bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating Feasibility and Acceptance of a Mobile Clinical Decision Support System in Botswana
Authors: Ndlovu Kagiso , Stein Nate , Gaopelo Ruth , Annechino Mike , Molwantwa Mmoloki , Monkge Mosadikhumo , Forrestel Amy , Williams Victoria L
Published: April 2022

Background
The health workforce in Botswana consists mainly of medical officers and primary care nurses working in remote areas with limited training and insufficient reference materials to support diagnosis and management of diseases in dermatology and other subspecialties. This suggests a need for clinical decision support tools for these healthcare providers. VisualDx, a well-established mobile clinical decision support system, offers a promising solution with documented benefits. However, implementation of eHealth systems is commonly associated with challenges. To inform sustainable implementation of VisualDx in Botswana, it is important to evaluate intended users’ perceptions of the technology. This study aims to determine healthcare workers acceptance of VisualDx to gauge feasibility of future adoption in Botswana and other similar healthcare systems.
Methods
The study's design was informed by constructs of the technology acceptance model. A convergent mixed methods feasibility study involving surveys and semi-structured interviews was conducted. The Research Electronic Data Capture (REDCap) platform supported online data capture from March 2021 through August 2021. Twenty eight healthcare workers across Botswana participated in the study and their usage data was tracked over time. Descriptive statistics were generated and analyzed using Excel and REDCap. Thematic analysis of interview transcripts was performed using Delve.
Results
All initial survey participants (n = 28) expressed interest in using mHealth technology to support their daily work. Prior to VisualDx access, participants referenced textbooks, journal articles, and Google search engines among others. Overall, participants' survey responses showed their confidence in the VisualDx platform (94.7%); however, some barriers were noted. Frequently used features included generating a differential diagnosis through manual entry of patient symptoms (48.5%) or using the artificial intelligence feature (22.0%). Seventeen (60.7%) participated in virtual interview sessions at different times and ultimately 4 themes (governance, infrastructure, human resource capacity development and usability) were derived.
Conclusions
Participants' responses indicated acceptance of the VisualDx platform. The ability to access information quickly without internet connection is crucial in resource constrained environments. Select enhancements to VisualDx may further increase the feasibility of a national roll-out in Botswana, improving acceptance and successful adoption of the platform by general practitioners needing decision support for dermatology and other subspecialties.
Infection of the malaria vector Anopheles coluzzii with the entomopathogenic bacteria Chromobacterium sp. Burkina (C.sp_B) highly reduces larval survival and adult reproductive potentials
Authors: Gnambani Edounou Jacques , Bilgo Etienne , Dabiré Roch K. , Gaston Adrien Marie , Diabaté Abdoulaye
Published: April 2022

BackgroundAdditional vector control tools are urgently needed to control malaria transmission in Africa. A native strain of Chromobacterium sp. from Burkina Faso (C.sp_B) was recently characterized. In bioassays, this bacterium showed a promising virulence and against adult mosquitoes and reduces their blood feeding propensity and fecundity. The current study aimed to assess entomopathogenic effects of C.sp_B on larval stages of mosquitoes, its impacts on infected mosquitoes reproductive capacity and their offsprings.MethodsThree different types of bioassays were performed in laboratory. The first bioassay aimed to evaluate the impact of C.sp_B infection on mosquito larvae survival using different bacterial concentrations. The second bioassay wanted to access the effect of C.sp_B infection on female insemination rates. The third bioassay investigated the impact of a non-lethal exposure of C.sp_B to parent mosquitoes on the body size of its offsprings. During bioassays mosquitoes were infected through the well-established systems of larvicidal procedure and through cotton ball soaked with 6% glucose containing. ResultsBurkina Faso native strain of Chromobacterium sp (C.sp_B). killed larvae of the pyrethroid resistant Anopheles coluzzii with LT80 of ~0.60 ± 0.03 days at 108 CFU/ml at larval breeding trays. Interestingly, this bacterium had important effects on mosquito reproductive success by reducing the insemination rate of uninfected females from 95 ±1.99 % to 21 ±3.76 % for the infected females. Moreover, C.sp_B considerably reduced the wing size of offspring from infected parents compared to uninfected parents. Within females, the wing size was 2104.157 ± 20.89 mm and 2547.569 ± 17.08 mm for offspring from C.sp_B. infected females and uninfected females respectively. For males the size of wings were respectively, 1991.059 ± 14.98 mm and 2436.220 ± 13.52 mm for offspring from C.sp_B infected males and uninfected males respectivelyConclusionThis study showed that the Burkina Faso Chromobacterium sp strain (C.sp_B) was highly virulent against larvae of insecticide-resistant An. coluzzii, and reduced both mosquito reproduction capacity and offspring fitness. However, additional lab, field, safety and social acceptance studies are needed to withdraw more conclusions about the practical utility of this promising bacterial strain for malaria vector control.
Short-term outcomes of anterior cruciate ligament tibial insertion avulsion fractures treated with a single tunnel using a double-strand suture anchor under arthroscopy: a single-center retrospective study
Authors: Guo Dan , Hu Hansheng
Published: April 2022

