bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rationale and Methodology of the 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey (CAFVMHS): A 16-year Follow-up Survey: Raison D’être Et Méthodologie De L’enquête De Suivi Sur La Santé Mentale Des Membres Des Forces Armées Canadiennes Et Des Anciens Combattants, 2018 (ESSMFACM)
Authors: Afifi Tracie O. , Bolton Shay-Lee , Mota Natalie , Marrie Ruth Ann , Stein Murray B. , Enns Murray W. , El-Gabalawy Renée , Bernstein Charles N. , Mackenzie Corey , VanTil Linda , MacLean Mary Beth , Wang Jian Li , Patten Scott , Asmundson Gordon J. G. , Sareen Jitender 
Published: December 2020

Objective: Knowledge is limited regarding the longitudinal course and predictors of mental health problems, suicide, and physical health outcomes among military and veterans. Statistics Canada, in collaboration with researchers at the University of Manitoba and an international team, conducted the Canadian Armed Forces Members and Veterans Mental Health Follow-Up Survey (CAFVMHS). Herein, we describe the rationale and methods of this important survey. Method: The CAFVMHS is a longitudinal survey design with 2 time points (2002 and 2018). Regular Force military personnel who participated in the first Canadian Community Health Survey Cycle 1.2—Mental Health and Well-Being, Canadian Forces Supplement (CCHS-CFS) in 2002 ( N = 5,155) were reinterviewed in 2018 ( n = 2,941). The World Mental Health Survey–Composite International Diagnostic Interview was used with the Diagnostic and Statistical Manual of Mental Disorders, fourth edition ( DSM-IV) criteria. Results: The CAFVMHS includes 2,941 respondents (66% veterans; 34% active duty) and includes data on mental disorder diagnoses, physical health conditions, substance use, medication use, general health, mental health services, perceived need for care, social support, moral injury, deployment experiences, stress, physical activity, military-related sexual assault, childhood experiences, and military and sociodemographic information. Conclusions: The CAFVMHS provides a unique opportunity to further understand the health and well-being of military personnel in Canada over time to inform intervention and prevention strategies and improve outcomes. The data are available through the Statistics Canada Research Data Centres across Canada and can be used cross-sectionally or be longitudinally linked to the 2002 CCHS-CFS data.
Validity of the Clinical Dementia Rating Scale Sum of Boxes in Staging and Detection of Cognitive Impairment in Mexican Americans
Authors: Julayanont Parunyou , DeToledo John C. 
Published: December 2020

Objective: We evaluated the utility of the Clinical Dementia Rating Sum of Boxes score (CDR-SB) in staging and detecting amnestic-mild cognitive impairment (a-MCI) and Alzheimer’s disease (AD) among Mexican Americans. Methods: Receiver operator curves were generated to evaluate the validity of the CDR-SB in staging and detecting a-MCI and AD in 1,073 Mexican Americans (758 controls, 163 a-MCI, and 152 AD). Results: Optimal ranges of the CDR-SB were 0, 0.5-4, 4.5-8.0, 8.5-13 and 13.5-18 for staging the global CDR score of 0, 0.5, 1, 2, and 3, respectively. The CDR-SB ≥ 0.5 differentiated the a-MCI patients from the controls (sensitivity 100% and specificity 99.5%) and ≥ 2.0 distinguished the AD from a-MCI patients (sensitivity 83.6% and specificity 87.1%). These cutoffs were also appropriate for patients with ≤6 years of education. Conclusion: The CDR-SB is useful to detect and stage a-MCI and AD in Mexican Americans with diverse education levels.
Nurses’ perspectives of an environment of optimum mental health: a grounded theory study
Authors: Atieno Wagoro Miriam Carole , Duma Sinegugu E 
Published: December 2020

