bluuebunny/crossref_metadata_2025 huggingface dataset:
Does Retirement Increase Fraud Exposure and Fraud Victimization?—Evidence From China
Authors: Liu Yang , Zhao Jianmei
Published: December 2024

This study investigates the impact of retirement on fraud exposure and victimization among the older adults in China. Using data from the China Health and Retirement Longitudinal Survey, it employs instrumental variable regression, exploiting the statutory retirement age in China as a source of exogenous variation. The findings indicate that retirement does not significant affect fraud exposure but significantly increases the risk of fraud victimization and associated financial losses for older adults. The primary channels through which retirement influences fraud victimization include changes in post-retirement time allocation and increased psychological vulnerability.
Design for Dissemination: Leaders Suggest Local Strategies for Implementing a Health Communications Campaign
Authors: Salvia Meg G. , Roberts Jane , Tan Andy S. L. , Hanby Elaine , Gordon Bob , Machado Ana , Scout  , Applegate Julia , Ramanadhan Shoba
Published: December 2024

Purpose

Using evidence-based health communication campaigns (EBHCC) is critical for addressing disparities in tobacco-related health outcomes among LGBTQ+ populations; therefore, this study aimed to examine processes and supports for community-based organizations (CBOs) to integrate evidence-based solutions into practice using a design-for-dissemination framework.

Approach

Qualitative interviews were conducted.

Setting

CBOs serving LGBTQ+ populations.

Participants

22 staff from U.S.-based CBOs participated in video interviews.

Method

We used reflexive thematic analysis to generate themes.

Results

3 key themes included: (1) leaders perceived storytelling as a desirable and effective way to operationalize hyperlocal adaptation of content, particularly when in-group stories came from the community and included video content (which was perceived to maximize reach); (2) researcher participation in content production/delivery was seen as a compelling implementation strategy; and (3) these requested components were seen as adding value rather than as substitutions for text- and image-based EBHCC content. Adaptations envisioned by participants are associated with increased demand for limited resources (ie, requiring more time or financial resources), on the part of CBOs, the research team, or both. Researcher strategies were identified to support meeting CBOs’ needs given these contextual constraints.

Conclusion

This research explores supports and processes requested by CBOs serving LGBTQ+ populations as part of the adaptations envisioned in implementing EBHCCs and highlights possible avenues to better meet CBOs’ needs in effectively utilizing interventions.
Is Less Commodity Dependence Better for Economic Equality, Economic Growth, and Human Development?
Authors: Natanael Yeremia
Published: December 2024

Commodity dependence constitutes an economy with primary goods dominating its export structure. It can promote economic diversification and improve societal well-being if managed considerably. However, the fluctuating global commodity prices can lead to economic instability, potentially causing widespread poverty and vulnerability among the population. While commodity-dependent countries have increased, some have transitioned to commodity independence in the past decade. Nevertheless, little is known about changes in economic development indicators for these countries compared to those still reliant on commodities. This study examines how commodity dependence relates to income inequality, economic growth, and human development indicators. Using the panel-corrected standard error, fixed effect, and two-step system generalized method of moments, results indicate that commodity dependence is inversely related to income inequality and economic growth but positively related to human development. Institutional quality also matters, with better institutions linked to lower inequality and higher economic growth and human development levels. This suggests that while commodity dependence can impede economic development, better institutional quality could help manage the benefits of commodity exports while mitigating their developmental costs.

JEL Classification F14, F43, O11, O15, O40
Parental Experiences on Learning About and Caring for Children with Cleft Lip and Palate: A Qualitative Study from South India
Authors: Kumar Shuba , Mohanraj Rani , Vaidhyalingam Thailavathy , Chakkaravarthi Subhiksha , Thiruvenkatachari Badri
Published: December 2024

Objectives

The study aimed to understand parents’ reactions to cleft, the manner in which they learned about its presence, and the challenges they faced in caring for their child with a view to providing healthcare professionals insights toward enhancing care delivery.

Design

Qualitative in-depth interviews using the grounded theory approach were carried out with 11 mothers and fathers of children with cleft lip and palate (CLP) attending a cleft speciality hospital in Chennai city, in South India.

Results

Analysis resulted in the discovery of 5 core categories, learning about CLP—when and how, reactions and attributions to CLP, learning about and expectations from treatment, caring for a child with CLP and support systems. Feelings of shock and bewilderment when they learned of the presence of cleft in their child was reported by most parents. Poor awareness of cleft, difficulties in feeding, and concerns for the child's future were major sources of disquiet. The presence of support from family and friends and interactions with other parents of children with cleft helped them to cope better.