Background
Anterior cruciate ligament (ACL) tibial insertion avulsion fractures cause instability of the knee joint, and minimally invasive techniques are the first choice for treating this type of intra-articular injury. The aim of this study was to investigate the clinical effect of a minimally invasive technique which treated ACL tibial insertion avulsion fractures under arthroscopy by a single tunnel with a double-strand suture anchor.
Methods
A retrospective analysis was performed on 29 patients with ACL tibial insertion avulsion fractures treated with this minimally invasive technique from January 2014 to June 2018. All patients were followed up for 12 months. X-ray were taken intermittently to determine fracture reduction and healing. During the follow-up period, CT and MRI were performed to evaluate reduction and healing. The Lachman test and ADT were performed by the same doctor to determine knee joint stability. The IKDC subjective score were used to evaluate postoperative knee function recovery
Results
All patients healed well without infection、fracture nonunion and instability. The preoperative IKDC subjective score was 51.24 ± 3.16; the IKDC subjective score at the last follow-up was 92.93 ± 2.59 (P < 0.05).
Conclusions
Within the limitations of this study, a single tunnel with a double-strand suture anchor under arthroscopy for the treatment of ACL tibial insertion avulsion fracture was a simple procedure. The procedure caused minimal trauma,had firm fixation, ensured quick recovery and provided satisfactory clinical results.
Mesophilic-thermophilic temperature-phased microbial aerobic biodegradation of food waste: feasibility study for rapid in-situ disposal strategy
Authors: Ke Xia , Ying Jiamin , Li Yixin , Yu Huan , Sun Jiacheng , Xue Yaping , Zheng Yuguo
Published: April 2022

Effective treatment of food waste (FW) is inherently difficult due to heterogeneous composition, high moisture content, and low heating value. Herein, a feasible FW disposal system via microbial biodegradation from vessel to pilot scale was developed. Facilitated by a novel microbial consortium of Bacillus amyloliquefaciens, Bacillus subtilis, and Aspergillus niger, the total solid removal was improved by 3.4-folds (46.6%) compared with negative control. To couple with bacterial growth and biodegradation related enzyme activity and reduce the electrical energy consumption, a mesophilic-thermophilic temperature-phased aerobic digestion processing was performed in a 40 L self-designed biodegradation tank via daily fed-batch mode, and up to 62.88% of protein, 62.22% of starch and 37.75% of waste oil was respectively decomposed, achieving a total mass reduction of 82.15%. Characterization of the final by-product confirmed its potential to be recycled into resources as organic fertilizers or biosolid fuel. The proposed microbial consortium agent and decentralized mass reduction strategy presented in this study offers practical and environmental approaches for FW management in urban areas.
Seismic Analysis and Experimental Validation for the Column-supported Concrete Group Silos Structure
Authors: xu qikeng , Ding Yonggang , Chen Jia , Liu Qiang
Published: April 2022

At present, codes of practice rely on the single-silo seismic calculation to assess the seismic performance of the column-supported concrete group silos structure (CSCGSS). It is unreasonable proved by the work given in this paper. To more accurately calculate the earthquake action of a CSCGSS, the dynamic model of the overall structure considering the effect of dynamical coupling between different single silo in group silos is established for the first time. More in detail, based on linear elastic theory and multiple-degrees of freedom system motion, the model is used to analyze the base shear of CSCGSS with different storage mass conditions. Moreover, the computational model and the finite model are validated as reasonable through a shaking table test. Finally, the traditional vibration displacement superposition method for the single silo is updated to calculate the seismic action of the CSCGSS by defining the base shear force distribution coefficient to reflect the dynamical coupling effect in group silos. The results show that the frequency of CSCGSS decreases with the increasing quality of the stored material. Compared with the independent single silo, the base shear of group silos is uniformly distributed to different single silos under earthquake, but its value is not a simple superposition composed of the single silo. The base shear distribution coefficient acquired in the case of the empty, half, and full condition is tabulated and so a simplified calculation method is provided for engineers with a simple and accurate tool to estimate the seismic capacity of CSCGSS.
Effect of Pre-operative Carbohydrate Loading in Femur Fracture: A Randomized Controlled Trial
Authors: Chaudhary Narendra Kumar , Sunuwar Dev Ram , Sharma Rachit , Karki Mandeep , Timilsena Mukti Nath , Gurung Anita , Badgami Sunil , Singh Devendra Raj , Karki Prabesh , Bhandari Kailash Kumar
Published: April 2022

