bluuebunny/crossref_metadata_2025_split huggingface dataset:
An enhanced individual placement and support (IPS) intervention based on the Model of Human Occupation (MOHO); a prospective cohort study
Authors: Prior Susan , Maciver Donald , Aas Randi W. , Kirsh Bonnie , Lexen Annika , van Niekerk Lana , Irvine Fitzpatrick Linda , Forsyth Kirsty 
Published: July 2020

Abstract
Background
Employment is good for physical and mental health, however people with severe mental illness (SMI) are often excluded from employment. Standard Individual Placement and Support (IPS) is effective in supporting around 55% of people with SMI into employment or education. Current research considers enhancements to IPS to improve outcomes for those requiring more complex interventions. Clinicians need to better understand who will benefit from these enhanced IPS interventions. This study offers a new enhanced IPS intervention and an approach to predicting who may achieve successful outcomes.

Methods
This prospective cohort study included people with SMI who participated in an enhanced IPS service and had prolonged absence from employment. Secondary data analysis was conducted of data gathered in routine clinical practice. Univariate analysis coupled with previous research and clinical consultation was used to select variables to be included in the initial model, followed by a backward stepwise approach to model building for the final multiple logistic regression model with an outcome of successful or unsuccessful goal attainment (employment or education).

Results
Sixty-three percent of participants in the enhanced IPS successfully attained employment or education. Significant relationships from bivariate analyses were identified between outcomes (employment or education) and seven psychosocial variables. Adapting Routines to Minimise Difficulties, Work Related Goals, and Living in an Area of Lesser Deprivation were found to be significant in predicting employment or education in the final multiple logistic regression model R2 = 0.16 (Hosmer-Lemeshow), 0.19 (Cox-Snell), 0.26 (Nagelkerke). Model χ2(7) = 41.38 p < .001.

Conclusion
An enhanced IPS service had a 63% rate success in achieving employment or education, higher than comparable studies and provides an alternative to IPS-Lite and IPS-standard for more complex populations. Motivational and habitual psychosocial variables are helpful in predicting who may benefit from an enhanced IPS intervention supporting people after prolonged absence from employment.

Trial registration
NCT04083404 Registered 05 September 2019 (retrospectively registered).
Sustainable solid waste management Measures in Tanzania: an exploratory descriptive case study among vendors at Majengo market in Dodoma City
Authors: Nyampundu Kepha , Mwegoha William J. S. , Millanzi Walter C. 
Published: July 2020

Abstract
Background
Solid waste management is both an urban and rural problem because every person is considered a producer of wastes. It has been noted to be a global universal issue, which affects every individual, families, communities and governments and thus, needs to be addressed through sustainable strategies. This study aimed at characterizing solid wastes; assessing the levels of awareness of vendors on the sustainable solid waste management measures; and identifying techniques used to handle solid waste generated at the Majengo market in Dodoma City, Tanzania.

Methods
The study adopted an exploratory descriptive case study, with a mixed research approaches with a minimum sample of 196 conviniently selected respondents. Semi-structured questionnaires developed by the researcher were the main data collection tools to characterize solid wastes, measure levels of awareness about sustainable solid waste management approaches (SWM) and identify solid waste handling techniques among vendors at the market. Quantitative and Qualitative data were analyzed by using the Statistical Product for Social Sciences version 23 and thematic analysis respectively.

Results
Findings showed that 55% of vendors were males. Majority of the sampled vendors (56%) were not aware of SWM. On the other hand, crops/food and animal product remains were reported to be the most generated solid wastes (94.4%) with the rate of > 2 tons/day equivalent to 72.4% of the overall solid waste generation at the market. SWM services were reported to be provided by City council (85.7%) with the main equipment/tool used to store solid wastes (SW) being containers without lids (88.3%). The dumpsite was the main site for SW disposal (80.1%). Nevertheless, 92.9% of the sampled vendors reported that SWM strategies were there at the market though not adhered to accordingly.

Conclusion
Vendors were not aware of sustainable solid waste management measures existing at the market. However, vendors’ education levels and the duration of doing business at the market were related to their levels of awareness on SWM (p < 0.05). The SWM measures were found to exist at the market, however, they were not sustainable because it was reported that they were ineffectively and inefficiently used to control SW generation, collection, storage, and disposal. There is a need of regular awareness-raising activities about sustainable SWM measures among vendors. Moreover, city council and market authorities need to have sustainable and scheduled implementation, supervision, monitoring and evaluation of SWM measures to maintain the management of solid wastes at Majengo market premises.
Determinants of institutional delivery service utilization in Ethiopia: a population based cross sectional study
Authors: Berelie Yebelay , Yeshiwas Dawit , Yismaw Leltework , Alene Muluneh 
Published: July 2020

Abstract
Background
The incidence of maternal mortality remains unacceptably high in developing countries. Ethiopia has developed many strategies to reduce maternal and child mortality by encouraging institutional delivery services. However, only one-fourth of women gave birth at health facility, in the country. This, this study aimed to identify individual level factors and to assess the regional variation of institutional delivery utilization in Ethiopia.

