bluuebunny/crossref_metadata_2025 huggingface dataset:
Permaculture and back‐to‐the‐land migration: Pursuing self‐sufficiency in Czech rural areas
Authors: Kolářová Marta
Published: July 2023

This article focuses on the contemporary back‐to‐the‐land migration of permaculture practitioners in post‐socialist (1989–) Czechia. It explores the ideals and practices of self‐sufficiency among back‐to‐the‐land migrants as they relate to their migration motives and post‐migration life, including the fulfilment of a dream of self‐sufficiency and local community integration. This article deals with individual in‐rural migrant projects and the experiences of permaculturists who live in intentional eco‐communities. It draws upon data from in‐depth interviews with back‐to‐the‐land migrants and analysis of documents and field notes. The article concludes that the self‐sufficient vision, part of a ‘family homestead’ concept promoted by permaculture teachers, is difficult to achieve for rural newcomers who must reformulate their visions to match the lived reality. The post‐migration life of this group is further complicated by disillusionment with local community relations and difficulties integrating within their migration destination because of their distinctive lifestyle. Czech back‐to‐the‐land migration related to permaculture differs from its western version in its inclination towards nature‐based spirituality and a specific land structure still influenced by the forced collectivisation of the communist era.
The interplay of post‐translational protein modifications in Arabidopsis leaves during photosynthesis induction
Authors: Giese Jonas , Eirich Jürgen , Walther Dirk , Zhang Youjun , Lassowskat Ines , Fernie Alisdair R. , Elsässer Marlene , Maurino Veronica G. , Schwarzländer Markus , Finkemeier Iris
Published: July 2023

Diurnal dark to light transition causes profound physiological changes in plant metabolism. These changes require distinct modes of regulation as a unique feature of photosynthetic lifestyle. The activities of several key metabolic enzymes are regulated by light‐dependent post‐translational modifications (PTM) and have been studied at depth at the level of individual proteins. In contrast, a global picture of the light‐dependent PTMome dynamics is lacking, leaving the response of a large proportion of cellular function undefined. Here, we investigated the light‐dependent metabolome and proteome changes in Arabidopsis rosettes in a time resolved manner to dissect their kinetic interplay, focusing on phosphorylation, lysine acetylation, and cysteine‐based redox switches. Of over 24 000 PTM sites that were detected, more than 1700 were changed during the transition from dark to light. While the first changes, as measured 5 min after onset of illumination, occurred mainly in the chloroplasts, PTM changes at proteins in other compartments coincided with the full activation of the Calvin–Benson cycle and the synthesis of sugars at later timepoints. Our data reveal connections between metabolism and PTM‐based regulation throughout the cell. The comprehensive multiome profiling analysis provides unique insight into the extent by which photosynthesis reprograms global cell function and adds a powerful resource for the dissection of diverse cellular processes in the context of photosynthetic function.
Impacts of globalisation on the adoption of remote work: Evidence from a survey in Japan during the COVID‐19 pandemic
Authors: Tomiura Eiichi , Ito Banri
Published: July 2023

Globalised firms manage face‐to‐face contacts for distant communications. Based on our survey on the responses of Japanese firms to the COVID‐19 pandemic, we find that firms that exported, imported, or directly invested abroad more before the pandemic tend to adopt remote work significantly more frequently during the pandemic. We confirm this relationship even after controlling for compositions of occupations, and various firm attributes. The effect of arm's‐length trade, not intra‐firm trade, is especially evident. These suggest that pre‐pandemic experiences in coordinating across borders are likely to facilitate the adoption of remote work during the pandemic.
Electrocortical activity correlated with locomotor adaptation during split‐belt treadmill walking
Authors: Jacobsen Noelle A. , Ferris Daniel P.
Published: July 2023

Locomotor adaptation is crucial for daily gait adjustments to changing environmental demands and obstacle avoidance. Mobile brain imaging with high‐density electroencephalography (EEG) now permits quantification of electrocortical dynamics during human locomotion. To determine the brain areas involved in human locomotor adaptation, we recorded high‐density EEG from healthy, young adults during split‐belt treadmill walking. We incorporated a dual‐electrode EEG system and neck electromyography to decrease motion and muscle artefacts. Voluntary movement preparation and execution have been linked to alpha (8–13 Hz) and beta band (13–30 Hz) desynchronizations in the sensorimotor and posterior parietal cortices, whereas theta band (4–7 Hz) modulations in the anterior cingulate have been correlated with movement error monitoring. We hypothesized that relative to normal walking, split‐belt walking would elicit: (1) decreases in alpha and beta band power in sensorimotor and posterior parietal cortices, reflecting enhanced motor flexibility; and (2) increases in theta band power in anterior cingulate cortex, reflecting instability and balance errors that will diminish with practice. We found electrocortical activity in multiple regions that was associated with stages of gait adaptation. Data indicated that sensorimotor and posterior parietal cortices had decreased alpha and beta band spectral power during early adaptation to split‐belt treadmill walking that gradually returned to pre‐adaptation levels by the end of the adaptation period. Our findings emphasize that multiple brain areas are involved in adjusting gait under changing environmental demands during human walking. Future studies could use these findings on healthy, young participants to identify dysfunctional supraspinal mechanisms that may be impairing gait adaptation.