BackgroundFemur fracture exhibits a major clinical burden among the elderly people, leading patients to be bedridden for a long time in the hospital. The body is more likely to be in a catabolic state as a result of the prolonged fasting period required for surgery, prominent to an increase in insulin resistance. Pre-operative carbohydrate loading has been shown to improve postoperative outcomes in several countries, however no studies on this topic have yet been reported in Nepal. The aim of the study was to evaluate the effect of pre-operative carbohydrate loading in femur fracture surgery.MethodsThis study was a hospital-based, open-label, two-armed, randomized controlled trial. A total of 66 participants were included in this study and assigned to control group (n = 33) and study group (n = 33). Participants aged 50 years and above were recruited randomly through computer-generated random number between August 2020 and November 2021. Those who underwent femur fracture surgery were enrolled in this study. The pre-operative nutritional status was identified and the post-operative outcomes were measured using the Visual Analogue Score (VAS), Cumulative Ambulatory Score (CAS), and Modified Barthel Index (MBI) score system. Statistical analysis were performed using the Chi-square test and independent t-test to compare between the outcomes between two groups.ResultsAll the participants completed the study. The effect of carbohydrate loading showed a significant reduction in the post-operative pain in the study group than that of the control group (4.1 ± 1.8 versus 6.1 ± 2.1, p = 0.010) and higher functional mobility (8.1 ± 2.6 versus 6.8 ± 2.8, p = 0.033). The hospital stay in the study group was also shorter than in the control group (6.7 ± 2.4 versus 8.8 ± 4.5, p = 0.024).ConclusionsThe uptake of carbohydrate loading showed reduced post-operative pain, enhanced functional mobility, and decreased length of hospital stay. This study warrants a revision of current guidelines, which shed more light on the necessity of the provision of pre-operative carbohydrate loading in a clinical setting.Trial registration: ClinicalTrials.gov identifier: NCT04838366. Registered 9 April, 2021, https://clinicaltrials.gov/ct2/show/NCT04838366
How Has Urban Community Led Total Sanitation (U-CLTS) Affected Open Defecation in Urban Communities in the Tamale Metropolis
Authors: mumin alhassan abdul
Published: April 2022

The study assessed the impact of Urban Community-Led Total Sanitation (U-CLTS) on open defecation in Tamale Metropolis. The objectives of the study were to assess frequency and reasons for open defecation and to assess the factors that influence the implementation of community-led total sanitation in the Tamale Metropolis. The study obtained data from 398 landlords and interviewed some officers of Civil Society Organisations (CSOs) and United Nations International Children Education Fund (UNICEF), some Opinion Leaders and Landlords. The study used structural equation model to determine the factors that influence implementation of U-CLTS at each stage. T-test was also used to determine the effect of U-CLTS programme on open defecation. Interview responses were also transcribed to complement the inferential analysis. The findings indicated that reasons for frequent open defecation before CLTS include poor maintenance of public and private latrines, financial hardship and social norms problems. The study also found that CLTS has significantly reduced open defecation in the Tamale Metropolis. Policy environment, community participation and implementation quality significantly affected effective implementation of U-CLTS. The study recommends that CLTS should be scaled-up in other communities where open defection is rampant.
Hospital nursing factors associated with decreased odds of mortality in older adult Medicare surgical patients with depression
Authors: KUMAR APARNA , Sloane Douglas , Aiken Linda , McHugh Matthew
Published: April 2022

Background: Depression is common, costly, and has deleterious effects in older adult surgical patients. Little research exists examining older adult surgical patient outcomes and depression and the potential for nursing factors to affect these outcomes. The purpose of this study was to determine the relationship between hospital nursing resources, 30-day mortality; and the impact of depression on this relationship. Results: Every added patient per nurse was associated with a 4% increase in the risk-adjusted odds of mortality in patients with depression (p<0.05). Among all patients, every 10% increase in the proportion of bachelor’s prepared nurses was associated with a 4% decrease in the odds of mortality (p<0.001) and a one standard deviation increase in the work environment was associated with a 5% decrease in the odds of mortality (p<0.05). Conclusions: For older adult patients hospitalized for surgery, the risk of mortality is associated with higher patient to nurse ratio, lower proportion of BSN prepared nurses in the hospital, and worse hospital work environment. Addressing the mental health care needs of older adults in the general care hospital setting is critical to ensuring positive outcomes after surgery. Hospital protocols to lower the risk of surgical mortality in older adults with and without depression could include improving nurse resources.
Effects of field-grown transgenic Cry1Ah1 poplar on the rhizosphere microbiome
Authors: Wei Hui Wei , Movahedi Ali , Liu Guoyuan , Kiani-Pouya Ali , Rasouli Fatemeh , Yu Chunmei , Chen Yanhong , Zhong Fei , Zhang Jian
Published: April 2022

