bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychosomatic complaints are indicative of stress in young individuals: findings from a Swedish national cohort study
Authors: Låftman Sara Brolin , Östberg Viveca 
Published: August 2024

Aims:Psychosomatic complaints are common in youth and are often assumed to indicate stress. Although several studies have confirmed that a cross-sectional association exists, few have empirically investigated whether or not perceived stress influences psychosomatic complaints. The objective of the present study was to build upon previous research by exploring whether changes in perceived stress over time are associated with corresponding changes in psychosomatic complaints. This analytical approach takes unmeasured time-invariant confounding into account, thereby offering more robust evidence for a causal association between the variables under study.Methods:Data was derived from the Swedish national cohort study Futura01, with information from 2,708 participants aged 17–18 in 2019 and 20–21 in 2022. Perceived stress was measured by Cohen’s Perceived Stress Scale. Psychosomatic complaints were measured by questions on the frequency of stomach aches, headaches and difficulties falling asleep, which were added to an index. Information on gender, parental education, and parental country of birth was derived from registries. Linear regression analyses were conducted and the first difference (FD) approach was used.Results:Perceived stress and psychosomatic complaints exhibited cross-sectional associations at both time points. The FD analyses showed that increases in perceived stress were associated with increases in psychosomatic complaints, and this was the case irrespective of sociodemographic characteristics.Conclusions:This study provides further empirical support for the assumption that psychosomatic complaints can be partially attributed to stress. Societal efforts aimed at reducing stressors and strengthening coping resources and strategies among young people may help mitigate perceived stress and, consequently, the likelihood of developing psychosomatic complaints.
Defining and distinguishing early life stress, trauma, adversity, toxic and chronic stress and allostatic load: a descriptive review
Authors: Remmers Maarten C.C. , Reijs Rianne P. , Hoebe Christian J.P.A. 
Published: August 2024

Aims: Various concepts are used to study the impact of stress on childhood development. These concepts are often used inconsistently or interchangeably. Our main objectives were to determine how selected stress concepts (chronic stress, toxic stress, allostatic load, early life stress, childhood adversity, childhood trauma and adverse childhood experiences; ACEs) are defined, operationalized and described, and to provide a theoretical context to aid the choice for a preferred concept in public health research. Methods: For this descriptive review, we systematically searched for literature published before 4 August 2021, on PubMed, Embase and PsycInfo. Two independent reviewers included studies. Exclusion criteria were: no systematic review, not peer reviewed, not published in English, selected stress concepts were no predetermined variable or a substantial topic in the discussion, full text was unobtainable or study described non-human or non-childhood populations. Data extraction forms were used. Descriptives were gathered, publication fields were identified through Journal Citation Reports categories, and verbatim descriptions were ordered in text and Venn diagrams. Results: Of 264 screened studies, 124 were included. ACEs, childhood adversity and childhood trauma were used most. ACEs were the main concept used most frequently (47.6%). A total of 11 of 14 public and environmental health journals used ACEs. All concepts refer to prolonged, repeated, interpersonal stress from 0 to 18 years, that can alter physiological systems. Four concepts were stressor oriented, two concepts focused on stress response and effect and one on the state of challenged homeostasis. Conclusions: ACEs seem most fitting for public health setting, due to their operationalizability, large set of core experiences and widespread use.
Design and performance evaluation of a novel slightly acidic electrolysed water spraying air purifier for airborne bacteria and endotoxin in indoor air
Authors: Liu Chang , Li Zonggang , Deng Senzhong , Zheng Weichao 
Published: August 2024

