bluuebunny/crossref_metadata_2025 huggingface dataset:
A stochastic simulation-based risk assessment method for water allocation under uncertainty
Authors: Chen Shu , Yuan Zhe , Lei Caixiu , Li Qingqing , Wang Yongqiang
Published: April 2022

There are a lot of uncertainties in the water resources system, which makes the water allocation plan very risky. In order to analyze the risks of water resources allocation under uncertain conditions, a new methodology called the stochastic simulation-based risk assessment approach is developed in this paper. First, the main hydrological stochastic variable is fitted by a proper probability distribution. Second, suitable two-stage stochastic programming is constructed to obtain the expected benefit and optimized water allocation targets. Third, the Monte Carlo method is used to obtain a suitable stochastic sample of the hydrological variable. Fourth, a pre-allocated water optimization model is proposed to obtain optimized actual benefit. The methodology can give a way for risk analysis of water allocation plans obtained by uncertain optimization models, which provides reliable assistance to water managers in decision-making. The proposed methodology is applied to the Zhanghe Irrigation District and the risk of the water allocation plan obtained under the randomness of annual inflow is assessed. In addition, three different division methods of the annual inflow are applied in the first step, namely three levels, five levels and seven levels, respectively. From the results, the risk of the water allocation scheme obtained by the TSP model is 0.372–0.411 and decreases with the increase of the number of hydrological levels. Considering both the risk and model complexity, seven hydrological levels are recommended when using the TSP model to optimize water allocation under stochastic uncertainty.
Coliform removal efficacy of polyurethane foam impregnated with chitosan nanoparticles and silver/silver oxide nanoparticles
Authors: Sasidharan Anjali P. , V Meera , Raphael Vinod P.
Published: April 2022

This study was intended to synthesise, characterise and evaluate the antibacterial activity and Escherichia coli removal efficacy of a novel polyurethane foam impregnated with nanochitosan and nanosilver/silver oxide (PFCA). The study also exposed the effectiveness of nanochitosan as a disinfectant and as a binder for AgNPs, which has not been explored so far. The E. coli removal mechanism and antibacterial activity of PFCA were established by FTIR spectroscopy, XRD pattern and SEM analysis. PFCA achieved complete removal of E. coli with sufficient reusing capacities and possessed 100% antibacterial efficiency in a bacterial suspension of 5 × 106 CFU/mL. The study also showed that varying pH from 5 to 9 did not make any significant changes in the removal of E. coli. The presence of co-existing ions and organic matter did not reduce the efficiency of PFCA. The elution of silver ions (a very common limitation in treatment processes involving silver ions) was found to be much less, well below the drinking water limit. The study proved excellent potential of PFCA in removing E. coli, making it a viable disinfectant for water/wastewater treatment.
O CORPO NA PÓS-GRADUAÇÃO EM EDUCAÇÃO
Authors: Magrin Natália , Weller Piloto Ricardo , Maria Rovigati Simões Regina , Wey Mireira Wagner
Published: April 2022

Entender uma educação de corpo inteiro requer o conhecimento da corporeidade, para tanto, parece-nos fundamental refletir esse tema em programas de pós-graduação em Educação no país. O presente artigo buscou identificar e analisar as linhas de pesquisa dos programas de pós-graduação em Educação no Brasil que especificam o tema Corpo/Corporeidade. Esta é uma pesquisa qualitativa de cunho documental. Para tal identificou-se que existem 85 universidades que possuem programas com área de concentração em Educação, destas, 14 apresentam linhas de pesquisa com os descritores: corpo, corporeidade e corporal(is). Nestas 14 universidades foram identificadas 17 linhas de pesquisas com foco de estudos em corpo/corporeidade. A categorização realizada através da Análise de Conteúdo identificou quatro categorias, sendo elas: “corpo e linguagens” que reúne seis linhas de pesquisa/IES, seguida por “corpo e cultura” com cinco, “corpo e ensino” e “corpo e inclusão” com quatro linhas cada. Conclui-se que o fenômeno corpo/corporeidade é pouco estudado pela pós-graduação em Educação brasileira, levando em consideração suas facetas e complexidade, e aparentemente é tratado em sua integralidade, superando a concepção cartesiana que estabeleceu a supremacia da mente sobre o corpo em direção à compreensão unitária do ser humano.
Facial Asymmetry Detected with 3D Methods in Orthodontics: A Systematic Review
Authors: Pedersoli Laura , Dalessandri Domenico , Tonni Ingrid , Bindi Marino , Isola Gaetano , Oliva Bruno , Visconti Luca , Bonetti Stefano
Published: April 2022

Background:

Historically, the development of two-dimensional (2D) imaging techniquesforerun that of three-dimensional (3D) ones. Some 2D methods are still considered valid and effective to diagnose facial asymmetry but 3D techniques may provide more precise and accurate measurements.

Objective:

The aim of this work is to analyze the accuracy and reliability of the imaging techniques available for the diagnosis of facial asymmetry in orthodontics and find the most reliable.

Methods:

A search strategy was implemented using PubMed (National Library of Medicine, NCBI).

Results:

A total of 3201 papers were identified in electronic searches. 90 articles, available in full text, were included in the qualitative synthesis consisting of 8 reviews on the diagnosis of facial asymmetry, 22 in vivo and in vitro studies on 2D methods and 60 in vivo and in vitro studies on 3D methods to quantify the asymmetry.

