bluuebunny/crossref_metadata_2025_split huggingface dataset:
Barriers and facilitators influencing referral and access to palliative care for children and young people with life-limiting and life-threatening conditions: a scoping review of the evidence
Authors: Holder Pru , Coombes Lucy , Chudleigh Jane , Harding Richard , Fraser Lorna K 
Published: September 2024

Background: Palliative care is an essential component of children’s health services but is accessed by fewer children than could potentially benefit. Aim: Appraise the evidence to identify factors influencing referral and access to children’s palliative care, and interventions to reduce barriers and improve referrals. Design: Scoping review following the six stages of the Arksey and O’Malley framework. Data were charted using an adapted version of the socioecological framework. Data sources: CINAHL, MEDLINE, PsycINFO, EMBASE, Cochrane Library were searched for primary studies of any design and literature/systematic reviews. Studies reporting barriers/facilitators and interventions in relation to referral of children with a life-limiting condition to palliative care, in any setting, were included. Results: One hundred ninety five articles (primary qualitative and quantitative studies, reviews) were retained (153 reporting barriers/facilitators; 40 interventions; 2 both). Multiple factors were identified as barriers/facilitators: Individual level: underlying diagnosis, prognostic uncertainty, parental attitudes, staff understanding/beliefs; Interpersonal level: family support, patient-provider relationships, interdisciplinary communication; Organisational level: referral protocols, workforce, leadership; Community level: cultural norms, community resources, geography; Society level: policies and legislation, national education, economic environment, medication availability. Most of these factors were bi-directional in terms of influence. Interventions ( n = 42) were mainly at the organisational level for example, educational programmes, screening tools/guidelines, workplace champions and new/enhanced services; one-third of these were evaluated. Conclusion: Barriers/facilitators to paediatric palliative care referral are well described. Interventions are less well described and often unevaluated. Multi-modal approaches incorporating stakeholders from all levels of the socioecological framework are required to improve paediatric palliative care referral and access.
The Downturn of Egypt’s Eastern Desert in the Middle Roman Imperial Period
Authors: McDonald Brandon 
Published: September 2024

Roman activity in Egypt’s Eastern Desert fluctuated significantly, ranging from intense exploitation of its resources and desert routes that facilitated Indo-Mediterranean trade, to the Roman Empire’s near total abandonment of the region. In those areas crucial to the Roman state – stone quarries, Red Sea ports, desert road stations and mining settlements – a nadir in occupation occurs near the mid-third century CE. But archaeological evidence indicates that significant reductions in activity occurred between the late second and early third centuries CE – i.e., in the Antonine and Severan Periods. The downturn was probably a result of distant geopolitical engagements, outbreaks of disease and/or shifting patterns of trade, which led to the Empire’s neglect of and gradual withdrawal from the area. This article reviews the archaeology of the Eastern Desert and considers the reason(s) this once-important region fell into decline. [Formula: see text]
The Evolving Context of MAID-Related Communications for Registered Nurses in Canada
Authors: Thorne Sally , Parker Heidi , Pesut Barbara 
Published: September 2024

Background Since legalization of Medical Assistance in Dying in Canada in 2016, nurses are increasingly faced with new and evolving communication challenges as patients in a diversity of settings and contexts contemplate their end-of-life options. Purpose The purposes of this study were: 1) to develop an understanding of the nuances and challenges associated with MAID-related communication from the perspective of registered nurses, and 2) to draw on the insights arising from this analysis to reflect on the evolution of MAID communication for nurses over time. Methods This study represented a secondary analysis of two primary qualitative data sets, including: 74 interviews of Canadian registered nurses self-identifying as having some exposure to MAID in their clinical practice; and 47 narrative reflections volunteered by respondents to questions posed in an online MAID reflective guide for nurses. Results Nurses described evolving complexities associated with introducing and engaging with the topic of MAID with their patients, helping patients navigate access to MAID assessment, managing family and community dynamics associated with opinions and beliefs surrounding MAID, supporting patients in their planning toward a MAID death, and being there for patients and their families in the moment of MAID. Conclusions MAID communication is highly complex, individualized, and context-specific. It is apparent that many nurses have developed an impressive degree of comfort and skill around navigating its nuances within a rapidly evolving legislative context. It is also apparent that dedicated basic and continuing MAID communication education will warranted for registered nurses in all health care settings.
Predictors of Intention to use Health Literacy Strategies in Patient Education among Health Care Professionals at Public Hospitals of Bahir Dar City: Application of Theory of Planned Behavior
Authors: Fetene Bezawit Mekonnen , Wondiye Habtamu , Yigzaw Zeamanuel Anteneh 
Published: September 2024

