bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the interplay between fat talk, social media use and body image among young women: New opportunities for health education?
Authors: Kennedy Lynne , Preston Grace , Kenny Ursula
Published: January 2023

Background:

‘Fat Talk’, or the act of negatively discussing one’s own or another person’s body, is linked to body image constructs, body dissatisfaction, low self-esteem and disordered eating. The spaces in which young women talk about the body are changing, as social media use escalates. Understanding the interplay between social media use, body image and fat talk, in different contexts, is needed.

Method:

Focus group interviews were used to explore how young women (aged 15–19) experience fat talk while using social media and the possible effect on body image constructs. Using purposive convenience sampling, young women who regularly used social media and were living in an inner city of England were recruited. Thematic analysis was used for analysis and six themes were identified, both a priori and inductively, to explore the interplay between them.

Findings:

Over 35 women were successfully recruited into the study, with 18 of these finally participating in focus group interviews. Among participants, social media use was linked to increased self-evaluation of the body, engagement in social comparative behaviour and negative self-talk about the body. Although fat talk was reportedly common and widespread, it was unacceptable in the online space. However, body talk, other than size or shape, was permissible.

Conclusion:

Fat talk can be divisive; however, if it becomes unacceptable in the online space, negative self-talk may increase. If fat talk is replaced by an all-encompassing ‘body talk’, then this too may exacerbate existing pressures on young people and their mental health and well-being. Understanding the relationship between social media, body dissatisfaction and body talk may provide new opportunities for health education to promote a more constructive prevention discourse of the body, including body talk, in or around the online space.
Expectations of caregivers of persons with severe mental illness from mental health rehabilitation services: A qualitative study
Authors: Singh Daljit , Tyagi Shikha , Malhotra Nidhi
Published: January 2023

Background:

Mental health rehabilitation services (MHRS) play an essential role in addressing the diverse and often complex needs of persons with severe mental illness (SMI). The rehabilitation services are of utmost importance in training these patients to lead an independent and meaningful life. In India, caregivers of persons with SMI play a significant role in the decision-making process concerning treatment and rehabilitation.

Aim:

The main objective of the present study was to understand and analyze the expectations of caregivers of persons with severe mental illness from mental health rehabilitation services in the Indian context.

Method:

The present study is qualitative in nature. A semi-structured interview schedule was used to capture the caregivers’ expectations. Fifteen caregivers who met inclusion and exclusion criteria were interviewed for the study. The data obtained was analyzed using Braun and Clarke’s six-phase data analysis framework.

Results:

Thematic analysis of the data emerged into five themes, namely (1) ‘proximity’, (2) ‘professionalism of staff’, (3) ‘treatment related expectations’, (4) ‘welfare benefits’, and (5) ‘infrastructure’. These themes and their sub-themes were subsequently discussed in the light of existing literature.

Conclusion:

Caregivers of persons with SMI identified the most relevant as well as generic expectations from MHRS. Understanding these expectations can help improvise the existing services delivery system and help institutes, non-government organizations (NGOs) and other concerned entities working in mental health rehabilitation to develop service user friendly rehabilitation models.
‘A lot of the time it’s dealing with victims who don’t want to know, it’s all made up, or they’ve got mental health’: Rape myths in a large English police force
Authors: Gekoski Anna , Massey Kristina , Allen Katherine , Ferreira Joana , Dalton Charlotte T , Horvath Miranda , Davies Kari
Published: January 2023

Despite an increase in the reporting of rape, convictions in England and Wales have fallen significantly in recent years. Previous research has found high rape myth acceptance among police officers. Given that the police act as gatekeepers to the criminal justice system, subscribing to rape myths may have significant effects upon victim attrition and conviction rates. This study explores police officers’ use of rape myths and how these may impact investigations and prosecutions. A total of 17 semi-structured interviews were conducted with police officers from a large English police force. The interview data were analysed using the qualitative method of thematic analysis. Although there were instances where officers demonstrated some awareness of the need to dispel or counter rape myths, rape myths were employed by most officers, with the most common relating to (1) victim fabrication (‘women lie’) and (2) victim precipitation (‘women ask for it’). Recommendations are made around screening and training for police officers.
Role of serotonin in modulation of decision-making in Parkinson’s disease
Authors: Nobis Lisa , Maio Maria Raquel , Saleh Youssuf , Manohar Sanjay , Kienast Annika , McGann Emily , Husain Masud
Published: January 2023

Background:

Dysfunction of dopaminergic pathways has been considered to play a pivotal role in Parkinson’s disease (PD), affecting the processing of emotional and rewarding information, and potentially leading to symptoms of depression or apathy. However, some aspects of motivation in PD might be affected by non-dopaminergic mechanisms.

Aim and method:

The objective of this experimental medicine study was to investigate the contribution of serotonergic modulation via administration of citalopram (20 mg) for 7 days on motivated decision-making in twenty PD patients, measured using several different computerised tasks and clinical questionnaires that probe different aspects of decision-making. Twenty healthy controls were additionally tested without medication to assess any baseline differences between the two groups.