Conclusions

The results highlight the need for enhancing understanding of cleft among parents and strengthening them emotionally, thereby empowering them to provide effective care for their child. There is an urgent need to develop standardized information materials for parents to ensure that they have clear, consistent, and reliable information on the care of their child.
Local Government and Natural Resource Management in Madhya Pradesh, India: A Critical Institutional Analysis
Authors: Upadhyay Mahima , Rajasekhar D
Published: December 2024

This paper investigates the factors that influence the involvement of local government in natural resource management in a decentralized institutional context. Institutions, regulating resource use patterns and practices are indicated to be decisive for the success or failure of resource management initiatives, and decentralization is considered a promising institutional arrangement in this regard. In this context, it is significant that India adopted decentralization through the 73rd Constitutional Amendment Act, devolving resource management functions to the local government. However, there is limited work on how local government engages with devolved functions and what factors influence its resource management interventions. Consequently, we investigate the factors that influence the involvement of local government in natural resource management across three village councils in India. Taking a critical realist approach, we find that although multiple factors exert their influence, institutional force and actors’ rational incentives serve as key causal factors explaining local government’s involvement with resource management.
Research and Scholarship at the William & Mary Center for Gifted Education
Authors: Cross Jennifer Riedl
Published: December 2024

Research has been conducted at The William & Mary Center for Gifted Education in a variety of subject areas, making a significant impact on the field of gifted education, particularly in the area of low-income, underrepresented high-ability students. Early research focused on curriculum efficacy and program quality. Following the retirement of the founder Joyce VanTassel-Baska in 2009, the research agenda included psychological and social research in line with the new Executive Director’s expertise. Collaborations have been a cornerstone of the scholarship at the Center throughout its history. This article includes an overview of research and scholarship at the Center, with a focus on the period since Tracy L. Cross became the Executive Director in 2009.
The Center for Gifted Education at William & Mary: Developing Talent Since 1987
Authors: Cross Tracy L.
Published: December 2024

The William & Mary Center for Gifted Education (CFGE) serves high-ability students and those with gifts and talents directly and indirectly through curriculum development, precollegiate learner programs, professional development for teachers and administrators, research, and doctoral programs. With an added focus on psychological needs, in 2015, the CFGE Executive Director created the Institute for Research on the Suicide of Gifted Students. The structure of the CFGE includes an executive director, directors in each area (curriculum, research, professional development, and precollegiate learner programs), support staff, and an advisory board. A recent move to a cost-center model enhances the sustainability of the program.
Self-Directed Developmental Stages for Differentiation: A Continuum of Interest-Curiosity-Dedication-Self-Perception-Learning Identity-Familial Expectation
Authors: Kaplan Sandra N.
Published: December 2024

The author describes the “Self-Directed Developmental Stages for Differentiation: A Continuum” intended to provide gifted students with items to consider as readiness for their understanding of who they are as a gifted learner and how they can derive personal benefits from their participation in a differentiated experience. The continuum is meant to facilitate gifted students understanding that differentiated experiences are not solely related to the student’s identification and label as a gifted individual. Continuum stages include interest, curiosity, dedication, self-perception, learning identify, and familial expectations.
It’s in the Syllabus: What Sport Media Instructors Communicate to Students
Authors: Petrotta Brian A. , Stamm Jason , Reisbig Madeleine
Published: December 2024

Due to the prosperity of sports and continued growth of sports media, colleges and universities are offering an increasing number of courses and majors related to the sports media industry. Via a systematic analysis of 76 syllabi from courses under the sports media umbrella at 30 colleges and universities, this study reveals what is being communicated to students. It also scrutinizes how diversity, equity, and inclusion–related topics are incorporated into sports media course syllabi. Findings include three broad themes across all courses’ descriptions and calendars: targeted skill-based approaches, current events/trends, and experiential learning. Limitations and future implications are also discussed.
Geographical variation in quality-adjusted life expectancy in the North Denmark Region
Authors: Christensen Jakob Juul , Jensen Cathrine Elgaard , Raunbak Sabine Michelsen , Sørensen Sabrina Storgaard , Sørensen Jan
Published: December 2024

Objective:

This study examined the geographical variations in quality-adjusted life expectancy (QALE) in the North Denmark Region.

Methods:

QALE was used to measure health expectancy within each municipality of the North Denmark Region. Measures of health-related quality of life (HRQoL) were obtained from a representative sample of 19,598 responses to the EQ-5D-5L questionnaire in the 2021 regional health survey. Abridged periodic life tables were constructed using mortality data from Statistics Denmark stratified by age, sex, and municipality. The stepwise replacement algorithm developed by Andreev et al. was applied to decompose QALE into its mortality and HRQoL components and investigate the main drivers of the QALE variations between municipalities.

Results:

The regional average QALE at 16 years of age was 52.6 quality-adjusted life years (QALYs) (95% CI: 52.1–53.0) for men and 53.1 QALYs (95% CI: 52.7–53.5) for women. No statistically significant variations in QALE were found between municipalities. Comparing the highest and lowest scoring municipalities for males, Rebild had 54.5 QALY (95% CI: 51.7–57.2) while Hjørring had 51.9 QALY (95% CI: 49.9–54.1), showing a variation of 2.57 QALE driven by higher HRQoL scores and lower mortality rates. For females, Rebild had 54.3 QALY (95% CI: 52.1–56.5) and Vesthimmerland had 51.3 QALY (95% CI: 49.1–53.4), showing a variation of 3.03 QALE, mostly driven by increased HRQoL scores and to some extent lower mortality rates.

