bluuebunny/crossref_metadata_2025 huggingface dataset:
The Impact of Older Age on Smoking Cessation Outcomes After Standard Advice to Quit
Authors: Fahey Margaret C. , Dahne Jennifer , Wahlquist Amy E. , Carpenter Mathew J.
Published: February 2023

Older adults are a high priority population for smoking cessation. This study observed the influence of older age on the relationship between quitting predictors and cessation. Secondary analysis was conducted of a primary care trial of adults who smoke cigarettes randomized to standard advice to quit or advice plus 2 week supply of nicotine replacement therapy. Logistic regressions assessed interactions of age (<60 vs. ≥ 60 years) by predictors in relation to quit attempts and 6-month cessation controlling for treatment. Predicting quit attempts, there was an interaction of age by motivation ( p = .025) and trend of age by nicotine dependence ( p = .057). Predicting 6-month cessation, an interaction of age by motivation was observed ( p = .020) and a trend of age by dependence ( p = .067). For those with high nicotine dependence, older adults had less successful outcomes compared to younger counterparts. Yet among participants unmotivated to quit, older adults had more successful outcomes than those younger.
“I’m in a Bloody Battle without Being Able to Stop It”: The Dissociative Experiences of Child Sexual Abuse Survivors
Authors: Goldner Limor , Lev-Wiesel Rachel , Bussakorn Binson
Published: February 2023

Dissociation in child sexual abuse (CSA) survivors remains under-recognized and diagnosed, partly because of the difficulties involved in identifying dissociative symptoms. Qualitative research can contribute to a better understanding of the lived experiences of dissociation. This study focused on the experiences of dissociation in the context of CSA. In all, 22 female incest survivors, all diagnosed with different dissociative disorders, provided narratives about their experiences of dissociation. The narratives were analyzed using interpretative phenomenological analysis. The narrative analysis revealed four central themes. The first theme deals with reliving the experience of the abuse. The second theme refers to the experience of disconnection from the body, the self, and the surroundings. The third theme covers the lack of coherence in the narrative, and the fourth theme describes the bridge between voluntary controlled and nonvoluntary uncontrolled use of dissociation. The data are discussed in light of several traumagenic constructs, including a lack of self-sense, being entrapped in a victim–aggressor relationship, and distorted time perception. It is suggested that the extent to which participants can control their dissociation and the coherency of their narratives reflects the severity of their dissociation. Clinicians can consider helping clients use dissociation as an adaptive defense mechanism.
Psychoanalytic practice in the light of psychiatric patient records: The elusive history of Freudian-inspired psychotherapy (Strasbourg, 1940s–1970s)
Authors: Serina Florent
Published: February 2023

This article delves into a problem that is still seldom addressed by historians—namely, the use of medical records testifying to the implementation of a psychoanalytically inspired treatment within a psychiatric institution for historical research. Based on publications, a broad spectrum of medical patient records, and interviews with former practitioners, it more broadly addresses issues related to the attention to patients’ voices at the University Psychiatric Clinic of Strasbourg, a central institution of psychiatric care in Northeastern France that was once considered a bastion of French Freudianism. Eventually, it contends with the fundamentally elusive nature of medical patient records when it comes to talking cures, highlighting the challenges and limitations inherent in the historical exploitation of this type of source.
Numerical analysis of local thermal non-equilibrium free convection in a porous enclosure with a wavy cold side wall
Authors: Barman Prabir , Srinivasa Rao Pentyala
Published: February 2023

In this piece of communication, numerical heat transfer and fluid flow in a Darcy porous enclosure are investigated. The right wavy wall is maintained at a constant low temperature, with the top and bottom preserved thermally insulated, while the left vertical wall is uniformly heated. The governing equations for non-dimensional systems are solved using the Galerkin finite element method; a local thermal non-equilibrium appears between the base fluid and porous matrix. The effects of interface heat transfer parameter [Formula: see text] along with porosity of porous media [Formula: see text], Rayleigh-Darcy number [Formula: see text], and parameters involving waviness of cavities, such as the number of undulations in a unit length [Formula: see text] and amplitude of the wave [Formula: see text] are investigated. The results show that increment waviness augments heat transfer enhancement for fluid and solid phases. The local thermal equilibrium cases for various parameters are pointed out at a 5% significance level of the average temperature difference between the two phases.
Urban fragments in the politics of infrastructure: land claims and livelihood spaces of a fishing community in Chennai
Authors: Fasal Fathima Rayammarakkar , Manalodiparambil Swathi
Published: February 2023

The land claims of urban-dwelling communities are inextricably intertwined with livelihood and dwelling issues. These are critical, multi-layered issues in cities of the global South, given the variety of ideas of ownership prevailing and the vast array of institutions with relevant roles. This field note discusses the situation of a fishing hamlet in coastal Chennai, India which is jeopardized by a judicial intervention ordaining the relocation of its fish vendors away from their current location to a designated market yet to be constructed, purportedly in the interest of beautification and to decongest the city’s traffic. It provides context for this situation, describing the prior process of the hamlet being subsumed into expanding urban infrastructure and how this fragmentation challenges the community’s socio-spatial life and practices. Through interviews and observation, the field note explores how this fishing community has preserved its sense of belonging and negotiated with the state to affirm its territorial claims.
On whose terms: utilities, enterprises or communities? The territorial political economy of water and sanitation sector reforms in Dhaka
Authors: Heidler Andri , Luies Sharmin Khan , Kamal Abul , Ul-Alam Mahbub , Lüthi Christoph , Crevoisier Olivier
Published: February 2023