Methods
Data were obtained from the 2016 Ethiopian demographic and health survey. In this study, a total of 7174 reproductive age women who had birth within five years were included. We fitted multilevel logistic regression model to identify significantly associated factors associated with institutional delivery. A mixture chi-square test was used to test random effects. Statistical significance was declared at p < 0.05, and we assessed the strength of association using odds ratios with 95% confidence intervals.

Result
The level of institutional delivery was 38.9%. Women’s who had focused antenatal care (FANC) visit (AOR = 3.12, 95% CI: 2.73–3.56), multiple gestations (AOR = 2.06, 95% CI: 1.32–3.21, and being urban residence (AOR = 7.18, 95% CI: 5.10–10.12) were more likely to give birth at health facility compared to its counterpart. Compared to women’s without formal education, giving birth at health facility was more likely for women’s who had primary education level (AOR = 1.77, 95% CI: 1.49–2.10), secondary education level (AOR = 3.79, 95% CI: 2.72–5.30), and higher education level (AOR = 5.86, 95% CI: 3.25–10.58). Furthermore, women who reside in rich (AOR = 2.39, 95% CI: 1.86–3.06) and middle (AOR = 1.66, 95% CI: 1.36–2.03) household wealth index were more likely to deliver at health facility compared to women’s who reside poor household wealth index. Moreover, this study revealed that 34% of the total variation in the odds of women delivered at health institution accounted by regional level.

Conclusion
The level of institutional delivery in Ethiopia remains low. Context specific and tailored programs that includes educating women and improving access to ANC services has a potential to improve institutional delivery in Ethiopia.
Co-occurrence patterns and the large-scale spatial structure of benthic communities in seagrass meadows and bare sand
Authors: Kraan Casper , Thrush Simon F. , Dormann Carsten F. 
Published: July 2020

Abstract
Background
Species distribution models are commonly used tools to describe diversity patterns and support conservation measures. There is a wide range of approaches to developing SDMs, each highlighting different characteristics of both the data and the ecology of the species or assemblages represented by the data. Yet, signals of species co-occurrences in community data are usually ignored, due to the assumption that such structuring roles of species co-occurrences are limited to small spatial scales and require experimental studies to be detected. Here, our aim is to explore associations among marine sandy-bottom sediment inhabitants and test for the structuring effect of seagrass on co-occurrences among these species across a New Zealand intertidal sandflat, using a joint species distribution model (JSDM).

Results
We ran a JSDM on a total of 27 macrobenthic species co-occurring in 300,000 m2 of sandflat. These species represented all major taxonomic groups, i.e. polychaetes, bivalves and crustaceans, collected in 400 sampling locations. A number of significant co-occurrences due to shared habitat preferences were present in vegetated areas, where negative and positive correlations were approximately equally common. A few species, among them the gastropods Cominella glandiformis and Notoacmea scapha, co-occurred randomly with other seagrass benthic inhabitants. Residual correlations were less apparent and mostly positive. In bare sand flats shared habitat preferences resulted in many significant co-occurrences of benthic species. Moreover, many negative and positive residual patterns between benthic species remained after accounting for habitat preferences. Some species occurring in both habitats showed similarities in their correlations, such as the polychaete Aglaophamus macroura, which shared habitat preferences with many other benthic species in both habitats, yet no residual correlations remained in either habitat.

Conclusions
Firstly, analyses based on a latent variable approach to joint distributions stressed the structuring role of species co-occurrences beyond experimental scales. Secondly, results showed context dependent interactions, highlighted by species having more interconnected networks in New Zealand bare sediment sandflats than in seagrass meadows. These findings stress the critical importance of natural history to modelling, as well as incorporating ecological reality in SDMs.
Effects of two peroxide enzymatic denture cleaners on Candida albicans biofilms and denture surface
Authors: Han Ying , Liu Xiaodan , Cai Yu 
Published: July 2020

Abstract
Objective
To compare the antifungal action of two commercially available denture cleaning agents to that of standard clinical solutions, and determine their effects on the polymethyl methacrylate (PMMA) acrylic resin denture surface.

Methods
Candida albicans growth was analyzed by colony forming assay, and the methyl thiazolyl tetrazolium (MTT) assay was used to evaluate biofilm formation and cell adhesion. The morphology and roughness of PMMA acrylic resin surface was measured by scanning electron microscopy (SEM) images and stylus method.