Populus is a genus of globally significant plantation trees used widely in industrial and agricultural production. Poplars are easily damaged by Micromelalopha troglodyta and Hyphantria cunea , resulting in decreasing quality. Because of their strong insect resistance, Bt toxin-encoded Cry genes have been widely adopted in poplar breeding. Therefore, the potential adverse effects of Cry1Ah1- modified (CM) poplars on the ecological environment have been concerned. The Illumina novaseq platform was used to perform high-throughput sequencing . Alpha diversity analyses were performed using the Chao1 index to determine community richness, and the Shannon index analyses were used to determine community richness and evenness. Our analysis of rhizosphere soil chemistry patterns revealed that rhizosphere soil available phosphorus, rhizosphere microbial biomass nitrogen, and rhizosphere phosphorus levels were declined. In contrast, rhizosphere microbial biomass carbon level increased in CM poplar rhizosphere samples. We applied metagenomic sequencing of non-transgenic (NT) and CM poplar rhizosphere samples collected from a natural field; the predominant taxa included Proteobacteria, Acidobacteria, and Actinobacteria. Together, these results showed that the Cry1Ah1 expression has no significant influences on the community composition of rhizosphere microbiomes . Also, the Cry1Ah1 expression in poplars has no notable effects on the relative abundances of most rhizosphere bacteria . In addition, there are no significant adverse effects of CM varieties on most rhizosphere fungal abundances. However, only a few rhizosphere fungal abundances differ in NT and CM varieties.
Weight Loss Severity and Functional Decline Among The Oldest Old in a Middle-Income Country: The Fibra Study Longitudinal Findings
Authors: Corona Ligiana Pires , Andrade Flavia C. D. , Borim Flavia S. A. , Aprahamian Ivan , Fattori André , Cesari Matteo , Neri Anita L. , Yassuda Mônica Sanches
Published: April 2022

Background and objective: Nutritional status is a key modifiable risk factor associated with disability, and further evidence suggests that weight change is also linked to this adverse outcome. Thus, the aim of this study is to evaluate weight loss severity and functional decline in instrumental activities of daily living (IADL) in a seven-year period among a sample of Brazilian oldest old adults. Methods: This is a longitudinal prospective study using data from FIBRA study (Frailty in Older Brazilians), a population-based investigation carried out in 2008/2009, with follow up data collected in 2016/2017 from participants who were 80 years and older in the follow-up in Campinas, Brazil. Of the 167 participants who were interviewed with complete data in 2016-2017, 16 had improved their functional status and were excluded, so the final sample was restricted to 151 participants who maintained or declined functional status. We considered functional decline when a subject had a greater number of IADL dependencies at follow‐up than at baseline. Logistic regression was performed to assess the effect of weight loss, according to severity (moderate weight loss: 5-10% of body weight; severe weight loss >10%) in increasing the number of disabilities, in relation to the group with stable weight, controlling for covariates (gender, age, education and morbidity). An alpha level <5% was adopted. Results: During the follow-up period, 60.3% of the participants kept stable weight, 21.8% had moderate weight loss and 17.9% had severe weight loss. During the follow-up, only severe weight loss was associated to higher risk of functional decline (OR=2.74;p=0.032). Conclusions: weight loss consisted in a risk factor to functional decline in this sample of oldest old, but severity of the loss must be considered as only severe loss was significant. Given that weight loss is expected for the oldest old, it is important to quantify this loss and measure its severity, and also to identify the magnitude of the loss that is associated with functional decline.
Analysis of the Structure, Conduct and Performance of the Chrysanthemum Flower Market in Pasuruan Regency (Study Case in Tutur Village)
Authors: Sulaiman Zakia , Anindita Ratya , Muhaimin Abdul
Published: April 2022

With a total FOB value of $792,698, chrysanthemums had a strong export performance in the previous four years (2014–2018). This demonstrates that chrysanthemums are very competitive in the global market (Balithi, 2019). When comparing the land area in 2018 to the previous year, 2017, the land area declined to 11,105,178 m2, with a production of 488,176,610 and a productivity of 43.96 per hectare of land in 2017. (BPS, 2019). In this research, the structure, behavior, and performance of the chrysanthemum market were investigated with the help of 25 respondents and 18 merchants, with the SCP technique being applied. The findings revealed that monopolistic institutions were responsible for the market structure, which consisted of perfect competition at the farmer level and a monopoly at the marketing agency level, as well as significant obstacles to entry, product differentiation, and vertical integration. According to the findings of an investigation into the behavior of the chrysanthemum market in Tutur Village, wholesalers and flower shops are the marketing agents who conduct the greatest number of marketing duties. Wholesalers have a monopoly on market information, with farmers serving as price takers and, subsequently, marketing organizations serving as price makers. Farmers' marketing options are constrained as a result of the presence of capital linkages between them and intermediaries, and many choose to sell their products through intermediaries rather than directly to consumers. In Tutur Village, there are four different ways in which chrysanthemums may be sold. As a result of the formation of a market structure, each marketing agent employs methods and colludes with others to achieve success. Following an investigation into market performance in Tutur Village, it has been discovered that channel 4 has the largest overall margin, followed by channel 5.
Analysis Poverty of Fishermen's Households in The Coastal Area of Ambulu District, Jember Regency
Authors: Maulidah Afsah , Sujarwo Sujarwo , Setiawan Budi
Published: April 2022