Citywide inclusive sanitation (CWIS) is becoming the dominant paradigm for achieving safe sanitation for all by 2030. Its technical benefits have been explored, but the bargaining over financial and organizational changes CWIS entails have not yet been adequately addressed. Our case study explains the stalled rollout of CWIS in Dhaka, Bangladesh. We analyse policy pathways over the past 30 years through a combined territorial political economy and power perspective to understand their effects on equality. We highlight how donors link the introduction of CWIS to the organization of sanitation through a market; how the utility uses CWIS as an opportunity to avoid costly responsibilities in non-sewered sanitation; and how service co-production through community-based solutions is neglected. CWIS has successfully overcome the dogmatic technological focus in the sanitation system, but for citywide sanitation to be scaled inclusively, the dogmatic focus in the organization and financing of the sanitation sector must also be overcome.
Why do People Avoid Visiting Specialist Doctors? Answers from a Developing Country: Turkey Case
Authors: Sulku Seher Nur , Tokatlioglu Yagmur
Published: February 2023

Avoid seeking medical care deemed necessary has severe negative effects on health. Indeed, delayed presentation of patients puts a significant burden on healthcare costs. There is limited literature examining the avoidance behaviour of people. Our study explores the reasons for avoiding considering the Turkey case. TurkStat’s health research survey 2012 data is employed to examine why people avoid visiting the specialist doctor when needed to consult a specialist for healthcare service. Descriptive statistics analysis is conducted. It is seen that among 28,056 respondents 12.6% were avoiders. Compared to non-avoiders, avoiders were more likely to be female, to live in rural area, to make out-of-pocket health payments, to be illiterate and to have low income. Indeed, the avoiders were more likely to have worse perceived health, negative emotions, mental disorders, serious health problems and chronic diseases. It is found that for approximately one-third of avoiders’ the main reason for avoiding was high costs. 22% of the avoiders reported that they could not take time. The other avoiding reasons were organisational factors, fear of medical treatment/surgery, distance/transportation, late appointment dates, having nobody to accompany and non-supportive family/relatives. In Turkey, interventions combating healthcare avoidance behaviours in at-risk populations should be developed.
Effects of Electronic Cigarette Exposure on Myocardial Infarction and No-Reflow, and Cardiac Function in a Rat Model
Authors: Dai Wangde , Shi Jianru , Siddarth Prabha , Zhao Lifu , Carreno Juan , Kleinman Michael T. , Herman David A. , Arechavala Rebecca J. , Renusch Samantha , Hasen Irene , Ting Amanda , Kloner Robert A.
Published: February 2023

Purpose:

We investigated the effects of exposure to electronic cigarettes (E-cig) vapor on the sizes of the no-reflow and myocardial infarction regions, and cardiovascular function compared to exposure to purified air and standard cigarette smoke.

Methods and Results:

Sprague Dawley rats (both male and female, 6 weeks old) were successfully exposed to filtered air (n = 32), E-cig with nicotine (E-cig Nic+, n = 26), E-cig without nicotine (E-cig Nic−, n = 26), or standard cigarette smoke (1R6F reference, n = 31). All rats were exposed to inhalation exposure for 8 weeks, prior to being subjected to 30 minutes of left coronary artery occlusion followed by 3 hours of reperfusion. Exposure to E-cig vapor with or without nicotine or exposure to standard cigarettes did not increase myocardial infarct size or worsen the no-reflow phenomenon. Exposure to E-cig Nic+ reduced the body weight gain, and increased the LV weight normalized to body weight and LV wall thickness and enhanced the collagen deposition within the LV wall. E-cig exposure led to cardiovascular dysfunction, such as reductions in cardiac output, LV positive and negative dp/dt, suggesting a reduction in contractility and relaxation, and increased systemic arterial resistance after coronary artery occlusion and reperfusion in rats compared to air or cigarette exposure.

Conclusions:

E-cig exposure did not increase myocardial infarct size or worsen the no-reflow phenomenon, but induced deleterious changes in LV structure leading to cardiovascular dysfunction and increased systemic arterial resistance after coronary artery occlusion followed by reperfusion.
Application of Kirchhoff’s equations of motion to the dynamically coupled system of a rigid body with a completely-liquid-filled cavity
Authors: Shashikanth Banavara N
Published: February 2023

This paper considers the dynamical problem of a rigid body with a cavity that is completely filled by a liquid. The dynamically coupled motion of the rigid body and the liquid is examined in the absence of any external forces or torques. This problem is not new, but the paper draws attention to the fact that Kirchhoff’s equation of motion, which was derived for the dynamically coupled motion of a homogeneous rigid body fully immersed in a liquid, applies to this problem as well. The methodology is explained. Details of a simple, idealized planar example, in which a vorticity field in the form of a single point vortex is also added to the fluid flow field, are presented. In principle, this simple model could be extended to an elastodynamic model to study the dynamically coupled motion of an elastic body and a cavity completely filled with liquid in the framework of linear elasticity.
Associations Between Dimensional Persistence of ADHD and Adult Sleep Quality in a Prospective Study of Girls
Authors: Yang Chun-Chi , Hinshaw Stephen P.
Published: February 2023

Objectives:

We investigated the prospective association between (a) ADHD symptom dimensions, including their persistence and (b) adult sleep quality in a female sample, covarying adult depressive symptoms.