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Key points

Identifying the location and time course of electrical changes in the brain correlating with gait adaptation increases our understanding of brain function and provides targets for brain stimulation interventions.

Using high‐density EEG in combination with 3D biomechanics, we found changes in neural oscillations localized near the sensorimotor, posterior parietal and cingulate cortices during split‐belt treadmill adaptation.

These findings suggest that multiple cortical mechanisms may be associated with locomotor adaptation, and their temporal dynamics can be quantified using mobile EEG.

Results from this study can serve as a reference model to examine brain dynamics in individuals with movement disorders that cause gait asymmetry and reduced gait adaptation.
Carnaval Mil Tambores 2021 (Valparaíso, Chile): el retorno a la calle luego de la revuelta social y la pandemia
Authors: Álvarez Bulacio Ricardo
Published: July 2023

El Carnaval Mil Tambores nace en 1999 en Valparaíso (Chile) como el resultado de una organización ciudadana autogestionada que buscaba la recuperación de un parque público que había sido vendido por el Estado chileno a una empresa inmobiliaria. Luego de la pandemia por covid-19, volvió a realizarse masivamente en octubre de 2021 retomando su denominación de Carnaval Constituyente, asociado al apoyo al proceso de redacción de una nueva constitución política en Chile que se encuentra en curso. El objetivo de este artículo fue indagar la historia de este carnaval como referente del activismo artístico en Chile y analizar su edición 2021, realizada luego del estallido social y la pandemia por covid-19, que interrumpió los cinco meses de movilizaciones asociadas que se habían iniciado el 18 de octubre de 2019. La metodología utiliza un enfoque cualitativo basado en trabajo de campo realizado por el autor en la celebración de 2021. Contiene entrevistas en profundidad con actores relevantes de la organización del festival, además del análisis de archivos de prensa y académicos sobre la percepción y representación de este carnaval en los medios. Los resultados de esta investigación permiten identificar el Carnaval Mil Tambores como un referente para entender el rol de las manifestaciones artísticas en los movimientos sociales desarrollados en Chile durante el siglo XXI que lograron su máxima visibilización durante la revuelta social. Junto con esto, permiten distinguir las estrategias desarrolladas tanto por sus organizadores como por las agrupaciones participantes para sobrevivir a la precariedad laboral generada tanto por el estallido como por la pandemia.
Decolonization from Root to Bloom: A Somatic Movement Approach to Reconnect with the Essence of our Sentient Body
Authors: Barragan Rosana
Published: July 2023

This article examines various definitions of colonization and decolonization with the attempt to view current issues that may be defined as new problematic ways of embodying coloniality. The field of somatic movement studies serves as a framework for viewing the roots of the argument and for offering a practical experience that may elicit ease and peace around what the truth is, when it comes to somatically identifying that our nature is to live freely in a decolonial soma. Activists, scholars, artists, and pioneers in fields such as somatic movement, somatic psychology, critical race, indigenous studies, and subaltern theory offer insight into the complexity of understanding the processes of decolonization that are necessary today and that can be experienced by utilizing specific tools from somatics, such as the embodiment of space and the return to notions from precolonial languages that expand our reality and have the potential to heal the wounds of our colonial self.
Pedagogías políticas y prácticas artísticas en el movimiento feminista de Guayaquil
Authors: Briceño Linares Ybelice
Published: July 2023

Este artículo es el producto de una investigación en curso en la cual se analiza el surgimiento, la trayectoria y las características del movimiento feminista y de mujeres en Guayaquil (Ecuador). Parte de la revisión de la composición interna del movimiento, de su discurso político y de las estrategias que ha desplegado para generar formas de articulación. Por otro lado, se analizan los repertorios de acción colectiva a los queel movimiento recurre, con énfasis en las políticas de cuidado y la valoración de las formas de lucha como espacios de encuentro, vínculo y goce. Por último, se ha prestado atención a las prácticas de activismo artístico que desarrollan las colectivas feministas que lo integran, defendiendo la idea de que no se trata de un uso instrumental de lenguajes artísticos (musicales, visuales, escénicos o performáticos), sino más bien de pedagogías que defienden la importancia de lo sensible y los afectos en el campo de la política. La investigación ha contemplado entrevistas a militantes, recopilación de material textual, gráfico y audiovisual del movimiento, así como el análisis del diario de campo que recoge la experiencia de la investigadora como activista.
Data-Driven Stochastic Averaging
Authors: Li Junyin , Huang Zhanchao , Wang Yong , Huang Zhilong , Zhu Weiqiu
Published: July 2023

Stochastic averaging, as an effective technique for dimension reduction, is of great significance in stochastic dynamics and control. However, its practical applications in industrial and engineering fields are severely hindered by its dependence on governing equations and the complexity of mathematical operations. Herein, a data-driven method, named data-driven stochastic averaging, is developed to automatically discover the low-dimensional stochastic differential equations using only the random state data captured from the original high-dimensional dynamical systems. This method includes two successive steps, that is, extracting all slowly varying processes hidden in fast-varying state data and identifying drift and diffusion coefficients by their mathematical definitions. It automates dimension reduction and is especially suitable for cases with unavailable governing equations and excitation data. Its application, efficacy, and comparison with theory-based stochastic averaging are illustrated through several examples, numerical or experimental, with pure Gaussian white noise excitation or combined excitations.
Self-Consistent Calculation of Nuclear Charge Radii in K Isotopes
Authors: Borzov I. N. , Tolokonnikov S. V.
Published: July 2023

