bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of monopoly learning media in lactation education classes
Authors: Hapitria Pepi , Nurlina Neli
Published: October 2024

Background: Exclusive breastfeeding is one of the rights that children should have, as breastfeeding for the first six months is the best way to fulfill a child's nutritional needs to continue the growth of their brain, liver, and immune system. Exclusive breastfeeding can also reduce infectious mortality by 88 percent in infants less than 3 months old. Currently, the achievement of exclusive breastfeeding is 69.7% and has met the 2021 target of 45%. One of the causes is influenced by the learning process. Interesting and fun learning media can affect learning outcomes. Therefore, it is important for midwives to grow the interest and attractiveness of pregnant women in the learning process with the help of appropriate learning media and involve pregnant women in lactation education classes through Monopoly games.

Objectives: This study aims to develop Monopoly game media in lactation education classes and describe the feasibility of Monopoly game media as learning media in lactation education classes for pregnant women.

Methods: This study uses research and development methods, namely expert sampling. The data collection instrument was a Likert scale questionnaire and descriptive statistical analysis techniques. The design of research activities only reached the feasibility test of monopoly learning media.

Results: The learning media developed regarding the feasibility of learning aspects by material experts and users obtained an average score of 4.32, entered the good category. Meanwhile, according to media experts, an average score of 4.9 was obtained based on media engineering aspects, and based on visual communication aspects, an average score of 4.62 was obtained.

Conclusions: This study shows that the development media for lactation education classes in the form of monopoly is in a good category and suitable for use
Comparison of cortisol, depression and stress hormone levels in primary dysmenorhore adolescents with the application of a combination of facial acupressure with classic music therapy
Authors: Anggraini Fitrya Ayu
Published: October 2024

Background : Constant chronic dysmenorrhea pain, should be screened with a single morning serum cortisol concentration. Uncontrolled pain (acute and chronic) initially indicates high serum cortisol concentrations. Then, one of the factors that can influence pain during menstruation is stress.

Objectives : This study aims to assess non-pharmacological interventions for facial acupressure (BL-2, Yin Tang, GV 23, GB 15, Tai Yang, GB 14, Ex Hn4, TE 23, Sang Ming , LI-20, Ex Hn 8, ST-3, Si 18, Du 26, REN 24, JiaCenjiang, SJ21, SJ17, GB-2) combined with Mozart classical music in reducing cortisol levels, depression and stress in dysmenorrhea primary.

Methods: This is quantitative research with a quasi-experimental design. The research approach used is pre-post test design. In November 2021-January 2022 at Megarezky University Makassar. There were 42 Adolescents with Primary Dysmenorrhea for respondents to this research. The sample in this study was divided into three groups, namely an intervention group (combination of facial acupressure with classical music) and 2 control groups which were only given classical music and facial acupressure treatment. Data collected included depression and stress. In addition, cortisol levels were checked using an ELISA Kit. Then the data was analyzed using the Paired T-test, while to see the differences if it was normally distributed using the One Way Anova test and if it was not normally distributed using Kruskal-Wallis.

Results: The results of the study found that there was a decrease in cortisol levels, depression and stress when given facial acupressure and classical music, but the reduction was more effective if a combination of facial acupressure and classical music.

Conclusions: Among the variables of cortisol levels, depression and stress, the combination of facial acupressure and classical music was significantly more effective in improving stress than just giving facial acupressure and classical music. 
Innovative android application for anthropometric assessment of nutritional status in boys aged 0-59 months
Authors: Alam Hilda Sulistia , Asriadi Asriadi
Published: October 2024

Background: Smartphone users in Indonesia mostly use smartphones to access mobile applications rather than mobile websites. As many as 82% of smartphone users in Indonesia access mobile applications while the remaining 9% of users each access mobile websites and websites via desktop. The majority of the population of smartphone users who access mobile applications come from productive age, namely 75% from 18-24 year olds and 79% from 25-34 year olds. The survey results prove that the development of information technology in mobile technology has developed rapidly. These technological developments have resulted in changes and developments in all fields, one of which is the health sector.

Objectives: The aim of this research is to design and create Android-based anthropometry of nutritional status aged 0-59 months. which can be downloaded via the cell phone used by Posyandu cadres.

Methods:.

This research developed an innovative Android application to assess the nutritional status of boys aged 0-59 months using the Waterfall development method in the Software Development Life Cycle (SDLC). This approach starts from requirements analysis, system design, coding, testing, to implementation and maintenance, which is carried out in a linear and gradual manner to ensure that each phase of development runs in a structured manner and produces effective and high-quality applications.

Results:

The research results show that this anthropometric application significantly increases the efficiency and effectiveness of Posyandu cadre service time. By reducing the need for manual recording and calculations, this application speeds up the process of assessing the nutritional status of children aged 0-59 months, reduces errors, and allows cadres to focus more on direct interactions with mothers and children, thereby improving the overall quality of services.