Results:

Results indicated that PD patients were overall less motivated than controls on an effort- and reward-based decision-making task. Citalopram increased or decreased willingness to exert effort for reward, depending on whether baseline motivation was high or low, respectively. A task assessing decision-making under risk revealed higher levels of risk aversion for potential losses in PD patients, which neither serotonin nor the patient’s regular dopaminergic medication seemed to restore. However, citalopram in PD was associated with more risk-seeking choices for gains, although patients and controls did not differ on this at baseline.

Conclusion:

The results provide evidence for a role of the serotonergic system in influencing some aspects of motivated decision-making in PD processes.
Screening and verification of genes related to polycystic ovary syndrome
Authors: Li Xuebing , Wang Chunxia , Yang Heng , Pei Dongxu , Liu Yuchun , Yan Sha , Li Yongwei
Published: January 2023

Objective

To identify key genes involved in occurrence and development of polycystic ovary syndrome (PCOS).

Methods

By downloading the GSE85932 dataset from the GEO database, we used bioinformatical analysis to analyse differentially expressed genes (DEGs) from blood samples of eight women with PCOS and eight matched controls. Following bioinformatic analysis, we performed a cross-sectional study of serum samples taken from 79 women with PCOS and 36 healthy controls.

Results

From the 178 DEGs identified by bioinformatical analysis, 15 genes were identified as significant, and of these, ORM1 and ORM2 were selected for further verification as potential biomarkers for PCOS. Serum ORM1 and ORM2 levels were significantly increased in women with PCOS, and had a high diagnostic value. ORM1 and ORM2 were positively correlated with testosterone, cholesterol, and triglycerides. ORM1 levels were negatively correlated with high density lipoprotein (HDL) while ORM2 levels showed no significant correlation.

Conclusions

ORM may be an effective biomarker for the diagnosis of PCOS and its monitoring may be a useful therapeutic strategy.
Nickel chloride induces anticancer biological responses in hepatocellular carcinoma cell lines
Authors: Kahraman Erkan , Goker Erdem
Published: January 2023

Nickel has long been known to have a toxic effect in humans and has been defined as a human carcinogen. However, recent studies have suggested that nickel chloride (NiCl2) may also possess anticancer properties. The liver is one of the target organs for nickel, and thus, the present study aims to evaluate the effect of NiCl2 on anticancer biological responses in hepatocellular carcinoma (HCC) cell lines. Both HuH-7, a well-differentiated HCC cell line, and Mahlavu cell line, a poorly differentiated HCC cell line, were exposed to NiCl2. It was determined that NiCl2 decreased cell viability in both cell lines in a dose- and time-dependent manner. Nickel chloride exposure at IC50 doses were observed to suppress the ability of HCC cells to produce colonies and also induce apoptosis of HCC cells by increasing Cleaved Caspase-3 protein levels. It was found that NiCl2 exposure affected cellular morphology, increased the LC3-II protein levels, and induced autophagy in parallel to increased apoptosis in HCC cells. It was also observed that NiCl2 suppressed cell migration, decreased the size and viability of HCC tumor spheroids generated in 3D cell cultures, and disrupted the spheroid structure of the tumor cells depending on E-cadherin expression levels. Furthermore, it was observed that all anticancer biological responses induced by NiCl2 occurred independently of the AKT signaling pathway. In conclusion, our results suggested that NiCl2 induced anticancer biological responses in HCC cell lines. Moreover, this study provided important new molecular and cellular biological basic data about the action mechanisms of NiCl2 in HCC.
Perspectives on development of biomedical polymer materials in artificial intelligence age
Authors: Xie Shijin
Published: January 2023

Polymer materials are widely used in biomedicine, chemistry and material science, whose traditional preparations are mainly based on experience, intuition and conceptual insight, having been applied to the development of many new materials, but facing great challenges due to the vast design space for biomedical polymers. So far, the best way to solve these problems is to accelerate material design through artificial intelligence, especially machine learning. Herein, this paper will introduce several successful cases, and analyze the latest progress of machine learning in the field of biomedical polymers, then discuss the opportunities of this novel method. In particular, this paper summarizes the material database, open-source determination tools, molecular generation methods and machine learning models that have been used for biopolymer synthesis and property prediction. Overall, machine learning could be more effectively deployed on the material design of biomedical polymers, and it is expected to become an extensive driving force to meet the huge demand for customized designs.
The Challenges of Women Housed in Internally Displaced Persons (IDP) Camps During an Armed Conflict in Ethiopia
Authors: Desalegn Shambel , Kasseye Eyayu , Gebeyaw Getachew , Meshelemiah Jacquelyn C.A.
Published: January 2023