Fully self-consistent study of the charge radii in Ca region is exemplified by the calculation in the long chains of K isotopes. The neutron-deficient and neutron-rich nuclei with pairing in both neutron and proton sectors, as well as the (semi-) magic nuclei around the closed neutron shells at N = 20, 28, 32 are treated within the Energy Density Functional (EDF) approach with the Fayans functional DF3-a. The performance of the DF3-a is analysed in describing the odd-even staggering effects found both in previous and in more recent CERN-ISOLDE experiments for 36–52K isotopes.
New Approach to Glauber Theory Description of Nucleus-Nucleus Scattering
Authors: Shabelski Yu. M. , Shuvaev A. G.
Published: July 2023

A new approach to describe the nuclear scattering amplitudes in Glauber theory is proposed. The method is based on the expression for the generating function of the Glauber amplitudes. The generating function has been explicitly found in all orders of the Glauber theory.
Effects of different aerobic exercises on the global cognitive function of the elderly with mild cognitive impairment: a meta-analysis
Authors: Han Conglin , Sun Weishuang , Zhang Dan , Xi Xiaoshuang , Zhang Rong , Gong Weijun
Published: July 2023

Objectives

To summarise the effects of various types of aerobic exercise on the global cognitive function of the elderly with mild cognitive impairment (MCI).

Design

A meta-analysis of randomised controlled trials (RCTs).

Data sources

PubMed, EMBASE and the Cochrane Library were searched for clinical RCTs from the earliest available records to March 2022.

Eligibility criteria for selecting studies

We included RCTs of subjects older than 60 years with MCI. The outcome indicators of cognitive function of interest were the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA).

Data extraction and synthesis

Two researchers independently screened the literature, extracted data and evaluated the quality of the included studies, with disagreements resolved by a third researcher. TheCochrane Handbook for Systematic Reviews of Interventionswas used to assess the risk of bias. Meta-analysis was performed by Review Manager V.5.3 software. Random-effect models were used for meta-analysis.

Results

A total of 1680 patients who participated in 20 RCTs were included in this study. Based on outcomes of MMSE analysis, the aerobic exercise, which was beneficial for global cognitive function in MCI patients, included multicomponent aerobic exercise (MD=1.79, 95% CI (1.41 to 2.17), p<0.01) and mind–body exercise (MD=1.28, 95% CI (0.83 to 1.74), p<0.01). The results of the meta-analysis of conventional aerobic exercise (MD=0.51, 95% CI (0.09 to 0.93), p=0.02) turned out to be statistically insignificant after sensitivity analysis (MD=0.14, 95% CI (-0.47 to 0.75), p=0.65). With the evaluation of MoCA, multicomponent aerobic exercise (MD=5.74, 95% CI (5.02 to 6.46), p<0.01), mind–body exercise (MD=1.29, 95% CI (0.67 to 1.90), p<0.01) and conventional aerobic exercise (MD=2.06, 95% CI (1.46 to 2.65), p<0.01) were showed significant beneficial effects for the patient. However, there was a high degree of heterogeneity between the results of multicomponent aerobic exercise (MMSE) and conventional aerobic exercise (MoCA), which was analysed and explored.

Conclusions

In general, multicomponent aerobic exercise and mind–body exercise were beneficial in improving global cognitive function in the elderly with MCI. Nevertheless, the improvement effect of mind–body exercise is more reliable compared with multicomponent aerobic exercise and conventional aerobic exercise.

PROSPERO registration number

CRD42022327386.
PARIST study protocol: a phase I/II randomised, controlled clinical trial to assess the feasibility, safety and effectiveness of paracetamol in resolving acute kidney injury in children with severe malaria
Authors: Paasi George , Okalebo Charles Benard , Ongodia Paul , Namayanja Cate , Eregu Egiru Emma Isaiah , Abongo Grace , Olupot Moses , Amorut Denis , Muhindo Rita , Okiror William , Ndila Carolyne , Olupot-Olupot Peter
Published: July 2023

Background

Acute kidney injury (AKI) has in the past been considered a rare complication of malaria in children living in high-transmission settings. More recently, however, a growing number of paediatric case series of AKI in severe malaria studies in African children have been published (Artesunate vs Quinine in the Treatment of SevereP. falciparumMalaria in African children and Fluids Expansion as Supportive Therapy trials). The Paracetamol for Acute Renal Injury in Severe Malaria Trial (PARIST) therefore, aims to assess feasibility, safety and determine the effective dose of paracetamol, which attenuates nephrotoxicity of haemoproteins, red-cell free haemoglobin and myoglobin in children with haemoglobinuric severe malaria.