Conclusions: Android-based Anthropometric Application for Nutritional Status Age 0-59 Months is a digital tools.
The influence of ANC cadre empowerment on ANC visits of pregnant women in Bengkulu City
Authors: Yuniarti Yuniarti , Yorita Epti , Widiyanti Desi , Destariyani Elvi
Published: October 2024

Background: Services during pregnancy are pregnancy health check-up services carried out  by health workers, especially midwives or doctors for pregnant women which are carried out at least four times in pregnancy   with details, namely one time gestational age 0-12 weeks, one time ANC gestational age 13-27 weeks and twice when the gestational age is 28-36 weeks. Based on the profile of K1 and K4 visits from 20 Public Health Centers in Bengkulu City, there are 3 Public Health Centers with K1 and K4 visits which are still low and have not reached the set targets and there is still a drop out where there is a decrease between K1 and K4 visits.

Objectives: The study aims to knowing the influence of the empowerment of ANC   the community health worker on the visit of ANC Pregnant Women in Bengkulu City

Methods: This research uses a quasi-experimental method. The samples taken for the study were all pregnant women in Bengkulu City who were selected by purposive sampling.  The sample consisted of 2 groups, namely the experimental group on pregnant women with the empowerment of ANC the community health worker  and  the ontrol group with counseling totaling 40 people.  Data collection is carried out through data collection sheets and analyzed data with univariate and bivariate Data analysis used bivariate

Results: The results of the study found that there was an Effect of Empowerment of ANC the community health worker  on ANC visits to pregnant women in Bengkulu City in 2020

Conclusions: The results Thisstudy was used as an alternative recommendation  for increasing ANC visits
Evolution of the “Internet Plus Health Care” Mode Enabled by Artificial Intelligence: Development and Application of an Outpatient Triage System
Authors: Yang Lingrui , Pang Jiali , Zuo Song , Xu Jian , Jin Wei , Zuo Feng , Xue Kui , Xiao Zhongzhou , Peng Xinwei , Xu Jie , Zhang Xiaofan , Chen Ruiyao , Luo Shuqing , Zhang Shaoting , Sun Xin
Published: October 2024

Background

Although new technologies have increased the efficiency and convenience of medical care, patients still struggle to identify specialized outpatient departments in Chinese tertiary hospitals due to a lack of medical knowledge.

Objective

The objective of our study was to develop a precise and subdividable outpatient triage system to improve the experiences and convenience of patient care.

Methods

We collected 395,790 electronic medical records (EMRs) and 500 medical dialogue groups. The EMRs were divided into 3 data sets to design and train the triage model (n=387,876, 98%) and test (n=3957, 1%) and validate (n=3957, 1%) it. The triage system was altered based on the current BERT (Bidirectional Encoder Representations from Transformers) framework and evaluated by recommendation accuracies in Xinhua Hospital using the cancellation rates in 2021 and 2022, from October 29 to December 5. Finally, a prospective observational study containing 306 samples was conducted to compare the system’s performance with that of triage nurses, which was evaluated by calculating precision, accuracy, recall of the top 3 recommended departments (recall@3), and time consumption.

Results

With 3957 (1%) records each, the testing and validation data sets achieved an accuracy of 0.8945 and 0.8941, respectively. Implemented in Xinhua Hospital, our triage system could accurately recommend 79 subspecialty departments and reduce the number of registration cancellations from 16,037 (3.83%) of the total 418,714 to 15,338 (3.53%) of the total 434200 (P<.05). In comparison to the triage system, the performance of the triage nurses was more accurate (0.9803 vs 0.9153) and precise (0.9213 vs 0.9049) since the system could identify subspecialty departments, whereas triage nurses or even general physicians can only recommend main departments. In addition, our triage system significantly outperformed triage nurses in recall@3 (0.6230 vs 0.5266; P<.001) and time consumption (10.11 vs 14.33 seconds; P<.001).

Conclusions

The triage system demonstrates high accuracy in outpatient triage of all departments and excels in subspecialty department recommendations, which could decrease the cancellation rate and time consumption. It also improves the efficiency and convenience of clinical care to fulfill better the usage of medical resources, expand hospital effectiveness, and improve patient satisfaction in Chinese tertiary hospitals.
Differences in Messenger RNA Expression of Fibulin-1, Elastin, Matrix Metalloproteinase-1, Basic Fibroblast Growth Factor, and α-Smooth Muscle Actin Between the Ventral and Dorsal Tunica Dartos in Patients With Hypospadias and Chordee: Protocol for a Prospective Cohort Study
Authors: Pitoyo Joko , Alvarino  , Darwin Eryati , Yanwirasti
Published: October 2024

Background

Hypospadias is a common congenital anomaly characterized by the displacement of the urethral opening to the ventral side of the penis. Surgical correction is often necessary for functional and psychological reasons. The etiology involves genetic and environmental factors, and chordee, a downward curvature of the penis, is a common complication. Proteins such as fibulin-1, elastin, matrix metalloproteinase-1, basic fibroblast growth factor, and α-smooth muscle actin play roles in hypospadias development.

Objective

The study’s aim is to investigate the differences in messenger RNA (mRNA) expression of fibulin-1, elastin, matrix metalloproteinase-1, basic fibroblast growth factor, and α-smooth muscle actin between the ventral and dorsal tunica dartos in patients with hypospadias and chordee.