Conclusions:

Variations in QALE, although not statistically significant, existed between the municipalities in the North Denmark Region. Further research should explore the reasons for these variations to inspire future policy development.
Stepping forth: Representation of people with mental health issues in Norwegian newspapers 1950-2020
Authors: Lånkan Kjersti Blehr
Published: December 2024

Since 1950, remarkable changes have occurred in both mass media, mental healthcare, and mental health discourse. Despite mass media’s pivotal role in reflecting and shaping societal attitudes about mental illness, little scholarly attention has been dedicated to the historical development of media representations of individuals with mental health issues. In this study, unique historical data serve as foundation for analysis of Norwegian newspaper articles about mental illness from 1950 to 2020. Through combining quantitative and qualitative methods, the analysis of selected news stories illuminates how these stories both complement and challenge medical and journalistic authority. Two main findings emerge. Firstly, notwithstanding the authoritative status of expert voices, individuals with mental health issues have transitioned from being essentially absent to becoming increasingly visible in the news. However, secondly, these individuals primarily represent lighter illnesses, or “general”, unspecified mental health conditions. Consequently, one may question the assumption of destigmatization for all mental illnesses, including more severe diagnosis. In conclusion, this study underscores the role of media professionalization, tabloidization, and technology in fostering societal openness to mental illness.
Metaphor as methodology: Methodological reflections on visualizing the dementia journey
Authors: Wiersma Elaine C , Dupuis Sherry L , Sameshima Pauline , Caffery Philip , Harvey David
Published: December 2024

Metaphors to describe and understand dementia have been used in Western culture for many years. However, the ways in which people living with dementia and care partners use metaphors and symbols to illustrate and give meaning to their own experiences has been less understood. In this paper we explore the use of metaphor as methodology-- a way to support people living with dementia and their care partners in reflecting on and sharing their experiences of dementia. More specifically, drawing on our experiences using metaphor and symbols to map out the dementia journey from the perspectives of people living with dementia, care partners, and health and social care providers in Ontario, Canada, we describe our process of employing metaphor as methodology. We reflect on the use of metaphor as methodology through framing the dementia experience, exploring complexity, and representing multidimensionality. The use of metaphors has the potential to open space for new understandings of dementia.
Californian Public University Students’ Attitudes, Beliefs, and Barriers to Plant-Based Nutrition
Authors: Massih Yasaman N. , Nelson Anna , Handysides Daniel , Segovia-Siapco Gina
Published: December 2024

Adopting a plant-based diet (PBD) has environmental sustainability benefits and has been shown to improve overall health and quality of life, yet for most people a diet shift towards a plant-based one remains a challenge, due to personal and environmental obstacles. Important independent decisions on self-care and nutritional habits occur in the first year of enrollment for college students. This cross-sectional quantitative study aims to examine the association between health beliefs, motivators, barriers, self-efficacy, and mental health status and following a more PBD in college students. A total of 449 Californian public university and junior college students completed an online survey. A stepwise multiple regression model was used to predict the level of intention to follow a PBD. Self-efficacy ( β = 0.28, P < .001), motivators ( β = 0.33, P < .001), and barriers ( β = −0.19, P < .001) significantly predicted and accounted for 35% of the variance in intention to follow a PBD. The results reveal that greater self-efficacy, higher motivation, and fewer barriers predicted higher intention to follow a PBD. Beliefs did not add significantly to following a PBD.
The Use of the Anterior Labral Circumferential Onlay Technique to Reconstruct the Anterior Labrum and Biomechanically Restore Glenohumeral Joint Stability
Authors: Dey Hazra Maria E. , Dey Hazra Rony-Orijit , Brady Alex W. , Ganokroj Phob , Brown Justin R. , Garcia Alexander R. , Drumm Amelia H. , Millett Peter J.
Published: December 2024

Background:

A labral injury contributes to glenohumeral instability. The Anterior Labral Circumferential Onlay Technique (ALCOT) reconstructs the labrum using the long head of the biceps tendon.

Hypothesis:

The ALCOT would restore glenohumeral joint stability in a cadaveric model without glenoid bone loss (1) comparable to the native state and (2) comparable to the Latarjet procedure.

Study Design:

Controlled laboratory study.

Methods:

A total of 10 fresh-frozen cadaveric shoulders were tested using a 6 degrees of freedom robotic arm in 5 consecutive states: (1) native, (2) capsular repair, (3) labral tear, (4) ALCOT, and (5) Latarjet procedure. Biomechanical testing consisted of 80 N of anteroinferior force and 50 N of compression in 90° of humerothoracic abduction. Lateral displacement of the humeral head and the force ratio during a dislocation were measured.

