bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influences on the physical activity behaviour of inpatients after stroke outside of staff-led rehabilitation sessions: a systematic review
Authors: Hartley Peter , Bond Katie , Dance Rachel , Kuhn Isla , McPeake Joanne , Forsyth Faye 
Published: November 2024

Objective To use behavioural science frameworks to synthesise evidence on the factors influencing physical activity of patients hospitalised after stroke outside of staff-led rehabilitation sessions. Data Sources A systematic review of qualitative and mixed-methods studies. MEDLINE, PsycINFO, CINAHL, and AMED were searched from inception to October 2024 for studies that explored influences on the physical activity of patients hospitalised after stroke. Review Methods Data were coded with reference to the Theoretical Domains Framework and the COM-B (‘capability’, ‘opportunity’, ‘motivation’ and ‘behaviour’) model. Thematic analysis was used to group data extracts into themes within each Theoretical Domains Framework domain. Risk of bias was assessed using the Mixed Methods Appraisal Tool. Results We identified 17 studies. There was no significant risk of bias concerns. We identified 19 themes across eight Theoretical Domains Framework domains and all COM-B model categories. The most frequently recognised themes were found in three Theoretical Domains Framework domains: Environmental Context and Resources (themes: 1 ­– availability of sufficient skilled staff to facilitate physical activity; 2 – design and use of the physical environment; 3 – lack of opportunities or incentives; 4 – passivity and institutionalisation; 5 – perceived and actual rules and culture of the ward); Skills (theme: physical impairments); and Social Influences (theme: activity influenced by family and friends). Conclusions The review highlights the complexity of the influences on the physical activity of patients hospitalised after stroke outside of staff-led rehabilitation sessions. It is likely multi-component interventions addressing a number of influences will be required to effectively improve physical activity. PROSPERO ID: CRD42022383506.
A Neoclassical Theory of Labor Exploitation: Some Comments
Authors: Basu Deepankar , Das Debarshi , Mukherjee Subhankar 
Published: November 2024

In this note, we comment on two aspects of the analysis presented in Eswaran’s article “The Nature of Labor’s Vulnerability to Exploitation.” First, we compare Eswaran’s neoclassical views of labor exploitation with the standard Marxian understanding of labor exploitation. Second, we delve deeper into Eswaran’s model and raise a set of questions about his analysis. JEL Classification: P12, J22, B14
Stratified Care in Cognitive Behavioural Therapy: A Comparative Evaluation of Predictive Modelling Approaches for Individualized Treatment: La stratification des soins pour l’orientation vers une thérapie cognitivo-comportementale: une évaluation comparative des approches de modélisation prédictive pour un traitement individualisé
Authors: Jamieson Margaret , Putman Andrew , Bryan Marsha , Hansen Bojay , Klassen Phillip E. , Li Nicholas , McQuaid Bethany , Rudoler David 
Published: November 2024

Objective In response to high demand and prolonged wait times for cognitive behavioural therapy (CBT) in Ontario, Canada, we developed predictive models to stratify patients into high- or low-intensity treatment, aiming to optimize limited healthcare resources. Method Using client records ( n = 953) from Ontario Shores Centre for Mental Health Sciences (January 2017–2021), we estimated four binary outcome models to assign patients into complex and standard cases based on the probability of reliable improvement in Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) scores. We evaluated two choices of cut-offs for patient complexity assignment: models at an ROC (receiver operating characteristic)-derived cut-off and a 0.5 probability cut-off. Final model effectiveness was assessed by assigning treatment intensity (high-intensity or low-intensity CBT) based on the combined performance of both GAD-7 and PHQ-9 models. We compared the treatment assignment recommendations provided by the models to those assigned by clinical assessors. Results The predictive models demonstrated higher accuracy in selecting treatment modality compared to provider-assigned treatment selection. The ROC cut-off achieved the highest prediction accuracy of case complexity (0.749). The predictive models exhibited large sensitivity and specificity trade-offs (which influence the rates of patient assignment to high-intensity CBT) despite having similar accuracy statistics (ROC cut-off = 0.749, 0.5 cut-off = 0.690), emphasizing the impact of cut-off choices when implementing predictive models. Conclusions Overall, our findings suggest that the predictive model has the potential to improve the allocation of CBT services by shifting incoming clients with milder symptoms of depression to low-intensity CBT, with those at highest risk of not improving beginning in high-intensity CBT. We have demonstrated that models can have significant sensitivity and specificity trade-offs depending on the chosen acceptable threshold for the model to make positive predictions of case complexity. Further research could assess the use of the predictive model in real-world clinical settings. Plain Language Summary Title: Stratified Care in Cognitive Behavioural Therapy: A Comparative Evaluation of Predictive Modeling Approaches for Individualized Treatment
The Psychological Health of Iranian Citizens Protesting the Actions of Their Country's Morality Police: La santé psychologique des citoyens iraniens qui manifestent contre les actions de la police des mœurs de leur pays
Authors: Marchetti Sophia , Feinstein Anthony 
Published: November 2024