Methods

This prospective cohort study aims to investigate differences in mRNA expression of the abovementioned proteins between the ventral and dorsal tunica dartos in patients with hypospadias and chordee. Ethics approval has been obtained, and consent from parents will be obtained before data collection. Eligible participants are aged 6-18 months, diagnosed with hypospadias and chordee, and planned for urethroplasty. Tissue samples will be collected from both aspects of the tunica dartos and analyzed using real-time quantitative reverse transcription–polymerase chain reaction. Data analysis will involve statistical tests and normalization of housekeeping genes.

Results

This study is at the protocol development stage. A pilot study regarding its feasibility has been ongoing as of August 2023. The study results are expected to be available by the end of 2024.

Conclusions

The study of mRNA expressions of various proteins in the tunica dartos of patients with hypospadias and chordee is expected to improve the understanding and expand the knowledge of the pathophysiology of hypospadias and chordee.

International Registered Report Identifier (IRRID)

DERR1-10.2196/52282
How Explainable Artificial Intelligence Can Increase or Decrease Clinicians’ Trust in AI Applications in Health Care: Systematic Review
Authors: Rosenbacke Rikard , Melhus Åsa , McKee Martin , Stuckler David
Published: October 2024

Background

Artificial intelligence (AI) has significant potential in clinical practice. However, its “black box” nature can lead clinicians to question its value. The challenge is to create sufficient trust for clinicians to feel comfortable using AI, but not so much that they defer to it even when it produces results that conflict with their clinical judgment in ways that lead to incorrect decisions. Explainable AI (XAI) aims to address this by providing explanations of how AI algorithms reach their conclusions. However, it remains unclear whether such explanations foster an appropriate degree of trust to ensure the optimal use of AI in clinical practice.

Objective

This study aims to systematically review and synthesize empirical evidence on the impact of XAI on clinicians’ trust in AI-driven clinical decision-making.

Methods

A systematic review was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, searching PubMed and Web of Science databases. Studies were included if they empirically measured the impact of XAI on clinicians’ trust using cognition- or affect-based measures. Out of 778 articles screened, 10 met the inclusion criteria. We assessed the risk of bias using standard tools appropriate to the methodology of each paper.

Results

The risk of bias in all papers was moderate or moderate to high. All included studies operationalized trust primarily through cognitive-based definitions, with 2 also incorporating affect-based measures. Out of these, 5 studies reported that XAI increased clinicians’ trust compared with standard AI, particularly when the explanations were clear, concise, and relevant to clinical practice. In addition, 3 studies found no significant effect of XAI on trust, and the presence of explanations does not automatically improve trust. Notably, 2 studies highlighted that XAI could either enhance or diminish trust, depending on the complexity and coherence of the provided explanations. The majority of studies suggest that XAI has the potential to enhance clinicians’ trust in recommendations generated by AI. However, complex or contradictory explanations can undermine this trust. More critically, trust in AI is not inherently beneficial, as AI recommendations are not infallible. These findings underscore the nuanced role of explanation quality and suggest that trust can be modulated through the careful design of XAI systems.

Conclusions

Excessive trust in incorrect advice generated by AI can adversely impact clinical accuracy, just as can happen when correct advice is distrusted. Future research should focus on refining both cognitive and affect-based measures of trust and on developing strategies to achieve an appropriate balance in terms of trust, preventing both blind trust and undue skepticism. Optimizing trust in AI systems is essential for their effective integration into clinical practice.
Effect of Multimodal App-Based Interventions on Glycemic Control in Patients With Type 2 Diabetes: Systematic Review and Meta-Analysis
Authors: Bodner Emma , Roth Lena , Wiencke Kathleen , Bischoff Christian , Schwarz Peter EH
Published: October 2024

Background

Digital technologies for type 2 diabetes mellitus (T2DM) care hold great potential to improve patients’ health in the long term. Only a subset of telemedicine offerings are digital interventions that meet the criteria for prescribable digitale Gesundheitsanwendung (digital health apps; DiGAs) in Germany. Digital treatments further provide vast amounts of patient data that are important to generate evidence.

Objective

This systematic review aims to analyze the efficacy of multimodal digital therapies that mainly meet the DiGA criteria for patients with T2DM and to elicit the potential of such therapies. This includes evidence from randomized controlled trials (RCTs) as well as from real-world data. The outcome of interest was a reduction in glycated hemoglobin (hemoglobin A1c [HbA1c]; long-term blood glucose measurements).

Methods

A systematic literature search was conducted in the literature bases PubMed, LIVIVO, and Cochrane, based on the predefined PICO (Population; Intervention; Control; Outcome) scheme. Identified studies were assessed for risk of bias, pragmatism, and overall quality of evidence. Meta-analyses were conducted for between group differences using RCTs only, and for within-group differences using RCTs and non-RCTs, to examine the effect of the interventions on HbA1c.