The outbreak of an ethnically and politically motivated armed warfare in Tigray in 2020, spread to the Amhara and Afar regions in Ethiopia, wreaking havoc on civilians. This armed conflict has had a significant impact on the lives of women who have been uprooted from their homes and are now living in internally displaced persons (IDP) camps. The purpose of this study was to examine the challenges faced by women living in two IDP camps in Dabat and Debark, Ethiopia. In-depth interviews were used to gather data from 13 participants. Challenges emerged that relate to three major themes: systemic (gender-based violence, family separation/disintegration, human trafficking, and genocide); psychological (trauma and stress; loss of home/personal belongings); and social (lack of social security and stability, reintegration and resettlement problems, unmet basic needs [physiological and physical health], and maladministration of supplies. The results of the study suggest that internally displaced women in Ethiopia are a group of targeted and victimized civilians suffering from a wide range of atrocities that are rooted in their gender identity, marginalized status, and extreme vulnerability. Lawmakers, politicians, advocacy groups, social work practitioners and women's activists must all advocate for stronger sanctions for those who perpetrate violence against women.
Visuoconstructional Abilities of Patients With Subjective Cognitive Decline, Mild Cognitive Impairment and Alzheimer’s Disease
Authors: Knechtl Paula , Lehrner Johann
Published: January 2023

Background

Via the Vienna Visuoconstructional Test 3.0 (VVT 3.0) delayed recall we combined the assessment of visuoconstructive abilities and memory and investigated the test’s potential to support diagnostic processes, including staging and the elaboration of a cognitive profile.

Methods

We retrospectively analysed the data of 368 patients of the Department of Neurology, Medical University of Vienna, between 04/2014 and 10/2020 that had performed the VVT 3.0. Our sample involved 70 healthy controls (HC), 29 patients with subjective cognitive decline (SCD), 154 patients with mild cognitive impairment (MCI) and 115 patients with Alzheimer’s disease (AD). We investigated the differences in the VVT 3.0 scores, as well as the VVT’s ability to differentiate between AD and nonAD by calculating receiver-operating-characteristic (ROC) curves, ideal cut-offs and a logistic regression model.

Results

Results stated that the VVT 3.0 delayed recall scores were able to differentiate between all diagnostic groups, respectively, except HC-SCD and SCD-MCI. The ROC analyses determined an AUC of 0.890, 95% CI [0.855; 0.925], P < .001, and the ideal cut-off at 29.5 points that maximised sensitivity at 0.896 and specificity at 0.81. The logistic regression model classified 83.4% of AD patients correctly and delivered a significant Cohen’s Kappa of 0.619 (P < .001).

Conclusion

As the VVT 3.0 revealed satisfactory values of diagnostic accuracy in our sample, it could enrich clinical diagnosing. However, for more clarity about its informative value in other populations, there remains a need for future studies with other samples.
Prevalence and determinants of heterosexual anal-intercourse among female sex workers in India: Findings from nationwide cross-sectional biological and behavioural survey
Authors: Haldar Partha , Kumar Pradeep , Rai Sanjay , Kant Shashi , Raj Yujwal , Reddy Chandrasekhar , Rajan Shobini , Pandey Arvind , Venkatesh S , Goswami Kiran , Misra Puneet
Published: January 2023

Background

The vulnerability of female sex workers (FSWs) to HIV infection increases if unprotected heterosexual anal intercourse (HAI) is practiced.

Objectives

To estimate the prevalence of HAI among FSWs, and associated factors, and prevalence of consistent condom use (CCU) during HAI and associated factors.

Methods

Analysis of cross-sectional data from nationwide biological and behavioural survey, conducted at 73 randomly selected domains with sample size of 27,000 in India.

Results

A total of 25,932 FSWs were included in the analysis, after excluding 1075 (3.9%) FSWs for which the data were incomplete. The prevalence of HAI was 29.9% (95% CI, 29.3, 30.4); The CCU during HAI in the last one month was 58.9%. Younger age at the start of sex work, use of mobile phone/internet for soliciting client, home as a place of sex work, consumption of alcohol/drug, and physical violence against FSWs were associated with higher odds of HAI. Frequent contact with outreach workers, awareness of sexually transmitted infection, and older age at the start of sex work was associated with CCU.

Conclusion

Prevalence of HAI was high among FSW in India. The national program could target those factors that reduce the odds of HAI and/or promote CCU.
Trends, patterns, and factors associated with HIV infection among males diagnosed with syphilis, 2014–2019, Hawaii
Authors: Li Fenfang , McCormick Timothy J , Katz Alan R , Komeya Alan Y , Sung Katherine , Hasty Gerald L , Wasserman Glenn M
Published: January 2023

Objective

This study describes HIV infection and associated risk factors among males diagnosed with syphilis in Hawaii.

Methods

Hawaii sexually transmitted infection (STI) registry records of males diagnosed with syphilis, 2014–2019, were crossmatched with Hawaii HIV surveillance registry records through 2020 using CDC’s Registry Plus Link Plus software. HIV status from the STI registry was validated by matching results. Logistic regression was used to examine demographic and behavioral factors associated with HIV infection.

Results

Among the 947 male syphilis cases, 257 (27.1%) had both syphilis and HIV infections. Dual infection rates were higher in earlier years (39.5% in 2015), among older patients (41.6% among persons ≥45 years old), males who have sex with males (MSM, 36.6%), and cases with repeated syphilis events (59.5%). The overall agreement on HIV status between the STI registry and matching results was 95.7%.