Background The Government’s aspiration to make Kenya a middle-income country and achieve the United Nations' sustainable development goal 3, ‘good health and well-being’, are threatened by poor quality of mental health services. Environment and lack of a conceptual model of nursing to guide care were some of the reasons that were attributed to poor quality of mental health services. The purpose of the study was to discover and describe an appropriate conceptual model of mental health nursing practice. This paper describes the environment which is one of the metaparadigms of a conceptual model grounded on data collected from Kenyan mental health nurses. Methods A grounded theory study was conducted with 33 mental health nurses selected by purposive, open and theoretical sampling procedures. The study sites were level 5 and 6 mental health facilities across the country. Data were collected over a period of 11 months through audio-recorded in-depth interviews and field notes. Analysis was performed using Straussian Grounded Theory steps of open, axial and selective coding processes aided by NVivo version 10. Dimensions and properties of environment metaparadigm grounded on nurses’ views were discovered. The study was conducted within the dictates of the institutional and national ethics and research review boards. Results Environment evolved as an intervening condition and a supra-system for mental health nursing. A homely environment emerged as a space with properties that nurture optimum mental health contrary to a hostile environment that precipitates mental disorders and prolongs recovery. Conclusion Grounded theory methodology was useful in discovering an environment metaparadigm as the context that influences mental health while nursing practice is the central phenomenon for optimum mental health. Nurses can ensure homely environments from diverse cultures and conduct comparative studies on the recovery of patients in the two environments.
Use of antidiabetic medications and risk of chronic obstructive pulmonary disease exacerbation requiring hospitalization: a disease risk score-matched nested case–control study
Authors: Wang Meng-Ting , Lai Jyun-Heng , Huang Ya-Ling , Kuo Feng-Chih , Wang Yun-Han , Tsai Chen-Liang , Tu Min-Yu 
Published: December 2020

AbstractBackgroundExacerbation of chronic obstructive pulmonary disease (COPD) severely impacts the quality of life and causes high mortality and morbidity. COPD is involved with systemic and pulmonary inflammation, which may be attenuated with antidiabetic agents exerting anti-inflammatory effects. Real-world evidence is scant regarding the effects of antidiabetic agents on COPD exacerbation. Accordingly, we conducted a disease risk score (DRS)-matched nested case–control study to systemically assess the association between each class of oral hypoglycemic agents (OHAs) and risk of severe COPD exacerbation in a nationwide COPD population co-diagnosed with diabetes mellitus (DM).MethodsWe enrolled 23,875 COPD patients receiving at least one OHA for management of DM by analyzing the Taiwan National Health Insurance claims database between January 1, 2000, and December 31, 2015. Cases of severe exacerbation were defined as those who had the first hospital admission for COPD. Each case was individually matched with four randomly-selected controls by cohort entry date, DRS (the estimated probability of encountering a severe COPD exacerbation), and COPD medication regimens using the incidence density sampling approach. Conditional logistic regressions were performed to estimate odds ratios (OR) of severe COPD exacerbation for each type of OHAs.ResultsWe analyzed 2700 cases of severe COPD exacerbation and 9272 corresponding controls after DRS matching. Current use of metformin versus other OHAs was associated with a 15% (adjusted OR [aOR], 0.85; 95% confidence interval [CI] 0.75–0.95) reduced risk of severe COPD exacerbation, whereas the reduced risk was not observed with other types of antidiabetic agents. When considering the duration of antidiabetic medication therapy, current use of metformin for 91–180 and 181–365 days was associated with a 28% (aOR, 0.72; 95% CI 0.58–0.89) and 37% (aOR, 0.63; 95% CI 0.51–0.77) reduced risk of severe COPD exacerbation, respectively. Similarly, 91–180 days of sulfonylureas therapy led to a 28% (aOR, 0.72; 95% CI 0.58–0.90) lower risk, and longer treatments consistently yielded 24–30% lower risks. Current use of thiazolidinediones for more than 181 days yielded an approximately 40% decreased risk.ConclusionsDuration-dependent beneficial effects of current metformin, sulfonylurea, and thiazolidinedione use on severe COPD exacerbation were observed in patients with COPD and DM.
Multi-factor authentication for shibboleth identity providers
Authors: Ribeiro de Mello Emerson , Silva Wangham Michelle , Bristot Loli Samuel , da Silva Carlos Eduardo , Cavalcanti da Silva Gabriela , de Chaves Shirlei Aparecida , Bristot Loli Bruno 
Published: December 2020

AbstractThe federated identity model provides a solution for user authentication across multiple administrative domains. The academic federations, such as the Brazilian federation, are examples of this model in practice. The majority of institutions that participate in academic federations employ password-based authentication for their users, with an attacker only needing to find out one password in order to personify the user in all federated service providers. Multi-factor authentication emerges as a solution to increase the robustness of the authentication process. This article aims to introduce a comprehensive and open source solution to offer multi-factor authentication for Shibboleth Identity Providers. Based on the Multi-factor Authentication Profile standard, our solution provides three extra second factors (One-Time Password, FIDO2 and Phone Prompt). The solution has been deployed in the Brazilian academic federation, where it was evaluated using functional and integration testing, as well as security and case study analysis.
Predictors of illness course and health maintenance following inpatient treatment among patients with anorexia nervosa
Authors: Glasofer Deborah R. , Muratore Alexandra F. , Attia Evelyn , Wu Peng , Wang Yuanjia , Minkoff Hillary , Rufin Teresa , Walsh B. Timothy , Steinglass Joanna E. 
Published: December 2020