Objective To determine the mental health of Iranian citizens protesting the actions of their country's Morality Police. Street protests across Iran were met with violent suppression that included security forces reportedly targeting protestors’ eyes. Method A group of 63 Iranian protestors (58.7% female; mean age 32.0 [SD = 9.43] years, from all socio-economic classes) who had been part of street protests against the regime's morality police, was recruited by convenience sampling between May and August 2023 by journalists working underground in Iran. The study was conducted in Farsi by telephone ( n = 60) and in-person ( n = 3). Demographic and psychometric data were collected, the latter including symptoms of posttraumatic stress disorder (PTSD; Impact of Events Scale–Revised) and depression (Beck Depression Inventory–Revised), in Farsi-validated scales. Between-group comparisons were undertaken with one-way ANOVA and post-hoc Tukey comparisons. Significance was set at P < 0.05. Results The protestors comprised three groups: not wounded ( n = 27: 59.26% female, mean age 34.44 [SD = 12.11] years), non-eye wound ( n = 23; 60.87% female, mean age 32.61 [SD = 5.89] years) and eye-wound ( n = 13; 53.85% female, mean age 27.54 [SD = 6.58] years). The eye wound group (blinded in one or both eyes) had less severe intrusion symptoms of PTSD ( P = 0.048) and depression ( P = 0.0001) than the non-eye wound group. The not wounded group had less severe symptoms of depression than the non-eye wound group ( P = 0.003). Every protestor who had lost sight regarded their actions, notwithstanding their physical consequences, in a positive psychological light. Conclusions Contrary to our a-prior hypothesis, Iranian protestors blinded in one or both eyes were faring better psychologically than protestors with non-eye wounds. Possible reasons for this included higher rates of psychological treatment and social support in the eye-wound group compared to the other two groups post-injury and the nascent development of posttraumatic growth.
Establishing a peritoneal dialysis technique survival core outcome measure: A standardised outcomes in nephrology-peritoneal dialysis consensus workshop report
Authors: Elphick Emma H , Manera Karine E , Viecelli Andrea K , Craig Jonathan C , Cho Yeoungjee , Ju Angela , Shen Jenny I , Wilkie Martin , Anumudu Samaya , Boudville Neil , Chow Josephine SF , Davies Simon J , Gooden Patricia , Harris Tess , Jain Arsh K , Liew Adrian , Matus-Gonzalez Andrea , Amir Noa , Nadeau-Fredette Annie-Claire , Nguyen Thu , Wang Angela Yee-Moon , Ponce Daniela , Quinn Rob , Jaure Alison , Johnson David W , Lambie Mark ,   on behalf of the SONG-PD Technique Survival Workshop Investigators
Published: November 2024

Background Technique survival, also reported with negative connotations as technique failure or transfer from peritoneal dialysis to haemodialysis, has been identified by patients, caregivers and health professionals as a critically important outcome to be reported in all trials. However, there is wide variation in how peritoneal dialysis technique survival is defined, measured and reported, leading to difficulty in comparing or consolidating results. Methods We conducted an online international consensus workshop to establish a core outcome measure of technique survival. Discussions were analysed thematically. Results Fifty-five participants including 14 patients and caregivers from 13 countries took part in facilitated breakout discussions using video-conferencing. The following themes were identified: capturing important aspects of the outcome (requiring a core event to define the outcome, distinguishing temporary from permanent events, recognising heterogeneous experiences of transfers), adopting appropriate neutral nomenclature (conveying with clarity, avoiding negative connotations), and ensuring feasibility and applicability (capturing data relevant to clinical and research settings, ease of adoption). The suggested definitions for the core outcome measure were ‘the event of a transfer to haemodialysis’, or ‘discontinuation of peritoneal dialysis’. Applying the principles described within the workshop, defining the outcome measure as a ‘transfer to haemodialysis’ was preferable. Conclusions It is proposed that the core outcome of technique survival is redefined as ‘transfer to haemodialysis’ and that its components are standardised using simple, neutral terminology Components considered important by stakeholders included recording the reasons for transfer from peritoneal dialysis, and focussing on permanent events whilst ensuring the outcome remains easy to implement.
Health Experiences of LGBTQ+ People Living With Dementia and Their Care Partners: A Scoping Review of Research and Policy
Authors: Harris-Gersten Melissa , Simmons Ames , Hendren Stephanie , May Jennifer 
Published: November 2024

