stroke: results of the prospective trans-regional network for stroke intervention with telemedicine registry (TRANSIT-Stroke)
Authors: Jírů-Hillmann Steffi , Gabriel Katharina M. A. , Schuler Michael , Wiedmann Silke , Mühler Johannes , Dötter Klaus , Soda Hassan , Rascher Alexandra , Benesch Sonka , Kraft Peter , Pfau Mathias , Stenzel Joachim , von Nippold Karin , Benghebrid Mohamed , Schulte Kerstin , Meinck Ralf , Volkmann Jens , Haeusler Karl Georg , Heuschmann Peter U.
Published: March 2022

Background

Long-term support of stroke patients living at home is often delivered by family caregivers (FC). We identified characteristics of stroke patients being associated with receiving care by a FC 3-months (3 M) after stroke, assessed positive and negative experiences and individual burden of FC caring for stroke patients and determined factors associated with caregiving experiences and burden of FC 3 M after stroke.

Methods

Data were collected within TRANSIT-Stroke, a regional telemedical stroke-network comprising 12 hospitals in Germany. Patients with stroke/TIA providing informed consent were followed up 3 M after the index event. The postal patient-questionnaire was accompanied by an anonymous questionnaire for FC comprising information on positive and negative experiences of FC as well as on burden of caregiving operationalized by the Caregiver Reaction Assessment and a self-rated burden-scale, respectively. Multivariable logistic and linear regression analyses were performed.

Results

Between 01/2016 and 06/2019, 3532 patients provided baseline and 3 M-follow-up- data and 1044 FC responded to questionnaires regarding positive and negative caregiving experiences and caregiving burden. 74.4% of FC were older than 55 years, 70.1% were women and 67.5% were spouses. Older age, diabetes and lower Barthel-Index in patients were significantly associated with a higher probability of receiving care by a FC at 3 M. Positive experiences of FC comprised the importance (81.5%) and the privilege (70.0%) of caring for their relative; negative experiences of FC included financial difficulties associated with caregiving (20.4%). Median overall self-rated burden was 30 (IQR: 0–50; range 0–100). Older age of stroke patients was associated with a lower caregiver burden, whereas younger age of FC led to higher burden. More than half of the stroke patients in whom a FC questionnaire was completed did self-report that they are not being cared by a FC. This stroke patient group tended to be younger, more often male with less severe stroke and less comorbidities who lived more often with a partner.

Conclusions

The majority of caregivers wanted to care for their relatives but experienced burden at the same time. Elderly patients, patients with a lower Barthel Index at discharge and diabetes are at higher risk of needing care by a family caregiver.

Trial registration

The study was registered at “German Clinical Trial Register”: DRKS00011696. https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00011696
Establishment of a nomogram model for predicting adverse outcomes in advanced-age pregnant women with preterm preeclampsia
Authors: Lv Bohan , Zhang Yan , Yuan Guanghui , Gu Ruting , Wang Jingyuan , Zou Yujiao , Wei Lili
Published: March 2022

Aim

To establish a model for predicting adverse outcomes in advanced-age pregnant women with preterm preeclampsia in China.

Methods

We retrospectively collected the medical records of 896 pregnant women with preterm preeclampsia who were older than 35 years and delivered at the Affiliated Hospital of Qingdao University from June 2018 to December 2020. The pregnant women were divided into an adverse outcome group and a non-adverse outcome group according to the occurrence of adverse outcomes. The data were divided into a training set and a verification set at a ratio of 8:2. A nomogram model was developed according to a binary logistic regression model created to predict the adverse outcomes in advanced-age pregnant women with preterm preeclampsia. ROC curves and their AUCs were used to evaluate the predictive ability of the model. The model was internally verified by using 1000 bootstrap samples, and a calibration diagram was drawn.

Results

Binary logistic regression analysis showed that platelet count (PLT), uric acid (UA), blood urea nitrogen (BUN), prothrombin time (PT), and lactate dehydrogenase (LDH) were the factors that independently influenced adverse outcomes (P < 0.05). The AUCs of the internal and external verification of the model were 0.788 (95% CI: 0.737 ~ 0.764) and 0.742 (95% CI: 0.565 ~ 0.847), respectively. The calibration curve was close to the diagonal.

Conclusions

The model we constructed can accurately predict the risk of adverse outcomes of pregnant women of advanced age with preterm preeclampsia, providing corresponding guidance and serving as a basis for preventing adverse outcomes and improving clinical treatment and maternal and infant prognosis.
Predicting the effect of sulfadoxine-pyrimethamine uptake by pregnant women on birth weight using a generalized ordered partial proportional odds model
Authors: Guure Chris , Afagbedzi Seth
Published: March 2022

Background

Low birth weight is a public health problem in Africa with the cause attributable to malaria in pregnancy. World Health Organization recommends the use of intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine to prevent malaria during pregnancy. The objective of this study was to evaluate the prevalence and trajectories of birth weight and the direct impact and relationship between sulfadoxine-pyrimethamine and birth weight in Ghana since 2003.