Results:

The mean lateral translation of the humeral head during a dislocation in the native state was 6.5 ± 2.2 mm and decreased to 5.4 ± 2.4 mm in the labral tear state ( P < .001). The mean lateral translation of the humeral head was restored to 6.4 ± 2.2 mm ( P > .99) with the ALCOT, showing no difference from the native state. The Latarjet procedure restored the mean force ratio during a dislocation to 1.3 ± 0.6 but failed to restore lateral translation, with a value of 5.6 ± 2.8 mm ( P = .003 vs native; P = .94 vs labral tear). The mean force ratio was 1.8 ± 0.1 in the native state, decreased to 1.1 ± 0.4 in the labral tear state, and was 1.4 ± 0.4 ( P < .27) with the ALCOT, showing no difference from the native state.

Conclusion:

The ALCOT is a novel technique for labral reconstruction that may have a role in the treatment of anterior glenohumeral instability in the setting of a deficient labrum without bone loss. In this study, the ALCOT restored the force ratio and lateral translation of the humeral head compared to the native state. The Latarjet procedure restored the force ratio but not lateral translation of the humeral head compared to the native state.

Clinical Relevance:

This study proposes and biomechanically validates the ALCOT as a surgical technique for labral reconstruction that may have a role in treating patients with chronic anterior shoulder instability in the setting of a deficient labrum.
Cross-national Differences in Socioeconomic Achievement Inequality in Early Primary School: The Role of Parental Education and Income in Six Countries
Authors: Dräger Jascha , Washbrook Elizabeth , Schneider Thorsten , Akabayashi Hideo , Keizer Renske , Solaz Anne , Waldfogel Jane , de la Rie Sanneke , Kameyama Yuriko , Kwon Sarah , Nozaki Kayo , Perinetti Casoni Valentina , Sano Shinpei , Sheridan Alexandra , Shikishima Chizuru
Published: December 2024

This paper presents comparative information on the strength of the association between socioeconomic status (SES) and literacy skills at ages 6–8, drawing on data from France, Germany, Japan, Rotterdam (Netherlands), the United Kingdom, and the United States. We investigate whether the strength of the association between SES and literacy skills in early-to-mid childhood depends on the operationalization of SES (parental education, income, or both) and whether differences in inequalities at the end of lower secondary schooling documented in international large-scale assessments are already present when children have experienced at most two years of compulsory schooling. We find marked differences in SES-related inequalities in early achievement across countries that are largely insensitive to the way SES is measured and that seem to mirror inequalities reported for older students. We conclude that country context shapes the link between parental SES and educational achievement, with country differences rooted in the early childhood period.
Evolution of landscape patterns and driving forces in rural areas of the Fuchun River Basin
Authors: Xu Tao , Wang Zhenguo , Wu Yilun , Zhang Yaping , Nie Wenbin , Xu Bin
Published: December 2024

At the optimal analysis granularity and extent, this study reveals the spatiotemporal evolution characteristics of landscape patterns in rural areas of the Fuchun River Basin from 1990 to 2020. It also explores the spatiotemporal differentiation of driving forces using Geodetector and Geographically Weighted Regression. The results indicate that: 1) The optimal analysis granularity for the study area is 30 m × 30 m, and the optimal analysis extent is 200 m. 2) Compared to the 1990s, the past two decades have seen an increased degree of landscape fragmentation, higher isolation, and stronger human disturbance in the study area, with significant differentiation. These changes are most pronounced in the semi-urbanized areas along the river and in the northern regions. 3) Digital Elevation Model and land cover type are the most critical driving factors. Over time, the explanatory power of most driving factors shows an overall increasing trend. 4) There is a significant spatial heterogeneity in the driving forces. The influence of the Digital Elevation Model and slope is stronger in the north and south, weaker in the central region, while the influence of temperature increases from north to south. The impact of land cover type is stronger in the central area and weaker in the periphery. This study provides a reference for the scientific use of land resources and the protection of ecological spaces in rural areas within highly urbanized regions at the basin scale.
Material Removal Uniformity in Water Dissolution Ultraprecision Continuous Polishing for Large-Size Water-Soluble Crystals
Authors: Cheng Zhipeng , Liu Ziyuan , Guo Dongming , Xu Qiao , Gao Hang
Published: December 2024