Methods

PARIST is a phase I/II unblinded randomised controlled trial of 40 children aged >6 months and <12 years admitted with confirmed haemoglobinuric severe malaria (blackwater fever), a positive blood smear forP. falciparummalaria and either serum creatinine (Cr) increase by ≥0.3 mg/dL within 48 hours or to ≥1.5 times baseline and elevated blood urea nitrogen (BUN) >20 mg/dL. Children will be randomly allocated on a 1:1 basis to paracetamol intervention dose arm (20 mg/kg orally 6-hourly for 48 hours) or to a control arm to receive standard of care for temperature control (ie, tepid sponging for 30 min if fever persists give rescue treatment). Primary outcome is renal recovery at 48 hours as indicated by stoppage of progression and decrease of Cr level below baseline, BUN (<20 mg/dL). Data analysis will be on the intention-to-treat principle and a per-protocol basis.

Results from this phase I/II clinical trial will provide preliminary effectiveness data of this highly potential treatment for AKI in paediatric malaria (in particular for haemoglobinuric severe malaria) for a larger phase III trial.

Ethics and dissemination

Ethical and regulatory approvals have been granted by the Mbale Hospital Institutional Ethics Review Committee (MRRH-REC OUT 002/2019), Uganda National Council of Science and Technology (UNCST-HS965ES) and the National drug Authority (NDA-CTC 0166/2021). We will be disseminating results through journals, conferences and policy briefs to policy makers and primary care providers.

Trial registration number

ISRCTN84974248.
Early recognition and management of maternal sepsis in Pakistan: a feasibility study of the implementation of FAST-M intervention
Authors: Ahmed Sheikh Irfan , Rind Ghulam Kubra , Sikandar Raheel , Raza Amir , Khowaja Bakhtawar M Hanif , Parveen Fahmida , Khan Sehrish , Memon Nazia , Jahangir Arshia , Mirza Daayl Naim , Cheshire James , Dunlop Catherine Louise , Shakoor Sadia , Barolia Rubina , Sheikh Lumaan , Saleem Sarah , Coomarasamy Arri , Lissauer David
Published: July 2023

Objective

Maternal sepsis is the third leading cause of maternal mortality globally. WHO and collaborators developed a care bundle called FAST-M (Fluids,Antibiotics,Source identification and treatment,Transfer andMonitoring) for early identification and management of maternal sepsis in low-resource settings. This study aimed to determine feasibility of FAST-M intervention in a low-resource setting in Pakistan. The FAST-M intervention consists of maternal sepsis screening tools, treatment bundle and implementation programme.

Design and setting

A feasibility study with before and after design was conducted in women with suspected maternal sepsis admitted at the Liaquat University of Medical and Health Sciences hospital Hyderabad. The study outcomes were compared between baseline and intervention phases. In the baseline phase (2 months), the existing sepsis care practices were recorded, followed by a training programme for healthcare providers on the application of FAST-M tools. These tools were implemented in the intervention phase (4 months) to assess any change in clinical practices compared with the baseline phase.

Results

During the FAST-M implementation, 439 women were included in the study. 242/439 were suspected maternal infection cases, and 138/242 were women with suspected maternal sepsis. The FAST-M bundle was implemented in women with suspected maternal sepsis. Following the FAST-M intervention, significant changes were observed. Improvements were seen in the monitoring of oxygen saturation measurements (25.5% vs 100%; difference: 74%; 95% CI: 68.4% to 80.5%; p<0.01), fetal heart rate assessment (58% vs 100%; difference: 42.0%; 95% CI: 33.7% to 50.3%; p≤0.01) and measurement of urine output (76.5% vs 100%; difference: 23.5%; 95% CI: 17.6% to 29.4%; p<0.01). Women with suspected maternal sepsis received all components of the treatment bundle within 1 hour of sepsis recognition (0% vs 70.5%; difference: 70.5%; 95% CI: 60.4% to 80.6%; p<0.01).

Conclusion

Implementation of the FAST-M intervention was considered feasible and enhanced early identification and management of maternal sepsis at the study site.

Trial registration number

ISRCTN17105658.
Awareness and readiness of mental healthcare providers to implement telemental health services and associated factors at public referral hospitals in Addis Ababa City, Ethiopia
Authors: Adem Jibril Bashir , Zeleke Tirualem , Walle Agmasie Damtew , Atinafu Wabi Temesgen , Tilahun Kefyalew Naniye , Melaku Mequannent Sharew , Kebede Shimels Derso
Published: July 2023

Objective

To assess the awareness and readiness of mental healthcare providers to implement telemental health services and the associated factors at public referral hospitals in Addis Ababa City, Ethiopia.

Study design

A cross-sectional study was conducted among mental health professionals working at public referral hospitals in Addis Ababa City from 4 May to 10 June 2022.

Participants

A total of 413 (55.7% male and 44.3% female) health professionals participated in the study. The study participants were selected using a simple random sampling technique. All mental healthcare providers working at public referral hospitals in Addis Ababa City were considered as the source population. Mental healthcare providers who meet the inclusion criteria were considered the study population. Having a minimum diploma qualification and 6 months or more of work experience and giving written consent were considered the inclusion criteria.

Outcome measure

The main outcome measure was awareness and readiness to implement telemental health services.