Method

This study used secondary data obtained from the Demographic and Health Survey conducted in Ghana since 2003. Low birth weight was defined as weight < 2500 g irrespective of the gestational age of the foetus, while normal birth weight was between 2500 g to < 4000 g and macrosomia was =  > 4000 g. In all the analysis, we adjusted for clustering, stratification and weighting to reduce bias and improve precision of the estimates. Analysis was performed on each survey year as well as the pooled dataset. The generalized ordered partial proportional odds model was used due to violations of the parallel regression model assumptions. Efforts were made to identify all confounding variables and these were adjusted for. Predictive analysis was also executed.

Results

The overall prevalence of low birth weight was 9% while that of macrosomia was 13%. The low birth weight for 2003 was 12% while in 2008 it was 21% and then 68% in 2014. The mean birth weight of the children in 2014 was 3.16 (3.14, 3.19), 2008 was 3.37 (3.28, 3.45) and 2003 was 3.59 (3.49, 3.69) while that of the pooled data was 3.28 (3.25, 3.30). The adjusted model (taking into consideration all confounding variables) showed that non-uptake of SP could result in 51% odds of giving birth to a low-birth-weight compared with normal birth weight child. An insignificant result was observed between macrosomia and low birth weight.

Conclusion

There is higher probability that low birth weight could increase over the next couple of years if measures are not taking to reverse the current trajectories. The uptake of sulfadoxine-pyrimethamine should continue to be encouraged and recommended because it has a direct beneficial effect on the weight of the child.
Effect of the Covid 19 pandemic on depression and mother-infant bonding in uninfected postpartum women in a rural region
Authors: Erten Özlem , Biyik İsmail , Soysal Cenk , Ince Onur , Keskin Nadi , Tascı Yasemin
Published: March 2022

Background

Postpartum depression and maternal-infant attachment scores were examined in uninfected women during the COVID 19 pandemic in Kutahya, a rural province in Turkey's North Aegean region.

Methods

This cohort study was conducted in the Kutahya Health Sciences University Hospital obstetrics unit between April 2021 and August 2021. 178 low-risk term pregnant women who gave birth were given the surveys Edinburgh Postpartum Depression Scale and Mother-to-Infant Bonding Scale (MIBQ) 6 weeks after birth. The Edinburgh Postpartum Depression Scale was used to determine postpartum depression and the Mother-to-Infant Bonding Scale was used to determine maternal attachment.

Results

In this study, the postpartum depression rate was calculated as 17.4%. When depressed and non-depressed patients were compared, education level, maternal age, BMI, MIBQ score, history of previous pregnancies, route of delivery, previous operation history, economic status, employment status and pregnancy follow-up information were found to be similar (p > 0.05). The ratings on the Mother-to-Infant Bonding Scale were found to be similar in depressed and non-depressed patients (p > 0.05). The odds of maternal depression for patients who received guests at home was 3.068 (95%CI [1.149–8.191]) times the odds of patients who did not receive guests at home.

Conclusions

Although a relationship has been found between accepting guests in the postpartum period and postpartum depression, it is necessary to investigate in further studies whether there is a causal relationship.
A prospective observational study exploring the association of comorbid chronic health conditions with total healthcare expenditure in people with mental health conditions in an Asian setting
Authors: Tyagi Shilpa , Ganesan Ganga , Subramaniam Mythily , Abdin Edimansyah , Vaingankar Janhavi Ajit , Chua Boon Yiang , Chong Siow Ann , Tan Kelvin Bryan
Published: March 2022

Background

It is pertinent to focus on chronic medical condition (CMC) comorbidity with mental health conditions (MHC) as their co-occurrence has significant cost and health implications. However, current evidence on co-occurrence of MHC with CMC is mixed and mostly from Western settings. Therefore, our study aimed to (i) describe the association between MHC and total healthcare expenditure, (ii) examine the association between CMC and total healthcare expenditure and (iii) examine determinants of total and different types of healthcare expenditure in respondents with and without MHC in an Asian setting.

Methods

The data from Singapore Mental Health Study (SMHS) 2016, a nationwide epidemiological survey, were linked with the National claims record (from 2017 to 2019). Multivariable Generalized Linear Models (GLM) were used to examine the association between MHC and total and different types of healthcare expenditure.

Results

A total of 3077 survey respondents were included in current analysis. Respondents with MHC had a lower mean age of 38.6 years as compared to those without MHC (47.1 years). MHC was associated with increased total healthcare expenditure after adjusting for covariates (b = 0.508,p < 0.05). In respondents with MHC, presence of CMC increased the total healthcare expenditure by 35% as compared to 40% increase in those without MHC. Interestingly, 35–49 years age group with MHC had almost 3 times higher total healthcare expenditure and 7.5 times higher inpatient expenditure as compared to the 18–34 years age group.