Methods:

Participants comprised four persistence groups (persisters, partials, desisters, and comparison) based on overall ADHD diagnosis and separate dimensions of inattention and hyperactivity/impulsivity (HI) in childhood, late adolescence, and early adulthood, featuring girls with ( n = 140) and without ( n = 88) carefully diagnosed ADHD.

Results:

Only persistence of inattention predicted lower adult sleep quality when covarying young-adult depression, which was also a significant predictor. When additionally covarying stimulant medication use in adulthood, inattention persistence lost significance, although depression maintained significance, with medication use predicting worse sleep quality.

Conclusions:

Persistence of inattentive (but not HI) symptoms was significantly related to adult sleep quality in the context of concurrent depression. Sleep quality is an important outcome for research on and treatment for ADHD.
Who endorses group-based violence?
Authors: Lindström Joanna , Bergh Robin , Akrami Nazar , Obaidi Milan , Lindholm Öymyr Torun
Published: February 2023

Collective action is often equated with progressive politics, but are there aspects of group mobilisations that generalise across contexts? We examine general social and personality psychological factors behind endorsement of group-based violence across different types of violent group mobilisation. Specifically, we focus on the endorsement of group-based violence amongst supporters of the Black Lives Matter (BLM) movement ( N = 394), an immigration-critical group ( N = 252), and soccer supporters ( N = 445). Across three preregistered studies, we tested an integrative model including personality and social psychological factors. Several effects were consistent across all three contexts, with group-based relative deprivation positively, and honesty-humility negatively, predicting support for violence. Further, amongst BLM supporters and the immigration-critical group, emotionality negatively predicted support for violence, violent intentions, and self-reported aggression/violence. Overall, our results suggest that individuals who endorse violence in different contexts have some psychological factors in common.
Effects of a Video Sequence Based Intervention on Anxiety, Fatigue and Depression in Cancer Patients: Results of a Randomized Controlled Trial
Authors: Neubert Sven , Schlecht Sina , Meng Karin , Rabe Antonia , Jentschke Elisabeth
Published: February 2023

Background:

Cancer patients often suffer from psychological symptoms and need psychological support. Especially during the COVID-19 pandemic, eHealth interventions might be helpful to overcome the obstacles of the pandemic. This study evaluates the effectiveness of a video sequence-based eHealth intervention on anxiety, fatigue, and depression in cancer patients.

Methods:

Patients (N = 157) with different tumor entities were randomly assigned to the video intervention group (IG) and the waiting control group (CG). Patients in the IG received a video intervention comprising 8 video sequences over 4 weeks. The videos included psychoeducation on distress and psychological symptoms, Acceptance and Commitment Therapy elements, and Yoga and Qigong exercises. Patients’ anxiety and fear of progression (primary outcomes) and secondary outcomes were assessed before randomization (T1) and after the end of the intervention for IG or the waiting period for CG (T2) using self-reported questionnaires (GAD-7, PA-F-KF, EORTC QLQ-FA12, PHQ-8).

Results:

Patients of the IG showed no significant improvement in anxiety (GAD-7; P = .75), fear of progression (FoP-Q-SF; P = .29), fatigue (EORTC QLQ-FA12; P = .72), and depression (PHQ-8; P = .95) compared to patients in the waiting CG. However, symptoms of anxiety, fatigue, and depression decreased in both groups. Exploratory subgroup analysis regarding sex, therapy status, therapy goal, and tumor entity showed no effects. Overall, the intervention had a high level of acceptance.

Conclusions:

The video intervention was ineffective in reducing the psychological burden compared to a waiting CG. The findings support prior observations of the value of therapeutic guidance and promoting self-management for improving patients’ psychological burdens. Further studies are required to evaluate the effectiveness of psycho-oncological eHealth delivered through video sequences.
Leading with DEI on my Mind: Examining the Interactive Effects of Supervisor Perceptions of Psychological Diversity Climate and Supervisor Characteristics on Leadership Style
Authors: Rice Darryl B. , Prosper Paul , Scott Catherine
Published: February 2023

