bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improve Mental Health (Improve-MH) in refugee families using a culturally adapted, general practitioner-delivered psychotherapeutic intervention combined with Triple P Online parenting programme: study protocol of a multicentre randomised controlled trial
Authors: Zagha Karim , Konietzny Kerstin , Brettschneider Christian , Chehadi Omar , Chehadi-Köster Angela , Chikhradze Nino , Dababneh Nesreen , Hegerath Flora-Marie , Heller Lisa , Dehnen Alessia , Hessbruegge Martina , in der Schmitten Jürgen , König Hans-Helmut , Krasko Julia , Kumsta Robert , Luhmann Maike , Lukaschek Karoline , Margraf Juergen , Pflug Verena , Roesgen David , Sönnichsen Andreas , Vollmar Horst Christian , Gensichen Jochen , Schneider Silvia 
Published: September 2024

IntroductionGermany and the European Union have experienced successive waves of refugees since 2014, resulting in over 1.6 million arrivals, including families with young children. These vulnerable populations often face xenophobia, discrimination, substandard living conditions and limited healthcare access, contributing to a high prevalence of mental health problems (MHP). Our primary goal is to proactively address MHP in refugee parents and prevent its potential impact on their children through effective early interventions. Using a low-threshold, primary care-based approach, we aim to enhance parenting skills and address parental psychopathology, creating a supportive environment for parents and children.Methods and analysisIn this randomised controlled trial, 188 refugee parents of 6-year-old children or younger who meet the clinical cut-off on the MHP scale will participate. They are randomly assigned to either the experimental psychotherapeutic intervention, delivered by general practitioners (10-week Improve intervention), or treatment as usual, in a ratio of 1:1. The randomisation will be masked only for outcome assessors. Improve includes face-to-face sessions with general practitioners, an interactive online parenting programme (Triple P Online) and regular protocol-based telephone calls by psychologists. Primary outcomes will assess the intervention’s effects on parental and child MHP and parenting skills, with secondary outcomes including psychosocial and physical health indicators. Outcomes will be assessed at pre, post and at 3-month and 6-month follow-ups. The study is scheduled to run from February 2019 to July 2025.Ethics and disseminationThe project Improve-MH (application number 602) was approved by the local ethics committee of Ruhr-University of Bochum and is being conducted in accordance with the Declaration of Helsinki. The study is also conducted in full accordance with the German Data Protection Act, and the Good Clinical Practice guideline (GCP) and is sensitive to specific ethical considerations. Results will be disseminated at scientific conferences, published in peer-reviewed journals and provided to consumers of healthcare.Trial registration numberThe trial was prospectively registered at the German Clinical Trials Register (Deutsches Register Klinischer Studien, DRKS-ID: DRKS00019072) on 16 March 2020.
How well does the academic performance of Ethiopian anaesthetists predict their National Licensing Examination scores: a cross-sectional study
Authors: Asemu Yohannes Molla , Yigzaw Tegbar , Ayalew Firew , Scheele Fedde , van den Akker Thomas 
Published: September 2024

ObjectivesThis study assessed the relationship between academic performance and National Licensing Examination (NLE) scores of Ethiopian anaesthetists and proposed academic performance thresholds that predict failing the NLE.DesignA retrospective cross-sectional study.SettingAcademic performance measures were collected from eight universities and matched to total and subdomain NLE scores for anaesthetists. Four universities were first generation (oldest), three were second generation and one was third generation (newest).Participants524 anaesthetists.MeasuresSelected course grades, yearly (Y1–Y4) and cumulative grade point averages (GPAs) and in-school exit exam status were correlated with NLE scores. Linear regression was used to identify predictors of NLE score. Receiver operating characteristic curves were plotted to estimate GPA thresholds that predict failing the NLE.ResultsTotal and general surgery anaesthesia subdomain NLE scores showed moderate to strong linear relationships with most academic performance indicators. However, correlations between the rest of the subdomain NLE scores and composite course scores were either small or negligible (r<0.5). For every 1-point increase in a 4-point cumulative GPA and composite senior year practicum course score, the first-attempt NLE score increased by 12.61 (95% CI 10.03 to 15.19; p<0.0001) and 3.98 (95% CI 1.77 to 6.19; p=0.001) percentage points, respectively. Those entering university directly from high school and those attending a third-generation university would, on average, score 2.79 (95% CI 0.23 to 5.35; p=0.033) and 4.34 (95% CI 1.42 to 7.26; p=0.004) higher NLE scores compared with nurse entrants and first-generation university graduates, respectively. On a 4-point grading system, the thresholds for failing the NLE were below 2.68 for year-1 GPA, 2.62 for year-2 GPA, 2.72 for year-3 GPA, 3.04 for year-4 GPA and 2.87 for cumulative GPA.ConclusionsThe Ethiopian anaesthetist’s NLE score modestly correlated with most academic performance indicators. Based on pass/fail thresholds, the NLE could assist training programmes in improving NLE pass rates.
What is known about nurse retention in peri-COVID-19 and post-COVID-19 work environments: protocol for a scoping review of factors, strategies and interventions
Authors: Buckley Laura , McGillis Hall Linda , Price Sheri , Visekruna Sanja , McTavish Candice 
Published: September 2024