This study aims to describe determine the factors that affect the household poverty of the Watu Ulo Sumberejo Village, Ambulu Sub District, Jember District. The research was conducted in watu ulo in Ambulu Sub District, Jember District. the selection of the research location was carried out deliberately (Purposive), with the consideration that the village is a coastal village with many fisherman household settlements, most of whom work as fishermen which own a fishing boat smaller or equal to five gross tonnages (GT). The population in this study were all the fisherman household of Watu Ulo in Ambulu Sub District, Jember district, namely 316 Household, with a total sample size of 38 respondents using the Yamane formula. To answer the objective, a binary probit model is used. The results showed that based on the binary probit test, the factors that significantly influenced household poverty of Watu Ulo in Ambulu Sub District, Jember District were the number of household members, education of the head of the household, the catch payment. It is necessary to improve distribution within the government, monitoring, counseling, and the support from the goverment so that the government is right on target.
Experimental Study of Lean-burning Limits of Hydrogen-enriched LPG Intended for Domestic Use
Authors:   School of Professional Education & Executive Development, College of Professional and Continuing Education, The Hong Kong Polytechnic University, Kowloon, Hong Kong, Kahangamage Udaya , Chen Yi ,   School of Marine Equipment and Mechanical Engineering, Jimei University, No. 9 Shigu Road, Jimei District, Xiamen, China, Leung Chun Wah ,   School of Professional Education & Executive Development, College of Professional and Continuing Education, The Hong Kong Polytechnic University, Kowloon, Hong Kong, Ngai Tung Yan ,   School of Professional Education & Executive Development, College of Professional and Continuing Education, The Hong Kong Polytechnic University, Kowloon, Hong Kong
Published: April 2022

The lean-burning limits of hydrogen-enriched Liquefied Petroleum Gas (LPG) have been studied using a Bunsen burner. The lean-burning limits under different conditions are important design considerations in developing gas-fired domestic appliances. In this study, the lean-burning limits of hydrogen-enriched LPG have been obtained across a wide range of Reynolds numbers (600 to 1800) and H2 volumetric fractions (0% to 25%). The results show that the lean-burning limit is increased, on average, by 4.0% to 7.2% for every 5% increment of H2 volumetric fraction under different Reynolds numbers. A numerical simulation carried out in CHEMKIN using the USC Mech II reaction mechanism, and the observation of flame characteristics show that the increase in lean-burning limit with increasing H2 content is due to the higher burning velocity of LPG-H2 mixtures compared with pure LPG. More fuel is required to offset the effect of increased burning velocity under the same Reynolds number, leading to an increase in the lean-burning limit. To facilitate the visualization of the variation of the lean-burning limit with increasing H2 volume fraction in the mixed fuel at different Reynolds numbers, a lean-burning limit map is developed based on correlations obtained. The results of this study provide reference values for the lean-burning performance of hydrogen-enriched LPG fuel for practical domestic use.
Mindfulness and the Wisdom of Advocates - Journeys in the Landscape of Health Care
Authors:   Sussex Mindfulness Centre, Sussex Partnership NHS Foundation Trust, East Brighton Community Mental Health Centre, Brighton General Hospital, Elm Grove, Brighton, BN1 3EW, UK, Hales Michael , Marx Robert ,   Sussex Mindfulness Centre, Sussex Partnership NHS Foundation Trust, East Brighton Community Mental Health Centre, Brighton General Hospital, Elm Grove, Brighton, BN1 3EW, UK
Published: April 2022

Service-user volunteers in a National Health Service (NHS) Mental Health Trust in the UK have made an unusual contribution to mindfulness teaching, training, research and governance as ‘advocates’ of mindfulness-based therapy interventions. We explore the nature of what has been named internally as the ‘wisdom’ of the ‘advocate’ group in this NHS Trust, and its impact on mental health provision. A clinician (clinical psychologist) and an advocate (anthropologist) conduct an investigative conversational journey using a grounded theory framework in an institutional-personal landscape. They look for roots of the ‘wisdom’ in the mindfulness-based therapy, in the practices of the Trust, and in the tradition out of which the therapy has emerged. The investigators find themselves focusing on matters of institutionalisation and professionalism (as forms of exclusion), on journeying and arriving (as expectations - in life, and in embarking on therapy) and on the advocates’ ‘wisdom’ as a deepening recognition of the intrinsic inclusiveness of mindfulness as a practice. The paper stands at a distance from typical healthcare presumptions of professionalism and delivery of treatment. This particular (mindfulness-based) therapy is presented as an intrinsically inclusive life-practice within a community of deepening capability, rather than a medicalised treatment. The method of writing the paper parallels the fluidity of professional/patient role and mutual contribution and journeying that the mindfulness-based approach itself embodies, and this offers an alternative model of ‘service-user participation’.
The Role of Vitamin D for Children with Inflammatory Bowel Disease
Authors:   Department of Paediatrics, University of Otago, Christchurch, New Zealand, Vernon-Roberts Angharad , Day Andrew S ,   Department of Paediatrics, University of Otago, Christchurch, New Zealand
Published: April 2022

Children with inflammatory bowel disease (IBD) have a high prevalence of vitamin D insufficiency secondary to factors such as malabsorption and decreased intake. In recent years the benefits of optimal vitamin D status have been highlighted for their potential to improve the disease course and long-term outcomes in this population. Clinical benefits have been seen to bone health, the immune system, and gut health, with further improvements to disease and treatment outcomes. Recommendations for vitamin D treatment parameters to optimize these benefits have been developed, as well as the identification of risk factors for insufficiency specific to children with IBD. While various supplementation regimens are available reports of efficacy are inconsistent, as are guidelines for frequency of testing. Further research is required to elucidate whether hypovitaminosis D is a cause or consequence of IBD, and the role of vitamin D supplementation in treatment warrants significant attention.
A Tailored Web-Based Video Intervention (ParentCoach) to Support Parents With Children With Sleeping Problems: User-Centered Design Approach
Authors: Preuhs Katharina , van Keulen Hilde , Andree Rosa , Wins Sophie , van Empelen Pepijn
Published: April 2022