Management researchers have recently shifted their focus to examine the effects of psychological diversity climate (PDC). Whereas the majority of this research has focused on front-line employees, we shift our attention to personnel in leadership positions to extend this literature. On the basis that PDC encourages the demonstration of fairness and discourages the demonstration of mistreatment, we rely on social information processing theory to explain why supervisor perceptions of PDC impact supervisory leadership style. Across three studies (one experiment and two multi-source field studies), we find that supervisor perceptions of PDC are positively related to employees’ evaluations of ethical leadership and negatively related to employees’ evaluations of abusive supervision. We also find that the impact of supervisor perceptions of PDC on ethical leadership and abusive supervisor is accentuated when supervisor negative affectivity is relatively high compared to relatively low. However, the impact of supervisor perceptions of PDC on ethical leadership and abusive supervision is attenuated when supervisor conscientiousness is relatively high compared to relatively low. In summary, our studies clarify why and when supervisor perceptions of PDC interact with supervisor characteristics to impact supervisory leadership style. Theoretical and practical implications are discussed.
Reconstructing the Turkish Jewish identity of Çanakkale between silence and speaking out: Nostalgia as an exit strategy
Authors: Cetin Önder
Published: February 2023

This article analyzes the discursive strategies of the Turkish Jewish community of Çanakkale to make sense of their troubled memories resulting in a mass emigration. Considering the emphasis on silence in the present literature on the memory practices of the Jewish community, I argue that they do not simply avoid facing the past but rather refer to nostalgia as a complementary, proactive strategy. My analysis is based on the memoirs and impressions of the individual members who took part in the annual visit to Çanakkale to highlight the role of nostalgia between silence and speaking out. The critical discourse analysis of the narratives published in the newsweekly Şalom reveals that nostalgia emerges as a silence-breaker. In addition to the constructive strategy of presenting the discourses of coexistence and good-neighborhood embodied in a distinctive local identity, they propose a strategy of dismantling the figures that challenge the former by de-ethnicizing them.
Pre-Peritoneal Dialysis Peritonitis After Saline Infusion Sonohysterogram in a Patient With an Embedded Catheter: A Case Report
Authors: Cosmatos Alexandre , McCormick Brendan , Blew Brian , Brown Pierre Antoine
Published: February 2023

Rationale:

Clear guidelines currently exist regarding antibiotic prophylaxis for patients on peritoneal dialysis (PD) prior to common diagnostic procedures. However, these guidelines do not include patients with subcutaneously embedded PD catheters who are awaiting PD initiation although both these populations share a great deal of risk factors for infections. Issues regarding antibiotic prophylaxis and avoidable infections are bound to keep occurring if physicians are not conscious of the risks of infections shared by all patients suffering from renal failure.

Presenting concerns:

Two weeks after a saline infusion sonohysterography (SIS), a 48-year-old woman with chronic kidney disease (CKD) G5 ND, type 2 diabetes, a subcutaneously embedded PD catheter, and prior abnormal uterine bleeding presented to the emergency department complaining of nausea, vomiting, diarrhea, weakness, and abdominal pain. The patient received no antibiotic prophylaxis prior to her SIS.

Diagnoses:

The final diagnosis of peritonitis was established after acute kidney injury, gastroenteritis, and small bowel obstruction were considered and ruled out. A delay in the final diagnosis occurred because of the complex presentation, the fact that the patient had not yet initiated PD, and the presence of concomitant anion gap metabolic acidosis and an acute elevation of the patient’s creatinine.

Interventions:

The patient was started on broad-spectrum intravenous antibiotics when the diagnosis of peritonitis was established. Insulin and intravenous bicarbonate infusions were used to correct the patient’s anion gap metabolic acidosis. Surgical debridement of the necrotic subcutaneous tissue and removal of the embedded PD catheter were necessary.

Outcomes:

The patient’s infection resolved completely as did her anion gap metabolic acidosis. The patient had to transfer permanently from PD to hemodialysis for her renal replacement therapy.

Teaching points:

This case report serves as a good reminder that physicians should keep in mind the possibility of peritonitis in patients with embedded PD catheters. As these patients are also at risk of infections, antibiotic prophylaxis should be used in patients with embedded catheters in the same way it is used for PD patients prior to obstetrical, gynecological, or gastrointestinal procedures.
Exploring the Spatiotemporal Heterogeneity and Stationarity in the Relationship between Street Vitality and Built Environment
Authors: Zhao Kai , Guo Jinhan , Ma Ziying , Wu Wanshu
Published: February 2023

Previous studies substantiate built environment influences street vitality. However, most of them focus on whether the built environmental elements have an influence on the street vitality, and ignore the spatiotemporal heterogeneity of the influences at the district scale. Using multisource big data, we comprehensively measure the street vitalities of different periods and the built environment in different dimensions on Xiamen Island. Geographically and temporally weighted regression (GTWR) models are constructed to systematically analyze the spatiotemporal heterogeneity of the influences of the built environment on the street vitality. Results show that the influence of function remains constant over time. Transit has the strongest effect on the improvement of street vitality during peak hours. The impact of design is strongest in the evening. The effect of accessibility gradually strengthened over time, reaching the highest in the evening. In terms of the spatial dimension, the heterogeneity brought about by the new and old urban areas is significant. The spatial heterogeneity of design’s influences is prominently brought about by large green lands and landscape streets. Density, bus station and spatial scale have strong temporal and spatial stability. Length is the most unstable during the weekdays. In order to maintain street vitality and form sustainable traffic, differentiated strategies of vitality enhancement should be formulated according to the locations and attributes of the streets.
Antenatal and Postnatal Diagnosis of Semilobar Holoprosencephaly: Two Case Reports
Authors: Meryem Benmoussa , Amine Naggar , Houssein Oukili , Siham El Haddad , Nazik Allali , Latifa Chat
Published: February 2023