Conclusions

Over a quarter (27.1%) of male syphilis cases were living with HIV. HIV infection rates were higher among older patients, MSM, and males with repeated syphilis events. Periodic matching between STI and HIV registries provides opportunities for quality control to both registries and opportunities to identify patients not linked to HIV care or who have fallen out of HIV care.
Spatial pattern and driving factors for interprovincial water use in China: Based on SNA and LMDI
Authors: Zhang Chenjun , Huang Hailiang , Shi Changfeng , Xu Jingru , Chiu Yung-ho
Published: January 2023

China, the world's largest developing country, faces a severe water shortage. As the government has set a goal of limiting water use to 7000 × 108 m3 by 2035, how to control the increase in water use will be a thorny issue for China. Unbalanced and uncoordinated regional socio-economic development is an important feature of China. Research on the interaction between provincial water use will help to optimize the rational allocation of water resources and control of water use. In this paper, SNA (social network analysis) method is first used to explore the characteristics of social network relationship between inter-provincial water use, construct a two-stage model of SNA–LMDI, and decompose the driving factors of inter-provincial water use evolution. We found the following points. (1) From 2000 to 2018, the spatial correlation network structure of water use is tending to be stable, and the stability and risk resistance of the whole network are enhanced. (2) From different angles to quantify the centricity analysis, can be found that eastern provinces located right in the heart of water network, obviously larger impact on water resources utilization in other provinces, Shanghai and Beijing is located in the former two, and central and western provinces in the edge position. (3) The national water use spatial correlation network can be divided into four blocks, net beneficial block, bidirectional spillover block, brokers block, and net spillover block. (4) Technological progress and industrial structure adjustment were the primary and secondary factors inhibiting the increase of total water use, while income increase was the main factor promoting the increase of total water use, population scale expansion had a weak role in promoting the increase of total water use. Some policy implications are put forward related to our research conclusions.
Self-Knowledge as self-improvement in Plato’s dialogues and cognitive behavioural therapy
Authors: Bamboulis Chloe
Published: January 2023

Some researchers who examine the similarities between philosophy and psychology conclude that engaging in philosophy can improve one’s mental health, instead of, or in addition to, traditional forms of therapy. This article reinforces this by establishing the relationship between self-knowledge as self-improvement in Plato’s dialogues and in cognitive behavioural therapy (CBT). Despite multiple important points of congruence, some authors have rejected the idea that self-knowledge in Plato can be assimilated to self-knowledge in psychotherapy. Here, I argue against this criticism by focusing on three key areas of interest: (a) self-knowledge as improving one’s beliefs via objective (nonsubjective) means, (b) self-knowledge as resulting in objective (nonsubjective) outcomes, and (c) self-knowledge as progress towards the Good. I reinforce the link by demonstrating that CBT uses methods which are equally objective as those of the Platonic dialogues. I then continue by claiming that the outcome of self-knowledge in both is also equally objective. Finally, I explore the nature of their relationship. Instead of arguing that self-knowledge in CBT is a modern version of Platonic self-knowledge, I propose that although not intended to, it functions as a preparatory process for one to be able to participate in Platonic self-knowledge.
Bi-Polar Convergence Analysis of Income and Related Factors in the BRICS Nations: A Stochastic Convergence Approach
Authors: Das Ramesh Chandra , Nayak Aloka
Published: January 2023

The present study focuses on the dynamics of the four key indicators, per capita gross domestic product (PCGDP), savings, capital-output ratio and population, for the Brazil, Russia, India, China and South Africa (BRICS) group in order to analyse the convergence, divergence or others, in line with the neoclassical and time series methods for 1991–2019. The cross-country regression results, as per the unconditional β convergence, show no signs of convergence or divergence in any of the four indicators, although there is sigma convergence in some of them. Further, the results of the time series analysis do not show any sign of convergence in income in any pair of the countries. There is non-diverging catching up in incomes per capita for two pairs of countries only, Brazil–China and Brazil–Russia, and divergence result in PCGDP for two other pairs, Brazil–India and India–Russia. Hence, there are maximum results in favour of non-consolidations of the group. Thus, the non-convergence results may hinder the group from establishing them as the parallel body in the global decision-making processes in different economic and political situations. In order to attain the basic objectives behind the BRICS group formation the policy makers should focus on reducing the inter-country disparities.
Collaboration Strategies for Private COVID-19 Vaccine Supply Chain Under Demand Uncertainty: An Indian Perspective
Authors: Adhikari Arnab , Kundu Tithishri , Jha Ashish Kumar
Published: January 2023