Conventional air purifiers are low effective in inactivating airborne bacteria and may cause secondary contamination by releasing endotoxins. In this study, a novel air purifier was developed and used in a static chamber, which used slightly acidic electrolysed water (SAEW) solutions as the circulating disinfectant spray medium that automatically renewed every 30 min. During the 30-minute operation, the air and solution samples were collected to measure the bacteria and endotoxin concentration by using a culturable-based method and a limulus amoebocyte lysate assay kit, respectively. The pH and endotoxin of the circulating solution were gradually increased, and the available chlorine concentration (ACC, from 87 to 50 mg/L) was decreased. Although airborne bacteria were reduced significantly, the levels of airborne endotoxins at the inlet and outlet of the purifier remained constant. Moreover, a validation experiment revealed that SAEW, with ACC of 20, 60 and 100 mg/L, cannot inactivate standard endotoxin solutions. In the experimental chamber, the airborne bacteria level (1142 CFU/m3) was significantly lower compared to the control chamber (3325 CFU/m3), with no significant difference in airborne endotoxin levels between the chambers. Our results showed that the SAEW spray air purifier could effectively remove airborne bacteria without increasing airborne endotoxin levels within a 30-minute operational period.
Orthodontic YouTube™ videos made by patients for patients: What are they about and are they accurate?
Authors: Liew Iris EJ , Sharif Mohammad Owaise , Cunningham Susan J 
Published: August 2024

Objectives: To evaluate the characteristics and content of YouTube™ videos created by patients undergoing orthodontic fixed appliance treatment and to assess the content accuracy of these videos. Design: A mixed-methods quantitative and qualitative study. Data source: YouTube™ webpage. Methods: The term ‘braces’ was used to search for relevant videos on the YouTube™ webpage between 18 August and 30 August 2020, with no limits imposed regarding how long the video had been available on YouTube™. Videos were included if they were made by patients and were predominantly about patients’ experiences during treatment with labial fixed appliances. The main themes/subthemes of the included videos were identified. A checklist was then developed to assess accuracy of the video content for two of the main themes and the videos were assessed against the checklist. Results: The video search identified 350 videos, of which 64 were selected as potentially eligible; 41 were subsequently excluded as they related primarily to the bond up/debond experience or had minimal information about orthodontics. This meant that 23 videos were ultimately included for analysis. Six main themes were identified in the videos: problems with fixed appliances, effects of fixed appliances, oral hygiene maintenance, dietary advice, treatment duration/appointment frequency and auxiliaries used with fixed appliances. From the 23 videos, 20 were assessed against the checklist for content accuracy related to two selected themes: oral hygiene maintenance and dietary advice. The majority of videos had low content accuracy scores, indicating that important and relevant content was generally missing. Conclusion: Several included videos focused on oral hygiene maintenance and dietary advice associated with fixed appliances; however, the content was incomplete and not always accurate. This is concerning to the profession, and it is therefore recommended that clinicians consider collaborating with patients to produce videos that are patient-centred and that also contain accurate information.
The treatment effect across ASPECTS in acute ischemic stroke: Analysis from the AcT trial
Authors: Kaveeta Chitapa , Alhabli Ibrahim , Bala Fouzi , Horn MacKenzie , Benali Faysal , Coutts Shelagh B , Zafar Atif , Bereznyakova Olena , Khaw Alexander , Khosravani Houman , Hunter Gary , Tkach Aleksander , Dowlatshahi Dar , Catanese Luciana , Bogiatzi Chrysi , Appireddy Ramana , Buck Brian H , Swartz Richard H , Sajobi Tolulope T , Almekhlafi Mohammed , Demchuk Andrew M , Ganesh Aravind , Menon Bijoy , Singh Nishita 
Published: August 2024