Holoprosencephaly (HPE) is a rare birth defect that occurs during the first few weeks of pregnancy. It results from a disturbance in the usual signaling pathways required for separation of the embryonic prosencephalon into 2 separate cerebral hemispheres. Classically four subtypes have been recognized: alobar, semilobar, lobar, and middle interhemispheric holoprosencephaly. The cause of HPE is unknown but may include genetic disorders. In most cases of holoprosencephaly, the malformations are so severe that babies die before birth. In less severe cases, babies are born with normal or near-normal brain development and facial deformities that may affect the eyes, nose, and upper lip. We report 2 cases of semilobar holoprosencephaly, diagnosed in Children’s Hospital of Rabat: the first one was a fetus diagnosed by ultrasonogram at 25 weeks of gestation. The second one was a newborn at 15 days of life diagnosed by brain scan.
Biologic Therapies for Moderate to Severe Asthma in the Pediatric Population: A Practice Update
Authors: Tolomeo Concettina
Published: February 2023

Introduction

Asthma is a common childhood condition. Up until recent years, the mainstay of long-term control treatment has been inhaled corticosteroids. While inhaled corticosteroids are very effective for most children with asthma, with the introduction of biologic therapies, additional options now exist for children with uncontrolled moderate to severe asthma.

Purpose

The purpose of this Practice Update is to provide nursing professionals with a summary of the biologic therapies currently available for the pediatric population and, to describe when they are indicated for inclusion in the plan of care for children with moderate to severe asthma.

Conclusion

By properly diagnosing asthma, and, selecting and administering appropriate asthma therapies, nursing professionals can help children with moderate to severe asthma lead healthy and active lives.
Data quality considerations for evaluating COVID-19 treatments using real world data: learnings from the National COVID Cohort Collaborative (N3C)
Authors: Sidky Hythem , Young Jessica C. , Girvin Andrew T. , Lee Eileen , Shao Yu Raymond , Hotaling Nathan , Michael Sam , Wilkins Kenneth J. , Setoguchi Soko , Funk Michele Jonsson ,   The N3C Consortium, Alexander G. Caleb , Bates Benjamin , Chute Christopher G. , Dahlin Jayme L. , Gersing Ken , Haendel Melissa A. , Mehta Hemalkumar B. , Pfaff Emily R. , Sahner David
Published: February 2023

Background

Multi-institution electronic health records (EHR) are a rich source of real world data (RWD) for generating real world evidence (RWE) regarding the utilization, benefits and harms of medical interventions. They provide access to clinical data from large pooled patient populations in addition to laboratory measurements unavailable in insurance claims-based data. However, secondary use of these data for research requires specialized knowledge and careful evaluation of data quality and completeness. We discuss data quality assessments undertaken during the conduct of prep-to-research, focusing on the investigation of treatment safety and effectiveness.

Methods

Using the National COVID Cohort Collaborative (N3C) enclave, we defined a patient population using criteria typical in non-interventional inpatient drug effectiveness studies. We present the challenges encountered when constructing this dataset, beginning with an examination of data quality across data partners. We then discuss the methods and best practices used to operationalize several important study elements: exposure to treatment, baseline health comorbidities, and key outcomes of interest.

Results

We share our experiences and lessons learned when working with heterogeneous EHR data from over 65 healthcare institutions and 4 common data models. We discuss six key areas of data variability and quality. (1) The specific EHR data elements captured from a site can vary depending on source data model and practice. (2) Data missingness remains a significant issue. (3) Drug exposures can be recorded at different levels and may not contain route of administration or dosage information. (4) Reconstruction of continuous drug exposure intervals may not always be possible. (5) EHR discontinuity is a major concern for capturing history of prior treatment and comorbidities. Lastly, (6) access to EHR data alone limits the potential outcomes which can be used in studies.

Conclusions

The creation of large scale centralized multi-site EHR databases such as N3C enables a wide range of research aimed at better understanding treatments and health impacts of many conditions including COVID-19. As with all observational research, it is important that research teams engage with appropriate domain experts to understand the data in order to define research questions that are both clinically important and feasible to address using these real world data.
Experiences with long-term care for geriatric patients by an interprofessional outpatient care approach – a qualitative study
Authors: Wilfling Denise , Budke Jona , Warkentin Nicole , Goetz Katja
Published: February 2023

Background

Outpatient care for geriatric patients is complex and requires the collaboration of different professions for supporting long-term care. Care and case management (CCM) could provide support with that. The long-term care of geriatric patients could be optimized with an interprofessional, cross-sectoral CCM. Therefore, the aim of the study was to evaluate the experiences and attitudes of those involved in the care with regard to the interprofessional design of the care for geriatric patients.

Methods

A qualitative study design was used. Focus group interviews were conducted with those involved in the care (general practitioners (GP), health care assistants (HCA) as well as care and case managers (CM)). The interviews were digitally recorded, transcribed and analysed by qualitative content analysis.