Objectives This scoping review aimed to synthesize research on the health experiences of LGBTQ+ people living with dementia (PLWD) and their caregivers, and the impact of health policies on this population. Methods Six databases were searched for research studies and policy literature. Titles, abstracts, and full texts were reviewed by a three-member team. Data was extracted and thematically analyzed. Feedback from 7 LGBTQ+ adults was collected through a community consultation session. Results A total of 9257 unique research and 945 policy citations were identified, of which 60 research and 19 policy papers were reviewed. Nine research studies and ten policy papers met eligibility criteria. Themes emerged through the analysis of research findings, the community listening session, and policy findings. Discussion Future work needs to disentangle the impact of policies on the health experiences of this population. Dementia-specific and LGBTQ+ inclusive services and policies are needed to address growing health disparities.
Enabling pharmacist prescribing: Lessons learned in Nova Scotia using behaviour change theory
Authors: Grant Amy , Kennie-Kaulbach Natalie , Bishop Andrea , Isenor Jennifer E. 
Published: November 2024

Background: The COVID-19 pandemic alongside increased patient demand, enablement of scope, and government funding has accelerated the need and demand for pharmacist prescribing in Nova Scotia. Methods: A sequential explanatory mixed-methods study was undertaken to understand barriers and facilitators to pharmacist prescribing in Nova Scotia, Canada. This consisted of: 1) a cross-sectional survey and 2) semistructured, qualitative interviews with pharmacists practising in the community. The survey and interviews were designed using the Behaviour Change Wheel that encompasses the Capability Opportunity Motivation Model of Behaviour Change (COM-B) and Theoretical Domains Framework version 2 (TDFv2). Results: Of 190 survey respondents, the percentage who prescribed 15+ times/month increased from 49% before to 80% during the COVID-19 pandemic (P<0.001). Pharmacists identified knowledge, social norms/pressures, and rewards or consequences related to how and when to prescribe as facilitators (Knowledge, Social Influences, and Motivation TDFv2 domains, respectively). Barriers included the environmental context and fear of negative outcomes (Environmental Context and Resources and Beliefs about Consequences, respectively). Through the interviews, the presence of prescribing decision tools (Memory, Attention and Decision Processes) and a supportive organizational culture (Environmental Context and Resources) were facilitators. Worry was expressed about making mistakes (Beliefs about Consequences) and feeling significant pressure to meet patient demand (Social Influences) in a busy setting (Environmental Context and Resources). Discussion: Supports to better enable pharmacist prescribing are described, with key messages for pharmacists, pharmacy owners/managers, educators, advocacy bodies, regulators, and government identified. Conclusion: Pharmacist prescribing has increased significantly over a short period of time. Environmental supports (e.g., time, space, access to patient records), government funding, peer support, and public awareness are needed to optimize and fully implement these practice changes.
Impact of COVID-19 on intrapartum care at public hospitals in the Sidama region, Ethiopia: A mixed-methods study
Authors: Kassa Zemenu Yohannes , Scarf Vanessa , Turkmani Sabera , Fox Deborah 
Published: November 2024

Background: The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted the health of pregnant women and their unborn babies. Objective: To explore the impact of COVID-19 on intrapartum care in Ethiopia. Design: A concurrent mixed-methods design was employed. Methods: An interrupted time series analysis was implemented using a Poisson regression model to estimate monthly changes in the incidence rates of institutional childbirth, instrumental vaginal birth, caesarean section, stillbirth, institutional neonatal death, institutional maternal death and availability of essential medical supplies before and during COVID-19. The dataset included data from all women who gave birth in 15 public hospitals, and the total number of childbirths in the cohort study before COVID-19 (12 months of data from March 2019 to February 2020) was 24,478, while during COVID-19 (6 months of data from March to August 2020), the total number of childbirths in the cohort study was 11,966, forming a combined final dataset of 36,444. Simultaneously, a descriptive qualitative study using a purposive sampling technique was conducted through in-depth interviews until data saturation was reached, with data were collected from 14 February to 10 May 2022. Data from the interviews were imported into NVivo 12 Plus to perform an inductive thematic analysis. Quantitative and qualitative data were integrated using joint display methods to identify corroboration or contradiction between the different forms of evidence. Results: Our findings indicate that the incidence rates of caesarean sections and instrumental vaginal births significantly increased in the first 6 months of COVID-19. Three themes were identified: ‘ Barriers to providing intrapartum care during COVID-19’, ‘ Delays to provision of intrapartum care during COVID-19’ and ‘ Inadequate COVID-19 preventive measures’. Conclusion: In combination, the three themes contributed to a considerable increase in neonatal and maternal deaths. Interventions such as fully equipped labour wards and obstetric triage systems are needed to restore disrupted maternal and perinatal care during the ongoing and future pandemics. In addition, stakeholders should inform the public that blood donations can help the community recover from recent shocks in emergency health and future pandemics. Further research should investigate the long-term impact of COVID-19 on maternity care and maternal and infant outcomes.
Identifying the Relationship Between CGM Time in Range and Basal Insulin Adherence in People With Type 2 Diabetes
Authors: Nørlev Jannie Toft Damsgaard , Kronborg Thomas , Jensen Morten Hasselstrøm , Vestergaard Peter , Hejlesen Ole , Hangaard Stine 
Published: November 2024