Conclusion:

2D techniques include X-ray techniques such as posterior-anterior cephalogram, which still represents the first level exam in the diagnosis of facial asymmetry. 3D techniques represent the second level exam in the diagnosis of facial asymmetry. The most current used techniques are CBCT, stereophotogrammetry, laser scanning, 3D optical sensors and contact digitization. The comparison between bilateral parameters (linear distances, angles, areas, volumes and contours) and the calculation of an asymmetry index represent the best choices for clinicians who use CBCT. The creation of a color-coded distance map seems to represent the most accurate, reliable and validated methods for clinicians who use stereophotogrammetry, laser scanning and 3D optical sensors.
Unstimulated Salivary Estrogen in Postmenopausal Women With and Without Oral Dryness: A Prospective Study
Authors: Gupta Aanchal , Pallagatti Shambulingappa , Gupta Deepak , Aggarwal Amit , Singh Ravinder
Published: April 2022

Objective:

This study aimed to compare the unstimulated salivary estrogen levels in postmenopausal women with and without oral dryness.

Methodology:

A study was carried out on 70 selected postmenopausal women, out of which 35 were in the case group and 35 were in the control group. A questionnaire related to oral dryness was given to all the patients to evaluate their response to oral dryness. Patients were asked to spit in a plastic container, and their unstimulated saliva samples were obtained and analyzed for estimation of salivary estrogen levels by ELISA technique. After analyzing the results of salivary estrogen levels, the patients in the case group with low levels of estrogen were subjected to HRT under the guidance of a gynecologist. The patients were followed after 3 months of therapy for their response to oral dryness by the questionnaire, and salivary estrogen levels were again reevaluated after the therapy. The statistical analysis was carried out using Statistical Package for Social Sciences (SPSS Inc, Chicago, IL, version 15.0 for windows). The Pearson’s correlation and Student’s unpaired t-test were used for comparisons.

Results:

Before hormone replacement therapy, the mean estrogen level of the case group was 1.0031, and the mean estrogen level of the control group was 4.0080 pg/ml. This suggested that the reduced levels of estrogen hormone after menopause were associated with the complaint of oral dryness in these females. The mean salivary estrogen levels in the case group after HRT were more than the levels before HRT.

Conclusion:

Estrogen levels were reduced in patients with oral dryness. Further, the patients receiving HRT showed significant improvement in symptoms of oral dryness.
Remoción de cefalexina en solución acuosa empleando ozono y radiación UV
Authors: Moreno Rojas Paula , Puerto Mora Natalia , Agudelo Valencia Rafael Nikolay , Villamil Edwar
Published: April 2022

Los fármacos como la cefalexina se catalogan como microcontaminantes emergentes, por estar presentes en cantidades mínimas en el ambiente y por el desconocimiento de sus efectos. En este proyecto se evaluó un proceso de oxidación avanzada (POA) que consistió en analizar la transformación de cefalexina en solución acuosa por medio de ozono como agente oxidante y radiación UV (254 nm, 5 W); el proceso fue comparado con ensayos en los cuales se utilizó solamente ozono en ausencia de radiación UV. Se empleó un diseño experimental de tipo Box-Behnken, para el cual los factores variables del proceso fueron el pH inicial de la solución acuosa (6,5, 7,5 y 8,5), el tiempo de reacción (30, 45 y 60 minutos) y la concentración inicial de cefalexina (7,5, 10 y 12,5 mg/L). Los parámetros de respuesta fueron el porcentaje de reducción de concentración de cefalexina y de carbono orgánico total (COT). Los resultados indican que las mayores reducciones de concentración fueron de 48,85 % utilizando ozono, y 62,53 % con ozono y radiación UV. Estos valores fueron alcanzados para un pH inicial de 8,5, con 60 minutos de reacción y 12,5 mg/L de concentración inicial de cefalexina. La comparación estadística de los resultados indica que la efectividad del proceso de ozonización intensificado por radiación UV es mayor que la ozonización sola. El análisis de varianza realizado a los datos obtenidos señala que con un pH alcalino la efectividad del proceso es mayor, lo cual se explica a través de las reacciones de descomposición del ozono y la formación de radicales OH● y de ozono por efecto de radiación UV.
Perspectiva del uso de Pseudomonas spp. como biocontrol de fitopatógenos en cultivos de hortalizas en Colombia: una revisión sistemática
Authors: Motta Escobar Stefany , Salazar Cabezas Lizeth D. , Sánchez Leal Ligia C.
Published: April 2022