Results

Overall, ten focus groups were conducted in the five practice networks with n = 46 participants (n = 15 GP, n = 14 HCA and n = 17 CM). The participants evaluated the care they received from a CCM positively. The HCA and the GP were the primary points of contact for the CM. The close collaboration with the CM was experienced to be rewarding and relieving. Through their home-visitations, the CM gained a deep insight into the homelives of their patients and were thus able to accurately reflect the gaps in the care back to the family physicians.

Conclusions

The different health care professionals involved in this type of care experience that an interprofessional and cross-sectoral CCM is able to optimally support the long-term care of geriatric patients. The different occupational groups involved in the care benefit from this type of care arrangement as well.
Risk of low birthweight associated with the timing and frequency of antenatal care visits in Lao PDR: a retrospective cohort study
Authors: Nagatani Shiori , Horiuchi Sayaka , Takahashi Kenzo , Matsuura Masaaki , Ounchit Kongsit , Yamaoka Kazue
Published: February 2023

Background

Antenatal care (ANC) plays an important role in preventing low birthweight (LBW). Whereas the government of Lao People’s Democratic Republic (Lao PDR) has committed to increasing the usage of ANC, little attention has been given to the early initiation of ANC. The present study assessed the influence of delayed and fewer ANC visits on LBW in the country.

Methods

This is a retrospective cohort study conducted at Salavan Provincial Hospital. Study participants were all pregnant women who gave birth at the hospital between 1 August 2016 and 31 July 31 2017. Data were collected from medical records. Logistic regression analyses were performed to quantify the relationship between ANC visits and LBW. We also investigated factors associated with inadequate ANC visits: first ANC visit after the first trimester or < 4 ANC visits.

Results

The mean birth weight was 2808.7 g [standard deviation: SD 455.6]. Among 1804 participants, 350 (19.4%) had babies with LBW, and 147 (8.2%) had inadequate ANC visits. In multivariate analyses, compared to participants with adequate ANC visits, those with ≥ 4 ANC visits and the first ANC visit after the second trimester, those with < 4 ANC visits, and those with no ANC visits had higher odds ratios (ORs) of LBW: 3.77 (95% confidence interval: CI = 1.66–8.57), 2.39 (95% CI = 1.18–4.83) and 2.22 (95% CI = 1.08–4.56), respectively. Younger maternal age (OR 1.42; 95% CI = 1.07–1.89), government subsidisation (OR 2.69; 95% CI = 1.97–3.68) and ethnic minority (OR 1.88; 95% CI = 1.50–2.34) were associated with increased risk of insufficient number of ANC visits after adjusting for covariates.

Conclusions

Frequent and early initiation of ANC was associated with a reduction in LBW in Lao PDR. Encouraging childbearing-aged women to receive sufficient ANC at proper timing may lead to a reduction in LBW and improvement in short- and long-term health outcomes of neonates. Special attention will be needed for ethnic minorities and women in lower socioeconomic classes.
Acceptability and preliminary effectiveness of a single-arm 12-week digital behavioral health intervention in patients with knee osteoarthritis
Authors: Godziuk Kristine , Prado Carla M. , Quintanilha Maira , Forhan Mary
Published: February 2023

Background

Digital health interventions may improve osteoarthritis (OA) management. This study evaluated the acceptability and preliminary effectiveness of a multimodal digital nutrition, exercise, and mindfulness intervention in adults with knee OA.

Methods

Adults with advanced knee OA and an orthopaedic referral were invited to self-enroll in a pragmatic 12-week single-arm intervention. OA-focused nutrition and exercise resources were delivered weekly by email, and secondary components accessed on-demand (web-platform, webinars, and nutrition consultation). Acceptability was assessed by qualitative interview data and completion rates. Preliminary effectiveness on clinical outcomes was assessed by change in health-related quality of life, well-being, mindfulness, self-efficacy, and interest in total knee arthroplasty (TKA) between baseline and 12-weeks.

Results

N = 102 patients self-enrolled (73.5% female, age 64 ± 7 years, body mass index 32.9 ± 7.3 kg/m2); n = 53 completed the 12-week intervention (71.7% female, age 65 ± 7 years, body mass index 33.4 ± 6.3 kg/m2). Acceptability was demonstrated by positive perceptions of tailored intervention resources. In study completers, health-related quality of life components of pain and physical functioning domains improved at 12-weeks [change in SF36 4.4 (95%CI 0.2–8.6), p = 0.016, and 6.7 (95%CI 2.7–10.7), p < 0.001, respectively]. Self-efficacy for managing daily activities improved [change in PROMIS T-score 4.4 (95%CI 2.8–6.0), p < 0.001].