In 2020, the COVD-19 pandemic emerged as the most severe crisis of the century. Several vaccine manufacturing firms have taken the necessary initiatives to combat this problem. However, profitability issues can bring down these firms’ vaccine manufacturing efforts, thus leading to lower vaccination coverage. Motivated by this issue, we depict a private COVID-19 vaccine supply chain with a supply chain framework comprising of one vaccine manufacturer and multiple private hospitals under demand uncertainty. We incorporate a Stackelberg game-theoretic approach to demonstrate the collaboration between the vaccine manufacturer and the private hospital using wholesale price, two-part tariff and revenue sharing contracts. We determine the optimal number of vaccines and coordination criteria for each contract. Using a real-life approximation of Indian data, we conduct several numerical studies and facilitate the visual depiction of all the theoretical insights obtained from the model. We also discuss the managerial implications of this study. As per our analysis, when private hospitals procure a higher number of vaccines from the vaccine manufacturer, the two-part tariff contract-based collaboration mechanism yields a win-win situation for both the private hospitals and the vaccine manufacturer and is better than the wholesale price contract.
Exploring Self and Habit in Addiction and Technology through an Enactivist Framework
Authors: Lam Austin A , Thiessen Karina A , Ramírez-Vizcaya Susana
Published: January 2023

From 24 August 2022 to 27 August 2022, a group of interdisciplinary experts from psychiatry, psychology, philosophy, cognitive science, and other related fields met in Vancouver, Canada, for a roundtable event. The aim of the roundtable was to discuss the concept of the “self” as it pertains to the deliberate, habitual, and addicted interactions of the individual with the world, including with information technology, through the lens of an enactivist framework.
Absence Versus Presence of Intimate Partner Violence in a Sample of Spanish Women: Conflict Resolution Strategies and Associated Variables
Authors: Badenes-Sastre Marta , Beltrán-Morillas Ana M. , Expósito Francisca
Published: January 2023

Through two studies ( N = 544 women), the role of types of relational problems (absence vs. presence of intimate partner violence [IPV]) in the use of conflict resolution strategies (exit and loyalty) was analyzed, considering the serial mediating effect of dependency and commitment and the moderating effect of benevolent sexism. The main results showed that higher scores in dependency and commitment predicted less use of exit strategies among women who reported IPV. No significant results were found regarding loyalty strategy and benevolent sexism. Ultimately, implications for women's perceived risk of future violence were discussed.
Psychosocial health in adolescent unmarried motherhood in rural Uganda: Implications for community-based collaborative mental health education, and empowerment strategies in the prevention of depression and suicide
Authors: Webb Lucy , Kyaddondo David , Ford Teri , Bergqvist Anna , Cox Nigel
Published: January 2023

Teenage pregnancy rates in Uganda are among the highest in sub-Saharan Africa. Child marriage is often the result of unmarried teenage pregnancy and is recognised by Uganda's government as a form of sexual violence and an outcome of inequality. However, unmarried motherhood incurs stigma and shame within traditionally living rural communities. Using co-produced Open Space and ethnographic methods, we examined the psychosocial impact of unmarried motherhood on girls and their communities, and explored problem-solving with key local stakeholders. Findings indicate that girls experience extreme stress, social exclusion and rejection by their families, and experience bereavement from school expulsion and the loss of their career aspirations. Depressive symptoms and suicidal behaviour are reportedly not uncommon among this population group. Community and family efforts to promote marriage for these mothers to avoid social stigma increased the mothers’ feelings of depression, whereas mothers who became independent appeared to fare better psychologically. Community members and local stakeholders demonstrated a willingness to act locally to reduce the negative impacts of unmarried motherhood but lacked knowledge and support resources. Our findings indicate that mental health promotion for teenage mothers is likely to be better served through empowerment strategies rather than marriage and, in a context of poor mental health service access, there is a substantial role for community mobilisation and the promotion of self-help strategies to support teenage mothers. This study raises important points regarding different community understandings of depression and indicates collaboration between professionals and communities for a values-based approach.
Can the ‘downward spiral’ of material conditions, mental health and faith in government be stopped? Evidence from surveys in ‘red wall’ constituencies
Authors: Johnson Matthew T , Aidan Johnson Elliott , Reed Howard , Nettle Daniel
Published: January 2023

If policy preferences follow material interests, the experience of socioeconomic disadvantage ought to increase support for redistributive policies. However, experiencing disadvantage might also reduce faith in government’s ability to make things better, indirectly reducing support for redistributive action, and leading to a spiral of widening disadvantage and increasing political disengagement. Indeed, disadvantaged communities sometimes favour right-wing platforms over those offering redistribution, as in the taking of ‘red wall’ constituencies in the North and Midlands of England by the UK Conservative party in 2019. This article uses quantitative data from a survey of ‘red wall’ voters (n = 805) to examine the bases of people’s perceptions of redistributive policies. We find that even a radical redistributive policy, Universal Basic Income (UBI), receives consistently high levels of support (69.45 SD 27.24). Lower socioeconomic status, greater financial distress and greater risk of destitution all increase support. These effects are partly mediated by mental distress, which is markedly higher among the less well off. However, the same socioeconomic factors also reduce faith in government, which in turn is associated with lower support. Thus, those who stand to benefit most from redistribution are aware of their material interests, but are also the least confident in the ability of government to improve their lives. As such, there is a clear political challenge for progressive politicians: those whose support they depend upon require a significant redistributive offer, but also need to be persuaded of the viability of reform to support progressive change.
A measure of alcohol affordability for Sweden: Capturing trends among different demographic groups
Authors: Müller Vibeke , Jarl Johan , Gerdham Ulf-Göran
Published: January 2023