AbstractBackgroundAnorexia nervosa (AN) is a life-threatening psychiatric disorder associated with significant medical and psychosocial impairment. Hospital-based behavioral treatment is an effective intervention in the short-term. However, relapse rates following discharge are high and thus, there is a need to identify predictors of longitudinal outcome. The current study provides information regarding illness course and health maintenance among patients with AN over 5 years following discharge from an eating disorder inpatient unit.MethodsParticipants were individuals with AN who were discharged from a specialized, inpatient behaviorally-based unit. Prior to discharge, height and weight were measured and participants completed self-report measures of eating disorder severity and general psychopathology (depression, anxiety, harm avoidance). Participants were contacted annually for self-report measures of weight, eating disorder severity and clinical impairment. Outcome was defined by illness course (body mass index (BMI) and clinical impairment during the 5 years) and health maintenance (categories of weight and eating disorder symptom severity) across follow-up, using all available data. Linear mixed models were used to examine whether demographic and clinical parameters at discharge predicted BMI and clinical impairment over time. Additional analyses examined whether these variables significantly influenced an individual’s likelihood of maintaining inpatient treatment gains.ResultsOne-hundred and sixty-eight individuals contributed data. Higher trait anxiety at discharge was associated with a lower BMI during follow-up (p = 0.012). There was a significant interaction between duration of illness and time, whereby duration of illness was associated with a faster rate of weight loss (p = 0.003) during follow-up. As duration of illness increased, there was a greater increase in self-reported clinical impairment (p = 0.011). Increased eating disorder severity at discharge was also associated with greater clinical impairment at follow-up (p = 0.004). Higher BMI at discharge was significantly associated with maintaining healthy weight across a priori BMI-based definitions of health maintenance.ConclusionsWeight status (higher BMI) and duration of illness are key factors in the prognosis of AN. Higher weight targets in intensive treatments may be of value in improving outcomes.
Management of bleeding in women on HRT
Authors: Holloway Debby 
Published: December 2020

Bleeding while on hormone replacement therapy is common. Debby Holloway explains the causes of this, investigations needed, and how to tailor treatment to the individual if no pathology is found Bleeding while taking hormone replacement therapy (HRT) is a relatively common problem. The majority of women with post-menopausal bleeding – on and off HRT – will have either no cause or a benign cause, but about 10% of women will have endometrial cancer. Post-menopausal bleeding is defined as unscheduled vaginal bleeding that occurs a year after the last natural menstrual period or any breakthrough bleeding on cyclical HRT or breakthrough bleeding after 6 months on continuous combined therapy when there has been established amenorrhoea. Practice nurses must be aware of the problem of bleeding on HRT and each individual needs to be assessed for pathology. If no pathology is found, treatment should be tailored to the individual to overcome the bleeding issues.
Early predictive factors of progression from severe type to critical ill type in patients with Coronavirus Disease 2019: A retrospective cohort study
Authors: Li Nan , Kong Hao , Zheng Xi-Zi , Li Xue-Ying , Ma Jing , Zhang Hong , Wang Dong-Xin , Li Hai-Chao , Liu Xin-Min 
Published: December 2020

Background
The current worldwide pandemic of Coronavirus Disease 2019 (COVID-19) has posed a serious threat to global public health, and the mortality rate of critical ill patients remains high. The purpose of this study was to identify factors that early predict the progression of COVID-19 from severe to critical illness.

Methods
This retrospective cohort study included adult patients with severe or critical ill COVID-19 who were consecutively admitted to the Zhongfaxincheng campus of Tongji Hospital (Wuhan, China) from February 8 to 18, 2020. Baseline variables, data at hospital admission and during hospital stay, as well as clinical outcomes were collected from electronic medical records system. The primary endpoint was the development of critical illness. A multivariable logistic regression model was used to identify independent factors that were associated with the progression from severe to critical illness.