Colombia ocupa el puesto 89 de 124 países que concentran la mayor cantidad de plagas, y los fitopatógenos fúngicos, por las condiciones climáticas que caracteriza la zona geográfica, son uno de los mayores problemas para los cultivos de hortalizas. El control biológico es una alternativa sustentable y prometedora al uso exclusivo de agroquímicos. En diversos estudios se ha observado que la bacteria Pseudomonas tiene un gran potencial biocontrolador para hongos fitopatógenos como Fusarium spp., Sclerotinia sclerotiorum, Rhizoctonia spp., entre otros, que causan pérdidas en la producción de hortalizas. Existen más de cien especies de Pseudomonas reportadas, de las cuales varias cepas han mostrado resultados prometedores. Materiales y métodos:  en esta esta revisión sistemática se emplearon los lineamientos del sitio web Systematic Reviews and Meta-Analyses y se realizaron búsquedas en bases de datos y en páginas web de instituciones como Agrosavia, Agronet, el Instituto Colombiano Agropecuario (ica), e Instituto de Hidrología, Meteorología y Estudios Ambientales (ideam). Resultados: se obtuvo un total de 97 artículos publicados entre 1980 y 2021. Posterior a la aplicación de los criterios de inclusión y exclusión, se eliminaron 43 publicaciones, por lo que, en total, 54 publicaciones se incluyeron. Discusión: diversas cepas de Pseudomonas evidencian un potencial biocontrolador favorable que permite adoptar y desarrollar técnicas innovadoras para introducirse en el manejo de fitopatógenos. Sus propiedades, además de contrarrestar la enfermedad, favorecen el crecimiento y la productividad de las plantas. Varios estudios comprueban los mecanismos que expresan las Pseudomonas y el rol prometedor de la genómica en su potenciación. Conclusiones: el género Pseudomonas ha resultado ser efectivo como biocontrolador de fitopatógenos en cultivos de hortalizas, cuyos tratamientos con esta bacteria pueden llegar a reducir el uso de agroquímicos. Sin embargo, es necesario implementar nuevas estrategias e incentivar la investigación en este campo.
Reflexiones sobre la política pública de protección y bienestar animal de Bogotá
Authors: Agudelo Ramírez Alexandra
Published: April 2022

Introduction: The ethical consideration for the well-being and protection of animals is supported in scientific studies on sentience, which means that they are capable of feeling pain, suffering, satisfaction, tranquility, among other emotions. For this reason, it has been recognized that animals are sentient beings that deserve special consideration and respect. Objective: to show how the concept of animal sentience is part of the Public Policy for Animal Protection and Well-being of Bogotá 2014-2038, and how it is measured from some social indicators. Methods: For this, two phases were developed: I) search for indicators about the sentience of animals, II) processing of a database of companion animals identified with a microchip. Results: I) Only one indicator was found about the opinion on the sentience of dogs and cats used in the “Survey of Cultural Factors Associated with the Relationship between People and Animals” applied in Bogotá. This is an impact indicator that aims to demonstrate the state of citizen culture with respect to the relationship with animals. II) The database contains records of 206,706 dogs and cats. Almost half of the companion animals that so far have a microchip are in socioeconomic stratum 2. Conclusion: The need to transform the culture of relationship between animals and humans is affirmed, in a way such that citizens may change their day-to-day practices and demand from their political leaders immediate actions for the protection of all animals.
¿Progreso social? Un análisis histórico-crítico de la medición en Colombia 2000-2018
Authors: Sánchez Cárcamo Ricardo Antonio , Cifuentes Sarmiento José Alejandro
Published: April 2022

Introduction: This research presents a critical analysis of the conventional concept of social progress from different indicators with which Human Development, income inequality, quality and standard of living are recorded. Objective: In this way, it is intended to explain why, factually, a positive behavior of the conventional indicators of social progress in Colombia can be found, which is opposed to the evolution of the social conflict in terms of the social and trade union struggle, and to the increase in number of people arrested. Results and/or conclusions:The results suggest the need to establish an approach to the concept of social cohesion in the redefinition of social progress with the aim of overcoming the exposed methodological contradictions.
Análisis jurisprudencial de la economía social de mercado en Colombia
Authors: Sánchez Cubides Pedro Alfonso , Sanabria Gómez Segundo Abrahán , Guío Guerrero Fernando
Published: April 2022

Objective: the most relevant decisions of the Constitutional Court of Colombia regarding the social market economy are analyzed, in order to establish the level of development and guarantee of this model of economy by the aforementioned Judicial Court. Method and/or methodology: The text is supported by the documentary method and is organized as follows: itinitially addresses some conceptual considerations, and then develops the analysis of the social market economy based on the jurisprudence of the Constitutional Court on the matter, and closes with the respective conclusions.
Narrative, Memory and PTSD. A Case Study of Autobiographical Narration After Trauma
Authors: De Muijnck Deborah
Published: April 2022

This paper argues that by structuring potentially traumatising memories through narration, autobiographical storytelling reduces the experience of contingency, supports narrators in regaining feelings of autonomy and thus enables traumatised individuals to complete their otherwise potentially incomplete autobiography. Post-trauma writing carries the chance to re-articulate highly emotional experiences with formerly 'random or isolated events' into a meaningful storyline. The effects of highly emotionally experienced trauma decrease and enable the individual to continue narration about their present and potential future. A case study of a veteran autobiography is used to emphasise the meaning of autobiographical writing when individuals suffer from Post-Traumatic Stress Disorder (PTSD). This paper is particularly relevant in times where war and terror are frequently not just communicated through the media but are experienced by millions of people worldwide. At the same time, it is a contribution to the rapidly developing field of Cognitive Narratology and Restorative Narratives.
Prepare for Health Care 2030
Authors: Miller BJ , Dolan Sonya , Warner Kimberly , Novack John , Jiwa Moyez
Published: April 2022