Background

Many parents frequently struggle with undesirable or problematic behavior (ie, temper tantrums and whining) displayed by their child. To support parents in promoting positive parenting skills (ie, recognizing challenging situations and reacting appropriately), the interactive video e-learning tool ParentCoach was developed. The tool aims to teach parents generic behavioral responses by means of situational learning, tailoring, and problem solving. The first demonstration focused on sleeping problems.

Objective

The aim of this paper is to illustrate the user-centered development of ParentCoach.

Methods

We conducted usability, understandability, and acceptance tests among the target group (29 parents, 7 youth health care professionals, and 4 individuals with former lower health literacy) in different phases of the development process via focus groups, interviews, and surveys. This allowed for relevant insights on specifications and user requirements to guide the development and revision of the tool in each iteration.

Results

Iterative testing and development allowed for the final demonstration of ParentCoach to be experienced as a relevant and accessible parenting intervention that can be used as a stand-alone program or in combination with another program.

Conclusions

This paper elaborates on the iterative development process and its benefits for the final demonstration of ParentCoach.
Barriers to Telemedicine Video Visits for Older Adults in Independent Living Facilities: Mixed Methods Cross-sectional Needs Assessment
Authors: Mao Alice , Tam Lydia , Xu Audrey , Osborn Kim , Sheffrin Meera , Gould Christine , Schillinger Erika , Martin Marina , Mesias Matthew
Published: April 2022

Background

Despite the increasing availability of telemedicine video visits during the COVID-19 pandemic, older adults have greater challenges in getting care through telemedicine.

Objective

We aim to better understand the barriers to telemedicine in community-dwelling older adults to improve the access to and experience of virtual visits.

Methods

We conducted a mixed methods needs assessment of older adults at two independent living facilities (sites A and B) in Northern California between September 2020 and March 2021. Voluntary surveys were distributed. Semistructured interviews were then conducted with participants who provided contact information. Surveys ascertained participants’ preferred devices as well as comfort level, support, and top barriers regarding telephonic and video visits. Qualitative analysis of transcribed interviews identified key themes.

Results

Survey respondents’ (N=249) average age was 84.6 (SD 6.6) years, and 76.7% (n=191) of the participants were female. At site A, 88.9% (111/125) had a bachelor’s degree or beyond, and 99.2% (124/125) listed English as their preferred language. At site B, 42.9% (51/119) had a bachelor’s degree or beyond, and 13.4% (16/119) preferred English, while 73.1% (87/119) preferred Mandarin. Regarding video visits, 36.5% (91/249) of all participants felt comfortable connecting with their health care team through video visits. Regarding top barriers, participants at site A reported not knowing how to connect to the platform (30/125, 24%), not being familiar with the technology (28/125, 22.4%), and having difficulty hearing (19/125, 15.2%), whereas for site B, the top barriers were not being able to speak English well (65/119, 54.6%), lack of familiarity with technology and the internet (44/119, 36.9%), and lack of interest in seeing providers outside of the clinic (42/119, 35.3%). Three key themes emerged from the follow-up interviews (n=15): (1) the perceived limitations of video visits, (2) the overwhelming process of learning the technology for telemedicine, and (3) the desire for in-person or on-demand help with telemedicine.

Conclusions

Substantial barriers exist for older adults in connecting with their health care team through telemedicine, particularly through video visits. The largest barriers include difficulty with technology or using the video visit platform, hearing difficulty, language barriers, and lack of desire to see providers virtually. Efforts to improve telemedicine access for older adults should take into account patient perspectives.
Automated Decision Support For Community Mental Health Services Using National Electronic Health Records: Qualitative Implementation Case Study
Authors: van Kasteren Yasmin , Strobel Jörg , Bastiampillai Tarun , Linedale Ecushla , Bidargaddi Niranjan
Published: April 2022

Background

A high proportion of patients with severe mental illness relapse due to nonadherence to psychotropic medication. In this paper, we use the normalization process theory (NPT) to describe the implementation of a web-based clinical decision support system (CDSS) for Community Mental Health Services (CMHS) called Actionable Intime Insights or AI2. AI2 has two distinct functions: (1) it provides an overview of medication and treatment history to assist in reviewing patient adherence and (2) gives alerts indicating nonadherence to support early intervention.

Objective

Our objective is to evaluate the pilot implementation of the AI2 application to better understand the challenges of implementing a web-based CDSS to support medication adherence and early intervention in CMHS.

Methods

The NPT and participatory action framework were used to both explore and support implementation. Qualitative data were collected over the course of the 14-month implementation, in which researchers were active participants. Data were analyzed and coded using the NPT framework. Qualitative data included discussions, meetings, and work products, including emails and documents.