Conclusion

A 12-week digital multimodal intervention for knee OA was acceptable to patients and shows preliminary effectiveness in improving self-efficacy, aspects of quality of life, and decreasing interest in TKA. Digital behavioral interventions for knee OA may be an acceptable approach to improve patient outcomes and OA self-management while potentially reducing utilization of costly health system resources.
Comparative evaluation of prevention of demineralization of artificial enamel caries treated with two fluoride varnishes and 38% SDF in primary teeth: an in vitro study
Authors: Mashhour Alshaimaa , Allam Gehan , Wassel Mariem
Published: February 2023

Background

This study aimed to compare the effect of Clinpro™ White varnish containing 5% sodium fluoride (NaF) and functionalized tricalcium phosphate, MI varnish containing 5% NaF and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and 38% Silver diamine fluoride (SDF) in preventing demineralization of treated white spot lesions (WSLs) in enamel of primary teeth.

Methods

Forty-eight primary molars with artificial WSLs were allocated into four groups as follows: Group 1: Clinpro white varnish, Group 2: MI varnish, Group 3: SDF, and Group 4: control (no treatment). The three surface treatments were applied for 24 h and then enamel specimens were subjected to pH cycling. Thereafter, the mineral content of specimens was evaluated by Energy Dispersive X-ray Spectrometer and the lesion depth was assessed via Polarized Light Microscope. One-way ANOVA followed by Tukey’s post hoc test were used at p ≤ 0.05 to identify significant differences.

Results

Insignificant difference in mineral content was observed among treatment groups. Treatment groups exhibited significantly higher mineral content compared to control except for Fluoride (F). MI varnish showed the highest mean calcium (Ca) ion content (66.57 ± 0.63), and Ca/P (2.19 ± 0.11), followed by Clinpro white varnish, and SDF. MI varnish also displayed the highest phosphate (P) ion content (31.46 ± 0.56), followed by SDF (30.93 ± 1.02), and Clinpro white varnish (30.53 ± 2.19). Fluoride content was highest in SDF (0.93 ± 1.18), followed by MI (0.89 ± 0.34) and Clinpro (0.66 ± 0.68) varnishes. Significant difference in lesion depth was observed among all groups (p < 0.001). The lowest mean lesion depth (µm) was found in MI varnish (226.23 ± 44.25) which was significantly lower than Clinpro white varnish (285.43 ± 44.70), SDF (293.32 ± 46.82), and control (576.69 ± 42.66). Insignificant difference in lesion depth was found between SDF and Clinpro varnish.

Conclusions

In primary teeth, WSLs treated with MI varnish displayed better resistance to demineralization compared to WSLs treated with Clinpro white varnish and SDF.
Matters arising: methodological issues on evaluating agreement between medical students’ attitudes towards drugs/alcohol use during pregnancy by Cohen’s kappa analysis
Authors: Yu Tianfei , Yang Lei , Jiang Xinjie , Shao Shuli , Sha Wei , Li Ming
Published: February 2023

Background

The purpose of this article is to discuss the statistical methods for agreement analysis used in Richelle’s article (BMC Med Educ 22:335, 2022). The authors investigated the attitudes of final-year medical students regarding substance use during pregnancy and identified the factors that influence these attitudes.

Methods

We found that Cohen’s kappa value for measuring the agreement between these medical students’ attitudes towards drugs/alcohol use during pregnancy was questionable. In addition, we recommend using weighted kappa instead of Cohen’s kappa for agreement analysis at the presence of three categories.

Results

The agreement improved from “good” (Cohen’s kappa) to “very good” (weighted kappa) for medical students’ attitudes towards drugs/alcohol use during pregnancy.

Conclusion

To conclude, we recognize that this does not significantly alter the conclusions of the Richelle et al. paper, but it is necessary to ensure that the appropriate statistical tools are used.
Stress responses in high-fidelity simulation and standard simulation training among medical students
Authors: Barbadoro Pamela , Brunzini Agnese , Dolcini Jacopo , Formenti Luca , Luciani Aurora , Messi Daniele , Papetti Alessandra , Ponzio Elisa , Germani Michele ,   Starlab Working Collaborative Group, Arsego Daniele , Bianchi Elena , De Angelis Rossella , Del Bene Luca , Landi Rosaria , Mandorli Ferruccio , Marcone Maria Rosaria , Micheletti Rebecca , Paolucci Guido , Pesaresi Mauro , Santarelli Andrea , Adrario Erica
Published: February 2023

Background

Simulation has been recognized as a shift in healthcare education that can improve skills and patient safety and outcomes. High-fidelity simulation of critical medical situations can be a source of stress among participants that can interfere with students' abilities leading to unexpected emotional responses. The aim of this study is to determine if two simulation methods, high-fidelity (HF) and procedural simulation (PS), may be associated with stress responses at a self-perceived and biological level (salivary cortisol variations), and to compare stress levels of the two different simulation method. We also wanted to find independent variables associated with cortisol total hormonal output.

Methods

A quasi-experimental before-after study was used including the administration of questionnaires, and biomarkers evaluation by salivary cortisol samples before and after simulation. A total of 148 students were eligible and agreed to participate in the study. We used paired T-test for mean comparison regarding State-trait anxiety for both HF and PT simulations. For NASA-TLX we performed a T-test mean comparison between groups. We used paired T-test mean comparison for cortisol analysis. Multivariable linear regression has been used to assess variables associated with AUCg values and perceived stress.