Results

In total, 795 records were identified, of which 24 were eligible for this systematic review and 23 studies were eligible for the meta-analysis. The results of the meta-analyses showed significant and clinically relevant reductions in HbA1c in patients with T2DM. Regarding the between-group difference for HbA1c reduction, the pooled effect of the RCTs showed a reduction of –0.36% (95% CI –0.59% to –0.14%; P<.001), favoring app-based interventions. The average mean within-group reduction in HbA1c was –0.79 (95% CI –1.02 to –0.55), with no significant difference between RCTs (–0.69, 95% CI –1.13 to –0.24) and non-RCTs (–0.87, 95% CI –1.16 to –0.57; P<.01, differences between RCTs and RCTs P=.44). A pragmatism rating showed that both study types were on average (very) pragmatic, that is, close to usual care. However, the overall quality of evidence was low to very low.

Conclusions

This systematic review shows that digital therapies that mainly meet the DiGA criteria can effectively improve HbA1c in patients with T2DM. The integration of digital health care into usual care holds great potential and should be considered as a complementary option to usual care in the future.

Trial Registration

PROSPERO CRD42023440203; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=440203
Evaluating the Implementation and Clinical Effectiveness of an Innovative Digital First Care Model for Behavioral Health Using the RE-AIM Framework: Quantitative Evaluation
Authors: Nordberg Samuel S , Jaso-Yim Brittany A , Sah Pratha , Schuler Keke , Eyllon Mara , Pennine Mariesa , Hoyler Georgia H , Barnes J Ben , Murillo Lily Hong , O'Dea Heather , Orth Laura , Rogers Elizabeth , Welch George , Peloquin Gabrielle , Youn Soo Jeong
Published: October 2024

Background

In the United States, innovation is needed to address the increasing need for mental health care services and widen the patient-to-provider ratio. Despite the benefits of digital mental health interventions (DMHIs), they have not been effective in addressing patients’ behavioral health challenges as stand-alone treatments.

Objective

This study evaluates the implementation and effectiveness of precision behavioral health (PBH), a digital-first behavioral health care model embedded within routine primary care that refers patients to an ecosystem of evidence-based DMHIs with strategically placed human support.

Methods

Patient demographic information, triage visit outcomes, multidimensional patient-reported outcome measure, enrollment, and engagement with the DMHIs were analyzed using data from the electronic health record and vendor-reported data files. The RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework was used to evaluate the implementation and clinical effectiveness outcomes of PBH.

Results

PBH had a 47.58% reach rate, defined as patients accepting the PBH referral from their behavioral health integrated clinician. PBH patients had high DMHI registration rates (79.62%), high activation rates (76.54%), and high retention rates at 15 days (57.69%) and 30 days (44.58%) compared to literature benchmarks. In total, 74.01% (n=168) of patients showed clinical improvement, 22.47% (n=51) showed no clinical change, and 3.52% (n=8) showed clinical deterioration in symptoms. PBH had high adoption rates, with behavioral health integrated clinicians referring on average 4.35 (SD 0.46) patients to PBH per month and 90%-100% of clinicians (n=12) consistently referring at least 1 patient to PBH each month. A third (32%, n=1114) of patients were offered PBH as a treatment option during their triage visit.

Conclusions

PBH as a care model with evidence-based DMHIs, human support for patients, and integration within routine settings offers a credible service to support patients with mild to moderate mental health challenges. This type of model has the potential to address real-life access to care problems faced by health care settings.
The Implementation of the Advocacy Intervention for Midlife and Older Women Who Have Experienced Intimate Partner Violence: Protocol for a Randomized Controlled Trial
Authors: Weeks Lori , Allen Kathleen , Holtmann Catherine , Leger Joni , Dupuis-Blanchard Suzanne , MacQuarrie Colleen , Macdonald Marilyn , Moody Elaine , Stilwell Christie , Helpard Heather , Gagnon Danie
Published: October 2024

Background

Midlife and older women who experience intimate partner violence (IPV) often have less access to supports and services than younger women. There is far less focus on research and supports for midlife and older women compared to younger women experiencing IPV, and often, neither elder abuse nor IPV services meet their needs. Few interventions are available to meet the needs of midlife and older women.

Objective

The goal of this randomized controlled trial is to test the effectiveness of an advocacy intervention for midlife and older women who experience IPV and to learn from the experiences of those who implement and participate in the program.

Methods

This trial is a 2-arm, unblinded, parallel, pragmatic randomized controlled trial with a qualitative component. Eligible participants will be women who live in the Maritime provinces of Canada (New Brunswick, Nova Scotia, and Prince Edward Island), who are in midlife and older (aged approximately ≥50 years), and who are currently in a relationship with an abusive partner or have recently left an abusive partner. Facilitators will be trained to deliver the intervention. The intervention will be entirely virtual and will consist of 2 components: (1) an empowerment component, which will involve sharing resources and information with the women; and (2) a social support component, which will include providing support and encouragement to women for 12 weeks. Quantitative effectiveness data will be collected from all trial participants at baseline, 3 months after the intervention, and 9 months after the intervention about the incidence and severity of IPV, physical and mental health, and safety behaviors and strategies. Qualitative interviews will be conducted with the facilitators and intervention group participants. Control group participants will receive a static, nontailored version of the advocacy intervention for midlife and older women (AIM) intervention materials after baseline data collection.