Water dissolution ultraprecision continuous polishing is a nontraditional machining method specifically designed for water-soluble crystals. The aim of this study is primarily to reduce the surface roughness for small sizes from an experimental standpoint. A trajectory uniformity simulation analysis is carried out for a consistent material removal. A material removal model is developed based on the water dissolution principle and kinematic analysis. Numerical simulations of single- and multiple-water-core polishing trajectories are performed to explore the influences of the processing parameters such as movement form, number of water cores, speed ratio, polishing time, and period ratio on the material removal uniformity. The material removal rate is calculated according to the Preston equation. The trajectory density nonuniformity is utilized to evaluate the global uniformity of the trajectory distributions and optimize the processing parameters for a better material removal uniformity. Verification experiments are conducted on a large-size ultraprecision continuous polisher using a typical potassium dihydrogen phosphate (KDP) crystal with a water-soluble structure. The edge collapse is improved from 51.499 μm to 1.477 μm by trajectory uniformity optimization. The changing trends of line profile variations in the validation experiment and simulation are similar. An ultrasmooth surface of a 180 mm × 180 mm KDP crystal with a surface roughness root mean square of 1.718 nm is obtained after water dissolution ultraprecision continuous polishing. This study provides a comprehensive method for evaluation of material removal uniformity, which is valuable for the realization of high-quality machining for water-soluble crystals.
Adolescents’ experiences of a whole-school preventive intervention addressing mental health and nonsuicidal self-injury: a qualitative study
Authors: Aspeqvist Erik , Münger Ann-Charlotte , Andersson Hedvig , Korhonen Laura , Baetens Imke , Dahlström Örjan , Zetterqvist Maria
Published: December 2024

Background

Programs for mental health promotion and prevention of nonsuicidal self-injury (NSSI) in schools have gained increased focus during the last decades, but less is known about adolescents’ experiences of such interventions.

Methods

A whole-school preventive intervention targeting mental health and NSSI was delivered to six secondary schools. Adolescents participated in the Youth Aware of Mental Health program combined with an NSSI-focused psychoeducation module. Caregivers and teachers were given online psychoeducation on NSSI, and school health care staff were given a workshop on self-injury. Eleven group interviews (n = 65 participants) were conducted with adolescents (ages 13–15 years, 65% females) exploring participant experiences. Interviews were analyzed using thematic analysis and interpreted in light of a biopsychosocial understanding of adolescence.

Results

The analysis generated two main themes. The first theme, Mental health in the context of adolescence, centered around adolescents’ conception of mental health, after having taken part in the intervention, framed in a context of coping with external stressors. The dilemma of autonomy versus help-seeking was also identified as part of the first main theme. The second theme, The who, when, what, and how of the intervention, described adolescents’ experiences of the intervention. This theme included increased awareness and knowledge of mental ill-health. The participants generally agreed that the topics included are important to adolescents and emphasized that the content needs to be relatable. Several factors that influence how a school-based program is received by adolescents were identified, such as who should be targeted and when. Adolescents also identified challenges and gave recommendations for future similar projects.

Conclusions

Adolescents generally perceived addressing mental health and NSSI in schools as important. Help-seeking initiatives need to be balanced against adolescents’ need for autonomy when planning mental health prevention and intervention.
Adult influenza vaccination coverage before, during and after the COVID-19 pandemic in Canada
Authors: Chen Ruoke , Gilbert Nicolas L. , Dubé Ève
Published: December 2024

Background

Vaccination prevents seasonal influenza and its complications, particularly among high-risk populations. The COVID-19 pandemic has been reported to impact healthcare behaviors and vaccination patterns. This study aims to assess influenza vaccination coverage and changes in vaccination settings among Canadian adults from the 2018–2019 to the 2023–2024 seasons.

Method

We conducted a retrospective analysis of data from multiple cycles of the Seasonal Influenza Vaccination Coverage Survey (SIVCS). Vaccination coverage was examined across different seasons, stratified by population groups. Odds ratios (ORs) were calculated to compare vaccination likelihoods across seasons, with 2018–2019 serving as the reference. Chi-square tests were applied to determine whether there were significant differences in the place of vaccination since the pre-pandemic season.

Results

When comparing vaccine uptake before, during and after the COVID-19 pandemic, we observed a temporary coverage decline in 2021–2022 season (OR = 0.882, 95% CI = 0.787–0.988) compared to the pre-pandemic season in 2018–2019. By the 2022–2023 and 2023–2024 seasons, vaccination coverage returned to pre-pandemic levels. Coverage among adults aged 18–64 without chronic medical condition consistently remained lower than in other groups. The places of vaccination shifted markedly, with pharmacies becoming the predominant site, increasing from 35.4% in 2018–2019 to 57.4% in 2023–2024, while doctor’s offices saw a decline from 32.7 to 15.2% over the same period.

Conclusion

Our findings highlight the transient effect of the pandemic on flu vaccine uptake in Canada. The increasing use of pharmacies for vaccinations underscores the importance of accessible and convenient vaccination sites. Future efforts should focus on maintaining and improving vaccination coverage through diverse and adaptable vaccination settings.
Predictive modelling of linear growth faltering among pediatric patients with Diarrhea in Rural Western Kenya: an explainable machine learning approach
Authors: Ogwel Billy , Mzazi Vincent H. , Awuor Alex O. , Okonji Caleb , Anyango Raphael O. , Oreso Caren , Ochieng John B. , Munga Stephen , Nasrin Dilruba , Tickell Kirkby D. , Pavlinac Patricia B. , Kotloff Karen L. , Omore Richard
Published: December 2024

Introduction

Stunting affects one-fifth of children globally with diarrhea accounting for an estimated 13.5% of stunting. Identifying risk factors for its precursor, linear growth faltering (LGF), is critical to designing interventions. Moreover, developing new predictive models for LGF using more recent data offers opportunity to enhance model accuracy, interpretability and capture new insights. We employed machine learning (ML) to derive and validate a predictive model for LGF among children enrolled with diarrhea in the Vaccine Impact on Diarrhea in Africa (VIDA) study and the Enterics for Global Heath (EFGH) ― Shigella study in rural western Kenya.