By 2030, nobody will accept poor results in health care. In most cases of chronic illness, people will benefit from becoming active partners in their own health care journey. Medical professionals will focus on communication skills to become trusted navigators rather than impersonal technicians. Patient advocates and multidisciplinary teams will be key sources of support in a borderless healthcare system. Patients and paymasters will drive these innovations. Doctors will recognise them as an opportunity to avoid burnout. There is room for optimism. The healthcare system has the potential to deliver better outcomes at a lower cost.
The Impact of an Evidence-Informed Spinal Cord Injury Activities of Daily Living Education Manual (SADL-eM): Protocol for a Randomized Controlled Trial
Authors: Abu Mostafa Moussa , Plastow Nicola Ann , Savin-Baden Maggi , Ayele Birhanu
Published: April 2022

Background

Spinal cord injury (SCI) is a catastrophic injury associated with functional loss and life-threatening complications. Many people with SCI in the Gaza Strip of Palestine are discharged from inpatient rehabilitation to the community while still lacking many daily life skills. This randomized controlled trial (RCT) seeks to test the impact of the Spinal Cord Injury Activities of Daily Living Education Manual (SADL-eM)—an evidence-based occupational therapy patient educational intervention—on rehabilitation outcomes.

Objective

The proposed trial aims to evaluate the SADL-eM intervention compared with standard treatment among people with SCI.

Methods

This is a parallel RCT with two study arms: intervention and control. A total of 90 patients treated in inpatient rehabilitation settings will be randomly allocated to two study groups. Both groups will receive standard care. The intervention group will also use the SADL-eM with their treating occupational therapist during rehabilitation. The SADL-eM is a comprehensive activities of daily living (ADL) educational tool that was codeveloped with people with SCI and stakeholders across Gaza. The self-report version of the Spinal Cord Independence Measure will be used on admission (ie, baseline measure) and after 6 weeks as the primary outcome measure. Secondary outcomes include the third version of the Spinal Cord Independence Measure, the Private Religiousness Practices Scale, the Organizational Religiousness Short-Form, additional ADL domains covered by the education manual, and adherence to the intervention. The effect of the intervention will be determined using repeated-measures analysis of variance.

Results

This study will be conducted from April 2021 through December 2022, with results expected to be available in January 2023.

Conclusions

If the SADL-eM is demonstrated as clinically effective, this will have significant implications for occupational therapy interventions in low- and middle-income countries.

Trial Registration

ClinicalTrials.gov NCT04735887; https://clinicaltrials.gov/ct2/show/NCT04735887
Modeling Data Journeys to Inform the Digital Transformation of Kidney Transplant Services: Observational Study
Authors: Sharma Videha , Eleftheriou Iliada , van der Veer Sabine N , Brass Andrew , Augustine Titus , Ainsworth John
Published: April 2022

Background

Data journey modeling is a methodology used to establish a high-level overview of information technology (IT) infrastructure in health care systems. It allows a better understanding of sociotechnical barriers and thus informs meaningful digital transformation. Kidney transplantation is a complex clinical service involving multiple specialists and providers. The referral pathway for a transplant requires the centralization of patient data across multiple IT solutions and health care organizations. At present, there is a poor understanding of the role of IT in this process, specifically regarding the management of patient data, clinical communication, and workflow support.

Objective

To apply data journey modeling to better understand interoperability, data access, and workflow requirements of a regional multicenter kidney transplant service.

Methods

An incremental methodology was used to develop the data journey model. This included review of service documents, domain expert interviews, and iterative modeling sessions. Results were analyzed based on the LOAD (landscape, organizations, actors, and data) framework to provide a meaningful assessment of current data management challenges and inform ways for IT to overcome these challenges.

Results

Results were presented as a diagram of the organizations (n=4), IT systems (n>9), actors (n>4), and data journeys (n=0) involved in the transplant referral pathway. The diagram revealed that all movement of data was dependent on actor interaction with IT systems and manual transcription of data into Microsoft Word (Microsoft, Inc) documents. Each actor had between 2 and 5 interactions with IT systems to capture all relevant data, a process that was reported to be time consuming and error prone. There was no interoperability within or across organizations, which led to delays as clinical teams manually transferred data, such as medical history and test results, via post or email.

Conclusions

Overall, data journey modeling demonstrated that human actors, rather than IT systems, formed the central focus of data movement. The IT landscape did not complement this workflow and exerted a significant administrative burden on clinical teams. Based on this study, future solutions must consider regional interoperability and specialty-specific views of data to support multi-organizational clinical services such as transplantation.
Effectiveness of Web-Based Personalized Nutrition Advice for Adults Using the eNutri Web App: Evidence From the EatWellUK Randomized Controlled Trial (Preprint)
Authors: Zenun Franco Rodrigo , Fallaize Rosalind , Weech Michelle , Hwang Faustina , Lovegrove Julie A
Published: April 2022

BACKGROUND

Evidence suggests that eating behaviors and adherence to dietary guidelines can be improved using nutrition-related apps. Apps delivering personalized nutrition (PN) advice to users can provide individual support at scale with relatively low cost.

OBJECTIVE

This study aims to investigate the effectiveness of a mobile web app (eNutri) that delivers automated PN advice for improving diet quality, relative to general population food-based dietary guidelines.