Result

A total of 413 participants were enrolled, with a response rate of 90.6%. The prevalence of good awareness towards telemental health services was 41% (95% CI 37%, 47%). Being female (adjusted OR (AOR)=0.34; 95% CI 0.15, 0.76), having poor information technology support (AOR=0.32; 95% CI 0.11, 0.99) and having electronic health technology experience (AOR=1.21; 95% CI 1.1, 2.44) were significantly associated with awareness of telemental health services, whereas computer access at the workplace (AOR=0.04; 95% CI 0.003, 0.55) and awareness (AOR=4.34; 95% CI 1.02, 18.48) and attitude (AOR=1.01; 95% CI 1.03, 2.19) towards telemental health services were the variables that showed statistically significant association with readiness of mental healthcare providers for telemental health services.

Conclusion

Although majority of healthcare providers in this survey were prepared to implement telemental health services, there was typically little awareness among mental healthcare providers.
Patient financial incentives to improve asthma management: a systematic review
Authors: Hine Jasmine , Lee Bohee , Bush Andrew , De Simoni Anna , Griffiths Chris , Judah Gaby , Fleming Louise
Published: July 2023

Objectives

The objectives of this systematic review are to identify studies that assess the effectiveness of patient-directed financial incentive interventions to improve asthma management behaviours, determine overall effectiveness of financial incentives, identify design characteristics of effective interventions and assess the impact on longer-term outcomes in the context of asthma.

Design

Systematic review with narrative synthesis.

Data sources

Electronic databases (MEDLINE, Embase, Global Health, PsycINFO, CINAHL, PubMed and Web of Science) and grey literature sources (NHS Digital, CORE, ProQuest, Clinical Trials Register and EU Clinical Trials Register) were searched in November 2021 and updated March 2023.

Eligiblity criteria

Eligible articles assessed financial incentives to improve asthma management behaviours (attendance at appointments, medication adherence, tobacco smoke/allergen exposure, inhaler technique and asthma education) for patients with asthma or parents/guardians of children with asthma. Eligible study design included randomised controlled, controlled or quasi-randomised trials and retrospective/prospective cohort, case-controlled or pilot/feasibility studies.

Synthesis

A narrative synthesis was conducted; eligible studies were grouped by asthma management behaviours and financial incentive framework domains.

Results

We identified 4268 articles; 8 met the inclusion criteria. The studies were from the USA (n=7) and the UK (n=1). Asthma management behaviours included attendance at appointments (n=4), reduction in smoke exposure (n=1) and medication adherence (n=3). Five studies demonstrated positive behaviour change, four of which were significant (attendance at appointments (n=3) showed significant differences between intervention and control: 73% and 49% in one study, 46.3% and 28.9% in another, and 35.7% and 18.9%, respectively; medication adherence (n=1) showed significant change from 80% during intervention to 33% post intervention). These four significant studies used ‘positive gain’, ‘certain’, ‘fixed’ financial incentives of smaller magnitude, given for ‘all’ instances of behaviour.

Conclusion

There is some evidence that patient-directed financial incentives improve asthma management behaviours. However, in view of the wide heterogeneity in study design and measured outcomes, determining overall effectiveness was challenging.

PROSPERO registration number

CRD42021266679.
Effects of internalised racism and internalised homophobia on sexual behaviours among black gay and bisexual men in the USA: a systematic review protocol
Authors: Whitfield Darren L , Miller Rebekah S , Escobar-Viera César G , Mammadli Tural , Brown Andre L , Gordon Jacob D , Chandler Cristian
Published: July 2023

Introduction

Black gay and bisexual men are overburdened by HIV in the USA. While the socioecological model has been applied to understand potential mechanisms of HIV acquisition among black gay and bisexual men, there is mixed evidence on the impact of internalised stigma on HIV risk among this population. This systematic review protocol paper outlines the systematic review being conducted to determine the relationship between internalised racism, internalised homophobia and engagement in sexual behaviour, which puts individuals at risk for HIV infection.

Methods and analysis

For the review, we will conduct a systematic review of the literature, summarise and critique published scholarly literature on the associations between forms of internalised stigma and sexual behaviours among black gay and bisexual men. We will conduct a systematic search of published qualitative and quantitative research studies published during and after 1993. The searches will be conducted in Ovid Medline, Ovid APA PsycInfo and EBSCO SocINDEX databases. Studies will be included if they were conducted in the USA, with samples that comprised African American/black cisgender gay, bisexual, queer and other men who have sex with men, measured internalised racism and/or internalised homophobia, and assessed sexual behaviour risk for HIV acquisition.

Ethics and dissemination

No ethical approval will be required for this review. We will report our findings using the guidelines outlined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Findings of this review may offer new opportunities to study internalised mechanisms impacting outcomes and to identify research gaps and spur additional queries in the group most disproportionately impacted by HIV.
Risk of cardiovascular disease associated with repeated proteinuria across annual kidney function screening among the middle-aged and older general population in Japan: a retrospective cohort study
Authors: Ohnishi Tsuyoshi , Mori Yuichiro , Fukuma Shingo
Published: July 2023

Objectives

We aimed to investigate the association between repetitive proteinuria and cardiovascular events among the middle-aged and older general Japanese population.

Design

Retrospective cohort study.