Methods

We used 7 diverse ML algorithms to retrospectively build prognostic models for the prediction of LGF (≥ 0.5 decrease in height/length for age z-score [HAZ]) among children 6–35 months. We used de-identified data from the VIDA study (n = 1,106) combined with synthetic data (n = 8,894) in model development, which entailed split-sampling and K-fold cross-validation with over-sampling technique, and data from EFGH-Shigella study (n = 655) for temporal validation. Potential predictors (n = 65) included demographic, household-level characteristics, illness history, anthropometric and clinical data were identified using boruta feature selection with an explanatory model analysis used to enhance interpretability.

Results

The prevalence of LGF in the development and temporal validation cohorts was 187 (16.9%) and 147 (22.4%), respectively. Feature selection identified the following 6 variables used in model development, ranked by importance: age (16.6%), temperature (6.0%), respiratory rate (4.1%), SAM (3.4%), rotavirus vaccination (3.3%), and skin turgor (2.1%). While all models showed good prediction capability, the gradient boosting model achieved the best performance (area under the curve % [95% Confidence Interval]: 83.5 [81.6–85.4] and 65.6 [60.8–70.4]) on the development and temporal validation datasets, respectively.

Conclusion

Our findings accentuate the enduring relevance of established predictors of LGF whilst demonstrating the practical utility of ML algorithms for rapid identification of at-risk children.
Research priorities for antimicrobial stewardship nurses in a middle-income country: a nominal group technique study
Authors: de Lima Gusmão Viviane Cristina , Abraão Lígia Maria , da Silva Felix Adriana Maria , Ciofi-Silva Caroline Lopes , Courtenay Molly , Ness Valerie , Castro-Sanchez Enrique , de Figueiredo Rosely Moralez , Padoveze Maria Clara ,   Workshop Participants Group, do Nascimento Lousada Monik Gomes , Marinho Claudia Silva , Costa Eliana Auxiliadora Magalhães , Oliveira Nayara Carvalho , Monteiro Waldélia , Murakami Beatriz Murata , Manhezi Andreza , do Carmo Filho José Rodrigues , das Neves Zilah Cândida Pereira , Sena Viviane Gonçalves , Goncalves Glaucia Ribeiro , da Cruz Ieda Pontes , Pinheiro Fernando Augusto , Preve Camila Piuco , Krummenauer Eliane Carlosso , Pires Renata Neto , Maciel Amanda Luiz Pires , Cascardo Ana Claudia , Cais Daiane Patrícia , dos Santos James Francisco Pedro , Farah Lilian , Gatti Maria Fernanda Zorzi , e Castro Meire Cristina Novelli , Taminato Mônica , da Silva Thatiara Cardoso , de Lima Tiago Cristiano
Published: December 2024

Background

Antimicrobial stewardship programs (ASPs) have become important strategies for addressing antimicrobial resistance (AMR). Despite the increasing number of international publications identifying the important roles played by nurses as part of ASPs in low- and middle-income countries, this topic is yet poorly researched. This study aimed to identify priority research gaps in the Brazilian context concerning nurses’ performance in ASPs from the perspective of nursing professionals and explore the main themes among the ideas generated by these nurses.

Methods

This qualitative study used the modified Nominal Group Technique (mNGT) during a three-day online workshop. Content analysis was performed on the basis of the ideas proposed by the participants after the clarification stage.

Results

The participants suggested 68 ideas in the first phase. After the idea’s clarification phase, 45 ideas were included in the voting rounds. The ideas prioritized by participants voting addressed (i) attributions and competencies of nurses in the ASP; (ii) planning and implementation of ASP nurses’ activities; and (iii) use of information and communication technologies to assist nurses. The content analysis highlighted nine main themes in the initial ideas.

Conclusions

The study identified significant gaps in research related to nurses’ roles in ASPs in the Brazilian context. These findings suggest that further investigation into nurses’ competences, the implementation of their roles, and the application of digital tools are priority subjects of future research to improve nurses’ participation in ASPs. These themes should be further studied in the Brazilian context but may be applicable to other similar socioeconomic contexts.
Integration of psychological interventions in multi-sectoral humanitarian programmes: a systematic review
Authors: Ndlovu Jacqueline N. , Lind Jonna , Patlán Andrés Barrera , Upadhaya Nawaraj , Leku Marx R. , Akellot Josephine , Skovdal Morten , Augustinavicius Jura L. , Tol Wietse A.
Published: December 2024

Background

Every year, millions of people are affected by humanitarian crises. With a growing population of people affected, the need for coordination and integration of services aiming to improve the effectiveness of mental health and psychosocial support also grows. In this study, we examine how psychological interventions in humanitarian settings globally have been implemented through integration into programming outside of formal healthcare delivery through multisectoral integration.