METHODS

Nondiseased UK adults (aged >18 years) were randomized to PN advice or control advice (population-based healthy eating guidelines) in a 12-week controlled, parallel, single-blinded dietary intervention, which was delivered on the web. Dietary intake was assessed using the eNutri Food Frequency Questionnaire (FFQ). An 11-item US modified Alternative Healthy Eating Index (m-AHEI), which aligned with UK dietary and nutritional recommendations, was used to derive the automated PN advice. The primary outcome was a change in diet quality (m-AHEI) at 12 weeks. Participant surveys evaluated the PN report (week 12) and longer-term impact of the PN advice (mean 5.9, SD 0.65 months, after completion of the study).

RESULTS

Following the baseline FFQ, 210 participants completed at least 1 additional FFQ, and 23 outliers were excluded for unfeasible dietary intakes. The mean interval between FFQs was 10.8 weeks. A total of 96 participants were included in the PN group (mean age 43.5, SD 15.9 years; mean BMI 24.8, SD 4.4 kg/m2) and 91 in the control group (mean age 42.8, SD 14.0 years; mean BMI 24.2, SD 4.4 kg/m2). Compared with that in the control group, the overall m-AHEI score increased by 3.5 out of 100 (95% CI 1.19-5.78) in the PN group, which was equivalent to an increase of 6.1% (P=.003). Specifically, the m-AHEI components nuts and legumes and red and processed meat showed significant improvements in the PN group (P=.04). At follow-up, 64% (27/42) of PN participants agreed that, compared with baseline, they were still following some (any) of the advice received and 31% (13/42) were still motivated to improve their diet.

CONCLUSIONS

These findings suggest that the eNutri app is an effective web-based tool for the automated delivery of PN advice. Furthermore, eNutri was demonstrated to improve short-term diet quality and increase engagement in healthy eating behaviors in UK adults, as compared with population-based healthy eating guidelines. This work represents an important landmark in the field of automatically delivered web-based personalized dietary interventions.

CLINICALTRIAL

ClinicalTrials.gov NCT03250858; https://clinicaltrials.gov/ct2/show/NCT03250858
Detecting Mental Health Behaviors Using Mobile Interactions: Exploratory Study Focusing on Binge Eating (Preprint)
Authors: Vega Julio , Bell Beth T , Taylor Caitlin , Xie Jue , Ng Heidi , Honary Mahsa , McNaney Roisin
Published: April 2022

BACKGROUND

Binge eating is a subjective loss of control while eating, which leads to the consumption of large amounts of food. It can cause significant emotional distress and is often accompanied by purging behaviors (eg, meal skipping, overexercising, or vomiting).

OBJECTIVE

The aim of this study was to explore the potential of mobile sensing to detect indicators of binge-eating episodes, with a view toward informing the design of future context-aware mobile interventions.

METHODS

This study was conducted in 2 stages. The first involved the development of the DeMMI (Detecting Mental health behaviors using Mobile Interactions) app. As part of this, we conducted a consultation session to explore whether the types of sensor data we were proposing to capture were useful and appropriate, as well as to gather feedback on some specific app features relating to self-reporting. The second stage involved conducting a 6-week period of data collection with 10 participants experiencing binge eating (logging both their mood and episodes of binge eating) and 10 comparison participants (logging only mood). An optional interview was conducted after the study, which discussed their experience using the app, and 8 participants (n=3, 38% binge eating and n=5, 63% comparisons) consented.

RESULTS

The findings showed unique differences in the types of sensor data that were triangulated with the individuals’ episodes (with nearby Bluetooth devices, screen and app use features, mobility features, and mood scores showing relevance). Participants had a largely positive opinion about the app, its unobtrusive role, and its ease of use. Interacting with the app increased participants’ awareness of and reflection on their mood and phone usage patterns. Moreover, they expressed no privacy concerns as these were alleviated by the study information sheet.

CONCLUSIONS

This study contributes a series of recommendations for future studies wishing to scale our approach and for the design of bespoke mobile interventions to support this population.
Contrasting Social Media Use Between Young Adults With Inflammatory Bowel Disease and Type 1 Diabetes: Cross-sectional Study (Preprint)
Authors: Rajanala Susruthi , Wilson Jennifer K , Mitchell Paul D , Garvey Katharine C , Fishman Laurie N
Published: April 2022

BACKGROUND

Social media is used by young adult patients for social connection and self-identification.

OBJECTIVE

This study aims to compare the social media habits of young adults with inflammatory bowel disease (IBD) and type 1 diabetes (T1D).

METHODS

This is a cross-sectional study of subjects from Boston Children’s Hospital outpatient IBD and diabetes clinics. Patients above 18 years of age were invited to complete a brief anonymous survey, which asked about the various ways they use several social media platforms.

RESULTS

Responses were received from 108 patients (92.5% response rate), evenly split across disease type. We found that 83% of participants spent at least 30 minutes per day on social media, most commonly on Instagram and Facebook. Although the content varied based on the platform, patients with IBD posted or shared content related to their disease significantly less than those with T1D (23% vs 38%, P=.02). Among Instagram users, patients with IBD were less likely to engage with support groups (22% vs 56%, P=.04). Among Twitter users, patients with IBD were less likely to seek disease information (77% vs 29%, P=.005). Among Facebook users, patients with IBD were less likely to post about research and clinical trials (31% vs 65%, P=.04) or for information seeking (49% vs 87%, P=.003). Patients with IBD were also less likely to share their diagnosis with friends or family in person.