IntroductionThe pandemic has highlighted a worsening of nurses’ working conditions and a global nursing shortage. Little is known about the factors, strategies and interventions that improve nurse retention in the peri-COVID and post-COVID time period. An improved understanding of approaches implemented to support and retain nurses will provide a blueprint for sustaining the nursing workforce. The objectives of this scoping review are to investigate and describe the following: (a) factors associated with nurse retention; (b) strategies suggested to support nurse retention and (c) interventions trialled to support nurse retention, during and after the COVID-19 pandemic.Methods and analysisMedline, Embase, CINAHL and Scopus will be searched. The included studies will be qualitative, quantitative, mixed methods and grey literature studies of nurses including factors, strategies and/or interventions to support nurse retention in the peri-COVID and post-COVID time period (2019 to present) that are in English or can be translated into English. The excluded studies will be those that focus on nurse managers, educators, students or those in advanced practice roles and studies where the population cannot be segmented to identify which data came from nurses. Systematic, scoping reviews and meta-syntheses will be excluded, but their reference lists will be hand-screened for suitable studies. Data will be evaluated for quality and synthesised qualitatively to map the current evidence available. The relevant studies will be reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.Ethics and disseminationApproval for the broader research study, including this scoping review, has been obtained from the university health sciences research board (protocol #00042510). All data for this scoping review will be collected from published literature, and findings will be published in a peer-reviewed journal and presented at relevant conferences.Trial registration numberThe protocol was registered on Open Science Framework (4 April 2024)https://doi.org/10.17605/OSF.IO/XWH45.
Role of mixed healthcare providers networks in strengthening primary care systems: a case study of a rural primary care site
Authors: Tan-Lim Carol Stephanie Chua , Marfori Jose Rafael A , Sanchez Josephine T , Galingana Cara Lois T , Rey Mia P , De Mesa Regine Ynez H , Dans Leonila F , Dans Antonio L 
Published: September 2024

IntroductionService delivery networks, also called healthcare providers networks (HCPNs) have been used to address health inequities and promote universal healthcare (UHC). This study described the effect of instituting a mixed HCPN (partnership of public health facilities with a private pharmacy) on the provision of medications in the rural primary care pilot site of the Philippine Primary Care Studies (PPCS).MethodsThis is a case study of the mixed HCPN in the PPCS rural site. A mixed HCPN involving one private pharmacy was instituted to increase the supply of drugs. The total number of medications prescribed per month from April 2019 to October 2021, and the number of medications dispensed from the public sector (rural health unit or RHU) and from the partner private pharmacy in the same time period were obtained.ResultsOf the 101 031 medications prescribed in the first year (April 2019 to March 2020), 21.7% were dispensed at the RHU and 66.7% were dispensed in the partner private pharmacy. The remaining 11.5% were unrendered or dispensed in other private pharmacies. Of the 35 408 medications prescribed in the second year (April 2020 to March 2021), 5.6% were dispensed at the RHU and 32.2% were dispensed at the partner private pharmacy. Majority (62.1%) were unrendered or dispensed in other private pharmacies. From April to October 2021, of the 6448 medications prescribed, 2.3% were dispensed at the RHU, and 47.3% were dispensed at the partner private pharmacy. Majority (50.3%) were unrendered or dispensed in other private pharmacies.ConclusionCreation of a mixed HCPN in a rural primary care site augmented access to essential medications. The mixed HCPN model in the study showed potential in strengthening access to consultations and medications in a rural community. Improving essential primary care services can facilitate implementation of UHC in the Philippines.
Machine learning to evaluate the relationship between social determinants and diabetes prevalence in New York City
Authors: Tanner Darren , Zhang Yongkang , Chang Ji Eun , Speyer Peter , Adamson Elizabeth , Aerts Ann , Lavista Ferres Juan M , Weeks William B 
Published: September 2024

