bluuebunny/crossref_metadata_2025 huggingface dataset:
Identification of circRNA-associated ceRNA networks using longissimus thoracis of pigs of different breeds and growth stages
Authors: Zhuang Xiaona , Lin Zekun , Xie Fang , Luo Junyi , Chen Ting , Xi Qianyun , Zhang Yongliang , Sun Jiajie
Published: April 2022

Background

Long-term artificial selection for growth rate and lean meat rate has eventually led to meat quality deterioration. Muscle fiber type is a key factor that markedly affects meat quality. circRNAs have been reported to participate in diverse biological activities, including myofiber growth and development; thus, we herein compared porcine circRNA transcriptome between oxidative and glycolytic muscle tissues.

Results

Longissimus thoracis muscle tissues were obtained from Lantang and Landrace pigs at birth (LT1D and LW1D, respectively) and 90 postnatal days (LT90D and LW90D, respectively). Hematoxylin and eosin staining and quantitative real-time PCR revealed that all structural traits of the muscle showed large variations between different breeds and growth stages. In total, 329 known miRNAs and 42,081 transcript candidates were identified; 6,962 differentially expressed transcripts were found to play a key role in myogenesis by gene ontology and Kyoto Encyclopedia of Genes and Genomes pathway analyses. In addition, 3,352 circRNAs were identified using five predicting algorithms, and 104 circRNA candidates were differentially expressed. Integrated analysis of differentially expressed miRNAs, mRNAs, and circRNAs led to the identification of 777, 855, and 22 convincing ceRNA interactions in LT1D vs. LT90D, LW1D vs. LW90D, and LT90D vs. LW90D, respectively. Finally, we identified a circRNA candidate circKANSL1L, which showed high homology between mice and pigs, and it was found to inhibit the proliferation of C2C12 cells but promote their differentiation.

Conclusions

We identified genome-wide circRNAs in 0- and 90-day-old Lantang and Landrace pigs by RNA-seq and found that circRNAs were abundant, differentially expressed, and associated with myogenesis. Our results should serve as a reference for future studies on pork quality.
Synthesis of silver nanoparticles with high efficiency and stability by culture supernatant of Bacillus ROM6 isolated from Zarshouran gold mine and evaluating its antibacterial effects
Authors: Esmail Rostampour , Afshar Alihosseini , Morteza Milani , Abolfazl Akbarzadeh , Akhondi Ebrahim
Published: April 2022

Background

The use of bacteria to synthesize nanoparticles as an environment-friendly method has recently been considered by researchers. Bacteria residing in different mines have shown high potential in the synthesis of metal nanoparticles due to their compatibility with the environment. The aim of this study was to evaluate the ability of Zarshouran gold mine bacteria to synthesize silver nanoparticles and their antibacterial activity.

Methods

After isolation of mine bacteria and several screening steps, silver ion tolerant bacteria that were able to synthesize extracellular silver nanoparticles were isolated and the most suitable isolate was selected and sequenced. The characteristics, stability, and production efficiency of silver nanoparticles were evaluated using UV–vis spectrophotometry, DLS, TEM, FTIR, and X-ray diffraction analysis. Finally, the antibacterial effect of silver nanoparticles against pathogenic bacteria was investigated.

Results

Among the eight silver-tolerant bacteria, isolate No. 6 had high antibacterial activity and high potential in the synthesis and stabilization of silver nanoparticles. Therefore, this isolate was selected for the next experiments. The results of 16S rDNA sequencing showed that this isolate is related to Bacillus pumilus. We registered in the NCBI Bank called ROM6 with access number MW440543. The DLS and TEM analysis showed that silver nanoparticles produced by this isolate were most spherical with a size of less than 25 nm and were stable for at least 180 days. The efficiency at concentrations less than 0.9 g/l silver nitrate was over 90% and the minimum inhibition concentration of nanoparticles was determined against S. aureus, E. coli, P. aeruginosa, and A. baumannii ranging from 1.4 to 5.6 µg/ml.

Conclusion

We found that the bacteria residing in the gold mine have a high capacity for the synthesis of spherical and high stable silver nanoparticles with a strong antibacterial effect.
Low-concentration iron promotes Klebsiella pneumoniae biofilm formation by suppressing succinic acid
Authors: Liu Kexin , Tan Shuang , Ye Weiyuan , Hou Limin , Fang Binghu
Published: April 2022

Background

Klebsiella pneumoniae is widely distributed in water and plays a major role in both human and poultry infections. Many K. pneumoniae strains form biofilms on various surfaces, enhancing their pathogenicity and resistance to antibiotics. The water supply pipeline of chicken farms has become a hotbed for the growth of K pneumoniae biofilm because of its humid environment, and because the chicken drinking water pipeline is thin, it is easily blocked by the biofilm, and the diffused cells can cause repeated and persistent infections. Iron is vital to the growth of microorganisms and the formation of biofilms. Therefore, the aim of this study was to examine the effects of iron on K. pneumoniae biofilm formation and any associated metabolic changes to provide a rationale for reducing the formation of biofilms.