Results

This study explores the barriers and enablers of implementing a CDSS to support early intervention within CMHS using Medicare data from Australia’s national electronic record system, My Health Record (MyHR). The implementation was a series of ongoing negotiations, which resulted in a staged implementation with compromises on both sides. Clinicians were initially hesitant about using a CDSS based on MyHR data and expressed concerns about the changes to their work practice required to support early intervention. Substantial workarounds were required to move the implementation forward. This pilot implementation allowed us to better understand the challenges of implementation and the resources and support required to implement and sustain a model of care based on automated alerts to support early intervention.

Conclusions

The use of decision support based on electronic health records is growing, and while implementation is challenging, the potential benefits of early intervention to prevent relapse and hospitalization and ensure increased efficiency of the health care system are worth pursuing.
The evolution of interdisciplinary approaches among research-oriented universities towards a modern industrial economy (Preprint)
Authors: Tran Bach Xuan , Nguyen Long Hoang , Nguyen Hao Anh Si , Vu Thuc Minh Thi , Do Anh Linh , Nguyen Lien Thi Khanh , Kim Nga Thanh Ngoc , Trinh Trang Thu Hong , Latkin Carl , Ho Cyrus S.H. , Ho Roger C.M.
Published: April 2022

BACKGROUND

Vietnam's 2045 development plan requires thorough reforms in science and technology (S&T), which underlines the role of research-oriented universities in generating and transforming knowledge. Understanding the current research performance and productivity is important to exploit future agendas.

OBJECTIVE

This paper aimed to explore the growth patterns and collaborations in the scientific publication of Vietnam.

METHODS

Data on documents in the Web of Science Core Collection database were searched and extracted to examine the research performance of Vietnam. Publication growth patterns in both quantity and quality were examined. The evolution of research disciplines and collaboration networks were also analyzed.

RESULTS

A total of 62,752 documents in 8,354 different sources from 1966 to 2020 were found. Results indicated a substantial growth in the Vietnamese scientific outputs during this period, which was mainly research with international collaboration. There was the emergence of multidisciplinary research-oriented universities in both public and private sectors, along with a significant increase in the number of interdisciplinary and multidisciplinary publications. Although the quality has improved, these publications are still of mostly medium quality when concentrated in middle-ranking journals.

CONCLUSIONS

Our study highlighted the notable growth of research performance in terms of both quality and quantity in Vietnam from 1966 to 2020. Building a multidisciplinary and interdisciplinary research agenda, developing networks of local and international researchers for addressing specific local issues, improving participation of private sectors, and S&T mechanisms are critical for boosting research productivity in Vietnam.
Positive Psychology (PERMA) Themes in Interviews of Children with Atopic Dermatitis: A Qualitative Study (Preprint)
Authors: Lou Terry M , Zhang Kenneth L , Slesinger Noël C , Taddeo Michelle , Serrano Eloisa , Begolka Wendy Smith , Capozza Korey , Paller Amy S , Griffith James W , Fishbein Anna B
Published: April 2022

BACKGROUND

Atopic dermatitis (AD) is a pruritic chronic condition associated with significant sleep disturbance, inattention, and sometimes behavioral problems. Enhancing resiliency in children with AD may promote coping strategies to improve quality of life. One strategy for strengthening resiliency is via positive psychology.

OBJECTIVE

Our objective was to identify positive psychology concepts mentioned by children with AD and their parent to inform strategies to strengthen resiliency in children with AD.

METHODS

Twenty patient-parent dyads were interviewed to provide feedback on a novel brief Cognitive Behavioral Therapy (CBT) intervention for itch rumination. Patients were 8-17 years-old and diagnosed with AD. Trained coders analyzed transcripts using a coding dictionary developed based on Seligman’s PERMA (Positive emotion, Engagement, Relationships, Meaning, Achievement) model of positive psychology. The frequency of unprompted mentions of PERMA themes and relevant quotations were captured. Transcripts were also separately coded for resiliency, the ultimate goal of PERMA.

RESULTS

Positive psychology concepts were mentioned by 100% of children and 95% of parents. Engagement and relationships, both negative and positive aspects, were the most common unprompted PERMA themes mentioned by children (70%) and parents (65%). Emotion elicited the most negative comments from children (95%) and parents (85%).

When analyzed for resiliency, 8 participants were identified with at least one resiliency code. On average, participants with a resiliency code versus none mentioned PERMA concepts 9.1±4.7 times versus 5.9±4.6 (p = 0.14). When participants were stratified by disease severity, positive psychology concepts were mentioned more by mild patients vs moderate patients vs severe patients, 13±3.0 vs 6.2±4.9 vs 6.13±4.0, respectively (p = 0.034).