Methods

A comprehensive search of six databases and reference checking was undertaken in 2022. We included studies focusing on implementation strategies and implementation outcomes of multi-sectoral, integrated psychological interventions, with no year limits. We extracted data using the software Covidence, and used the software to manage screening and reviewing processes. All studies were critically appraised for quality and rigor using the mixed-methods appraisal tool.

Results

Eight studies were included in total. We found that interventions targeted conflict affected, displaced and disaster recovering populations. The interventions demonstrated moderate success in reducing psychological distress and enhancing disaster preparedness. We found that key implementation outcomes investigated and prioritised include acceptability, feasibility, and relevance. The studies reported on integration processes that involved task shifting primarily, with an emphasis on different formats of adaptation, partnership creation and capacity development to maximise effectiveness of integrated interventions.

Conclusion

Overall, there is little research being done to rigorously document the processes and experiences of integrating psychological interventions with non-health interventions. This could be an indication that, while multisectoral integration may be more common in practice, little research is being done or reported in this area formally. There is an urgent need for further research into integrated multi-sectoral interventions. This research should aim to understand how social, cultural, and environmental contexts in different ways, and to different degrees, affect what is acceptable and feasible to deliver and how these ultimately influence the impact of integrated interventions.
Multiomics profiling of DNA methylation, microRNA, and mRNA in skeletal muscle from monozygotic twin pairs discordant for type 2 diabetes identifies dysregulated genes controlling metabolism
Authors: Ling Charlotte , Vavakova Magdalena , Ahmad Mir Bilal , Säll Johanna , Perfilyev Alexander , Martin Melina , Jansson Per-Anders , Davegårdh Cajsa , Asplund Olof , Hansson Ola , Vaag Allan , Nilsson Emma
Published: December 2024

Background

A large proportion of skeletal muscle insulin resistance in type 2 diabetes (T2D) is caused by environmental factors.

Methods

By applying multiomics mRNA, microRNA (miRNA), and DNA methylation platforms in biopsies from 20 monozygotic twin pairs discordant for T2D, we aimed to delineate the epigenetic and transcriptional machinery underlying non-genetic muscle insulin resistance in T2D.

Results

Using gene set enrichment analysis (GSEA), we found decreased mRNA expression of genes involved in extracellular matrix organization, branched-chain amino acid catabolism, metabolism of vitamins and cofactors, lipid metabolism, muscle contraction, signaling by receptor tyrosine kinases pathways, and translocation of glucose transporter 4 (GLUT4) to the plasma membrane in muscle from twins with T2D. Differential expression levels of one or more predicted target relevant miRNA(s) were identified for approximately 35% of the dysregulated GSEA pathways. These include miRNAs with a significant overrepresentation of targets involved in GLUT4 translocation (miR-4643 and miR-548z), signaling by receptor tyrosine kinases pathways (miR-607), and muscle contraction (miR-4658). Acquired DNA methylation changes in skeletal muscle were quantitatively small in twins with T2D compared with the co-twins without T2D. Key methylation and expression results were validated in muscle, myotubes, and/or myoblasts from unrelated subjects with T2D and controls. Finally, mimicking T2D-associated changes by overexpressing miR-548 and miR-607 in cultured myotubes decreased expression of target genes, GLUT4 and FGFR4, respectively, and impaired insulin-stimulated phosphorylation of Akt (Ser473) and TBC1D4.

Conclusions

Together, we show that T2D is associated with non- and epigenetically determined differential transcriptional regulation of pathways regulating skeletal muscle metabolism and contraction.
Green space visits among Turkish and South Asian Surinamese women with a high cardiometabolic risk living in disadvantaged neighborhoods in the Netherlands: motives, means and prerequisites
Authors: van den Brekel Lieke , Voogdt-Pruis Helene R. , Wispelweij Lian , Jawalapershad Laxmie , Narain Soerinder , Klipstein-Grobusch Kerstin , Grobbee Diederick E. , Lenters Virissa , Mackenbach Joreintje D. , Vaartjes Ilonca
Published: December 2024

Background

The use of urban green spaces differs by social characteristics, including gender, ethnicity, and socioeconomic position. We examined motives, means and prerequisites to visit green space of marginalised populations with high cardiometabolic risk in the Netherlands, namely women with a Turkish or South Asian Surinamese background residing in disadvantaged neighbourhoods.

Methods

We conducted six focus group discussions in two Dutch cities. The study was performed in collaboration with social workers from the local communities with similar ethnic backgrounds as the participants. A thematic analysis was carried out.