The World Health Organization has rated alcohol abuse as one of the leading risk factors for population health worldwide and emphasises the relevance of alcohol affordability (AA) measures as important instruments to monitor alcohol control policy. The present study suggests an AA index that is suitable for measuring AA in Sweden, where off-premises alcohol is exclusively distributed by Systembolaget, the government-owned chain of liquor stores. Sweden provides uniform off-premises prices for alcohol and extensive register data, which profits the accuracy of this index. By allowing for AA comparisons across types of alcoholic beverages (beer, wine, spirits) and price categories, as well as across population groups (age, sex and family composition), and by being transferable to other Nordic countries with uniform off-premises prices, this study will facilitate governmental monitoring and supervision of the alcohol policy in Nordic countries. The suggested AA index is defined as the ratio of the median equivalised disposable income and the price per litre of 100% ethanol for alcohol, scaled to equal 100% in the base year. The income can be measured for the reviewed population or a subgroup, and the price measure can include all sold alcoholic beverages or separate them by beverage type and/or price category. Thereby, the index measures the number of litres of 100% ethanol that are affordable with the median income. Applying the index to the publicly available data for 2011–2019 from Statistics Sweden and Systembolaget reveals that alcohol in Sweden generally became more affordable, with high-priced alcoholic beverages becoming comparably more affordable than low-priced alcohol. However, low-priced beer became less affordable over the last decade. Future studies may validate the AA index against alcohol consumption.
Integrating an innovative social work practice into a pediatric dental residency program
Authors: Purkis Elisabeth A , Hill Brittaney , da Fonseca Marcio A , Stanford Clark M
Published: January 2023

This article describes the implementation and outcomes of a social work program in a university pediatric dental clinic serving low-income families. The goal was to decrease barriers to dental care access, decrease appointment failure, and improve interprofessional practice (IPP). Funding was obtained through a foundation to hire a social worker and two interns, and cover program costs. A survey identified barriers families faced to obtain and complete pediatric dental care. Residents, dental students, and faculty make referrals to the social workers who intervene to help families overcome challenges for their children's care.

Findings

The program started in January 2019 and outcomes are reported through June 2021. The largest barriers families identified were lack of a pediatric dentist near home accepting public insurance (91%), the dentist who saw their child only did exams and cleanings but not fillings (84%), and need for specialized dental care (77%). Five hundred and eleven families were referred to the social workers, most commonly for resources, information or other referrals (30.5%), dental insurance lapse (14.9%), caregiver guidance on oral health (10.6%), mental health concerns (10.4%), and poor treatment compliance (9.6%). Social workers provided 424 interventions, mostly about information regarding community resources (26.8%), transportation issues (15.9%), and telephone consults (14.2%). Appointment failure rates decreased from 17% to 13.5%, while the cancelation rate decreased from 19.2% to 14.3% from January 2019 to June 2021, respectively.

Applications

Social workers helped decrease barriers to pediatric dental care, improve attendance to dental appointments, and enhance IPP for pediatric dental residents, students, and faculty.
A “three-legged model”: (De)constructing school autonomy, accountability, and innovation in the Italian National Evaluation System
Authors: Mentini Laura , Levatino Antonina
Published: January 2023

The widespread adoption of school autonomy with accountability reforms in education has generated debate regarding the relationship between autonomy, innovation and accountability. While at the policy design level, these three elements are highly related, several authors highlight the contradictions among them. By analyzing key documents and interviews, this paper aims to identify the program ontology behind the current Italian National Evaluation System (SNV), with a focus on the way in which autonomy, accountability and innovation have been conceptualized and linked together. The paper also aims to explore whether pitfalls and/or tensions exist that might hamper the achievement of the SNV goals. The findings highlight the peculiarities of the Italian autonomy with accountability system, which has resulted from the involvement of different stakeholders in the design and implementation of the reforms. The findings also reveal contradictions regarding some of its premises. Various rationales (improvement, efficiency, equity and transparency) emerge that seem to have acted as drivers of the reforms, however, the influence of globalizing discourses on international competition and the benefits of datafication also appears significant. A number of contextual aspects are finally considered which hamper the expected change mechanisms, highlighting the discontinuous ground in which such policy dispositifs operate.
The Beautiful Rule: Thinking the Aesthetics of Game Rules
Authors: Sicart Miguel
Published: January 2023

This paper introduces a model for analyzing the aesthetic value of game rules. Drawing on Nguyen's theory of agential aesthetics, this paper argues that the aesthetic value of a rule is related to the ways in which it contains modalities of agency. Using football's (soccer) offside rule as a case study, this article provides a way of thinking about the aesthetics of game rules.
Virtual Community Engagement for Retention of Black Men in Clinical Research
Authors: Nolan Timiya S. , McKoy Alicia , Gray Darrell M. , Metlock Faith , Addison Sarah , Ogonuwe Stephanie S. , Gregory John , Lavender Dana , Reopell Luiza , Joseph Joshua J.
Published: January 2023