Background: Early ischemic changes on baseline imaging are commonly evaluated for acute stroke decision-making and prognostication. Aims: We assess the association of early ischemic changes on clinical outcomes and whether it differs between intravenous tenecteplase and Alteplase. Methods: Data are from the phase 3, Alteplase compared to Tenecteplase (AcT) trial. Subjects with anterior circulation stroke were included. Early ischemic changes were assessed using the Alberta Stroke Program Early CT score (ASPECTS). Efficacy outcomes included modified Rankin scale (mRS) 0–1, mRS 0–2, and ordinal mRS at 90 days. Safety outcomes included 24-h symptomatic intracerebral hemorrhage (sICH), any hemorrhage on follow-up scan, and 90-day mortality rate. Mixed-effects logistic regression was used to assess the association of ASPECTS (continuous and categorical (0–4 vs 5–7 vs 8–10)) with outcomes and if these associations were modified by thrombolytic type after adjusting for age, sex, and baseline stroke severity. Results: Of the 1577 patients in the trial, 901 patients (56.3%; median age 75 years (IQR 65–84), 50.8% females, median National Institute of Health Stroke Scale (NIHSS) 14 (IQR 17–19)) with anterior circulation stroke were included. mRS 0–1 at 90 days was achieved in 1/14 (0.3%), 43/160 (14.7%), and 252/726 (85.1%) in the ASPECTS 0–4, 5–7, and 8–10 groups respectively. Every one-point decrease in ASPECTS was associated with 2.7% and 1.9% decrease in chances of mRS 0–1 and mRS 0–2 at 90 days, respectively, and 1.9% chances of increase in mortality at 90 days. Subgroup analysis in endovascular thrombectomy (EVT)-treated population showed similar results. Thrombolytic type did not modify this association between ASPECTS and 90-day mRS 0–1 (P-interaction 0.75). There was no significant interaction by thrombolytic type with any other outcomes. Conclusion: Similar to prior studies, we found that every one-point decrease in ASPECTS was associated with poorer clinical and safety outcomes. This effect did not differ between alteplase and tenecteplase. Data access statement: Data shall made available on reasonable request from the PI (BMM).
A Healthy Conversation Skills intervention to support changes to physical activity and dietary behaviours in community-dwelling older adults during the COVID-19 pandemic
Authors: Zhang J , Bloom I , Westbury LD , Bevilacqua G , Ward KA , Barker M , Lawrence W , Cooper C , Dennison EM 
Published: August 2024

Aims: Physical activity (PA) and nutrition are important determinants of health in late adulthood. However, low levels of PA and poor nutrition are common in older adults and have become more prevalent during the COVID-19 pandemic. We hypothesised that Healthy Conversation Skills could be used to support health behaviour changes beneficial for health in older adults and thus conducted a study nested within the UK Hertfordshire Cohort Study. Methods: Between November 2019 and March 2020, 176 participants were visited at home. A trained researcher administered a questionnaire and undertook anthropometric and physical performance tests. A total of 89 participants were randomised to the control group and received a healthy living leaflet; 87 participants in the intervention group were interviewed using Healthy Conversation Skills at the initial visit with follow-up telephone calls at 1, 3, 6 and 9 months. Follow-up at 1 year by postal questionnaire assessed change in PA and diet. In total, 155 participants (79 control and 76 intervention) completed the baseline and 1-year follow-up. Results: At baseline, median (lower quartile, upper quartile) age (years) was 83.1 (81.5, 85.5) and median PA time (min/day) from walking, cycling and sports was 30.0 (15.0, 60.0). In total, 95% of participants completed the intervention; the total response rate for postal questionnaires was 94%. There were no statistically significant differences in outcomes between the trial arms. In women, there was a tendency for greater increases in diet quality in the intervention group compared to the control group ( p = 0.075), while among men, there was a tendency for reduced decline in self-reported physical function in the intervention group compared to the control group ( p = 0.081). Conclusion: We have shown that it is viable to utilise Healthy Conversation Skills via telephone to promote healthier lifestyles in older adults. Larger appropriately powered studies to determine the efficacy of such an intervention are now warranted.
Pilot evaluation of the effectiveness of an ergonomics awareness educational programme addressed to middle-school children
Authors: Pani Sara M. , Gaccetta Fabrizio , Cadoni Federica , Della Salda Andrea , Liori Arianna , Contu Paolo 
Published: August 2024