Results
A total of 138 patients were included in the analysis; of them 119 were diagnosed as severe cases and 16 as critical ill cases at hospital admission. During hospital stay, 19 more severe cases progressed to critical illness. For all enrolled patients, longer duration from diagnosis to admission (odds ratio [OR] 1.108, 95% CI 1.022–1.202; P = 0.013), pulse oxygen saturation at admission <93% (OR 5.775, 95% CI 1.257–26.535; P = 0.024), higher neutrophil count (OR 1.495, 95% CI 1.177–1.899; P = 0.001) and higher creatine kinase-MB level at admission (OR 2.449, 95% CI 1.089–5.511; P = 0.030) were associated with a higher risk, whereas higher lymphocyte count at admission (OR 0.149, 95% CI 0.026–0.852; P = 0.032) was associated with a lower risk of critical illness development. For the subgroup of severe cases at hospital admission, the above factors except creatine kinase-MB level were also found to have similar correlation with critical illness development.

Conclusions
Higher neutrophil count and lower lymphocyte count at admission were early independent predictors of progression to critical illness in severe COVID-19 patients.
Emprego da gastronomia como ferramenta para promover a aceitação de verduras por crianças com excesso de peso
Authors: Santos Virgínia Souza , De Melo Letícia Maria , Carleto Cíntia Tavares , De Almeida Martha Elisa Ferreira , Augusto Thaís Amanda Teixeira , Pedrosa Leila Aparecida Kauchakje 
Published: December 2020

A infância é uma das fases mais importantes para o estabelecimento de hábitos saudáveis. De acordo com a pesquisa do Sistema de Vigilância Alimentar e Nutricional (SISVAN) realizada em 2008 com 26.000 crianças e adolescentes, o consumo de verduras mostrou-se inadequado, uma vez que mais de 30% dos avaliados relataram não consumir estes alimentos durante a semana. O emprego de técnicas gastronômicas pode tornar o ato de comer um motivo de grande prazer, buscando o bem-estar e a saúde das pessoas. Avaliar a influência da gastronomia na aceitação de verduras por crianças com excesso de peso. Participaram da pesquisa 25 crianças, com idade entre 7 a 9 anos, sendo 60% (n=15) do gênero feminino, matriculadas em uma escola pública de Rio Paranaíba, MG, diagnosticadas com excesso de peso, cujos pais autorizaram a participação mediante a assinatura do Termo de Consentimento Livre e Esclarecido. Aplicou-se um questionário de frequência do consumo de verduras entre as crianças, e posteriormente utilizou-se o teste de análise sensorial de aceitação através da escala hedônica facial de cinco pontos. Foram selecionadas três tipos de verduras: a abobrinha caipira, o chuchu e a beterraba. Os alimentos foram servidos durante dois momentos. Primeiramente eles foram apresentados na sua forma habitual de consumo, corte maceidoine e soufflé. Após 15 dias, os mesmos alimentos foram oferecidos com o emprego de técnicas gastronômicas, adotando as seguintes formas: chuchu – peixes; abobrinha caipira – sol; beterraba – flor. Para a análise dos dados foi aplicado o teste Wilcoxon e o Qui-quadrado. Ambos os testes foram realizados a 5% de significância no software Statistical Package for the Social Sciences - SPSS, versão 20.0. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal de Viçosa, protocolo no 473.739. Ao avaliar o consumo das verduras, percebeu-se que 28% (n=7) das crianças não consumiam abobrinha, 44% (n=11) e 40% (n=10) não ingeriam chuchu e beterraba, respectivamente. As notas atribuídas para as verduras aumentaram após a utilização das técnicas gastronômicas, apontando que a metodologia foi eficaz para melhorar a aceitação. Entretanto, não foram observadas diferenças estatísticas entre as pontuações. O gênero apresentou associação com as notas atribuídas para o chuchu após o emprego da gastronomia. A idade não demonstrou associação com as notas conferidas a nenhum alimento. Já o consumo alimentar foi associado às pontuações obtidas pela abobrinha caipira (antes) e a beterraba (depois) da aplicação das técnicas. A frequência de consumo das verduras entre as crianças avaliadas foi baixa. As notas atribuídas às verduras após a aplicação da gastronomia foram maiores do que aquelas conferidas aos alimentos oferecidos em suas formas habituais de consumo.
Interprofissionalidade e a construção de protocolos assistenciais: uma aproximação entre a graduação e o serviço de saúde
Authors: Soares Patrícia Danielle Feitosa Lopes , Da Costa Andréa Ribeiro , Malcher André 
Published: December 2020