Results

Biofilm formation was enhanced to the greatest extent by the presence of 0.16 mM FeCl2, producing a denser structure under electron microscopy. The number of biofilm-forming and planktonic bacteria did not change, but protein and polysaccharide concentrations in the bacterial extracellular polymeric substances (EPS) were significantly increased by iron supplementation. To clarify this mechanism, intracellular metabolomic analysis was carried out, showing that the differential, down-regulated metabolites included succinic acid. The addition of 1.7 mM succinic acid counteracted the biofilm-forming effect of iron, with no bactericidal side effects.

Conclusion

This study demonstrates the importance of succinic acid and iron in K. pneumoniae biofilms, and provides insight into the formation of K. pneumoniae biofilms and direction for the development of new antibacterial agents.
Neuroprotective effects of strength training in a neuroinflammatory animal model
Authors: de Gregório Elizama , Mendes Gabriela Cristiane , Somensi Lincon Bordignon , Freire Cassio Geremia , Lopes Luiza Freitas , Lima Karine Ramires , Carrazoni Guilherme Salgado , Neves Ben-Hur Souto , Picua Steffanie Severo , da Silva Luisa Mota , Mello-Carpes Pamela Billig , Bonini Juliana Sartori , da Silva Weber Claudio
Published: April 2022

Background

The preventive role of muscular strength on diminishing neuroinflammation is yet unknown. In this study, the role of the prophylactic muscular strength exercise was investigated in order to verify whether it would diminish cognitive alterations and modify the antioxidant intracellular scenery in an animal neuroinflammatory model in of the CA1 region of the hippocampus.

Methods

The animals received muscular strength training (SE) three times a week for eight weeks. Subsequently, the stereotaxic surgery was performed with an intra-hippocampal infusion of either saline solution (SAL) or lipopolysaccharide (LPS). Next, we performed the behavioral tests: object recognition and social recognition. Then, the animals were euthanized, and their hippocampus and prefrontal cortex were collected. In another moment, we performed the dosage of the antioxidant activity and histological analysis.

Results

The results showed that the muscular strength exercises could show a beneficial prophylactic effect in the cognitive deficiencies caused by acute neuroinflammation. Regarding oxidative stress, there was an increase in catalase enzyme activity (CAT) in the group (SE + LPS) compared to the control groups (p < 0.05). As for the cognitive alterations, there were found in the (SE + LPS) group, diminishing the mnemonic hazard of the discriminative and social memories compared to the control groups (p < 0.05).

Conclusion

We concluded, therefore, that the exercise performed prophylactically presents a protective effect capable of minimizing such mnemonic deficits and increasing catalase enzyme activity in rats that suffered a local neuroinflammatory process in the hippocampus.
Accumulation in nutrient acquisition strategies of arbuscular mycorrhizal fungi and plant roots in poor and heterogeneous soils of karst shrub ecosystems
Authors: Liang Yueming , Pan Fujing , Jiang Zhongcheng , Li Qiang , Pu Junbing , Liu Kunping
Published: April 2022

Background

Arbuscular mycorrhizal (AM) fungi and roots play important roles in plant nutrient acquisition, especially in nutrient poor and heterogeneous soils. However, whether an accumulation strategy of AM fungi and root exists in such soils of karst shrubland ecosystems remains unclear. Root traits related to nutrient acquisition (root biomass, AM colonisation, root acid phosphatase activity and N2 fixation) were measured in two N2-fixing plants (i.e. Albizia odoratissima (Linn. f.) Benth. and Cajanus cajan (Linn.) Millsp.) that were grown in heterogeneous or homogeneous nutrient (ammonium) soil with and without AM fungi inoculation.

Results

Both of these plants had higher AM colonisation, root biomass and relative growth rate (RGR), but lower N2 fixation and root acid phosphatase activity in the rhizosphere in the heterogeneous soil environment, than that in the homogeneous soil environment. Plants grown in the AM fungi-inoculated heterogeneous soil environment had increased root biomass and root acid phosphatase activity compared with those grown in soil without inoculation. AM colonisation was negatively correlated with the N2 fixation rate of A. odoratissima, while it was not significantly correlated with the root phosphatase activity.

Conclusions

Our results indicated that enhanced AM symbiosis and root biomass increased the absorptive surfaces for nutrient acquisition, highlighting the accumulation strategies of AM and root traits for plant nutrient acquisition in nutrient poor and heterogeneous soils of the karst shrubland ecosystem.
Association between short-term neurological outcomes and extreme hyperoxia in patients with out-of-hospital cardiac arrest who underwent extracorporeal cardiopulmonary resuscitation: a retrospective observational study from a multicenter registry
Authors: Kashiura Masahiro , Yasuda Hideto , Kishihara Yuki , Tominaga Keiichiro , Nishihara Masaaki , Hiasa Ken-ichi , Tsutsui Hiroyuki , Moriya Takashi
Published: April 2022

Background

To investigate the impact of hyperoxia that developed immediately after extracorporeal membrane oxygenation (ECMO)-assisted cardiopulmonary resuscitation (ECPR) on patients’ short-term neurological outcomes after out-of-hospital cardiac arrest (OHCA).