Results
Clene®, Polident® and 3% NaHCO3 solutions showed significantly greater antifungal effects in terms of both inhibiting growth and biofilm formation. In addition, Clene® solution prevented adhesion of C. albicans on cell culture plates compared to filter-sterile tap water, whereas other reagents did not have an inhibitory effect. One-month immersion in the different cleaning reagents significantly inhibited fungal adhesion on the PMMA surface Clene®, Polident® and 3% NaHCO3 showed greater effect compared to PBS and filter-sterile tap water. Finally, none of the cleansing agents significantly affected the morphology and roughness of the PMMA surface.

Conclusion
Clene®, Polident® and 3% NaHCO3 solutions can inhibit C. albicans growth and biofilm formation to some extent on cell culture plates, and significantly inhibit fungal adhesion on the PMMA surface without affecting surface morphology and roughness.
Barriers to patient, provider, and caregiver adoption and use of electronic personal health records in chronic care: a systematic review
Authors: Niazkhani Zahra , Toni Esmaeel , Cheshmekaboodi Mojgan , Georgiou Andrew , Pirnejad Habibollah 
Published: July 2020

Abstract
Background
Electronic personal health records (ePHRs) are defined as electronic applications through which individuals can access, manage, and share health information in a private, secure, and confidential environment. Existing evidence shows their benefits in improving outcomes, especially for chronic disease patients. However, their use has not been as widespread as expected partly due to barriers faced in their adoption and use. We aimed to identify the types of barriers to a patient, provider, and caregiver adoption/use of ePHRs and to analyze their extent in chronic disease care.

Methods
A systematic search in Medline, PubMed, Science Direct, Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Cochrane Central Register of Controlled Trials, and the Institute of Electrical and Electronics Engineers (IEEE) database was performed to find original studies assessing barriers to ePHR adoption/use in chronic care until the end of 2018. Two researchers independently screened and extracted data. We used the PHR adoption model and the Unified Theory of Acceptance and Use of Technology to analyze the results. The Mixed Methods Appraisal Tool (MMAT) version 2018 was used to assess the quality of evidence in the included studies.

Results
Sixty publications met our inclusion criteria. Issues found hindering ePHR adoption/use in chronic disease care were associated with demographic factors (e.g., patient age and gender) along with key variables related to health status, computer literacy, preferences for direct communication, and patient’s strategy for coping with a chronic condition; as well as factors related to medical practice/environment (e.g., providers’ lack of interest or resistance to adopting ePHRs due to workload, lack of reimbursement, and lack of user training); technological (e.g., concerns over privacy and security, interoperability with electronic health record systems, and lack of customized features for chronic conditions); and chronic disease characteristics (e.g., multiplicities of co-morbid conditions, settings, and providers involved in chronic care).

Conclusions
ePHRs can be meaningfully used in chronic disease care if they are implemented as a component of comprehensive care models specifically developed for this care. Our results provide insight into hurdles and barriers mitigating ePHR adoption/use in chronic disease care. A deeper understating of the interplay between these barriers will provide opportunities that can lead to an enhanced ePHR adoption/use.
Differentially private release of medical microdata: an efficient and practical approach for preserving informative attribute values
Authors: Lee Hyukki , Chung Yon Dohn 
Published: July 2020

Abstract
Background
Various methods based on k-anonymity have been proposed for publishing medical data while preserving privacy. However, the k-anonymity property assumes that adversaries possess fixed background knowledge. Although differential privacy overcomes this limitation, it is specialized for aggregated results. Thus, it is difficult to obtain high-quality microdata. To address this issue, we propose a differentially private medical microdata release method featuring high utility.

Methods
We propose a method of anonymizing medical data under differential privacy. To improve data utility, especially by preserving informative attribute values, the proposed method adopts three data perturbation approaches: (1) generalization, (2) suppression, and (3) insertion. The proposed method produces an anonymized dataset that is nearly optimal with regard to utility, while preserving privacy.

Results
The proposed method achieves lower information loss than existing methods. Based on a real-world case study, we prove that the results of data analyses using the original dataset and those obtained using a dataset anonymized via the proposed method are considerably similar.

Conclusions
We propose a novel differentially private anonymization method that preserves informative values for the release of medical data. Through experiments, we show that the utility of medical data that has been anonymized via the proposed method is significantly better than that of existing methods.
‘To give or not to give medication, that is the question.’ Healthcare personnel’s perceptions of factors affecting pro re nata medication in sheltered housing for older adults — a focus-group interview study
Authors: Nilsen Marianne Kollerøs , Sletvold Hege , Olsen Rose Mari 
Published: July 2020

Abstract
Background
Residents living in sheltered housing depend on help from healthcare personnel (HCP) with medication management, regarding regular long-term and pro re nata (PRN) medication. The HCP assess the need for PRN medication prior to administration to the residents. The purpose of this study was to describe HCP’s perceptions of factors affecting PRN medication management in sheltered housing for older adults.