Background: The study aimed to determine the relationship between basal insulin adherence and glycemic control evaluated by time in range (TIR) in people with insulin-treated type 2 diabetes (T2D), using data from both continuous glucose monitors (CGM) and connected insulin pens. Furthermore, the study aimed to determine the best basal insulin adherence metric. Methods: CGM data and basal insulin data were collected from 106 insulin-treated people (aged ≥18 years) with T2D. Three different adherence metrics were employed (dose deviation, dose deviation ≤20%, and a traditional metric) and a three-step methodology was used to measure insulin adherence level. The coefficient of determination (R2), based on a univariate linear regression analysis, was used to determine the relationship between each adherence metric and TIR. Results: A statistically significant relationship was observed between TIR and adherence quantified as the dose deviation ≤20% metric (R2 = 0.67, P = .006). Neither the relationship between the dose deviation metric and TIR (R2 = 0.43, P = .08) nor the relationship between the traditional metric and TIR (R2 = 0.35, P =.23) was found to be statistically significant. Conclusions: Our study indicates a relationship between basal insulin adherence and TIR in people with insulin-treated T2D. This seems to underscore the role of basal insulin adherence for optimal glycemic outcomes and utilizing TIR as a clinical marker. Furthermore, the results suggest that the magnitude of deviation from the recommended basal insulin dose impacts glycemic control, indicating dose deviation ≤20% as a more accurate metric for quantifying adherence.
Biodegradable nanocellulose hydrogels from agricultural waste: Impact of defibrillation on mechanical and antimicrobial properties
Authors: Hongrattanavichit Intatch , Somsesta Noppon , Aht-Ong Duangdao 
Published: November 2024

Food spoilage, which often leads to food waste, occurs throughout the entire food supply chain, from the upstream to downstream stages of food production. Biobased hydrogels made from cellulose nanofiber (CNF) have emerged as potential materials for extending food shelf-life. Despite this potential, the impact of defibrillation time during the production of CNF on the properties of CNF-based hydrogels (CNF-H) has not been thoroughly investigated. In this study, the defibrillation time of CNF was varied at 50–90 min to examine its effect on both the CNF itself and the resulting hydrogel properties. The findings revealed that longer mechanical defibrillation times significantly reduced the size of the CNF, leading to a denser CNF-H structure. At extended defibrillation times, the diameter of the CNF decreased from 25 to 20 nm, which strengthened the inter- and intramolecular forces between CNF fibers, resulting in a more crystallinity (from 66.64% to 77.51%) and compact hydrogel network. This denser structure reduced water absorption capacity, thereby limiting moisture penetration and decreasing biodegradability. Additionally, the antimicrobial activity of CNF-H, tested after soaking in ethanol, showed enhanced effectiveness against both gram-positive and gram-negative bacteria with increased defibrillation time, all without exhibiting cytotoxic effects.
Towards privacy-preserving Alzheimer’s disease classification: Federated learning on T1-weighted magnetic resonance imaging data
Authors: Sahid Md Abdus , Uddin Md Palash , Saha Hasi , Islam Md Rashedul 
Published: November 2024

Objective This study aims to address the challenge of privacy-preserving Alzheimer’s disease classification using federated learning across various data distributions, focusing on real-world applicability. The goal is to improve the efficiency of classification by minimizing communication rounds between clients and the central server. Methods The proposed approach leverages two key strategies: increasing parallelism by utilizing more clients in each communication round and increasing computation per client during the intervals between rounds. To reflect real-world scenarios, data is divided into three distributions: identical and independently distributed, non-identical and independently distributed equal, and non-identical and independently distributed unequal. The impact of extreme quantity distribution skew is also examined. A convolutional neural network is used to evaluate the performance across these setups. Results The empirical study demonstrates that the proposed federated learning approach achieves a maximum accuracy of 84.75%, a precision of 86%, a recall of 85%, and an F1-score of 84%. Increasing the number of local epochs improves classification performance and reduces communication needs. The experiments show that federated learning is effective in handling heterogeneous datasets when all clients participate in each round of training. However, the results also indicate that extreme quantity distribution skew negatively impacts classification performance. Conclusions The study confirms that federated learning is a viable solution for Alzheimer’s disease classification while preserving data privacy. Increasing local computation and client participation enhances classification performance, though extreme distribution imbalances present a challenge. Further investigation is needed to address these limitations in real-world scenarios.