Results

Sixteen Turkish women and 30 South Asian Surinamese women participated. Motives, means and prerequisites that emerged covered four themes: social, personal, environmental characteristics and undertaking activities. Socializing was an important motive to visit green space. Personal motives mainly consisted of positive effects on mental and physical well-being. Activities undertaken in green space were often a means to socialize or improve well-being. Many environmental factors, including safety, aesthetics, and (sanitary) facilities, influenced motivation to visit green space. Except for environmental characteristics, motives, means and prerequisites largely overlapped between ethnic groups. There were notable interactions between the themes.

Conclusion

Motives, means and prerequisites to visit green space of women with a Turkish or South Asian Surinamese background who live in disadvantaged neighborhoods span multiple interacting themes. Future studies examining the relationship between green space and health should consider interactions between motives, means, prerequisites and ethnicity. The possibility of expanding the multifunctionality of green spaces to provide marginalized populations with more equitable access and activities should be further explored.
Research utilization competency development in the health workforce pipeline: Design and formative evaluation of learning objectives for health professions students
Authors: Yini Karway Olive W. , Wleh Jeremiah , Kpatakolee Yamah , Sieka Joseph , Candy Neima , Talbert-Slagle Kristina , Dahn Bernice T. , Harmon-Gray Wahdae-Mai , Skrip Laura A.
Published: December 2024

Background

It is widely recognized that use of research evidence to guide health policy and practice could lead to adoption of life-saving interventions and more effective resource allocation. However, the skills around research utilization are often assumed and rarely taught, particularly in low- and middle-income country contexts. Here we present a set of competency areas and learning objectives developed for institutionalization of research utilization across health professions schools in Liberia. Ahead of implementation and to gauge their perceived value and utility, a participatory formative evaluation was undertaken.

Methods

Focus group discussions were held to gain feedback on a set of research utilization learning objectives and the proposed implementation approach. Focus group participants were drawn from faculty and students at the University of Liberia College of Health Sciences (ULCHS), which houses the country’s only medical and pharmacy schools, along with schools of public health and nursing and midwifery. ULCHS serves an essential role in the health workforce pipeline.

Results

Findings from the focus group discussions identified a limited understanding of research utilization at the ULCHS but a demand for stronger understanding of research methodology and evidence. Participants identified clear examples of how the skills represented in the learning objectives could help specifically their personal careers as well as more broadly the health sector of Liberia. Potential challenges were noted around the incorporation of research utilization learning objectives into existing courses and tended to be logistical (for example, poor internet connectivity and low digital literacy) or around lack of foundational understanding and skills (for example, lack of experience with literature searches and reviews). However, the approach was generally perceived as contextually aware since it would not add new courses, which come with credit fees and extra time commitment, and would focus on practical skills-building rather than theoretical content.

Conclusions

Integrating research utilization learning objectives into existing curricula in health professions schools is expected to enhance uptake and application of research evidence in the Liberian health sector, as students emerge from the workforce pipeline to fill positions in clinical and policy settings. The success of the approach will warrant ongoing evaluation, along with mentorship of faculty, to increasingly incorporate skills and content of local relevance into courses.
Combining immunoscore and tumor budding in colon cancer: an insightful prognostication based on the tumor-host interface
Authors: Haddad T. S. , Bokhorst J. M. , Berger M. D. , Dobbelsteen L. v. d. , Simmer F. , Ciompi F. , Galon J. , Laak J. v. d. , Pagès F. , Zlobec I. , Lugli A. , Nagtegaal I. D.
Published: December 2024

Background

Tumor Budding (TB) and Immunoscore are independent prognostic markers in colon cancer (CC). Given their respective representation of tumor aggressiveness and immune response, we examined their combination in association with patient disease-free survival (DFS) in pTNM stage I-III CC.

Methods

In a series of pTNM stage I-III CCs (n = 654), the Immunoscore was computed and TB detected automatically using a deep learning network. Two-tiered systems for both biomarkers were used with cut-offs of 25% and ten buds for Immunoscore and TB according to clinical guidelines, respectively. Associations of Immunoscore with TB with 5-year DFS were examined using Kaplan–Meier survival analysis in addition to multivariable modeling and relative contribution analysis using Cox regression.

Results

Immunoscore and TB independently are prognostic with hazard ratio (HR) = 2.0, 95% confidence interval (CI) 1.4–2.8 and HR 2.5, with 95% CI 1.4–4.5, respectively; P value < 0.0001. By combining Immunoscore with TB, patients with Immunoscore Low, TB High tumors had a significantly poorer DFS (HR 5.6, 95% CI 2.6–12.0; P value < 0.0001) than those with Immunoscore High, TB Low tumors. The combined Immunoscore with TB score was independently prognostic (P value = 0.009) in comparison to N-stage, T-stage, and MSI. Immunoscore with TB had the highest relative contribution (35%) to DFS in pTNM stage I-II CCs.

Conclusions

The association of Immunoscore and TB with patient survival suggests that both biomarkers are complementary and should be interpreted in combination to identify high-risk Stage I-II patients who should be considered for adjuvant therapy or further diagnostic testing.