IntroductionDiabetes is a leading contributor to cardiovascular disease and mortality; social determinants of health (SDOH) are associated with disparities in diabetes risk. Quantifying the cumulative impact of SDOH and identifying the SDOH most associated with diabetes prevalence at the neighbourhood level can help policy-makers design and target local interventions to mitigate these disparities. Machine learning (ML) methods can provide novel insights and help inform public health intervention strategies in a place-based manner.MethodsIn a cross-sectional study, we used gradient boosting ML models to estimate the cumulative contribution of a set of SDOH variables to diabetes prevalence (%) at the census tract level within New York City (NYC); Shapley Additive Explanations were used to assess the magnitude and shape of relationships between our SDOH variables and model-predicted NYC diabetes prevalence. SDOH measures included socioeconomic position, educational attainment, food access, air quality, neighbourhood environment, housing conditions and insurance coverage.ResultsAcross 2096 NYC census tracts (population 8 170 505), mean diabetes prevalence was 11.5% (SD 3.7%; range 1.9%–42.8%). A set of 16 SDOH variables representing a framework of 16 distinct SDOH concepts accounted for 67% of the between-tract variance in model-derived NYC diabetes prevalence estimates (95% CI 66% to 68%); a set of 81 variables representing these 16 concepts accounted for 80% of variance (95% CI 78% to 81%). Models showed excellent across-location generalisation. The most important variables driving model predictions within NYC were measures of low educational attainment and poverty.ConclusionsSDOH accounted for a substantial proportion of neighbourhood-level variation in diabetes prevalence within NYC, independent of the demographics and health behaviours associated with those SDOH. Our place-based findings suggest that, within NYC, where approximately one million residents have diabetes and there are legislative requirements to reduce the impacts from diabetes, policies reducing socioeconomic and educational inequality could have the greatest potential to equitably achieve this.
Reducing strain on primary healthcare systems through innovative models of care: the impact of direct access physiotherapy for musculoskeletal conditions—an interrupted time series analysis
Authors: Zouch James Henry , Berg Bjørnar , Pripp Are Hugo , Storheim Kjersti , Ashton-James Claire E , Ferreira Manuela L , Grotle Margreth , Ferreira Paulo H 
Published: September 2024