Method
This was a qualitative study with five focus-group interviews with 22 HCP working in sheltered housing for older adults. The HCP were heterogenous regarding scholarly education and experiences, working in four different municipalities in mid-Norway, representing urban, sub-urban and rural districts. The analysis was inductive, based on qualitative, manifest, content analysis. The main outcome was HCP perceptions of the factors affecting PRN medication management in sheltered housing.

Results
Four main factors affecting the PRN medication management were identified in the data and were related to either: 1) the medication; 2) the resident; 3) the HCP; or 4) the organisation. These categories included 14 subcategories. Overall, the HCP described the management of PRN medication as a complex process, where the above factors all have impact on the residents’ health and safety.

Conclusion
HCP working in sheltered housing describe that PRN medication management is affected by numerous human factors, that consequently may affect patient outcomes and safety. HCP involved in PRN medication management should be aware of factors that affect their decision-making, and safe management requires a professional practice built on medicines competence, practical skills and experience.
Introducing a single point of access (SPA) to child and adolescent mental health services in England: a mixed-methods observational study
Authors: Rocks Stephen , Glogowska Margaret , Stepney Melissa , Tsiachristas Apostolos , Fazel Mina 
Published: July 2020

Abstract
Background
In many high-income countries, primary care practitioners are the main point of referral for specialist mental health services. In England, Child and Adolescent Mental Health Services (CAMHS) are increasingly adopting a Single Point of Access (SPA) to streamline referrals and introduce self and parent/carer-referrals. This involves a significant shift of responsibility from primary care towards CAMHS who adopt a more active role as gatekeeper for their service. This study evaluates the adoption of a SPA in CAMHS across a large region in England.

Methods
We conducted an observational mixed methods study in two CAMHS from January 2018 to March 2019 to evaluate the adoption of a SPA. We collected quantitative data from electronic patient records and qualitative data through ethnographic observation and in-depth interviews of staff and stakeholders with experience of using CAMHS. Additional data on volumes was shared directly from the SPAs and a further snapshot of 1 week’s users was collected.

Results
A similar SPA model emerged across the two services. Staff were positive about what the model could achieve and access rates grew quickly following awareness-raising activities. Despite the initial focus being on a telephone line, online referrals became the more regularly used referral method. Increased access brought challenges in terms of resourcing, including identifying the right staff for the role of call handlers. A further challenge was to impose consistency on triage decisions, which required structured information collection during the assessment process. Similar to GP referrals, those self-referring via the SPA were mainly from the least deprived areas.

Conclusions
The introduction of a SPA has the potential to improve young people’s access to mental health services. By addressing some of the barriers to access, simplifying where to go to get help and making it easier to contact the service directly, a SPA can help more individuals and families access timely support. However, the introduction of a SPA does not in itself expand the capacity of CAMHS, and therefore expectations within services and across sectors need to be tempered accordingly. SPA services providing different referral approaches can further improve access for the harder to reach populations.
Respiratory metabolites in bronchoalveolar lavage fluid (BALF) and exhaled breath condensate (EBC) can differentiate horses affected by severe equine asthma from healthy horses
Authors: Bazzano Marilena , Laghi Luca , Zhu Chenglin , Magi Gian Enrico , Tesei Beniamino , Laus Fulvio 
Published: July 2020

AbstractBackgroundThe use of an untargeted metabolomic approach to investigate biofluids of respiratory origin is of increasing interest in human and veterinary lung research. Considering the high incidence of equine asthma (> 14%) within horse population and the importance of this animal model for human disease, we aimed to investigate the metabolomic profile of bronchoalveolar lavage fluid (BALF) and exhaled breath condensate (EBC) in healthy and asthmatic horses.ResultsOn the basis of clinical, endoscopic and BALF cytology findings, 6 horses with severe asthma (Group A) and 6 healthy horses (Group C) were included in the study.1H-NMR analysis was used to identified metabolites in BALF and EBC samples. Metabolomic analysis allowed to identify and quantify 12 metabolites in BALF and seven metabolites in EBC. Among respiratory metabolites, myo-inositol, formate, glycerol and isopropanol in BALF, and methanol and ethanol in EBC, differed between groups (p < 0.05).ConclusionsThe application of metabolomic studies to investigate equine asthma using minimally invasive diagnostic methods, such as EBC metabolomics, provided promising results. According to our research, the study of selective profiles of BALF and EBC metabolites might be useful for identifying molecules like myo-inositol and methanol as possible biomarkers for airways diseases in horses.