Background: Ergonomics programmes addressed to children fit the health-promoting schools (HPS) framework. Beyond the integration of ergonomics in curricula, an important aspect is the effectiveness of the programme. This pilot study aims to evaluate the effectiveness of the programme proposed to a sample of middle-school children (aged 10–13 years) of the metropolitan city of Cagliari. Methods: The programme was designed along the lines of the INAIL (Italian National Institute for Insurance against Accidents at Work) scheme and proposed to 260 children. It consisted of three phases: 1) assessment of students’ background with a pre-intervention questionnaire (completed by 142 students); 2) teaching of the ergonomics training modules and evaluation of the weight of a sample of 160 backpacks, and of students’ perception to be able to sit by putting their feet on the ground; 3) evaluation of conceptual understanding of ergonomics concepts with a post-intervention questionnaire (completed by 107 students out of the 142 students who completed phase 1). Results: There was a substantial improvement in the percentage of correct responses post-intervention, confirmed by the chi-square test, regarding concepts about ergonomics, backpack weight and handling. Most of the backpacks exceeded the maximum allowed value, and 20% of students were perceived to be unable to sit putting their feet on the ground. Conclusions: The practical application of ergonomics pedagogy proved effective in the school setting and should be integrated into school curricula. The prevention technicians can offer a holistic approach, while the teachers are essential to implement the programme on a large scale. Effectiveness evaluation is necessary to guide resource allocation and implement and sustain the HPS approach. A tailored programme has a greater chance of reaching its target audience and maximizing effectiveness.
The 100 highest-cited original articles in large vessel occlusions: A bibliometric analysis
Authors: Shahbandi Ataollah , Holt Matthew , Shlobin Nathan A. 
Published: August 2024

Background Large vessel occlusions (LVO) are a common etiology of morbidity and mortality. The current literature lacks a synthesis of the landscape and trends in research. Objective We aimed to conduct a bibliometric analysis of the 100 most cited original articles on LVOs to assess the current state of research. Methods Scopus database was queried from inception to December 2022 to identify the most cited original articles from 4506 retrieved records on LVOs. Publication year, country of origin, total and average annual citation count, and type of study were collected for each article. The journal impact factor (JIF) was obtained from the Journal Citation Reports database. Results The articles were published between 1994 and 2021, with most ( n = 82) published during the 2011–2020 decade. The median total citation count was 108.5, with an interquartile range (IQR) of 81–149.5. The median (IQR) average annual citation count was 15.9 (11.5–22.9). Half of the articles were published in Stroke ( n = 35) and Journal of NeuroInterventional Surgery ( n = 15), with JIFs ranging from 1.8 to 202.7. The USA was the leading country in contributing to LVO research ( n = 45). Most studies focused on the treatment ( n = 63) and diagnosis ( n = 22) of LVOs. Conclusions Most articles were published during the past decade, highlighting the impact of the clinical trials of endovascular treatment on the discipline. With several ongoing clinical trials on the horizon, continued growth of the field is anticipated in the upcoming decades.
‘Someone must do it’: multiple views on family’s role in end-of-life care – an international qualitative study
Authors: Tripodoro Vilma A. , Veloso Verónica I. , Víbora Martín Eva , Kodba-Čeh Hana , Bakan Miša , Rasmussen Birgit H. , Zambrano Sofía C. , Joshi Melanie , Hálfdánardóttir Svandis Íris , Ásgeirsdóttir Guðlaug Helga , Romarheim Elisabeth , Haugen Dagny Faksvåg , McGlinchey Tamsin , Yildiz Berivan , Barnestein-Fonseca Pilar , Goossensen Anne , Lunder Urška , van der Heide Agnes 
Published: August 2024