Setting

We used repeated health screening results and medical claim data from one of the largest health insurers in Japan.

Participants

Among the middle-aged and older participants (40–74 years, n=179 840), 90 752 were excluded for undergoing health screening fewer than two times and 344 were excluded for having a history of cardiovascular diseases; 88 744 who underwent kidney function screenings at least two times (from April 2011 to March 2015) were included in the analysis. Based on dipstick proteinuria test results, the participants were divided into ‘Repetitively-positive’ (positive two times or more (positive proteinuria was defined as≥1+)), ‘Once-positive’ and ‘All-negative’ groups.

Primary and secondary outcome measures

The primary outcome of major cardiovascular events from baseline screening to June 2021 was hospitalisation or death due to acute myocardial infarction (AMI), cerebrovascular diseases, heart failure (HF) or peripheral vascular diseases (PVDs). The association between proteinuria and major cardiovascular events was assessed using a Cox proportional hazards model.

Results

Of the 88 744 participants, 8775 (9.9%) and 5498 (6.2%) had Once-positive and Repetitively-positive proteinuria, respectively. During the follow-up period of 402 799 person-years (median 5.25 years), 660 cardiovascular events were observed, with an incidence of 1.64 per 1000 person-years (95% CI 1.52 to 1.77). Despite adjusting for major cardiovascular risk factors, we observed a high incidence of cardiovascular events in the Repetitively-positive (HR 2.08, 95% CI 1.67 to 2.59) and Once-positive groups (HR 1.36, 95% CI 1.07 to 1.72). We found similar associations for AMI, cerebrovascular disease, HF and PVD.

Conclusions

Proteinuria is often repeatedly detected during annual renal screening in the general population. Repetitive proteinuria is a risk factor for major cardiovascular events.
Patients’ experiences of being touched by their general practitioner: a qualitative study
Authors: Devillers Louise , Subts Amélie , De Bandt David , Druais Pierre-Louis , Gilles de la Londe Julie
Published: July 2023

Objective

This study aimed to explore patients’ experiences and perceptions of touch, as practised by their general practitioner during their medical appointment.

Design

Qualitative study using grounded theory method, based on individual interviews. Data collection and analysis occurred iteratively; themes were identified using constant comparison.

Setting

Recruitment among general practitioners’ private practices and health centres in Ile-de-France.

Participants

Twenty-one patients aged 19–88 years old, interviewed between June 2018 and May 2019.

Results

Physical examination was described as a ritual enabling the establishment of patients’ and doctors’ roles, the verification of the doctor’s skills and the construction of a caring experience. Touch was also a media for the doctor to exercise power that the patient authorised. Finally, it had relational and emotional value.

Discussion and conclusion

Physical examination is so internalised by the patients that it becomes unquestionable. It may be inappropriate when this touch does not belong to physical examination or on the contrary represents a proof of the doctor’s humanity. The patient is not necessarily aware of the relational dimension that underpins touching and, in particular, clinical examination. This raises the question of why should doctor use it and how they can communicate about it, so that it may become an active tool in favour of trust and the construction of the relationship.
Potential social marketing applications for knowledge translation in healthcare: a scoping review protocol
Authors: Colquhoun Heather , Ellen Moriah , Brehaut Jamie , Weinreich Nedra Kline , Morvinski Coby , Zarshenas Sareh , Nguyen Tram , Presseau Justin , McCleary Nicola , Proctor Enola
Published: July 2023

Introduction

Knowledge translation has emerged as a practice and a science to bridge the gap between evidence and practice in healthcare. While the field has appropriately borrowed from other related fields to advance its science, there remain fields less mined. One such field with potential relevance to knowledge translation, but limited application to date, is social marketing. This review aims to determine elements of social marketing interventions that could be applied to knowledge translation science. Our objectives are to: (1) summarise the types of studies that have tested social marketing interventions in controlled intervention study designs; (2) describe the social marketing interventions and their effects; and (3) propose strategies for the integration of social marketing interventions into knowledge translation science.

Methods and analysis

This scoping review will be conducted using the Joanna Briggs Institute Methodological Guidance. For the first and second objectives, all English-language studies published from 1971 onwards will be included if they (1) used a randomised or non-randomised controlled intervention design, and (2) tested a social marketing intervention as defined by five essential social marketing criteria. The research team will address the third objective through discussion and consensus. All screening and extraction will be performed independently by two reviewers. Variables extracted will include intervention details using essential and desirable social marketing criteria and the context, mechanism and outcomes of the interventions.

Ethics and dissemination

This project is a secondary analysis of published papers and does not require ethics approval. We will disseminate our review outputs in knowledge translation journals and present at relevant conferences across the spectrum of the field. We will produce a short and long version of a plain language summary that will be tailored to various groups including implementation scientists and quality improvement researchers.