ObjectivesTo evaluate the longitudinal impact of introducing a national, direct access physiotherapy model of care on the rates of primary and secondary care consultations for musculoskeletal (MSK) conditions.DesignInterrupted time series analysis using segmented linear regression.SettingNorway primary careParticipantsA cohort of 82 072 participants was derived from 3 population-based health surveys conducted across separate geographical regions in Norway. All participants surveyed were eligible for inclusion as a national representative sample of the Norwegian population. Registered MSK consultations were linked to the Norwegian Control and Payment of Health Reimbursement database and the Norwegian Patient Register using the International Classification of Primary Care diagnostic medical codes L-chapter for MSK conditions and spine related International Classification of Diseases, 10th Revision, codes.InterventionDirect access to physiotherapy model of care introduced nationally in Norway in 2018. This model allowed Norwegians to consult directly with qualified physiotherapists for MSK conditions (eg, back pain, knee osteoarthritis) without the need for a medical referral in order to claim a social security reimbursement.Main outcomes measuredRates of primary care consultations per 10 000 population (general practitioner (GP) and physiotherapist consultations) and secondary care (specialist consultations and surgical procedures) measured from 2014 to 2021.ResultsThe introduction of the direct access physiotherapy model was associated with an immediate stepped reduction of 391 general practice consultations per 10 000 population, (95% CI: −564 to −216), without an associated change in physiotherapy consultations. Subgroup analyses suggested there was an associated reduction in physiotherapy consultations for those in the lowest education group of 150 consultations per quarter (95% CI:−203 to −97), 70 consultations per quarter in the intermediate education group (95% CI:−115 to −27) and a stepped reduction of 2 spinal surgical procedures per 10 000 population, for those aged between 40 and 60 years (95% CI: −3 to −1) following the introduction of the direct access physiotherapy model.ConclusionThe national introduction of a direct access to physiotherapy model of care was associated with a reduction in the workload of GPs for the management of MSK conditions. The use of physiotherapists in direct contact roles is a potential strategic model to reduce the burden on the GP workforce in primary care worldwide.
Neurofilament light chain levels as an early predictive biomarker of neurotoxicity after CAR T-cell therapy
Authors: Larue Marion , Bouvier Amélie , Maillard Alexis , Cuffel Alexis , Allain Vincent , Ursu Renata , Carpentier Antoine F , Azoulay Elie , Thieblemont Catherine , Di Blasi Roberta , Caillat-Zucman Sophie 
Published: September 2024

Immune effector cell-associated neurotoxicity syndrome (ICANS) remains a significant cause of morbidity associated with CD19-targeted chimeric antigen receptor (CAR) T-cell therapy. Early prediction of patients who will develop ICANS would be crucial to better guide individualized management of high-risk patients, but specific predictive markers are still missing. Serum neurofilament light chain (NfL) levels are a sensitive indicator of neuroaxonal injury in neurological diseases. Elevated NfL levels at the time of CAR T-cell infusion have been associated with the severity of ICANS, but their utility for earlier identification of patients with subclinical neurological damage has not been evaluated.We studied all consecutive adult patients who received commercial CAR T cells for relapsed/refractory B-cell lymphomas at Saint-Louis Hospital between January 2019 and February 2023. Patients with pre-existing or current neurological disease were excluded. NfL levels were quantified in frozen serum collected at the time of the decision to treat (ie, the day of leukapheresis) and at the time of treatment (ie, the day of infusion).Of the 150 study patients, 28% developed ICANS of any grade, including 15.3% of grade 2–4. Receiving a CAR construct with a CD28 domain (58% of patients) was the strongest predictor of grade 2–4 ICANS. Serum NfL levels were significantly higher in patients with grade 2–4 ICANS than in those with grade 0–1 ICANS, both at the time of leukapheresis and infusion. In multivariate models, NfL above the cut-off value was independently associated with grade 2–4 ICANS at leukapheresis (NfL>75 pg/mL, OR 4.2, 95% CI 1.2 to 14.2, p=0.022) and infusion (NfL>58 pg/mL, OR 4.3, 95% CI 1.3 to 13.7, p=0.015).In conclusion, high NfL levels at the time of the decision to proceed with CAR T-cell manufacturing may represent an early surrogate of underlying loss of neuroaxonal integrity that increases the risk of subsequent neurotoxicity. Incorporating NfL levels into the decision-making process based on each patient’s risk profile could help determine the appropriate CAR product when possible, and guide the prophylactic or therapeutic management of ICANS.
Metabolic reprogramming of hypoxic tumor-associated macrophages through CSF-1R targeting favors treatment efficiency in colorectal cancers
Authors: Gharzeddine Khaldoun , Gonzalez Prieto Cristina , Malier Marie , Hennot Clara , Grespan Renata , Yamaryo-Botté Yoshiki , Botté Cyrille Y , Thomas Fabienne , Laverriere Marie-Hélène , Girard Edouard , Roth Gael , Millet Arnaud 
Published: September 2024