Background: Family is a crucial social institution in end-of-life care. Family caregivers are encouraged to take on more responsibility at different times during the illness, providing personal and medical care. Unpaid work can be overburdening, with women often spending more time in care work than men. Objectives: This study explored multiple views on the family’s role in end-of-life care from a critical perspective and a relational autonomy lens, considering gender in a socio-cultural context and applying a relational autonomy framework. It explored patients, relatives and healthcare providers’ points of view. Design: This qualitative study was part of the iLIVE project, involving patients with incurable diseases, their relatives and health carers from hospital and non-hospital sites. Methods: Individual interviews of at least five patients, five relatives and five healthcare providers in each of the 10 participating countries using a semi-structured interview guide based on Giger–Davidhizar–Haff’s model for cultural assessment in end-of-life care. Thematic analysis was performed initially within each country and across the complete dataset. Data sources, including researchers’ field notes, were translated into English for international collaborative analysis. Results: We conducted 158 interviews (57 patients, 48 relatives and 53 healthcare providers). After collaborative analysis, five themes were identified across the countries: family as a finite care resource, families’ active role in decision-making, open communication with the family, care burden and socio-cultural mandates. Families were crucial for providing informal care during severe illness, often acting as the only resource. Patients acknowledged the strain on carers, leading to a conceptual model highlighting socio-cultural influences, relational autonomy, care burden and feminisation of care. Conclusion: Society, health teams and family systems still need to better support the role of family caregivers described across countries. The model implies that family roles in end-of-life care balance relational autonomy with socio-cultural values. Real-world end-of-life scenarios do not occur in a wholly individualistic, closed-off atmosphere but in an interpersonal setting. Gender is often prominent, but normative ideas influence the decisions and actions of all involved.
Describing the characteristics and symptom profile of a group of urban patients experiencing socioeconomic inequity and receiving palliative care: a descriptive exploratory analysis
Authors: Moore Harrison , Bablitz Cara , Santos Salas Anna , Morris Heather , Sinnarajah Aynharan , Watanabe Sharon M. 
Published: August 2024

Background: Individuals experiencing socioeconomic inequity have worse health outcomes and face barriers to palliative and end-of-life care. There is a need to develop palliative care programs tailored to this underserved population. Objectives: To understand the characteristics and symptom profiles of a group of urban patients experiencing socioeconomic inequity and receiving palliative care. Design: Descriptive exploratory analysis of a patient dataset. The patient dataset was generated through a pilot research study with patients experiencing socioeconomic inequity and life-limiting illness who received a community-based palliative care intervention. Methods: The intervention took place over 1 year in the Palliative Care Outreach and Advocacy Team, a community-based urban palliative care clinic in Edmonton, Alberta, Canada, serving persons experiencing socioeconomic inequity. Participants had to be at least 18 years of age, be able to communicate in English, require palliative care for a life-limiting illness, and be able to consent to inclusion in the study. Results: Twenty-five participants were enrolled. Participants predominantly identified as male and Indigenous, experienced poverty and housing instability, and had metastatic cancer. Our participants rated their pain, shortness of breath, and anxiety as more severe than the broader community-based palliative care population in the same city. Most patients died in inpatient hospices (73%). Conclusion: Our analysis provides an in-depth picture of an understudied, underserved population requiring palliative care. Given the higher symptom severity experienced by participants, our analysis highlights the importance of person-centered palliative care. We suggest that socioeconomic inequity should be considered in patients with life-limiting illnesses. Further research is needed to explore palliative care delivery to those facing socioeconomic inequity.
Mid-Atlantic primary care providers’ perception of barriers and facilitators to end-of-life conversation
Authors: Horning Melanie A. , Habermann Barbara 
Published: August 2024

Background: Among the chronically ill, end-of-life conversations are often delayed until emergently necessary and the quality of those conversations and subsequent decision-making become compromised by critical illness, uncertainty, and anxiety. Many patients receive treatment that they would have declined if they had a better understanding of benefits and risks. Primary care providers are ideal people to facilitate end-of-life conversations, but these conversations rarely occur in the out-patient setting. Objective: To investigate the self-reported experiences of physicians and advanced practice nurses with conversational barriers and facilitators while leading end-of-life discussions in the primary care setting. Design: A qualitative descriptive study. Methods: Six physicians and eight advanced practice nurses participated in singular semi-structured interviews. Results were analyzed using a qualitative descriptive design and content analysis approach to coding. Results: Reported barriers in descending order included resistance from patients and families, insufficient time, and insufficient understanding of prognosis and associated expectations. Reported facilitators in descending order included established trusting relationship with provider, physical and/or cognitive decline and poor prognosis; and discussion standardization per Medicare guidelines. Conclusion: Recommendations for improving the end-of-life conversational process in the primary care setting include further research regarding end-of-life conversational facilitators within families, the improvement of patient/family education about hospice/palliative care resources and examining the feasibility of longer appointment allotment.1