PurposeHealth literacy strategies were using plain language, using visual aids, using the teach-back method, limiting the number of items provided, and providing culture-sensitive care. This study aimed to assess predictors of intention to use health literacy strategies in patient education among healthcare professionals.DesignAn institutional-based cross-sectional study, theory of planned behavior.SettingBahir Dar, Northwest Ethiopia, from March 10 to April 10, 2023.Subjects422 healthcare professionals.MeasuresSix items with a response range from 1 = strongly disagree to 5 = strongly agree each item was summed on a five-point Likert scale and its score range (6-30).AnalysisLinear regression, SPSS version 25.ResultsA total of 389 healthcare professionals participated with a response rate of 92.18%. The overall mean intention towards health literacy strategies score was 24.02 with (SD ± 3.84). Subjective norm [(β, .231; 95% CI: .129, .333)], attitude [β, .162; 95% CI: .072, .252], perceived behavioral control [(β, .121; 95% CI: .022, .221)], having got training [(β, .125; 95% CI: .348, .530)] and knowing health literacy [(β, .251; 95% CI: .131, .371)] were factors.ConclusionThe mean score of intention to use health literacy strategies was very low. Attitude, subjective norm, perceived behavioral control, training, and knowledge of health literacy strategies were predictors. Therefore, different strategies should be applied to increase the utilization of health literacy strategies.
Exploring the strain rate influence on shear yield behavior of acrylonitrile-butadiene-styrene: Experimental and numerical study
Authors: Dundar Mehmet Akif 
Published: September 2024

Most experimental and numerical studies are limited to examining the effect of strain rate on the compressive and tensile yield behavior of Acrylonitrile-Butadiene-Styrene (ABS), an amorphous material of significant industrial relevance, rather than its shear yield behavior; therefore, this study is dedicated to addressing this notable gap in the literature by exploring the effect of strain rate on the shear yield behavior of ABS. To this end, shear tests were carried out using the Wyoming version of the Iosipescu (V-notched) shear test fixture at five distinct loading rates, ranging from 5 × 10−3 to 1 × 101 mm/s, which correspond to strain rates between 5.5 × 10−4 s−1 and 7 × 10−1 s−1. Shear strain distributions in the specimens were measured using the Digital Image Correlation (DIC) technique. The shear test results not only revealed a substantial increase in the shear yield strength of ABS with increasing strain rate, but also demonstrated that the shear yield strength of ABS is more sensitive to strain rate than its compressive and tensile yield strengths. The findings of the study also suggested that using shear-tension test data pairs at the same strain rates is more effective for determining the hydrostatic pressure sensitivity parameter than using tension-compression and shear-compression test data pairs. The experimental results were validated against numerical predictions obtained through finite element analyses employing an elastic-viscoplastic constitutive model, which comprehensively accounted for non-linear material properties, geometric complexities, and non-linearities arising from boundary contacts.
Anxiety and disease awareness in individuals with heredity for abdominal aortic aneurysm
Authors: Fattahi Nina , Nilsson Olga , Svensjö Sverker , Roy Joy , Linné Anneli , Hultgren Rebecka 
Published: September 2024