Methods

This study retrospectively analyzed data from the Japanese OHCA registry from June 2014 to December 2017. We analyzed adult patients (≥ 18 years) who had undergone ECPR. Eligible patients were divided into the following three groups based on their initial partial pressure of oxygen in arterial blood (PaO2) levels after ECMO pump-on: normoxia group, PaO2 ≤ 200 mm Hg; moderate hyperoxia group, 200 mm Hg < PaO2 ≤ 400 mm Hg; and extreme hyperoxia group, PaO2 > 400 mm Hg. The primary and secondary outcomes were 30-day favorable neurological outcomes. Logistic regression statistical analysis model of 30-day favorable neurological outcomes was performed after adjusting for multiple propensity scores calculated using pre-ECPR covariates and for confounding factors post-ECPR.

Results

Of the 34,754 patients with OHCA enrolled in the registry, 847 were included. The median PaO2 level was 300 mm Hg (interquartile range: 148–427 mm Hg). Among the eligible patients, 277, 313, and 257 were categorized as normoxic, moderately hyperoxic, and extremely hyperoxic, respectively. Moderate hyperoxia was not significantly associated with 30-day neurologically favorable outcomes compared with normoxia as a reference (adjusted odds ratio, 0.86; 95% confidence interval: 0.55–1.35; p = 0.51). However, extreme hyperoxia was associated with less 30-day neurologically favorable outcomes when compared with normoxia (adjusted odds ratio, 0.48; 95% confidence interval: 0.29–0.82; p = 0.007).

Conclusions

For patients with OHCA who received ECPR, extreme hyperoxia (PaO2 > 400 mm Hg) was associated with 30-day poor neurological outcomes. Avoidance of extreme hyperoxia may improve neurological outcomes in patients with OHCA treated with ECPR.
Barriers and facilitators for isoniazid preventive therapy (IPT) administration in children under 5 years of age in the Dominican Republic
Authors: Benoit Vásquez Grey Idalia , Morrobel Ana Lucia , Benjumea-Bedoya Dione , del Corral-Londoño Helena
Published: April 2022

Introduction

Throughout the world tuberculosis (TB) is the second leading cause of death due to an infectious agent. The World Health Organization promotes Isoniazid Preventive Therapy (IPT) in children under 5 years who are contacts of persons diagnosed with smear-positive pulmonary TB (SPPTB). In 2019, 33% of children identified as contacts received IPT globally, while in the Americas 11 countries reached coverages ≥ 75%, only 35% did so in the Dominican Republic (DR). The aim of this study was to identify barriers and facilitators for IPT administration in children under 5 in the Area IV Directorate of Health of the DR’s National District.

Methods

Descriptive study, using mixed methods and sequential explanatory approach. We characterized children under 5 years who were contacts of a person with SPPTB. Later, semi-structured interviews and content analysis allowed identification of barriers and facilitators for IPT administration in children who were contacts of a person diagnosed with SPPTB, as perceived by relatives and health system personnel.

Results

A total of 238 children were identified as contacts of 174 persons with SPPTB: 36% of these received IPT while no data on IPT administration was found for 11% of them. The proportion of children who had a tuberculin skin test (TST) done was < 20%. However, those who had the test done had a greater opportunity to receive IPT (OR: 8.12, CI 95%: 1.60–41.35). Barriers identified include socioeconomic conditions of children and families, stigma, lack of information in clinical and follow-up records, lack of coordination between public and private providers and lack of coherence within national regulations. Facilitators include home based care of persons with TB and their contacts, transfer of treatment to a health centre near household, isoniazid availability, provision of information by health-workers and economic support for food and transportation.

Conclusions

Incomplete data, lack of use of TST to rule out active TB, socioeconomic and cultural conditions, were barriers for IPT administration. Implementation of a person centred approach to care was found to be the main facilitator for IPT uptake. Administration of IPT depends predominantly on modifiable health system factors. This allows rapid identification of strategies to improve IPT administration.
Minimal change disease associated with gastrointestinal stromal tumor accompanied by significantly elevated serum IgE level: a case report
Authors: Yu Chun-Yang , Liu Jie , Qi Chang-Hai , Wu Zhen-Yu , Xiao Yue-Fei , Zhang Xue-Guang
Published: April 2022

Background

Minimal change disease (MCD) is a common cause of the nephrotic syndrome. Several studies have shown an increased incidence of cancer in patients with MCD. However, there are no reports on the association between MCD and gastrointestinal stromal tumor (GIST).

Case presentation

We report a case of a 66-year-old female with severe nephrotic syndrome and concomitant duodenal GIST. Immunoglobulin test showed a significant increase of IgE levels. The diagnosis of renal histopathology was MCD with subacute tubulointerstitial injury. The combination of preoperative Imatinib mesylate chemotherapy and tumor excision was accompanied by significant remission of proteinuria, and IgE level decreasing, without immunosuppressivetherapy.