Conclusion

Our study highlights variations in association of CMC and age with total healthcare expenditure in those with versus without MHC in an Asian setting. Practical recommendations include appropriate planning and resource allocation for early diagnosis and management of MHC, proactive screening for CMC in those with MHC and addressing the dual issues of treatment gap and stigma to facilitate early help seeking and prevent episodic, costly healthcare utilization.
Prevalence of lifetime self-injurious thoughts and behaviors in a global sample of 599 patients reporting prospectively confirmed diagnosis with premenstrual dysphoric disorder
Authors: Eisenlohr-Moul Tory , Divine Madeline , Schmalenberger Katja , Murphy Laura , Buchert Brett , Wagner-Schuman Melissa , Kania Alyssa , Raja Sabina , Miller Adam Bryant , Barone Jordan , Ross Jaclyn
Published: March 2022

Background

Suicide is the second leading cause of death among Americans ages 10 to 34, with alarming recent increases in suicide rates among those assigned female at birth. A large body of evidence points to menstrual cycle influences on self-injurious thoughts and behaviors (STBs), suggesting that neurobiological hormone sensitivities, such as in premenstrual dysphoric disorder (PMDD), may drive suicide risk in females. However, existing studies of STBs in PMDD use cross-sectional self-report measures of PMDD with poor validity. As a first step to establish accurate prevalence rates of STBs in PMDD, we examined the lifetime prevalence of STBs in a large global survey of patients reporting a diagnosis of PMDD based on daily ratings.

Method

Individuals with self-reported PMDD symptoms were invited to an online survey through online support groups for PMDD and social media posts from PMDD awareness accounts. Participants reported demographics, whether they had been diagnosed with PMDD by a healthcare provider using daily ratings, STBs using the Columbia Suicide Severity Rating Scale, and history of lifetime comorbid psychiatric diagnoses.

Results

Of 2,689 survey completers, 599 (23%) reported a diagnosis with PMDD based on two months of daily ratings and were included in analyses. We observed high rates of lifetime active suicidal ideation (72%), planning (49%), intent (42%), preparing for an attempt (40%), and attempt (34%), as well as non-suicidal self-injury (51%). The majority (70%) of the sample reported at least one lifetime comorbid psychiatric diagnosis. Predictors of lifetime active suicidal ideation included nulliparity, low-to-moderate (vs. high) income, and history of diagnosis with major depression or post-traumatic stress disorder. Predictors of lifetime attempts among those reporting lifetime active ideation included older age, nulliparity, lower income, and history of diagnosis with post-traumatic stress disorder or borderline personality disorder.

Conclusions

These data indicate high rates of STBs among those reporting prospective diagnosis of PMDD and highlight the need for prospective research on mechanisms and prevention of STBs in PMDD. Clinical practice guidelines for PMDD should accommodate comorbidities and recommend frequent screenings for STB risk. STBs should be considered for inclusion in future iterations of the DSM PMDD diagnostic criteria.
Association between weather and utilisation of physical therapy in patients with osteoarthritis: a case-crossover study
Authors: Wu Ruo-Yan , Pan Ren-Hao , Wu Chiung-Yi , Chan Chien-Lung , Yeh Huan-Jui
Published: March 2022

Background

During varied weather conditions, patients with osteoarthritis experience different severity of symptoms and signs. However, weather may also cause barriers or incentives for patients to seek medical services. These factors may result in changes in medical utilisation; however, no studies have investigated whether the probability of physical therapy utilisation among patients with osteoarthritis is associated with changes in meteorological factors.

Method

By using a secondary data of NHID in Taiwan, we conducted a population-based, retrospective study with case-crossover design for patients initially diagnosed with osteoarthritis between 2000 and 2013. The meteorological factors of months with the lowest treatment rate were used as patients’ own control periods and compared with the parameters of months with high treatment frequency. The risk of exposure to different meteorological factors, including mean temperature, daily highest temperature, daily minimum temperature, diurnal temperature range, relative humidity, and barometric pressure, was estimated and represented by odds ratios (ORs) and 95% confidence intervals (CIs).

Results

A total of 8,130 patients were recruited. Regardless of univariate or multivariable analysis, increased daily highest temperature enhanced the frequency of physical therapy (OR: 1.04; 95% CI: 1.02–1.05; p < 0.01; OR: 1.07; 95% CI: 1.04–1.10; p < 0.01). When the weather was hotter (> 23 °C), higher diurnal temperature range and humidity resulted in an increase in the utilisation of physical therapy. However, when the weather was colder (< 23 °C), reverse effects were observed.

Conclusions

An increase in temperature increases the probability of physical therapy resource use. Therefore, temperature, along with other meteorological factors, may play a key role in the utilization of physical therapy among patients with osteoarthritis.