BackgroundTumor-associated macrophages participate in the complex network of support that favors tumor growth. Among the various strategies that have been developed to target these cells, the blockade of the colony-stimulating factor 1 receptor (CSF-1R) receptor is one of the most promising ones. Here, we characterize the resulting state of human macrophages exposed to a CSF-1R kinase inhibitor.MethodsUsing RNA sequencing and metabolomics approach, we characterize the reprogramming of human monocyte-derived macrophages under CSF-1R targeting.ResultsWe find that CSF-1R receptor inhibition in human macrophages is able to impair cholesterol synthesis, fatty acid metabolism and hypoxia-driven expression of dihydropyrimidine dehydrogenase, an enzyme responsible for the 5-fluorouracil macrophage-mediated chemoresistance. We show that this inhibition of the CSF-1R receptor leads to a downregulation of the expression of sterol regulatory element-binding protein 2, a transcription factor that controls cholesterol and fatty acid synthesis. We also show that the inhibition of extracellular signal-regulated kinase 1/2 phosphorylation resulting from targeting the CSF-1R receptor destabilizes the expression of hypoxic induced factor 2 alpha in hypoxia resulting in the downregulation of dihydropyrimidine dehydrogenase expression restoring the sensitivity to 5-fluorouracil in colorectal cancer.ConclusionsThese results reveal the unexpected metabolic rewiring resulting from the CSF-1R receptor targeting of human macrophages and its potential to reverse macrophage-mediated chemoresistance in colorectal tumors.
Development of home-based care educational programme for the family caregivers of activity limited older people: an educational programme model for community nurses
Authors: Wijesiri H S Maliga S K 
Published: September 2024

Background/aimA home-based care educational programme for family caregivers of activity-limited older people was developed and implemented to provide caregiver education and to teach basic caregiving techniques. The purpose of the home-based care educational programme was to improve the caregivers’ knowledge, skills and attitudes necessary to perform the caregiving tasks with reduced physical strain.MethodsThe educational programme model comprises the knowledge and skills necessary to carry out the caretaking responsibilities of older people, especially those with limited activities. It was conducted as an interventional study recruiting two groups (n=72) as intervention (n=36) and control group (n=36), and the knowledge of the caregivers was evaluated. The teaching sessions were planned considering the adult educational learning theories and guided by a developed educational handbook.ResultsThe pre and post mean±SD knowledge scores of the intervention group (43.78±12.41; 89.78±5.61) showed a significant difference (p<0.001), whereas the pre and post knowledge mean±SD scores of the control group (50.69±17.90; 51.43±17.79) showed no significant improvement (p>0.05). The difference between the pre-test and post-test between the two groups was significant (p<0.0001).ConclusionsAt the end of the educational programme, participants valued the opportunity that they received, and the assessment of knowledge before and after the programme showed an improvement in caregivers’ knowledge. The study suggests conducting home-based or community-based health education programmes for caregivers of older people with limited activities, with the involvement of responsible healthcare professionals and leaders.
Digital health for cancer symptom management in palliative medicine: systematic review
Authors: Hamdoune Meryem , Jounaidi Khaoula , Ammari Nada , Gantare Abdellah 
Published: September 2024

Background
Digital health technologies (DHTs) play a crucial role in symptom management, particularly in palliative care, by providing patients with accessible tools to monitor and manage their symptoms effectively. The aim of this systematic review was to examine and synthesise the scientific literature on DHTs for symptom management in palliative oncology care.

Methods
A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews and meta-analyses from 2 June to 20 June 2024. Databases including Scopus, Web of Science, ScienceDirect, PubMed and the Cochrane Library were searched. Data were extracted using a standardised form based on the PICOTT (Population, Intervention, Comparison, Outcome, Type and Technology) framework. The quality of the included studies was assessed using the Appraisal of Guidelines for Research & Evaluation (AGREE) II tool during the selection process.

Results
The systematic review included seven articles describing six DHTs from five countries: the UK, Kenya, Tanzania, the Netherlands and the USA. The findings of this comprehensive literature review elucidate four principal themes: the specific types of DHTs used for symptom management in palliative cancer care, their roles and advantages, as well as the factors that limit or promote their adoption by patients and healthcare professionals.

Conclusion
The findings of this review give valuable insights into the ongoing discourse on integrating digital health solutions into palliative care practices, highlighting its potential role in enhancing symptom management within palliative cancer care and showcasing its possible benefits while also identifying key factors influencing their adoption among patients and healthcare professionals.