Black American men have worse cardiovascular health compared with their White counterparts, yet are highly underrepresented in clinical trials. In 2020, Black men were recruited to participate in Black Impact, a community-based lifestyle intervention to increase cardiovascular health. Due to the research pause during the Coronavirus Disease (COVID-19) pandemic, a virtual community engagement (VCE) process was co-designed with community stakeholders and evaluated for its effect on retention for the clinical trial. VCE via weekly virtual video conference sessions occurred for 9 weeks as a run-in phase prior to in-person research activities. Data collected during sessions included attendance, anecdotes on acceptability, and topical requests for subsequent weeks. Content analysis was performed on scribe notes from sessions to ascertain themes describing the implementation and participant perceptions of the VCE. Descriptive statistics were used to analyze quantitative data. The VCE provided opportunities to co-create a safe atmosphere in small groups, discuss mental health, foster trust, capitalize on the power of spirituality, and establish a brotherhood. Following the VCE run-in phase, 74 of 100 participants remained engaged for participation in the Black Impact study. The VCE described provides a framework that can be used to retain Black men during study delays or disruptions through fostering engagement and building community among participants and researchers.
Effects of statin on hypertension patients: A systematic review and meta-analysis
Authors: Wan Jianwei , Chen Min
Published: January 2023

Objective

To conduct a systematic review and meta-analysis to compare the effects of statins and placebo on systolic blood pressure (SBP) and diastolic blood pressure (DBP) in patients with hypertension.

Methods

We used different databases such as MEDLINE and the Cochrane Library Central Register of Controlled Trials (CENTRAL) to search for randomized controlled trials published from 1 January 2000 to 1 January 2022 to retrieve relevant studies and full-text articles evaluating statins versus placebo in patients with hypertension. Data were taken from eligible studies. The included articles also performed Cochran’s Q statistics, forest plots, funnel plots, Egger’s test, and sensitivity analyses.

Results

This study included 8 studies with a total of 3086 patients. We sought to assess patients' SBP and DBP. The results were expressed as mean differences (MD) with 95% confidence intervals. There was no difference in DBP between the statin and placebo groups (MD = 2.48, 95% CI [−2.00, 6.96], p = .28, random effects model). In terms of SBP, the statin group was superior to the placebo group (MD = 4.37, 95% CI [0.72, 8.02], p = .02, random-effects model). Sensitivity analyses and funnel plots showed that our study was robust, with low publication bias.

Conclusion

The results show that statins could be clinically more effective than placebo in patients with hypertension.
Partially clustered designs for clinical trials: Unifying existing designs using consistent terminology
Authors: Lange Kylie M , Kasza Jessica , Sullivan Thomas R , Yelland Lisa N
Published: January 2023

Introduction:

Clinical trial designs based on the assumption of independent observations are well established. Clustered clinical trial designs, where all observational units belong to a cluster and outcomes within clusters are expected to be correlated, have also received considerable attention. However, many clinical trials involve partially clustered data, where only some observational units belong to a cluster. Examples of such trials occur in neonatology, where participants include infants from both singleton and multiple births, and ophthalmology, where one or two eyes per participant may need treatment. Partial clustering can also arise in trials of group-based treatments (e.g. group education or counselling sessions) or treatments administered individually by a discrete number of health care professionals (e.g. surgeons or physical therapists), when this is compared to an unclustered control arm. Trials involving partially clustered data have received limited attention in the literature and the current lack of standardised terminology may be hampering the development and dissemination of methods for designing and analysing these trials.

Methods and examples:

In this article, we present an overarching definition of partially clustered trials, bringing together several existing trial designs including those for group-based treatments, clustering due to facilitator effects and the re-randomisation design. We define and describe four types of partially clustered trial designs, characterised by whether the clustering occurs pre-randomisation or post-randomisation and, in the case of pre-randomisation clustering, by the method of randomisation that is used for the clustered observations (individual randomisation, cluster randomisation or balanced randomisation within clusters). Real life examples are provided to highlight the occurrence of partially clustered trials across a variety of fields. To assess how partially clustered trials are currently reported, we review published reports of partially clustered trials.