CONCLUSIONS

Young adults with IBD were less willing to share their diagnosis and post about or explore the disease on social media compared to those with T1D. This could lead to a sense of isolation and should be further explored.
The Association of Medical Preoperative Evaluation Using Clinical Video Telehealth With Hospital Length of Stay: Descriptive Analysis (Preprint)
Authors: Burton Brittany Nicole , Arastoo Sara , Wu Simon , Liu Nancy , Ong Michael K , Vazirani Sondra
Published: April 2022

BACKGROUND

Preoperative medical evaluation serves to identify risk factors and optimize patients before surgery. Providing a telehealth option in the perioperative setting has played a significant role in reducing barriers to quality perioperative health care.

OBJECTIVE

We aimed to evaluate how telemedicine preoperative evaluations using Clinical Video Telehealth (CVT) impact hospital length of stay.

METHODS

We performed a retrospective chart review between 2016 and 2017 of adult patients who underwent evaluations in our hospitalist-run preoperative medicine clinic. Patients seen in our preoperative CVT program were compared to patients seen in person to evaluate the association of visit type (preoperative CVT versus in-person evaluation) with hospital length of stay, defined as hospital stay from postoperative day 0 to discharge. There were 62 patients included in this retrospective study.

RESULTS

The adjusted incidence rate ratio (IRR) for hospital length of stay was significantly shorter in patients who underwent preoperative CVT compared to an in-person visit (IRR 0.52, 95% CI 0.29-0.92, P=.02).

CONCLUSIONS

After adjusting for age and comorbidities, we show that preoperative telemedicine in the perioperative setting is associated with a shorter hospital length of stay compared to in-person visits. This suggests that telemedicine can play a viable role in this clinical setting.
DETERMINANTS OF SEXUAL ABUSE AMONG SELECTED FEMALE ADOLESCENTS IN SEMI-URBAN CALABAR MUNICIPALITY CROSS RIVER STATE NIGERIA; DESCRIPTIVE SURVEY (Preprint)
Authors: Agba Mathias
Published: April 2022

BACKGROUND

One of the public health problems affecting the entire world is sexual abuse. Sexual abuse is a worldwide problem affecting both developed and developing countries alike. Sexual abuse also known as sexual violence refers to any act perpetuated with the intension of obtaining sex through force, violence or coercion, which, according to World Health Organization (WHO), encompasses a variety of situations, namely rape, sexual or physical abuse, forced marriage and child marriage

OBJECTIVE

The specific objectives of the study are to:
1. To determine the environmental determinants of sexual abuse among female adolescents in semi-urban Calabar Municipality, Cross River State, Nigeria.
2. To explore the social determinants of sexual abuse among female adolescents in semi-urban Calabar Municipality, Cross River State, Nigeria,
3. To ascertain the psychological determinants of sexual abuse among female adolescents in semi-urban Calabar Municipality, Cross River State, Nigeria.

METHODS

A total of 241 female senior secondary schools (SS I & SS II) students of four (4) public secondary schools in semi-urban Calabar Municipality were selected as sample of the study using simple random sampling techniques. The instrument of data collection was a structured questionnaire. Data collected were presented and analyzed using frequencies, percentages and descriptive statistics (Means [ ]). The hypothesis was tested using Chi-square (X2) analysis.

RESULTS

The results of the study revealed that, 57(23.6%) respondents strongly agreed that walking in lonely places at night can expose a teenage girl to sexual abuse; 64 (26.6%) respondents agreed; 61 (25.3%) respondents disagreed; while 59 (24.5%) respondents strongly disagreed. Also, 121 (50.2%) respondents strongly agreed that girls who attend clubs and parties can easily be abused sexually; 94 (41.5%) respondents agreed; 19 (7.96%) respondents disagreed; while 7 (2.9%) respondents strongly disagreed 94 (39.0%) respondents strongly agreed that girls who have poor self-concept are at risk of being sexually abused 104 (43.2%) respondents agreed; 21 (8.7%) respondents disagreed; while 22 (9.1%) respondents strongly disagreed. There is a significant relationship between age and occurrence of sexual abuse among female adolescents in semi-urban Calabar Municipality

CONCLUSIONS

Those living in isolated environment surrounded by men, walking in lonely places at night, living in city slums and living in neighbourhoods where crime rate is high attending clubs and parties, poor parent-child relationship, making friends with males, peer pressure indecent dressing, having poor self-concept, low self-confidence, negative attitude to sex, and lacking the sense of decency often leads to sexual abuse.
Use Intention and User Expectations of Human-Supported and Self-Help eHealth Interventions: Internet-Based Randomized Controlled Trial (Preprint)
Authors: Cohen Rodrigues Talia R , Reijnders Thomas , Breeman Linda D , Janssen Veronica R , Kraaijenhagen Roderik A , Atsma Douwe E , Evers Andrea WM
Published: April 2022

BACKGROUND

Self-help eHealth interventions provide automated support to change health behaviors without any further human assistance. The main advantage of self-help eHealth interventions is that they have the potential to lower the workload of health care professionals. However, one disadvantage is that they generally have a lower uptake. Possibly, the absence of a relationship with a health care professional (referred to as the working alliance) could lead to negative expectations that hinder the uptake of self-help interventions. The Unified Theory of Acceptance and Use of Technology (UTAUT) identifies which expectations predict use intention. As there has been no previous research exploring how expectations affect the adoption of both self-help and human-supported eHealth interventions, this study is the first to investigate the impact of expectations on the uptake of both kinds of eHealth interventions.