Registration details

Open Science Framework Registration link: osf.io/6q834.
Trends of frequency, mortality and risk factors among patients admitted with stroke from 2017 to 2019 to the medical ward at Kilimanjaro Christian Medical Centre hospital: a retrospective observational study
Authors: Moshi Baraka , Yongolo Nateiya , Biswaro Sanjura Mandela , Maro Hans , Linus Sakanda , Siebert Stefan , Nkenguye William , McIntosh Emma , Shirima Febronia , Njau Rosalia E , Andongolile Alice A , Mwanswila Manasseh Joel , Halliday Jo E B , Krauth Stefanie , Kilonzo Kajiru , Walker Richard William , Temu Gloria August , Mmbaga Blandina T
Published: July 2023

Objective

The burden of stroke has increased in recent years worldwide, particularly in low-income and middle-income countries. In this study we aim to determine the number of stroke admissions, and associated comorbidities, at a referral hospital in Northern Tanzania.

Design

This was a retrospective observational study.

Setting

The study was conducted at a tertiary referral hospital, Kilimanjaro Christian Medical Centre (KCMC), in the orthern zone of Tanzania.

Participants

The study included adults aged 18 years and above, who were admitted to the medical wards from 2017 to 2019.

Outcome

The primary outcome was the proportion of patients who had a stroke admitted in the medical ward at KCMC and the secondary outcome was clinical outcome such as mortality.

Methods

We conducted a retrospective audit of medical records from 2017 to 2019 for adult patients admitted to the medical ward at KCMC. Data extracted included demographic characteristics, previous history of stroke and outcome of the admission. Factors associated with stroke were investigated using logistic regression.

Results

Among 7976 patients admitted between 2017 and 2019, 972 (12.2%) were patients who had a stroke. Trends show an increase in patients admitted with stroke over the 3 years with 222, 292 and 458 in 2017, 2018 and 2019, respectively. Of the patients who had a stroke, 568 (58.4%) had hypertension while 167 (17.2%) had diabetes mellitus. The proportion of admitted stroke patients aged 18–45 years, increased from 2017 (n=28, 3.4%) to 2019 (n=40, 4.3%). The in-hospital mortality related to stroke was 229 (23.6%) among 972 patients who had a stroke and female patients had 50% higher odds of death as compared with male patients (OR:1.5; CI 1.30 to 1.80).

Conclusion

The burden of stroke on individuals and health services is increasing over time, which reflects a lack of awareness on the cause of stroke and effective preventive measures. Prioritising interventions directed towards the reduction of non-communicable diseases and associated complications, such as stroke, is urgently needed.
Effect of portable HEPA filters on COVID-19 period prevalence: an observational quasi-interventional study in German kindergartens
Authors: Falkenberg Timo , Wasser Felix , Zacharias Nicole , Mutters Nico , Kistemann Thomas
Published: July 2023

Objectives

The aim of the study was to evaluate the effect of high-efficiency particulate air (HEPA) filters on COVID-19 period prevalence in kindergartens.

Design

The observational study follows an intervention design with the intervention group using HEPA filters and the control group not.

Setting

The study was conducted in 32 (10 intervention, 22 control) kindergartens (daycare centres) in Rhineland Palatinate (Germany).

Participants

Data of 2360 children (663 intervention, 1697 control) were reported by the kindergarten heads. Data were collected on institutional level without any identifying information on individuals. Thus, all children of all facilities were included; however, no demographic data were recorded.

Interventions

The study followed a quasi-interventional design, as no formal intervention was conducted. A charity foundation equipped kindergartens with HEPA filters. These kindergartens were enrolled as intervention group. The control group was recruited from the neighbouring communities and districts.

Outcome measures

The primary outcome measure was the number of COVID-19 cases reported by the kindergarten heads, converted into period prevalence rates per 1000 population.

Results

The mean COVID-19 period prevalence rates of the control and intervention groups were 186 (95% CI: 137.8 to 238.9) and 372 (95% CI: 226.6 to 517.6) per 1000 children, respectively. The one-sided Wilcoxon rank-sum test indicates a p value of 0.989; thus, the hypothesised preventive effect of HEPA filters could not be confirmed in the kindergarten setting.

Conclusions

While HEPA filters can significantly reduce the viral load in room air, this does not lead to reduced COVID-19 prevalence in the selected kindergartens in Germany. It is known that contagion mainly occurs via direct face-to-face air exchange during play and that the contaminated air does not necessarily pass through the filter prior to air exchange between children. The use of HEPA filters may also lead to a sense of security, leading to reduced preventive behaviour.
Health risk communication and infodemic management in Iran: development and validation of a conceptual framework
Authors: Bazrafshan Azam , Sadeghi Azadeh , Bazrafshan Maliheh Sadat , Mirzaie Hossein , Shafiee Mehdi , Geerts Jaason , Sharifi Hamid
Published: July 2023

Objective

The COVID-19 pandemic exposed significant gaps in Iran’s and other health systems’ risk communication. The accompanying infodemic undermined policy responses, amplified distrust in government and reduced adherence to public health recommendations among the Iranian population. This study aimed to develop a conceptual framework for health risk communication and infodemic management (RCIM) during epidemics and health emergencies in Iran that could have potential applications in other contexts.

Design

This study was designed in two phases. Phase 1 involved semistructured qualitative interviews with key informants to explore effective RCIM strategies across public health settings in Iran and to develop a conceptual framework. Phase 2 involved revising the framework based on feedback from an online expert panel regarding its comprehensiveness and validity.

Setting

Provincial/national public health settings in Iran.