Results

A total of 12 facilitators have been trained to deliver the AIM intervention to trial participants. Participant recruitment and data collection will be completed in January 2025. Data analysis will continue throughout the data collection period, and the results will be disseminated by December 2025.

Conclusions

This research will result in the adaptation and testing of a program to support and empower midlife and older women in the Maritime provinces of Canada who experience IPV.

Trial Registration

International Standard Randomized Controlled Trial Registry ISRCTN30646991; https://doi.org/10.1186/ISRCTN30646991

International Registered Report Identifier (IRRID)

DERR1-10.2196/57886
Ensuring Accuracy and Equity in Vaccination Information From ChatGPT and CDC: Mixed-Methods Cross-Language Evaluation
Authors: Joshi Saubhagya , Ha Eunbin , Amaya Andee , Mendoza Melissa , Rivera Yonaira , Singh Vivek K
Published: October 2024

Background

In the digital age, large language models (LLMs) like ChatGPT have emerged as important sources of health care information. Their interactive capabilities offer promise for enhancing health access, particularly for groups facing traditional barriers such as insurance and language constraints. Despite their growing public health use, with millions of medical queries processed weekly, the quality of LLM-provided information remains inconsistent. Previous studies have predominantly assessed ChatGPT’s English responses, overlooking the needs of non–English speakers in the United States. This study addresses this gap by evaluating the quality and linguistic parity of vaccination information from ChatGPT and the Centers for Disease Control and Prevention (CDC), emphasizing health equity.

Objective

This study aims to assess the quality and language equity of vaccination information provided by ChatGPT and the CDC in English and Spanish. It highlights the critical need for cross-language evaluation to ensure equitable health information access for all linguistic groups.

Methods

We conducted a comparative analysis of ChatGPT’s and CDC’s responses to frequently asked vaccination-related questions in both languages. The evaluation encompassed quantitative and qualitative assessments of accuracy, readability, and understandability. Accuracy was gauged by the perceived level of misinformation; readability, by the Flesch-Kincaid grade level and readability score; and understandability, by items from the National Institutes of Health’s Patient Education Materials Assessment Tool (PEMAT) instrument.

Results

The study found that both ChatGPT and CDC provided mostly accurate and understandable (eg, scores over 95 out of 100) responses. However, Flesch-Kincaid grade levels often exceeded the American Medical Association’s recommended levels, particularly in English (eg, average grade level in English for ChatGPT=12.84, Spanish=7.93, recommended=6). CDC responses outperformed ChatGPT in readability across both languages. Notably, some Spanish responses appeared to be direct translations from English, leading to unnatural phrasing. The findings underscore the potential and challenges of using ChatGPT for health care access.

Conclusions

ChatGPT holds potential as a health information resource but requires improvements in readability and linguistic equity to be truly effective for diverse populations. Crucially, the default user experience with ChatGPT, typically encountered by those without advanced language and prompting skills, can significantly shape health perceptions. This is vital from a public health standpoint, as the majority of users will interact with LLMs in their most accessible form. Ensuring that default responses are accurate, understandable, and equitable is imperative for fostering informed health decisions across diverse communities.
Experiences of Older Mental Health Patients and Their Care Partners Using a Proxy Account to Access Open Notes: Qualitative Interview Study
Authors: Meier-Diedrich Eva , Esch Tobias , Hägglund Maria , Heinze Martin , Hochwarter Stefan , Speck Justin , Wagener Marie , Dahling Volker , Schwarz Julian
Published: October 2024

Background

Older patients with serious mental illnesses such as cognitive disorders often rely on family members or spouses (care partners [CPs]) to meet their health care needs. CPs frequently lack essential information to fully understand the patients’ illnesses and effectively support their treatment. Open Notes provide patients with digital access to their health care professionals’ clinical notes and are associated with many positive outcomes, such as increased adherence and empowerment. However, older patients who use Open Notes may encounter use barriers such as limited digital literacy. Recent developments allow CPs to access Open Notes (proxy access) and receive valuable information, which holds significant potential for improving the care of older patients.

Objective

This study explored the experiences, barriers, and opportunities of older mental health patients and their CPs related to using Open Notes. Furthermore, influencing factors and interdependencies were identified.

Methods

Older patients (n=10) and their CPs (n=10) were provided with web-based proxy access to clinical documentation through a web-based patient portal. In-depth qualitative interviews (N=20) were conducted to explore experiences with this access. Data analysis was conducted in accordance with the constructivist grounded theory approach.

Results

The prerequisites for using Open Notes with proxy access were sufficient digital literacy on the part of the patient or CP, as well as the establishment of a trusting relationship between patients and CPs. Access to Open Notes enabled patients and CPs to gain a deeper understanding of the illness and its treatment while also facilitating enhanced contact with health care professionals. This resulted in greater involvement in the treatment process but may also prompt changes in relationship dynamics—CPs are better equipped to support patients in their health care but may also tend to monitor or control them through Open Notes. As a result, the introduction of Open Notes was accompanied by mixed feelings.