Conclusions

It is the first case report that MCD was associated with GIST and elevated IgE level. Clinically, in patients with elevated IgE level associated with nephrotic syndrome, the possibility of tumor must be taken into account when allergic factors are excluded.
Epilepsy in patients undergoing cardiac surgery with ExtraCorporeal Circulation: case series and description of a peculiar clinical phenotype
Authors: Pugnaghi Matteo , Cavallieri Francesco , Zennaro Mauro , Zedde Marialuisa , Rizzi Romana , Gabbieri Davide , Valzania Franco
Published: April 2022

Background

Extracorporeal circulation (ECC) is now being increasingly used in critical care settings. Epileptic seizures are a recognized but under reported complication in patients receiving this care. Acute symptomatic post-operative seizures have been described, as well as remote seizure, mostly in the form of convulsive seizures. Epilepsy has also been reported, although with lower frequency and mainly with convulsive seizures, while different seizure semiology is rarely described.

Case presentation

We report a case series of four patients developing epilepsy with homogeneous features following heart surgery with ECC. We present neurophysiological and neuroradiological data and we describe the peculiar characteristics of epilepsies in terms of seizure semiology, frequency, and drug response. The main features are: an insulo-temporal or parieto-occipital semiology, often multifocal and without loss of consciousness or motor manifestations, a high frequency of seizures but with low impact on daily life, and a good response to anti-epileptic therapy.

Conclusions

We hypothesize a pathogenetic mechanism and we discuss the clinical implications of identifying these forms of epilepsy which tend to be often under-recognized.
Referral care for high-risk pregnant women in rural Rajasthan, India: a qualitative analysis of barriers and facilitators
Authors: Dalal Saachi , Nagar Ruchit , Hegde Rohaan , Vaishnav Surya , Abdullah Hamid , Kasper Jennifer
Published: April 2022

Objective

To qualitatively assess the barriers and facilitators to uptake of referral services amongst high-risk pregnant women in rural Rajasthan.

Methods

A purposive sample of pregnant women with high-risk conditions requiring referral follow-up care (severe hypertension, moderate anemia, and severe anemia) were considered for inclusion. In-depth individual interviews were conducted in the local dialect, Mewari. Interviews were transcribed, coded, and organized for thematic generation as per the analytical framework described in the socio-ecological model.

Results

19 high risk pregnant women of low socioeconomic backgrounds across 15 villages were interviewed. Barriers to referral care included lack of transportation, household responsibilities, and limited awareness, education, and social support. The most prominent barrier was lack of accompaniment to the referral center by a family member or health worker. Facilitators included available husbands, engaged heath workers, supportive neighbors, and other female family members who shared past experiences.

Conclusions

Social support at the interpersonal and community level was key to overcoming referral care barriers faced by high-risk pregnant women in rural Rajasthan. Interventions that enhance social support may improve uptake of referral care services by high-risk pregnant women.
Comment: silent burden no more: a global call to action to prioritize perinatal mental health
Authors: McNab Shanon , Fisher Jane , Honikman Simone , Muvhu Linos , Levine Rebecca , Chorwe-Sungani Genesis , Bar-Zeev Sarah , Hailegebriel Tedbabe Degefie , Yusuf Ifeyinwa , Chowdhary Neerja , Rahman Atif , Bolton Paul , Mershon Claire-Helene , Bormet Mona , Henry-Ernest Diana , Portela Anayda , Stalls Suzanne
Published: April 2022

Common perinatal mental disorders are the most frequent complications of pregnancy, childbirth and the postpartum period, and the prevalence among women in low- and middle-income countries is the highest at nearly 20%. Women are the cornerstone of a healthy and prosperous society and until their mental health is taken as seriously as their physical wellbeing, we will not improve maternal mortality, morbidity and the ability of women to thrive. On the heels of several international efforts to put perinatal mental health on the global agenda, we propose seven urgent actions that the international community, governments, health systems, academia, civil society, and individuals should take to ensure that women everywhere have access to high-quality, respectful care for both their physical and mental wellbeing. Addressing perinatal mental health promotion, prevention, early intervention and treatment of common perinatal mental disorders must be a global priority.
Atypical fetal junctional ectopic tachycardia: a case report and literature review
Authors: Katsura Daisuke , Tsuji Shunichiro , Tokoro Shinsuke , Hoshiyama Takako , Hoshino Shinsuke , Furukawa Ouki , Murakami Takashi
Published: April 2022

Background

Junctional ectopic tachycardia (JET) is caused by ectopic rhythms, originating in the atrioventricular node, typically with heart rate between 200 and 250 bpm. Herein, we present a case of fetal JET with normal fetal heart rate and a review of nine cases.