OBJECTIVE

This study investigated the intention to use a self-help eHealth intervention compared to a human-supported eHealth intervention and the expectations that moderate this relationship.

METHODS

A total of 146 participants were randomly assigned to 1 of 2 conditions (human-supported or self-help eHealth interventions). Participants evaluated screenshots of a human-supported or self-help app–based stress intervention. We measured intention to use the intervention-expected working alliance and the UTAUT constructs: performance expectancy, effort expectancy, and social influence.

RESULTS

Use intention did not differ significantly between the 2 conditions (t142=–1.133; P=.26). Performance expectancy (F1,140=69.269; P<.001), effort expectancy (F1,140=3.961; P=.049), social influence (F1,140=90.025; P<.001), and expected working alliance (F1,140=26.435; P<.001) were positively related to use intention regardless of condition. The interaction analysis showed that performance expectancy (F1,140=4.363; P=.04) and effort expectancy (F1,140=4.102; P=.045) more strongly influenced use intention in the self-help condition compared to the human-supported condition.

CONCLUSIONS

As we found no difference in use intention, our results suggest that we could expect an equal uptake of self-help eHealth interventions and human-supported ones. However, attention should be paid to people who have doubts about the intervention’s helpfulness or ease of use. For those people, providing additional human support would be beneficial to ensure uptake. Screening user expectations could help health care professionals optimize self-help eHealth intervention uptake in practice.

CLINICALTRIAL

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Barriers and Facilitators to Implementing a Digital Adherence Technology for Tuberculosis Treatment Supervision in Uganda: Qualitative Study (Preprint)
Authors: Leddy Anna , Ggita Joseph , Berger Christopher A , Kityamuwesi Alex , Sanyu Agnes Nakate , Tinka Lynn Kunihira , Crowder Rebecca , Turyahabwe Stavia , Katamba Achilles , Cattamanchi Adithya
Published: April 2022

BACKGROUND

Ensuring the completion of treatment for tuberculosis (TB) remains a key challenge in many high-burden countries. 99DOTS is a low-cost digital adherence technology that has emerged as a promising tool for monitoring and supporting TB treatment completion.

OBJECTIVE

We aimed to understand the feasibility and acceptability of 99DOTS, a mobile phone–based TB treatment support method, and characterize barriers and facilitators to its implementation during a pragmatic trial in Uganda.

METHODS

Between April 1 and August 31, 2021, we conducted in-depth interviews with people with TB and key informant interviews with health workers and district and regional TB officers involved in the implementation of 99DOTS at 18 health facilities in Uganda. Semistructured interview guides were informed by the capability, opportunity, motivation, and behavior (COM-B) model and explored perceptions of, and experiences with, 99DOTS, including barriers and facilitators to its use. Qualitative analysis was conducted using the framework approach.

RESULTS

Interviews were conducted with 30 people with TB, 12 health workers, and 7 TB officers. All people with TB, health workers, and TB officers noted that 99DOTS supported and encouraged people with TB to take their anti-TB medication, facilitated treatment monitoring, and improved relationships between people with TB and health workers. Participants also liked that the platform was free, easy to use, and improved TB treatment outcomes. Barriers to 99DOTS implementation for some people with TB were related to limited literacy, including technology literacy; limited access to electricity to charge their mobile phone to make dosing confirmation calls; and poor network connection. Gender differences in 99DOTS uptake also emerged. Specifically, women with TB were described to be more concerned that 99DOTS use would expose them to TB stigma and to be more likely to have mobile phone–access issues than men with TB. By contrast, men with TB not only had access to mobile phones but also received substantial support from their female partners to take their anti-TB medication and make 99DOTS dosing confirmation calls. Finally, although women with TB were described to face more barriers to 99DOTS use than men with TB, the women’s narratives centered on the ways the platform facilitated and improved their adherence, whereas the men’s narratives did not.

CONCLUSIONS

Overall, 99DOTS seems to be a feasible and acceptable strategy to support anti-TB medication adherence in Uganda. However, access to mobile phones, inability to charge mobile phones, and concerns about stigma should be considered and addressed as part of programmatic implementation to maximize uptake among all people with TB, particularly women and those with fewer financial resources.
Early Prediction of Imminent Hospital Admission of Adult ED Patients: Data Evaluation and Model Development to Reduce ED Crowding (Preprint)
Authors: Monahan Ann Corneille , Feldman Sue S , Fitzgerald Tony
Published: April 2022

BACKGROUND

ED crowding continues to threaten patient safety and cause poor patient outcomes. Prior models designed to predict hospital admission have had biases. Predictive models that successfully estimate the probability of patient hospital admission would be useful in reducing or preventing emergency department boarding and hospital exit block and would reduce emergency department crowding by initiating earlier hospital admission and protracted bed procurement processes.