Conclusions

It is of utmost importance to provide older patients with comprehensive access to Open Notes to preserve their health autonomy. However, the involvement of CPs through proxy access is of great value in improving the care of older patients, especially those with cognitive impairments.
The development of a co-created decision aid for patients with depression: Combining data-driven prediction with patients’ and clinicians’ needs and perspectives (Preprint)
Authors: Kan Kaying , Jörg Frederike , Wardenaar Klaas J. , Blaauw Frank J. , Brilman Maarten F. , Visser Ellen , Raven Dennis , Meijnckens Dwayne , Buskens Erik , Cath Danielle C. , Doornbos Bennard , Schoevers Robert A. , Feenstra Talitha L.
Published: October 2024

BACKGROUND

To enable patient-centred treatment choices, shared decision-making (SDM) is essential. To date, instruments facilitating SDM in depression treatment are scarce, especially those that add personalized information, next to more general patient information. Co-creation is essential and seldom used in the development of such tools.

OBJECTIVE

We describe the development of an instrument that provides patients with depression and their clinicians with: (1) systematic information regarding symptoms, medical history, situational factors and potentially successful treatment strategies in a digital report and (2) objective treatment information guiding treatment decisions.

METHODS

The study was co-led by researchers and patient representatives, indicating all decisions regarding the development of the instrument were taken together. Data collection, analyses and tool development took place between 2017 – 2021. A mixed-methods approach was applied. Qualitative research provided insight into the end-users’ needs and preferences. A scoping review provided a summary of the available literature on identified predictors of treatment response. K-means cluster analysis was applied to suggest potentially successful treatment options based on similar patients and their outcomes in the past. These data were combined in a digital report. Treatment option grids were developed by patient advocacy groups to provide objective information on evidence-based treatment options.

RESULTS

The ‘Instrument for SDM in Depression’ (I-SHARED) was developed, incorporating individual characteristics and preferences. Qualitative analysis and the scoping review resulted in the identification of four categories of predictors of treatment response. The cluster analysis identified five distinct clusters based on symptoms, functioning and age. The co-created I-SHARED report combined all findings and was integrated into an existing electronic health record system ready for piloting, together with the treatment option grids.

CONCLUSIONS

The collaboratively developed decision aid for depression, including a clustering algorithm to predict potentially successful treatment options, has the potential to support SDM between patients and clinicians.
Blue Carbon Potential of Mangrove Ecosystems and Its Management to Promote Climate Change Mitigation in Indonesia
Authors: Rahman  , Lokollo Frijona F , Wawo Mintje , Ceanturi Ardan , Lewerissa Yona A , Hulopi Mahriyana , Handayani Luluk D , Zuhri Muhammad Isnan , Effendi Hefni , Wardiatno Yusli
Published: October 2024

This research aimed to analyze blue carbon potential and mangrove ecosystem management in promoting climate change mitigation in Indonesia. The collected data included mangrove area data obtained through the Indonesian National Ecosystem Monitoring System (SIMONTANA). This research calculated the carbon stock using the global average of mangrove carbon stock. The results showed that the total blue carbon stored in mangrove ecosystems reached 3,267.87 Megaton Carbon (MtC). Papua and Kalimantan regions contributed the most significant potential, with 1,707.22 MtC and 608.17 MtC, respectively. The absorption of carbon dioxide (CO2) reached 11,982.21 MtCO2e. The most significant CO2 gas emissions absorption was observed in the Papua region, amounting to 6,259.80 MtCO2e, followed by Sumatra with 2,118.59 MtCO2e. This high potential value correlated with mangrove ecosystem management policies, such as conservation, restoration, and blue carbon monetization. Mangrove management for climate change mitigation was carried out through national and international cooperation to achieve the 26% to 40% emission reduction target. The existing management model of mangrove ecosystems focused on improving ecological sustainability with less orientation on improving community welfare. Implementing blue carbon monetization at the district level by involving the community as the owners or managers of the mangrove ecosystems is crucial.
Research on Quality Evaluation of Climate Information Disclosure in Cement Industry
Authors: Ma Yue
Published: October 2024

This paper discusses the current situation and framework of climate information disclosure through the review of domestic and foreign literature. Based on relevant international guidelines and Chinese policies and regulations, the evaluation system is constructed from four dimensions of governance, strategy, risk management, index and target report by using analytic hierarchy process (AHP) and content analysis method. Taking the content of climate-related information disclosure of Tianshan Stock in 2023 as an example, this paper studies the gap between domestic cement enterprises in their climate information disclosure and the global benchmark, and puts forward relevant countermeasures and suggestions to promote the improvement of the quality of climate information disclosure of listed companies in the cement industry.
RELIGIOUS NORMS AND ECONOMIC ACTIVITY OF THE SECT OF THE EUNUCHS IN RUSSIA (THE SECOND HALF OF THE XIX-EARLY XX CENTURIES.)
Authors:   Smolensk Orthodox Theological Seminary (Russia), Gavrilenkov A.F.
Published: October 2024