CONCLUSIONS

Among PERMA themes, engagement and relationships are the two most commonly mentioned categories for children with AD. Strategies targeting PERMA such as affirmations and positive reframing may improve psychosocial wellbeing and resiliency in pediatric AD. Future directions will look at incorporating “positive medicine” in AD treatment to not only relieve symptoms but also strengthen positive aspects of life.
The impact of the Covid-19 pandemic on perinatal loss experienced in the parental couple: Protocol for a Multicenter Study in Italy (Preprint)
Authors: Cena Loredana , Trainini Alice , Tralli Nella , Nodari Luisella , Iacona Erika , Testoni Ines
Published: April 2022

BACKGROUND

At the beginning of the year 2020, mothers and fathers who experienced perinatal loss events found themselves experiencing further problems relating to the emergency situation caused by the COVID-19 pandemic, and the associated difficulties for the Healthcare Centres in offering the bereavement care. Perinatal loss (miscarriage, stillbirth, neonatal death) is an unexpected and complex life event that negatively affects a couple's life: the child dies and the couple's family generative project is abruptly interrupted. Perinatal loss is a painful and traumatic experience that can cause grief and affective disorders for the parental couple, such as true mourning. During the COVID-19 pandemic, the lockdown measures of medical Healthcare Centres and the social distancing for the prevention of contagion made relationships between people very difficult. Limited access to bereavement care in health services is a risk factor for complicated grief, such as unresolved grief.

OBJECTIVE

The main aims of this study are: to investigate how the impact of Covid-19 affected mothers and fathers who went through perinatal loss during the COVID-19 pandemic; to verify how and if these traumatic experiences can lead to a crisis of faith, thus reducing the chances of resorting to this as a coping mechanism; to identify the potential predictors of developments in complicated grief; to investigate which psychosocial factors can negatively affect the mourning process.

METHODS

This longitudinal observational research study is structured with a mixed-method design, with a quantitative and qualitative section. It will include a sample of parents who had an experience of perinatal loss during the COVID-19 pandemic. There are two phases: a baseline and a three-month follow-up.

RESULTS

This protocol was approved by the Ethics Committee of Psychological Research, University of Padova, and by the Institutional Ethics Board of the Spedali Civili of Brescia, Italy. The recruitment and data collection are underway.

CONCLUSIONS

This multicenter study will make a substantial contribution towards the understanding of the psychological processes related to perinatal loss during the COVID-19 pandemic, and will promote mourning and interventions for bereavement care to prevent the risk of complicated grief.
Dampak Pembangunan Infrastruktur Terhadap Kondisi Ketahanan Pangan Di Indonesia (Studi Kasus Provinsi Bali)
Authors: Mulyani Sri , Putri Firda Mardhatillah , Andoko Bhimo Widyo , Akbar Paisal , Novalia Savira
Published: April 2022

ABSTRACT This study had an aim to saw how the impact of infrastructure development on food resilience conditions in Indonesia, focusing on Bali Province. The result of infrastructure development was one of the main factors in realizing the presence of Food Resilience in Indonesia, so the government needed to built supporting infrastructure intended for people who had conditions far from food resilience and good infrastructure. This research used a descriptive method, with taking data from literatur, document, journal, and internet. This study found that the impact of infrastructure development was closely related to the condition of a region's resilience; Bali Province was one of the provinces that had a high food resilence index score, even in the national food resilience index ranking, Bali Province had an index score of 85.15 making Bali Province as the first place in food resilience when compared to other provinces. The food resilience conditions of regencies/cities in Bali Province also showed high index scores; this could be seen in the last two years the position of Denpasar City, Tabanan Regency, Gianyar Regency, and Badung Regency to became cities and regencies that occupied the highest place in the national food resilience index score. Penelitian ini bertujuan untuk melihat bagaimana dampak pembangunan infrastruktur terhadap kondisi ketahanan pangan di Indonesia yang berfokus di Provinsi Bali. Perkembangan pembangunan infrastruktur menjadi salah satu faktor utama untuk mewujudkan hadirnya Ketahanan Pangan di Indonesia, sehingga pemerintah perlu membangun infrastruktur penunjang yang diperuntukkan bagi masyarakat yang memiliki kondisi jauh dari angka ketahanan pangan dan infrastruktur yang baik.Penelitian ini menggunakan metode deskriptif, dengan mengambil data dari kepustakaan, dokumen, jurnal, dan internetPenelitian ini menemukan bahwa dampak pembangunan infrastruktur menjadi sangat berkaitan dengan kondisi ketahanan suatu wilayah, Provinsi Bali menjadi salah satu provinsi yang memiliki skor indeks ketahanan pangan yang tinggi, bahkan dalam ranking indeks ketahanan pangan nasional Provinsi Bali memiliki skor indeks 85,15 menjadikan Provinsi Bali sebagai urutan pertama dalam ketahanan pangan jika dibandingkan dengan provinsi-provinsi lainnya. Kondisi ketahanan pangan kabupaten/kota di Provinsi Bali juga menunjukkan skor indeks yang tinggi, hal ini dapat dilihat dalam 2 tahun terakhir posisi Kota Denpasar, Kabupaten Tabanan, Kabupaten Gianyar dan Kabupaten Badung menjadi kota dan kabupaten yang menduduki posisi teratas dalam skor indeks ketahanan pangan nasional.