Objective The psychological consequences of being aware of an increased risk of developing abdominal aortic aneurysm as a first-degree relative of a person with abdominal aortic aneurysm are hitherto unexplored. This study investigates the awareness of heritability and anxiety in male and female adult offspring of abdominal aortic aneurysm patients compared to controls. Health-related quality of life among participants with aortic pathology was compared to participants with normal aortic diameters. Methods This was a cross-sectional point prevalence study based on the participants examined in the Detecting Abdominal Aortic Aneurysm in First Degree Relatives Trial (DAAAD; 752 adult offspring, 756 matched controls), 2020–2022. Questionnaires about health-related quality of life and study-specific questions regarding awareness of heritability were collected prior to the aortic ultrasound. Results Attendance rate was higher among individuals with heredity compared to controls (67% vs. 52%, p < 0.001). Of 1508 adult offspring examined, 65% reported having a close relative with abdominal aortic aneurysm (6% in controls). Female adult offspring reported higher awareness of heritability than controls (38% vs. 12%, p < 0.001), as did males (32% vs. 8%, p < 0.001). A slight majority of participants with awareness reported anxiety (54% of female offspring; 51% of male). There were no measured differences in health-related quality of life between the groups when standard health-related quality of life instruments were used. Conclusion The higher-than-expected proportion of adult offspring with awareness of heritability and anxiety about such risk indicates that we fail to communicate risk to this group appropriately via the current channels of information within the healthcare system. This calls for the development of dedicated strategies for improved communication of abdominal aortic aneurysm risk to patients and their next of kin.
Gender-Based Violence in the Lives of Somali Women With Refugee Status: A Framework for Analysis and Action
Authors: Olukotun Oluwatoyin , Abusbaitan Hanan , Hearst Mary O. , Pirsch Anna , Hoffman Sarah J. , Martin Lauren , Connor Jennifer Jo , Adebayo Comfort Tosin , Eyadat Anwar , Dressel Anne , Giama Nasra , McMorris Barbara J. , Adams Shukri , Gondwe Kaboni W. , Lopez Alexa A. , Graf Maria , Mekonnen Hussen , Mersha Sisay Bekele , Demissie Ashenafi Ayalneh , Mkandawire-Valhmu Lucy 
Published: September 2024

Introduction: Gender-based violence (GBV) poses a significant threat to women with refugee status. Methodology: Following our analysis based on a previously published scoping review, we introduce a conceptual framework based on postcolonial feminist theory to inform research, policy, and practice that addresses the unique risk factors faced by Somali women with refugee status experiencing GBV and encountering barriers to care. Result: The framework synthesizes existing literature, incorporates findings from previous work with Somali women, and emphasizes the importance of understanding structural and sociocultural factors influencing help-seeking. Discussion: By developing women-centered interventions, health care and social service institutions can play a pivotal role in addressing GBV for Somali women with refugee status.
Antibiotics at End of Life: Where Are We Now and Where Are We Going? A Narrative Review
Authors: Crowley Patrick D. , Whalen Francis X. , Siegel Leslie R. , Challener Douglas W. 
Published: September 2024

Background Antibiotics are frequently prescribed at the end of life, though the benefits and harms are not well understood. Methods We abstracted relevant findings from articles published in English in the past 25 years to answer questions generated by discussion among the authors and with stakeholders in Palliative Care and Infectious Diseases. Findings Prescribing practices vary based on individual situation and geographic location. Patients with cancer and those hospitalized receive more antibiotics than those enrolled in outpatient hospice. Urinary tract infections and pulmonary infections are the most common conditions treated with antibiotics at the end of life -most often with penicillin derivatives and vancomycin in the hospital, fluoroquinolones in outpatient, and cephalosporins in both settings. When asked, patients most often prefer limiting antibiotics to symptom management at the end of life. Physicians’ over-estimation of patient preference for antibiotics and the increased probability of misdiagnosis increases antibiotic prescription rates. Antibiotics can improve symptoms when used for specific diseases at the cost of drug reactions, resistant organisms, and delayed discharge. Antibiotic use has variable results on survival duration. Antimicrobial stewardship exists in hospital and long-term care facilities, but not outpatient hospice groups. Stewardship interventions could increase proper use of antibiotics, but more information is needed to apply these interventions to hospice groups. Conclusions Antibiotics at the end of life are impactful and efforts to educate patients and providers will be invaluable in optimizing care.
Development of a Hospice Perceptions Instrument for Diverse Patients and Families: Establishing Content and Face Validity
Authors: Wallace Cara L. , Subramaniam Divya S. , Wray Ricardo , Bullock Karen , Dant Dani , Coccia Kathryn , Bennett Antonia V. , White Patrick , Hendricks-Ferguson Verna L. 
Published: September 2024