Case presentation

A 32-year-old, gravida 2, para 1, woman in whom fetal JET could not be diagnosed prenatally because the fetal heart rate was within the normal range. The fetus was diagnosed with premature restriction of the foramen ovale, and a cesarean section was performed, owing to the right heart overload that was characterized by fetal ascites and abnormal fetal Doppler velocity. Postnatally, the female neonate was diagnosed with JET on a 12-lead electrocardiogram, which revealed a neonatal heart rate of 158 bpm with narrow QRS and atrioventricular dissociation. After failure to respond to amiodarone therapy, she was treated with flecainide, which controlled the JET rate from 120 to 150 bpm. Fetal tachycardia with ventriculo-atrial (VA) dissociation or 1:1 VA conduction with a shorter VA interval than that of atrioventricular reentrant tachycardia confirmed the diagnosis of fetal JET.

Conclusions

JET should be suspected even in the absence of tachycardia in patients with ductus venosus and pulmonary vein retrograde flow or tricuspid and mitral regurgitation without a cardiac anomaly, as tachycardia might sometimes be intermittent in cases of JET.
Trends, projection and inequalities in full immunization coverage in Ethiopia: in the period 2000-2019
Authors: Yibeltal Kalkidan , Tsegaye Sitota , Zelealem Hasset , Worku Walelegn , Demissie Meaza , Worku Alemayehu , Berhane Yemane
Published: April 2022

Background

Immunization is among the most cost-effective health interventions to improve child survival. However, many countries in sub-Saharan Africa failed to achieve their national and international coverage targets repeatedly. The present study investigated trends of coverage and inequalities in coverage in Ethiopia.

Methods

This study used data from five rounds of the Demographic and Health Surveys conducted in Ethiopia in 2000, 2005, 2011, 2016, and 2019. The surveys used a multistage cluster sampling procedure to obtain a nationally and sub-nationally representative data. The outcome variables included in the study were full immunization coverage and inequality. The World Health Organization’s Health Equity Assessment Toolkit was used to conduct the inequality analysis. Projections for 2025 were based on smoothed averages generated using the demographic and health survey data from 2000 to 2019.

Results

The full (basic) immunization coverage in Ethiopia has increased steadily from 14.3% in 2000 to 44.1% in 2019. Based on the average past performance, the immunization coverage is projected to reach 53.6% by 2025, which will be short of the 75% national full (basic) immunization coverage target for the year 2025. Mothers with higher levels of education are more likely to get their children all basic vaccinations than those with lower levels of education. Similarly, the inequality gaps due to wealth and residency are significant; where children in the lowest wealth strata and those living in rural areas remained disadvantaged.

Conclusion

Despite a steady increase in immunization coverage in the past two decades the country is yet to achieve its immunization target. Thus, more efforts are needed to achieve the current and future national immunization targets. A more focused intervention targeting the disadvantaged groups could be an effective strategy to achieve coverage and minimize the inequality gaps in immunization.
Posttraumatic growth and recovery among a sample of Egyptian mental health service users: a phenomenological study
Authors: Ibrahim Nashwa , Ng Fiona , Selim Abeer , Ghallab Eman , Ali Amira , Slade Mike
Published: April 2022

Background

Delivery of recovery-oriented mental health practice is fundamental to personal recovery. Yet, there is lack of service users’ accounts on what constitutes mental health recovery in Egypt.

Objectives

The aim of this study was to explore mental health recovery meaning informed by people with personal experience of recovery.

Methods

A phenomenological research design was used. Semi-structured qualitative interviews were conducted with 17 adult community-dwelling individuals who identified as recovered/recovering from mental health issues. An inductive thematic analysis approach was used to analyses participants’ responses.

Results

Participants predominately reported personal and functional definitions of mental health recovery. Posttraumatic growth was the strongest theme comprising: relation to others, spirituality, new possibilities, identity & strengths, and appreciation of life. Themes of acceptance and forgiveness, functional and clinical recovery, and finding hope were also identified.

Conclusions

This is the first study to explore mental health recovery meaning among a sample of people with lived experience of mental health issues in Egypt. Findings suggest that developing and implementing psychosocial interventions to support posttraumatic growth among people with mental health issues is a priority.
Determinants of food insecurity among households with children in Villa el Salvador, Lima, Peru: the role of gender and employment, a cross-sectional study
Authors: Santos M. Patrizia , Brewer Jessica D. , Lopez Miguel A. , Paz-Soldan Valerie A. , Chaparro M. Pia
Published: April 2022

Background

From 2014–2019, Latin America and the Caribbean had the fastest growth of moderate-to-severe food insecurity than any other region, rising from 22.9% to 31.7%. While the prevalence of food insecurity is higher among women than men in every continent, Latin America has the largest food insecurity gender gap. Factors contributing to this gender inequity include underrepresentation of women in formal employment, heightened burden of dependent care on women, and unequal compensation of labor for women vs. men. The objective of this study was to investigate the association between the gender of the head of the household, employment status of household members, and food insecurity in households with children in a low-income district of Lima, Peru.

Methods

This cross-sectional study was carried out in Villa El Salvador, the fifth largest district in Metropolitan Lima, Peru, where over 20% of the population lives in poverty. Data were collected on a stratified random sample (n = 329) using a household questionnaire, including a validated food security tool (HFIAS). We ran multivariate logistic regression models predicting household food insecurity, with independent variables including gender of household head, education of household head, employment of household head, household-level employment status, age, and weekly food expenses per person.