The article discusses the features of the economic activity of the sect of the Scopians in the conditions of exile in the Yakut region of Siberia of the Russian Empire. It is noted that the religious norms of the faith of the Scopians provoked the peculiarities of their economic activity. Castration, especially the "royal seal", created conditions for the isolation of the Scopians from Russian society. The economic activity of the Scopians, on the contrary, allowed them to return to society. The Scopians could not count on full loyalty to themselves from society, since society rejected the rite of castration. Nevertheless, in the conditions of exile, the Scopians introduced capitalist relations, exploiting the local population (Yakuts) and their less well-off co-religionists. The working day of agricultural salaried workers at the Skoptsy lasted 19-20 hours a day. It should be borne in mind that the process of enrichment among the Scopians was significantly different from the similar process among European Protestants and Russian Old Believers. Protestants created religious norms, which then influenced the process of enrichment, forming a specific economic ethics of capitalist relations. The Old Believers, through enrichment, created conditions for achieving a righteous life. The Scopians sought to get out of isolation and return to society through the enrichment and development of capitalist relations.
Beyond sustainability reporting: A theoretical framework for ethical sustainability governance
Authors: Suhardjo Iwan , Akroyd Chris , Suparman Meiliana
Published: October 2024

Current sustainability efforts, often focused solely on reporting, have not had the expected impact. This conceptual paper proposes a framework based on ethical sustainability governance and incorporates a theory of change (ToC) (Organizational Research Services [ORS], 2004), that seeks to show how organizations can move beyond reporting and embrace ethical governance to achieve sustainable outcomes for people and the planet. Unlike frameworks like ESG (environmental, social, and governance), which emphasize external metrics, our framework prioritizes ethical governance and internal drivers for measurable outcomes. The framework also integrates a ToC which informs the framework’s design by outlining the desired long-term outcomes, necessary preconditions for implementation, specific interventions, and methods for measuring progress. Drawing inspiration from diverse theories such as the triple bottom line (TBL), corporate governance, purpose-led organizations, the theory of planned behavior (TPB), dynamic capabilities theory (DCT), and stakeholder theory, our framework establishes four interconnected pillars: environmental, social, cultural, and technological. It emphasizes that ethical governance needs to be the cornerstone of good sustainability-focused action (Ehrenfeld, 2005). Finally, it emphasizes actionable implementation to increase the likelihood of tangible progress toward sustainability goals. By guiding organizations in implementing ethical governance there is a higher chance that sustainability-focused action plans can enable positive outcomes
Environmental factors and risks affecting the adoption of e-wallets by small and medium-sized enterprises during disasters: The case of COVID-19 pandemic
Authors: Rababah Abedalqader , AlKasasbeh Islam , Khan Azeem Ahmad
Published: October 2024

Financial technology (FinTech) represents an innovative shift in the financial services industry, transforming the business model from traditional to technological, notably through digital wallets (e-wallets). Despite mobile payments becoming increasingly popular during the COVID-19 pandemic, there remains a scarcity of studies on this topic. Small companies faced numerous challenges during the pandemic, including layoffs, absenteeism, reduced sales, financial crises, weakened consumer demand due to closures, movement restrictions, and supply chain disruptions. Consequently, companies are actively seeking effective solutions to mitigate these impacts, such as adopting new FinTech. This research aims to investigate how environmental factors influenced the adoption of e-wallets by small and medium-sized enterprises (SMEs) during the COVID-19 pandemic. The authors will base the conceptual model on the technological, organizational, and environmental (TOE) framework (Tornatzky et al., 1990). The study will employ an electronic survey method to gather data from a community of small companies in Jordan, with a sample size of 600. The study will analyze five environmental factors that affect the decision to adopt e-wallets, including competition pressure, customer, supplier, and government pressure, support from government and technology suppliers, related technologies, and network externalities. This research will contribute to the literature by providing insights into the environmental challenges faced by SMEs during the pandemic and offering a model to explain the key factors that influence the adoption of e-wallets. Furthermore, it will serve as a valuable resource for policymakers in the financial sector to promote the adoption of e-wallets and other FinTech solutions.
Psychological Impact Of Kidnapping On Social Reintegration And Academic Pursuits Of Female Undergraduates In Zamfara State
Authors: Isma'il Akilu , Ibrahim Halimat Bashir
Published: October 2024

Although kidnapping and banditry are increasingly rampant in northern Nigeria, research on their psychological impact on female undergraduate students is lacking. To fill this gap, this study investigated the psychological impact of kidnapping on female undergraduate students in Zamfara State, Nigeria, focusing on their social reintegration and academic pursuits. Kidnapping and banditry have become pervasive in northern Nigeria, severely disrupting the lives of vulnerable communities including students in both pre-tertiary and tertiary institutions, particularly Zamfara State. The study adopted qualitative research design. Seven out of the female undergraduates of Federal University Gusau who had recently been released after prolonged captivity participated in the study. A combination of purposive and snowball sampling techniques was used to select participants based on availability, willingness, and ability to provide detailed accounts. Data was collected through structured interview. Thematic analysis revealed profound psychological trauma, including symptoms of Post-Traumatic Stress Disorder (PTSD), anxiety, and depression. Social reintegration challenges found in the study include stigmatization and alienation, while academic difficulties involved concentration, memory issues, and decreased motivation. The study recommends implementing comprehensive psychological support programmes within educational institutions located in high risk locations such as Zamfara State, including professional counseling and peer support groups, to address the long-term psychological effects and facilitate better social and academic reintegration of the victims
Retirement Illusion And Retirement Reality Compared: Reports Of Prospective Retirees And Retired Teachers In Nigeria
Authors: Olatomide Onijuni Olufemi
Published: October 2024