Participants

Twenty key informants from provincial and national public health authorities who contributed to COVID-19 response programmes participated in interviews. Nine experts from diverse academic disciplines, provincial and national settings, and geographical locations participated in an online expert panel.

Results

The conceptual model was created based on qualitative interviews and expert panel discussions and was structured according to six pillars of the WHO health system framework: leadership and governance, information, health workforce and financial resources, along with media and community. Leadership and governance, including trustworthy leaders, were recommended as the foundation for developing RCIM in Iran. Developing an official strategy with information infrastructures, including high-quality surveillance systems, identified personnel and training for specialists among the health workforce, financial resources, communication channels and community engagement were recognised as other dimensions for developing health risk communication in Iran.

Conclusion

The proposed framework represents a step toward establishing a national RCIM strategy in Iran. Further validation of the conceptual framework and experiments on how it could potentially influence policy and practice is recommended. This model has the potential to be applied in other contexts in its current form or as the foundation for customised local versions.
Association of vaccine stockout with immunisation coverage in low-income and middle-income countries: a retrospective cohort study
Authors: Lee Donghoon , Lavayen Manuel Celestino , Kim Taeksoo Ted , Legins Ken , Seidel Michelle
Published: July 2023

Objectives

This study investigated the association between vaccine stockout and immunisation coverage, and infant/under 5 mortality rates.

Design

A retrospective cohort study.

Setting

Low-income and middle-income countries.

Participants

A cohort of 131 low-income and middle-income countries from 2004 to 2019.

Primary outcome measures

Main outcomes included immunisation coverages of (1) diphtheria-tetanus-pertussis containing vaccine (DTP), (2) measles containing vaccine (MCV), (3) BCG and (4) oral polio vaccine (OPV). We also included infant and under 5 mortality rates as secondary outcomes.

Results

The countries that experienced national-level stockouts of DTP and MCV had 3.7 and 4 percentage points lower coverage rates of DTP3 and MCV1, respectively, compared with the countries without the stockout events (p<0.01). Moreover, the statistically significant differences in the immunisation coverage rates across the countries with and without the stockout events are 2.4 percentage points and 2.6 percentage points for BCG and OPV, respectively (p<0.01).

Conclusion

Our findings show that the incidence of vaccine stockout events is associated with the decreased immunisation coverages for children in low-income and middle-income countries. However, we did not observe a statistically significant association between the increasing frequency of vaccine stockout and infant and under 5 mortality rates.
Neurobiological basis and risk factors of persistent fatigue and concentration problems after COVID-19: study protocol for a prospective case–control study (VeCosCO)
Authors: Verveen Anouk , Verfaillie Sander C J , Visser Denise , Csorba Irene , Coomans Emma M , Koch Dook W , Appelman Brent , Barkhof Frederik , Boellaard Ronald , de Bree Godelieve , van de Giessen Elsmarieke M , Golla Sandeep , van Heugten Caroline M , Horn Janneke , Hulst Hanneke E , de Jong Menno D , Kuut Tanja A , van der Maaden Tessa , van Os Yvonne M G , Prins Maria , Slooter Arjen J C , Visser-Meily Johanna M A , van Vugt Michele , van den Wijngaard Cees C , Nieuwkerk P T , Knoop H , Tolboom Nelleke , van Berckel Bart N M
Published: July 2023

Introduction

The risk factors for persistent fatigue and cognitive complaints after infection with SARS-CoV-2 and the underlying pathophysiology are largely unknown. Both clinical factors and cognitive-behavioural factors have been suggested to play a role in the perpetuation of complaints. A neurobiological aetiology, such as neuroinflammation, could be the underlying pathophysiological mechanism for persisting complaints.

To unravel factors associated with persisting complaints, VeCosCO will compare individuals with and without persistent fatigue and cognitive complaints >3 months after infection with SARS-CoV-2. The study consists of two work packages. The first work package aims to (1) investigate the relation between persisting complaints and neuropsychological functioning; (2) determine risk factors and at-risk phenotypes for the development of persistent fatigue and cognitive complaints, including the presence of postexertional malaise and (3) describe consequences of persistent complaints on quality of life, healthcare consumption and physical functioning. The second work package aims to (1) determine the presence of neuroinflammation with [18F]DPA-714 whole-body positron emission tomography (PET) scans in patients with persisting complaints and (2) explore the relationship between (neuro)inflammation and brain structure and functioning measured with MRI.

Methods and analysis

This is a prospective case–control study in participants with and without persistent fatigue and cognitive complaints, >3 months after laboratory-confirmed SARS-CoV-2 infection. Participants will be mainly included from existing COVID-19 cohorts in the Netherlands covering the full spectrum of COVID-19 acute disease severity. Primary outcomes are neuropsychological functioning, postexertional malaise, neuroinflammation measured using [18F]DPA-714 PET, and brain functioning and structure using (f)MRI.

Ethics and dissemination

Work package 1 (NL79575.018.21) and 2 (NL77033.029.21) were approved by the medical ethical review board of the Amsterdam University Medical Centers (The Netherlands). Informed consent is required prior to participation in the study. Results of this study will be submitted for publication in peer-reviewed journals and shared with the key population.