Discussion:

Our findings demonstrate that the description of these trials is often incomplete and the terminology used to describe the trial designs is inconsistent, restricting the ability to identify these trials in the literature. By adopting the definitions and terminology presented in this article, the reporting of partially clustered trials can be substantially improved, and we present several recommendations for reporting these trial designs in practice. Greater awareness of partially clustered trials will facilitate more methodological research into their design and analysis, ultimately improving the quality of these trials.
Metabolic bone health considerations in giant cell arteritis and polymyalgia rheumatica
Authors: Low Candice , Conway Richard
Published: January 2023

Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) are two common systemic inflammatory conditions with a combined lifetime risk of approximately 3.5% in women and 1.5% in men. They are intimately associated with the aging process, virtually never occurring prior to 50 years of age and becoming more common over time. The reasons for this are unclear, but likely relate in part to factors related to aging of the immune system. The treatment of both GCA and PMR is traditionally based on glucocorticoids, frequently requiring a prolonged treatment course over long periods of time. Other medications are belatedly entering our treatment armamentarium, but their exact place in treatment algorithms remains to be fully defined and it is likely glucocorticoids will remain a cornerstone of our treatment in GCA and PMR for the foreseeable future. As a result, people with GCA and PMR will continue to be exposed to a significant cumulative glucocorticoid burden with all of the attendant potential adverse events, including osteoporosis. The predominantly post-menopausal female population that most commonly develops PMR and GCA is also the population that is most affected by osteoporosis. Given the risk of glucocorticoid-induced osteoporosis and subsequent fragility fractures, a planned treatment approach from glucocorticoid initiation is needed in these conditions. For the majority of patients, this will entail ensuring sufficiency of calcium and vitamin D as well as antiresorptive treatments. In this article, we discuss considerations around optimisation of metabolic bone health in GCA and PMR.
Outcomes of pregnant women hospitalized with unrepaired congenital heart disease: Insights from a multidisciplinary center in Vietnam
Authors: Truong Thanh-Huong , Kim Ngoc-Thanh , Nguyen Dinh-Phuc , Thi Nguyen Mai-Ngoc , Do Doan-Loi , Le Thanh-Tung , Le Hong-An
Published: January 2023

Background

In developing countries, fewer women have access to multidisciplinary congenital heart disease and reproductive programs staffed by experts. We report pregnancy outcomes of a multidisciplinary healthcare strategy utilizing an in-hospital teamwork approach in Vietnam.

Methods

This retrospective cohort study included pregnant women with unrepaired congenital heart disease managed at a referral cardiovascular center.

Results

Undiagnosed congenital heart disease before pregnancy, a lack of pre-pregnancy cardiology counseling, and modified World Health Organization class III/IV were common. Under the multispecialty healthcare strategy, although the rate of maternal death was 8.2% in the modified World Health Organization class IV group, no deaths occurred in any other group. Fetal/neonatal complications occurred in 54% of pregnancies, and 49.4% of neonates survived. Poor pregnancy outcomes were associated with admission during the first/seconde trimester for fetus/neonates, third trimester for mother, modified World Health Organization class III/IV, cyanosis, and heart failure.

Conclusion

The outcomes of pregnant women with unrepaired congenital heart disease were poor but seemed to improve with a multidisciplinary in-hospital healthcare teamwork strategy.
High-dose dual therapy versus bismuth-containing quadruple therapy for Helicobacter pylori eradication: a systematic review and meta-analysis with trial sequential analysis
Authors: Zhou Ben-Gang , Mei Yu-Zhou , Zhang Min , Jiang Xin , Li Yao-Yao , Ding Yan-Bing
Published: January 2023

Background and objective:

Recently, a large number of trials on proton pump inhibitor-amoxicillin-containing high-dose dual therapy (HDDT) versus bismuth-containing quadruple therapy (BQT) for Helicobacter pylori ( H. pylori) eradication have been published with controversial and inconsistent conclusions. The aim of this meta-analysis was to determine the effects of HDDT for H. pylori eradication compared to BQT.

Design:

A systematic review and meta-analysis was conducted.

Methods:

PubMed, Embase, and the Cochrane library database were searched to collect all randomized controlled trials (RCTs) assessing the effects of HDDT versus BQT to H. pylori eradication from inception to September 2022. Meta-analysis was conducted to estimate the pooled relative risk (RR) with 95% confidence intervals (CIs) using a random-effects model. Quality of evidence was appraised using Grading of Recommendations, Assessment, Development and Evaluation system. Trial sequential analysis (TSA) was performed to determine the reliability and conclusiveness.

Results:

A total of 14 RCTs with 5121 patients were included. The results of meta-analysis showed that there was no statistical significance in the eradication rate between HDDT and BQT (intention-to-treat analysis: 86.7% versus 85.1%, RR = 1.01, 95% CI: 0.98–1.04; per-protocol analysis: 89.9% versus 89.4%, RR = 1.01, 95% CI: 0.98–1.03; moderate-quality evidence). The incidence of total adverse effects in HDDT group was significantly lower than in BQT group (5.9% versus 34.1%, RR = 0.42, 95% CI: 0.34–0.50; low-quality evidence). No statistical significance was observed in compliance between HDDT and BQT (RR = 1.01, 95% CI, 1.00–1.03, p = 0.07; low-quality evidence). The TSA result for H. pylori eradication rate indicated that the effect was conclusive.

Conclusions:

Evidence from our updated meta-analysis suggests that HDDT is as effective as BQT in eradicating H. pylori, with fewer adverse effects and similar compliance.

Registration:

Open Science Framework registries (No: osf.io/th4vd)