Prospective retirees usually prepare for what they thought they would need for retirement adjustment while retired ones are better positioned to evaluate adequacy of their earlier preparedness, judged by retirement reality. Will the future and the past align? This survey investigated pre-retirement guidance needs of retirement-eligible teachers, explored retroactive retirement guidance needs of retired teachers, and compared the results of the two groups. A sample (n=305; 151 prospective teacher-retirees; 154 retired teachers) was selected, while three research questions guided the study. Results showed the 16 items in the pre-retirement guidance needs are potential needs for teachers entering retirement (Item’s RSI >0.05), and the 16 items in the retrospective retirement guidance needs are areas that retired teachers opined they missed while preparing for retirement (Item’s RSI >0.05). Also, prospective retirees and the retired teachers reported dissimilar ranking in the order in which they desired retirement counselling, but they tallied in two items of needs. The findings underpin the necessity for periodically administering retirement preparedness and retirement readiness instruments on workers with a view to offering person-fit retirement counselling as they advance toward retirement.
Stereotactic body radiation therapy on abdominal-pelvic lymph node oligometastases: a systematic review on toxicity
Authors: Van Werkhoven Lucy A. , Cammareri Eugenio , Hoogeman Mischa S. , Nout Remi A. , Milder Maaike T.W. , Nuyttens Joost J.M.E.
Published: October 2024

Background and purpose: To review available data on toxicity during and/or after treatment of abdominal-pelvic lymph node oligometastases (A-P LN) with stereotactic body radiation therapy (SBRT) and to provide an overview of adverse events and its relation to dose or fractionation.
Material and methods: For this systematic review, we searched MEDLINE, Embase, Web of Science Core Collection, and CINAH for studies published between the database inception and October 3rd, 2023. Inclusion criteria were (1) patients with 1–5 A-P LN oligometastases, (2) treatment with SBRT to a median prescribed dose of ≥55 Gy BED10, and (3) description of acute and/or late toxicity. There were no language or date restrictions.
Results: A total of 35 studies, including 1,512 patients, were selected. Late grade 3 and 4 adverse events occurred in 0.6% and 0.1% of the patients treated for A-P LN oligometastases. All late adverse events grade ≥ 3 occurred after treatment of the tumor with a minimum BED10 of 72 Gy. Of the 11 patients with severe late toxicity, five patients were re-irradiated. Late grade 2 and 1 toxicity was reported in 3.4% and 8.3% of the patients. Acute toxicity grades 4, 3, 2, and 1 occurred in 0.1%, 0.2%, 4.4%, and 19.8% of the patients, respectively.
Interpretation: SBRT for A-P LN oligometastases show low toxicity rates. Nearly 50% of late adverse events ≥ grade 3 were associated with re-irradiation.
An Elderly Man with Facial Oedema and a Photosensitive Rash: A Quiz
Authors: Drivenes Jakob L. , Bygum Anette
Published: October 2024

Abstract is missing (Quiz)
APLICAÇÃO DE HIDROGEL COM DOSES DE SULFATO DE POTÁSSIO NO DESENVOLVIMENTO DA SOJA
Authors: Deminski Leonardo Henrique , Bariccatti Reinaldo Aparecido , Bassegio Doglas , Demetrio Tanicler , Siqueira Jair Antonio Cruz , Souza Samuel Nelson Melegari de , Machado Junior Waldir Mariano , Nogueira Carlos Eduardo Camargo
Published: October 2024

O objetivo deste estudo foi avaliar a utilização de sulfato de potássio incorporado ao hidrogel na cultura da soja (Glycine max L.) em diferentes doses. O experimento foi conduzido em delineamento de blocos casualizados no esquema fatorial 2 x 6 com 4 repetições. Os tratamentos foram constituídos pelas fontes de hidrogel (ForthGel® e ForthGel® incorporado com Sulfato de Potássio) e doses crescentes de hidrogel (0, 15, 20, 30, 40 e 45 kg ha-1). A primeira contagem de germinação foi realizada 5 dias após o cultivo, a germinação total aos 21 dias e a medição da altura total aos 40 dias. Os dados foram submetidos à análise de variância, aplicando-se o teste F ao nível de 5% de probabilidade e regressão. Os dados mostraram diferença estatisticamente significativa entre as parcelas em relação à produtividade total, para as doses de 30 e 40 kg ha-1 de hidrogel, e na primeira contagem de germinação nas doses de 15, 30 e 45 kg ha-1 de hidrogel, enquanto a altura total, massa de 100 grãos e número de plantas por área não apresentaram diferença estatisticamente mínima entre as parcelas e doses de hidrogel e hidrogel incorporado.