INTRODUÇÃO: o Programa de Educação pelo Trabalho para a Saúde (PET-Saúde) foi instituído pela Portaria Interministerial n. 421/10. Enquanto política indutora formativa tem-se o PET Saúde Redes de Atenção (RAS) - 2013-2015, com objetivos de fomentar a interprofissionalidade. A Universidade Federal do Pará (UFPA) aprovou grupos Rede Cegonha (RC), desenvolvendo por meio de acadêmicos, docentes e profissionais do serviço, ações de educação permanente e o fomento à interprofissionalidade do cuidado, em diferentes cenários, incluindo a atenção primária. OBJETIVOS: apresentar as contribuições do PET-Saúde RAS, mediadas pelo diálogo interprofissional, na construção de protocolo de atenção ao pré-natal de baixo risco. MÉTODOS: construção aprovada pelo Comitê de Ética da UFPA nº 1337334. O construir do protocolo emergiu da necessidade dos profissionais preceptores e suas equipes ao encontro dos pressupostos da RC e consonante aos critérios da Organização Mundial de Saúde, por meio de: revisão sistemática da literatura individual e coletiva; diagnóstico situacional; reuniões entre o grupo elaborador–roda de diálogos dos sujeitos supracitados na construção coletiva do cuidado; revisão externa; fluxograma; validação pelos profissionais/usuários; limitações e implantação. As discussões englobaram os diferentes atores envolvidos: acadêmicos de enfermagem, farmácia, fisioterapia, medicina, nutrição, odontologia e terapia ocupacional; docente-tutora e preceptores do PET; profissionais da Estratégia Saúde da Família e gestores de Benevides-Pará. RESULTADOS: a elaboração do protocolo sustentou-se interprofissionalmente, apresentando todos os sujeitos como co-participes, na organização das oficinas; rodas de encontro e estudos dirigidos. Ao final de 02 anos foi elaborado o Protocolo de Atenção ao Pré-natal de baixo risco ao encontro das preconizações de saúde, necessidades epidemiológicas e dos serviços do município e olhares interprofissionais. CONCLUSÕES: a construção do protocolo mediado pelo diálogo interprofissional foi protagonista de aprendizado dos envolvidos, favorecendo o refletir e viver processos que promoveram desenvolver trabalho em equipe com integração e colaboração primando pela qualidade da atenção.
TRAINING AND IMPROVING BILLIARD TECHNIQUE IN STUDENTS WITH RESPECT TO THE SEQUENCE OF SOLUTIONS TO MOTOR TASKS IN THE NERVOUS SYSTEM
Authors: Gimazov R , Jenanyan S 
Published: December 2020

Aim. The paper aims to compare the effectiveness of training of billiard players, who follow the program of sports school, and those, who participate in the experiment for improving billiard technique based on the sequence of solutions to motor tasks in the nervous system. Materials and methods. The experiment involved control and experimental groups of young males and females of 8 people each with sports skills from 1st junior category to a candidate for master of sport in billiards. For an objective assessment of billiard skills acquisition a force platform was used to study muscle coordination and neural regulation of vertical position (patent № 2547991 and № 2547992, Russia). Results. At the beginning of the experiment, two groups were equal in competitive performance (Z = 0.866, р = 0.3865). The experimental method allowed athletes to increase a growth rate of kinesthetic sensitivity by 33.5 % (from 0.242 ± 0.08 units to 0.161 ± ± 0.07 units (хaverage ± σ)), muscle synergy – by 56.1 % (from 95.9 ± 31.1 units to 117.6 ± 27.7 units (хaverage ± σ)). In the control group, a deterioration of kinesthetic sensitivity by 6.3 % was recorded (from 0.347 ± 0.12 units to 0.369 ± 0.12 units (хaverage ± σ)), as well as a decrease in muscle synergy by 15.8 % (from 66.4 ± 30.8 units to 55.9 ± 20.1 units (хaverage ± σ)). The analysis of billiard performance is confirmed statistically (Z = –2.252, p = 0.02436) in favor of the experimental group. Conclusion. The results of the study statistically prove the effectiveness of the experimental method of improving billiard technique based on the sequence of solutions to motor tasks in the nervous system. The coach's support of natural biological sequence when solving motor tasks in the nervous system allowed the experimental group to double its competitive performance compared to the control group.