Results

In fully adjusted models, woman-headed households had almost thrice the odds of being food insecure compared to man-headed households. Education also had a significant effect size: a household whose household head did not complete high school was 3.4 times more likely to be food insecure than if they had some post-secondary education. Woman-headed households had a significantly higher proportion of members not formally employed, compared to man-headed households, but employment status was not associated with food insecurity.

Conclusions

Gender of the household head was a major contributing factor to household food insecurity in Villa el Salvador. Gender dynamics affecting opportunities for employment, education, and non-remunerated work should inform national food security policies and interventions with the goal to not only lower food insecurity, but also reduce gender inequities in food insecurity and other nutritional outcomes.
The effects of received grandmothers’ affection on adult grandchildren’s health behaviors using affection exchange theory
Authors: Salazar Leslie Ramos , Khandelwal Priyanka , Castillo Yvette
Published: April 2022

Background

Affection exchange theory (AET) explains the value of received affection for overall wellbeing in family relationships. However, this study extends prior work by investigating AET in grandmother-grandchild relationships and grandchildren’s individual well-being. This study seeks to understand the relationships between adult grandchildren’s received grandmother affection and health-related behaviors such as diet, exercise, substance abuse, and sleep.

Methods

This cross-sectional study included 229 university student participants. Multiple regression analyses were performed to analyze received grandmother affection and grandchildren’s health behaviors.

Results

Using cross-sectional survey methods, it was found that grandchildren’s reports of received memories and humor, and celebratory affection influenced grandchildren’s dietary behaviors. Received love and esteem, memories and humor, and celebratory affection was also associated with grandchildren’s exercise behaviors.

Conclusions

Grandchildren who receive grandmother affection may be likely to engage in the well-being process by engaging in health behaviors, while those who are not receiving affection might suffer the health consequences in adulthood. These findings support the assumption of affection exchange theory that received family affection, in this case, grandmother affection leads to positive health outcomes such as enhanced dietary and exercise behaviors among grandchildren.
Barriers to help-seeking from healthcare professionals amongst women who experience domestic violence - a qualitative study in Sri Lanka
Authors: Silva Tharuka , Agampodi Thilini , Evans Maggie , Knipe Duleeka , Rathnayake Abey , Rajapakse Thilini
Published: April 2022

Background

Domestic violence (DV) is a major global public health problem which is associated with significant adverse consequences. Although Sri Lankan women who experience DV receive treatment from healthcare professionals (HCPs) for DV related physical and psychological problems, disclosure of DV within health services is quite low. This study explored barriers to disclosure of DV to HCPs among Sri Lankan women who experience DV.

Method

This qualitative study took place in the Central Province of Sri Lanka. Twenty women who had experienced DV were recruited from Gender Based Violence Centers (Mithuru Piyasa Centers) and a toxicology unit of the two selected hospitals. Participants were purposefully selected using maximum variation sampling technique. In-depth interviews were conducted until data saturation was reached. Interviews were recorded, and analyzed using thematic analysis.

Results

Survivor related barriers to help seeking included women’s lack of knowledge and perceptions about the role of HCPs, lack of confidence in HCPs, fear of repercussions, personal attitudes towards DV, and their love and loyalty towards the perpetrator. Women preferred it if HCPs initiated discussions about DV, and they valued it when HCPs could be confidential and protect their privacy, and give enough time for DV related issues during consultations. A perpetrator related barrier was the controlling behavior of the perpetrator. Social stigma and social and cultural norms about the role of women emerged as the socio-cultural constraints to disclosure.

Conclusions

Barriers to help seeking for DV from HCPs exist at individual, healthcare level, and societal level. Community programs are needed to increase women’s access to healthcare services and interventions should be implemented to develop effective, preventive, and supportive strategies at the healthcare system level.
A community engagement approach for an integrated early childhood development intervention: a case study of an urban informal settlement with Kenyans and embedded refugees
Authors: Kabue Margaret , Abubakar Amina , Ssewanyana Derrick , Angwenyi Vibian , Marangu Joyce , Njoroge Eunice , Ombech Eunice , Mokaya Mercy Moraa , Obulemire Emmanuel Kepha , Mugo Catherine , Malti Tina , Moran Greg , Martin Marie-Claude , Proulx Kerrie , Marfo Kofi , Zhang Linlin , Lye Stephen
Published: April 2022

Background

Community engagement is crucial for the design and implementation of community-based early childhood development (ECD) programmes. This paper aims to share key components and learnings of a community engagement process for an integrated ECD intervention. The lessons shared are drawn from a case study of urban informal settlement with embedded refugees in Nairobi, Kenya.

Methods

We conducted three stakeholder meetings with representatives from the Ministry of Health at County and Sub-County, actors in the ECD sector, and United Nations agency in refugee management, a transect walk across five villages (Ngando, Muslim, Congo, Riruta and Kivumbini); and, six debrief meetings by staff from the implementing organization. The specific steps and key activities undertaken, the challenges faced and benefits accrued from the community engagement process are highlighted drawing from the implementation team’s perspective.