Context For many, the perception of “hospice” is synonymous with “death.” Even clinicians struggle to have conversations that distinguish between hospice and palliative care for fear that discussing hospice may diminish hope. To date, there are no existing measurement tools to evaluate patient and family perceptions of hospice care. Objective This research aimed to develop a Hospice Perceptions Instrument (HPI) to capture these perceptions among diverse patients and families. Methods Building on previous studies and literature, 79 potential items were drafted for the instrument. Our interprofessional team independently and collectively evaluated these, resulting in 36 items rated on a 5-point Likert scale. Overarching domains include (1) hospice philosophy and definitions; (2) hospice services; (3) values; and (4) counter-perceptions. Sixteen national subject matter experts from various professions and roles were invited to participate in the content-validity index and five hospice caregivers were invited to participate in face validity. Results Fourteen experts responded, with ten meeting inclusion criteria: one physician, four nurses, three social workers, and two chaplains. Six of the ten identified as Black. Three items were removed (I-CVI ranged from 0.5-06), and nine items were revised (I-CVI ranged from 0.6-07). The overall Content Validity Index (CVI) was 0.83, indicating excellent content validity. After revisions, five hospice caregivers assessed face validity and no changes were made based on feedback. Conclusion Results reveal a disconnect between professional expertise and patient/family voices related to hospice perceptions. Development of this instrument invites a better understanding of perceptions leading to new opportunities for patient/family engagement.
Relation of native acetabular anteversion to the orientation of transverse acetabular ligament
Authors: Kuchař Michal , Pelc Ondřej , Morávek Alexander , Henyš Petr , Heinemann Axel , Ondruschka Benjamin , Kučera Tomáš 
Published: September 2024

Background: Precise positioning of the acetabular component during total hip replacement is the key to achieving optimal implant function and ensuring long-term patient comfort. However, different anatomical variations, degenerative changes, dysplasia, and other diseases make it difficult. In this study, we discuss a method based on the three-dimensional direction of the transverse ligament, predicting native acetabular anteversion with higher accuracy. Methods: Angular positions of the acetabulum and direction of the transverse ligament were automatically calculated from routine computed tomography data of 270 patients using a registration algorithm. The relationship between acetabular angles and ligament direction and their relationship with sex, age, and pelvic tilt were sought. These relationships were then modelled using multilinear regression. Results: Including the direction of the transverse ligament in the sagittal and transverse planes as a regressor in the multilinear model explained the variation in acetabular anteversion (R2 = 0.76 for men, R2 = 0.63 for women; standard deviation in prediction: men, 3.92° and women, 4.00°). Conclusions: The results indicate that the ligament was suitable as a guidance structure almost insensitive to the ligament in the sagittal and transverse planes must be considered. Estimation based on the direction in only 1 plane was not sufficiently accurate. The operative acetabular inclination was not correlated with the direction of the ligament. The correlations were higher in men than in women.
Correlation Analyses Between Serum Interleukin-7, Interleukin-15 and Lactate Provide Insights Into Their Potential Roles in the Regulation of Inflammation in Elderly Septic Patients
Authors: Zhao Jingjing , Zhang Ye , Wang Jun-Yu , Wei Bing , Liu Yu-Geng 
Published: September 2024