Results

values of STAI-Y scores were relatively higher at the end of the HF and PS sessions. NASA-TLX was significantly higher at baseline for the HF simulations, with respect to the PS simulation. Cortisol fold increase was significantly different in the two groups. Linear regression showed that cortisol AUCg was related to the STAI-Y score in both groups.

Conclusion

Participating students developed a stress response both after in the HF and PS training, testified by psychological and biological outputs. According to our results, stress levels were increased for simply being in a simulation scenario than to the intrinsic complexity of the task required. More studies are needed to confirm this trend and to clarify the role of simulated stress response in a long-term learning scenario.
Early-life residential green spaces and traffic exposure in association with young adult body composition: a longitudinal birth cohort study of twins
Authors: Figaroa M. N. S. , Gielen M. , Casas L. , Loos R. J. F. , Derom C. , Weyers S. , Nawrot T. S. , Zeegers M. P. , Bijnens E. M.
Published: February 2023

Background

Globally, the rapid increase of obesity is reaching alarming proportions. A new approach to reduce obesity and its comorbidities involves tackling the built environment. Environmental influences seem to play an important role, but the environmental influences in early life on adult body composition have not been thoroughly investigated. This study seeks to fill the research gap by examining early-life exposure to residential green spaces and traffic exposure in association with body composition among a population of young adult twins.

Methods

As part of the East Flanders Prospective Twin Survey (EFPTS) cohort, this study included 332 twins. Residential addresses of the mothers at time of birth of the twins were geocoded to determine residential green spaces and traffic exposure. To capture body composition, body mass index, waist-to-hip ratio (WHR), waist circumference, skinfold thickness, leptin levels, and fat percentage were measured at adult age. Linear mixed modelling analyses were conducted to investigate early-life environmental exposures in association with body composition, while accounting for potential confounders. In addition, moderator effects of zygosity/chorionicity, sex and socio-economic status were tested.

Results

Each interquartile range (IQR) increase in distance to highway was found associated with an increase of 1.2% in WHR (95%CI 0.2–2.2%). For landcover of green spaces, each IQR increase was associated with 0.8% increase in WHR (95%CI 0.4–1.3%), 1.4% increase in waist circumference (95%CI 0.5–2.2%), and 2.3% increase in body fat (95%CI 0.2–4.4%). Stratified analyses by zygosity/chorionicity type indicated that in monozygotic monochorionic twins, each IQR increase in land cover of green spaces was associated with 1.3% increase in WHR (95%CI 0.5–2.1%). In monozygotic dichorionic twins, each IQR increase in land cover of green spaces was associated with 1.4% increase in waist-circumference (95%CI 0.6–2.2%).

Conclusions

The built environment in which mothers reside during pregnancy might play a role on body composition among young adult twins. Our study revealed that based on zygosity/chorionicity type differential effects of prenatal exposure to green spaces on body composition at adult age might exist.
High rate of postoperative upstaging of ductal carcinoma in situ when prioritizing ultrasound evaluation of mammography-detected lesions: a single-center retrospective cohort study
Authors: Hsieh Yung-Chun , Lo Chiao , Lee Yi-Hsuan , Chien Ning , Lu Tzu-Pin , Tsai Li-Wei , Wang Ming-Yang , Kuo Wen-Hung , Chang Yeun-Chung , Huang Chiun-Sheng
Published: February 2023

Background

The initial diagnosis of ductal carcinoma in situ (DCIS) can be upstaged to invasive cancer after definitive surgery. This study aimed to identify risk factors for DCIS upstaging using routine breast ultrasonography and mammography (MG) and to propose a prediction model.

Methods

In this single-center retrospective study, patients initially diagnosed with DCIS (January 2016–December 2017) were enrolled (final sample size = 272 lesions). Diagnostic modalities included ultrasound-guided core needle biopsy (US-CNB), MG-guided vacuum-assisted breast biopsy, and wire-localized surgical biopsy. Breast ultrasonography was routinely performed for all patients. US-CNB was prioritized for lesions visible on ultrasound. Lesions initially diagnosed as DCIS on biopsy with a final diagnosis of invasive cancer at definitive surgery were defined as “upstaged.”

Results

The postoperative upstaging rates were 70.5%, 9.7%, and 4.8% in the US-CNB, MG-guided vacuum-assisted breast biopsy, and wire-localized surgical biopsy groups, respectively. US-CNB, ultrasonographic lesion size, and high-grade DCIS were independent predictive factors for postoperative upstaging, which were used to construct a logistic regression model. Receiver operating characteristic analysis showed good internal validation (area under the curve = 0.88).

Conclusions

Supplemental screening breast ultrasonography possibly contributes to lesion stratification. The low upstaging rate for ultrasound-invisible DCIS diagnosed by MG-guided procedures suggests that it is unnecessary to perform sentinel lymph node biopsy for lesions invisible on ultrasound. Case-by-case evaluation of DCIS detected by US-CNB can help surgeons determine if repeating biopsy with vacuum-assisted breast biopsy is necessary or if sentinel lymph node biopsy should accompany breast-preserving surgery.

Trial registration

This single-center retrospective cohort study was conducted with the approval of the institutional review board of our hospital (approval number 201610005RIND). As this was a retrospective review of clinical data, it was not registered prospectively.