Results

Context relevant, well-planned community engagement approaches can be integrated into the five broad components of stakeholder engagement, formative research, identification of local resources, integration into local lives, and shared control/leadership with the local community. These can yield meaningful stakeholder buy-in, community support and trust, which are crucial for enabling ECD programme sustainability.

Conclusion

Our experiences underscore that intervention research on ECD programmes in urban informal settlements requires a well-planned and custom-tailored community engagement model that is sensitive to the needs of each sub-group within the community to avoid unintentionally leaving anyone out.
Translation, adaptation, and validation of the Self-efficacy in Palliative Care scale (SEPC) for use in Swedish healthcare settings
Authors: Granat Lisa , Andersson Sofia , Hadziabdic Emina , Brännström Margareta , Sandgren Anna
Published: April 2022

Background

One challenge for healthcare professionals when delivering palliative care can be their lack of confidence. The Self-efficacy in Palliative Care Scale (SEPC) is considered a valid and reliable assessment scale to evaluate confidence when delivering palliative care. Currently, there is not a reliable instrument aimed to measure healthcare professionals’ confidence in palliative care in Swedish. Therefore, this study aimed to translate, culturally adapt, and validate the SEPC-scale for use in a Swedish healthcare context.

Methods

This study applied the World Health Organization’s (WHO) guidelines for translating and adapting instruments, using forward and back-translation, an expert panel, and cognitive interviews. Swedish experts in palliative care (n = 6) assessed the Swedish version of the SEPC-scale based on its relevance, understandability, clarity, and sensitivity on a Likert scale. Methods involved calculation of content validity index (CVI) with modified kappa statistics and cognitive interviewing with healthcare professionals (n = 10) according to the “think-aloud” method.

Results

Calculation of I-CVI (Item-CVI) showed that the Swedish SEPC-scale was considered relevant but needed some modifications to improve its understandability and clarity. The experts recognized an absence of precision in some items that affected clarity and understanding. Likewise, the healthcare professionals highlighted some challenges with understandability and clarity. They indicated that the scale was relevant, but a few items needed adjustment to fit a broader range of healthcare professionals. Items that referred to death and dying could be sensitive but were considered relevant.

Conclusions

The SEPC-scale is considered valid for use in Swedish healthcare practice, for a broad range of healthcare professionals, and for diagnoses other than cancer. This study shows that cultural adaptation is necessary for establishing relevance and enabling acceptance to various healthcare professionals and contexts in the target country.
Medical students’ attitudes towards and views of general practice careers in Singapore: a cross-sectional survey and qualitative analysis
Authors: Fang Yang , Soljak Michael , Tan Shawn Lien Ler , Smith Helen E.
Published: April 2022

Background

Like many other countries, Singapore needs to support its ageing population by attracting more doctors into general practice (GP) and family medicine (FM). To achieve this requires a better understanding of what attracts or deters medical students. We conducted a cross-sectional survey among medical students in Singapore.

Methods

An online survey was distributed to students from all three medical schools to understand their likelihood of choosing primary care careers, what they valued in their careers, their attitude towards different aspects of general practice and family medicine relative to other medical fields, and the positive and negative perceptions of primary care held by themselves, their lecturers, and clinical mentors. They were able to elaborate the negativity encountered in the open-ended questions. Quantitative data was analyzed with descriptive statistics, principal component analysis, and linear regression; qualitative data was analyzed thematically.

Results

The survey was completed by 391 students. Slightly over half indicated a likelihood of choosing a career in primary care. For their own careers, the students valued job satisfaction and career development opportunities the most. They perceived careers in primary care as being most likely to offer reasonable hours and close patient relationships, but least likely to offer career advancement potential relative to other medical fields. Their likelihood of choosing primary care careers was significantly predicted by what they value in their own career and their attitudes toward GP/FM relative to other medical fields, but not by the perceptions of GP/FM by others. Free-text responses illustrated how students encounter derogatory comments about GP/FM: the work being “mundane and repetitive”, the careers non-competitive, and the doctors poor in clinical competence.

Conclusion

While the shortage of primary care doctors is a global issue, our findings highlight the value of situating inquiries in localized contexts. Medical curriculum should emphasize the critical role of primary care in the healthcare system and primary care doctors should be given due recognition to build a strong and motivated primary care workforce to serve the future healthcare needs of the population.
Locally adapting generic rubrics for the implementation of outcome-based medical education: a mixed-methods approach
Authors: Kondo Takeshi , Nishigori Hiroshi , van der Vleuten Cees
Published: April 2022

Background

Rubrics are frequently used to assess competencies in outcome-based medical education (OBE). The implementation of assessment systems using rubrics is usually realised through years of involvement in projects with various stakeholders. However, for countries or specialities new to OBE, faster and more simplified processes are required. In March 2019, Japan introduced nine competencies and generic rubrics of competencies for medical residents. We explored the local adaptation of these generic rubrics and its consequences for assessors.