Background: Our previous research have identified Interleukin (IL)-7 and IL-15 as prognostic biomarkers for elderly septic patients, however, little is known about the link between the serum levels of IL-7, IL-15, and lactate as well as their potential roles in the regulation of inflammation in elderly septic patients. Objectives: This study aimed at investigating the link between the serum levels of IL-7, IL-15, and lactate as well as with other factors in elderly septic patients. Design: This is a retrospective study including 129 elderly patients with sepsis who were divided into the survival group (N = 34) and the nonsurvival group (N = 95) and further subgrouped based on the Acute Physiology and Chronic Health Evaluation II (APACHE II) scores. Methods: The baseline data and clinical parameters were recorded within 24 h upon admission. Serum levels of the cytokines were quantified by the Luminex assay. Spearman correlation analysis were performed. Results: Serum levels of IL-6, IL-7, IL-15, and tumor necrosis factor-α (TNF-α) were significantly higher in the nonsurvival group ( P < .05). Correlations between serum levels of IL-7 and platelet-derived growth factor-AA (PDGF-AA), as well as correlations between IL-15, IL-6, and TNF-α were confirmed ( P < .05). Both the serum levels of lactate and IL-15 correlated with the total counts of platelet (PLT) in the survival subgroup with low APACHE Ⅱ scores while the serum levels of IL-7, IL-15, and total counts of monocytes correlated with each other in the nonsurvival subgroup with different APACHE Ⅱ scores ( P < .05). Conclusion: Knowledge of the regulation networks between serum levels of IL-7, IL-15, lactate, and other cytokines may provide insights into potential mechanisms in the modulation of inflammation in elderly septic patients and facilitate more prompt and accurate treatment to reduce the mortality rate.
Aging is associated with reduced inflammatory disease activity independent of disease duration in relapsing multiple sclerosis trial populations
Authors: Coerver Eline ME , Kaçar Sezgi , Ciccarelli Olga , Sormani Maria P , Barkhof Frederik , Arnold Douglas L , Schoonheim Menno M , Van Kempen Zoé LE , Mostert Jop , Koch Marcus W , Killestein Joep , Eshaghi Arman , Uitdehaag Bernard MJ , Strijbis Eva MM 
Published: September 2024

Background: Higher age is associated with less inflammatory disease activity in relapsing-remitting multiple sclerosis (RRMS). It is unknown whether age itself or disease duration underlies this association. Objectives: This study investigated the effects of age, disease duration, and inflammatory disease activity in people with RRMS. Methods: Individual patient-level data from five large phase III randomized controlled trials (RCTs) was utilized to investigate the association of both age and disease duration with annualized relapse rate (ARR), contrast-enhancing lesions (CELs), and new T2 lesions on magnetic resonance imaging (MRI) at baseline and follow-up. Results: The data set included 5626 participants. Higher age was associated with lower ARRs, lower CEL number on MRI at baseline and follow-up, and lower new T2 lesion numbers at follow-up. This effect was present in all disease duration groups. For example, we found a lower number of new T2 lesions on MRI during follow-up in higher age groups compared to lower age groups, independent of disease duration. Conclusion: Aging in RRMS is associated with a lower risk of inflammatory disease activity, across different disease durations. Age should be taken into account when designing clinical trials and future research should investigate how age should be integrated into personalized predictions of treatment response and risk profiling.
Choroid plexus enlargement correlates with periventricular pathology but not with disease activity in radiologically isolated syndrome
Authors: Landes-Château Cassandre , Ricigliano Vito AG , Mondot Lydiane , Thouvenot Eric , Labauge Pierre , Louapre Céline , Zéphir Hélène , Durand-Dubief Françoise , Le Page Emmanuelle , Siva Aksel , Cohen Mikael , Yazdan Panah Arya , Azevedo Christina J. , Okuda Darin T. , Stankoff Bruno , Lebrun-Frénay Christine 
Published: September 2024

Background: Choroid plexus (ChP) enlargement is an emerging radiological biomarker in multiple sclerosis (MS). Objectives: This study aims to assess ChP volume in a large cohort of patients with radiologically isolated syndrome (RIS) versus healthy controls (HC) and explore its relationship with other brain volumes, disease activity, and biological markers. Methods: RIS individuals were included retrospectively and compared with HC. ChPs were automatically segmented using an in-house automated algorithm and manually corrected. Results: A total of 124 patients fulfilled the 2023 RIS criteria, and 55 HCs were included. We confirmed that ChPs are enlarged in RIS versus HC (mean (±SD) normalized ChP volume: 17.24 (±4.95) and 11.61 (±3.58), respectively, p < 0.001). Larger ChPs were associated with more periventricular lesions (ρ = 0.26; r2 = 0.27; p = 0.005 for the correlation with lesion volume, and ρ = 0.2; r2 = 0.21; p = 0.002 for the correlation with lesion number) and lower thalamic volume (ρ = −0.38; r2 = 0.44; p < 0.001), but not with lesions in other brain regions. Conversely, ChP volume did not correlate with biological markers. No significant difference in ChP volume was observed between subjects who presented or did not have a clinical event or between those with or without imaging disease activity. Conclusions: This study provides evidence that ChP volume is higher in RIS and is associated with measures reflecting periventricular pathology but does not correlate with biological, radiological, or clinical markers of disease activity.