OBJECTIVE

To develop a model to predict imminent adult patient hospital admission from the ED early in the patient visit by utilizing existing, routinely collected, clinical descriptors that were captured in the hospital’s EMR.

METHODS

This retrospective cohort study evaluated 1 year of consecutive data events of adult patients admitted to the ED to develop an algorithm that predicted which patients would require imminent hospital admission. Eight predictor variables were evaluated for their role in the outcome of the patient ED visit. Logistic regression was used to model the study data.

RESULTS

The 8-predictor model included age, systolic BP, diastolic BP, heart rate, respiration rate, temperature, gender, and acuity level. Our model performed well, with good agreement between observed and expected admissions, indicating a well-fitting and well-calibrated model and showing good ability to discriminate between patients who will and will not be admitted.

CONCLUSIONS

This prediction model based on primary data identified ED patients with an increased risk of hospital admission. This actionable information can be used to improve patient care and hospital operations and especially reduce ED crowding by looking ahead to predict which patients will be admitted, providing needed information to initiate admission and bed assignment processes much earlier in the care continuum.
The Ontario Rectal Cancer Cohort (OntaReCC): protocol for a comprehensive population-based registry of individuals with rectal cancer (Preprint)
Authors: Patel Sunil , McClintock Chad , Booth Chris , Merchant Shaila J , Heneghan Carl , Bankhead Clare
Published: April 2022

BACKGROUND

Individuals with rectal cancer require a number of pretreatment investigations, often require multidisciplinary treatment and require ongoing follow up after treatment is completed. Due to the complexity of treatments, large variations in practice patterns and outcomes have been identified. At present, few comprehensive population level datasets are available to assess interventions and outcomes in this group. The objective of the proposed study is to create a comprehensive database of individuals treated with rectal cancer in a single payer, universal health care system. This database will provide an excellent resource for investigators to study the variations in the delivery of care, and real world outcomes in this population.

OBJECTIVE

The objective of this study is to create a comprehensive database to allow for assessment of the delivery of care and outcomes in those with rectal cancer

METHODS

The Ontario Rectal Cancer Cohort (OntaReCC) database will include comprehensive details of the management and outcomes of those with rectal cancer, diagnosed in Ontario, Canada (population 14.6 million) between 2010 – 2019. Linked administrative datasets will be used to construct this comprehensive database. Individual and care provider characteristics, investigations, treatments, follow up and outcomes will be derived and linked. Surgical pathology details, including stage of disease, histopathology characteristics and quality of surgical excision, will be included. Ethics approval for this study was obtained through Queen’s University Health Sciences and Affiliated Teaching Hospitals Research Ethics Board. A number of research themes will initially be explored using the OntaRecc Database, including (i) the regional variability in the delivery of care and outcomes, (ii) predictors and impact of adherence to recommended care, and (iii) assessments of other understudied areas of rectal cancer care.

RESULTS

Approximately 20,000 individuals were identified who meet the inclusion criteria for this study. Data analysis is ongoing, with an expected completion date of March, 2023. This study was funded through the Canadian Institute of Health Research (CIHR) Operating Grant.

CONCLUSIONS

The Ontario Rectal Cancer Cohort will include a comprehensive dataset of individuals with rectal cancer who received care within a single payer, universal health care system. This cohort will be used to determine factors associated with regional variability, adherence to recommended care and allow for an assessment of a number of understudies areas within the delivery of rectal cancer treatment.
Cultural Adaption of a Sobriety Support App for Alaska Native and American Indian People: A Qualitative Study (Preprint)
Authors: Trinidad Susan Brown , Shane Aliassa L. , Guinn Tiffany R. , Apok Charlene R. , Collier Ann F. , Avey Jaedon P. , Donovan Dennis M.
Published: April 2022

BACKGROUND

Despite high rates of alcohol abstinence, Alaska Native and American Indian (ANAI) people experience a disproportionate burden of alcohol-related morbidity and mortality. Lack of culturally relevant resources, combined with limited treatment access and privacy concerns regarding peer-support programs in rural areas, poses particular treatment barriers for ANAI people.

OBJECTIVE

Objective: This study was the first phase of a feasibility study of a culturally tailored version of an off-the-shelf smartphone app to aid ANAI people in managing or reducing their use of alcohol. Its goal was to gather insights and preferences from ANAI people and ANAI-serving healthcare providers to guide feature development and cultural adaptation.

METHODS

In October 2018 – September 2019, we conducted semi-structured interviews with 24 ANAI patients and 8 providers in a Tribal healthcare organization in southcentral Alaska.

RESULTS

Participants generally endorsed the usefulness of a smartphone app for alcohol self-management, citing anonymity, 24/7 access, peer support, and patient choice as key attributes. Desired cultural adaptations included ANAI and land-themed design elements, cultural content (e.g., stories from Elders), and spiritual resources.

CONCLUSIONS

ANAI patients and their providers were receptive to the idea of a culturally adapted smartphone app for sobriety support. They considered an app especially useful for rural-dwelling ANAI people, as well as those who lack timely access to treatment services or prefer to work toward managing their alcohol use outside the clinical setting. These results are guiding the next phase of the study.