Methods

The study followed three steps. First, we locally adapted the generic rubrics. This was followed by conducting mixed-method research to explore the effect of the local adaptation. In step two, we examined the correlations between the scores in the locally adapted assessment sheets for supervising doctors and generic rubrics. In step three, we conducted interviews with supervising doctors. The study was conducted in the General Internal Medicine Department of Nagoya University, Japan. In the first step, doctors in the Medical Education Center and other medical departments, clerks, and residents participated. Supervising doctors in the General Internal Medicine Department participated in the second and third steps.

Results

A locally adapted assessment system was developed and implemented in seven months. The scores of the generic rubrics and the adapted assessment tool completed by the supervising doctors showed good correlations in some items as opposed to others, assessed mainly with other tools. Participant interviews revealed that local adaptation decreased their cognitive load leading to consistent ratings, increased writing of comments, and promoting reflection on instruction.

Conclusions

This adaptation process is a feasible way to begin the implementation of OBE. Local adaptation has advantages over direct use of generic rubrics.
Barriers and facilitators for disease registry systems: a mixed-method study
Authors: Lazem Mina , Sheikhtaheri Abbas
Published: April 2022

Background

A Disease Registry System (DRS) is a system that collects standard data on a specific disease with an organized method for specific purposes in a population. Barriers and facilitators for DRSs are different according to the health system of each country, and identifying these factors is necessary to improve DRSs, so the purpose of this study was to identify and prioritize these factors.

Methods

First, by conducting 13 interviews with DRS specialists, barriers and facilitators for DRSs were identified and then, a questionnaire was developed to prioritize these factors. Then, 15 experts answered the questionnaires. We prioritized these factors based on the mean of scores in four levels including first priority (3.76–5), second priority (2.51–3.75), third priority (1.26–2.50), and the fourth priority (1–1.25).

Results

At first, 139 unique codes (63 barriers and 76 facilitators) were extracted from the interviews. We classified barriers into 9 themes, including management problems (24 codes), data collection-related problems (8 codes), poor cooperation/coordination (7 codes), technological problems and lack of motivation/interest (6 codes for each), threats to ethics/data security/confidentiality (5 codes), data quality-related problems (3 codes), limited patients’ participation and lack of or non-use of standards (2 codes for each). We also classified facilitators into 9 themes including management facilitators (36 codes), improving data quality (8 codes), proper data collection and observing ethics/data security/confidentiality (7 codes for each), appropriate technology (6 codes), increasing patients’ participation, increasing motivation/interest, improving cooperation/coordination, and the use of standards (3 codes for each). The first three ranked barriers based on mean scores included poor stakeholder cooperation/coordination (4.30), lack of standards (4.26), and data quality-related problems (4.06). The first three ranked facilitators included improving data quality (4.54), increasing motivation/interest (4.48), and observing ethics/data security/confidentiality (4.36).

Conclusion

Stakeholders’ coordination, proper data management, standardization and observing ethics, security/confidentiality are the most important areas for planning and investment that managers must consider for the continuation and success of DRSs.
Hospital healthcare utilizers with medical and psychiatric claims in the Netherlands: a nationwide study
Authors: van Schijndel Maarten , Jansen Luc , Busschbach Jan , van Waarde Jeroen , Wierdsma Andre , Tiemeier Henning
Published: April 2022

Background

Psychiatric and medical multimorbidity is associated with low quality of life, poor functioning and excess mortality. Differences in healthcare utilization between those receiving co-occurring medical and psychiatric healthcare (HUMPCs) and those only receiving medical (HUMCs) or only psychiatric healthcare (HUPCs) may indicate differences in care accessibility, help-seeking behavior and the risk patterns of medical illness. We aimed to assess the occurrence of psychiatric diagnostic groups in HUMPCs compared to HUPCs and to compare their medical and psychiatric claims expenditures.

Methods

Using Dutch claims data covering psychiatric and medical hospital care in 2010–2011, healthcare utilization differences between HUMPCs and HUPCs were expressed as differences and ratios, accounting for differences in age and sex between groups. Median claims expenditures were then compared between HUMPCs and HUPCs.

Results

HUMPCs had 40% higher median medical cost of claims compared to HUMCs and a 10% increased number of psychiatric claims compared to HUPCs. HUMPCs were more often diagnosed with: organic disorders; behavioral syndromes associated with physiological disturbances and physical factors; mood [affective] disorders; neurotic, stress related and somatoform disorders; and disorders of adult personality and behavior. By contrast, disorders of psychological development, schizophrenia, schizotypal and delusional disorders, behavioral and emotional disorders with usual onset occurring in childhood, and mental and behavioral disorders due to psychoactive substance abuse were less often diagnosed in this group.

Conclusions

Both medical and psychiatric disease become more costly where both are present. For HUMPCs the costs of both medical and psychiatric claims for almost all diagnostic groups were higher than for HUPCs and HUMCs.