bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cerebrovascular lesion loads and accelerated brain aging: insights into the cognitive spectrum
Authors: Beheshti Iman , Potvin Olivier , Dadar Mahsa , Duchesne Simon 
Published: June 2024

IntroductionWhite matter hyperintensities (WMHs) and cerebral microbleeds are widespread among aging population and linked with cognitive deficits in mild cognitive impairment (MCI), vascular MCI (V-MCI), and Alzheimer's disease without (AD) or with a vascular component (V-AD). In this study, we aimed to investigate the association between brain age, which reflects global brain health, and cerebrovascular lesion load in the context of pathological aging in diverse forms of clinically-defined neurodegenerative conditions.MethodsWe computed brain-predicted age difference (brain-PAD: predicted brain age minus chronological age) in the Comprehensive Assessment of Neurodegeneration and Dementia cohort of the Canadian Consortium on Neurodegeneration in Aging including 70 cognitively intact elderly (CIE), 173 MCI, 88 V-MCI, 50 AD, and 47 V-AD using T1-weighted magnetic resonance imaging (MRI) scans. We used a well-established automated methodology that leveraged fluid attenuated inversion recovery MRIs for precise quantification of WMH burden. Additionally, cerebral microbleeds were detected utilizing a validated segmentation tool based on the ResNet50 network, utilizing routine T1-weighted, T2-weighted, and T2* MRI scans.ResultsThe mean brain-PAD in the CIE cohort was around zero, whereas the four categories showed a significantly higher mean brain-PAD compared to CIE, except MCI group. A notable association trend between brain-PAD and WMH loads was observed in aging and across the spectrum of cognitive impairment due to AD, but not between brain-PAD and microbleed loads.DiscussionWMHs were associated with faster brain aging and should be considered as a risk factor which imperils brain health in aging and exacerbate brain abnormalities in the context of neurodegeneration of presumed AD origin. Our findings underscore the significance of novel research endeavors aimed at elucidating the etiology, prevention, and treatment of WMH in the area of brain aging.
What helps, what hinders?—Focus group findings on barriers and facilitators for mobile service robot use in a psychosocial group therapy for people with dementia
Authors: Wasic Catharina , Erzgräber Robert , Unger-Büttner Manja , Donath Carolin , Böhme Hans-Joachim , Graessel Elmar 
Published: June 2024

IntroductionMany countries are facing a shortage of healthcare workers. Furthermore, healthcare workers are experiencing many stressors, resulting in psychological issues, impaired health, and increased intentions to leave the workplace. In recent years, different technologies have been implemented to lighten workload on healthcare workers, such as electronic patient files. Robotic solutions are still rather uncommon. To help with acceptance and actual use of robots their functionalities should correspond to the users’ needs.MethodIn the pilot study Care4All–Initial, we developed and field-tested applications for a mobile service robot in a psychosocial, multimodal group therapy for people with dementia. To guide the process and assess possible facilitators and barriers, we conducted a reoccurring focus group including people with dementia, therapists, professional caregivers as well as researchers from different disciplines with a user-centered design approach. The focus group suggested and reviewed applications and discussed ethical implications. We recorded the focus group discussions in writing and used content analysis.ResultsThe focus group discussed 15 different topics regarding ethical concerns that we used as a framework for the research project: Ethical facilitators were respect for the autonomy of the people with dementia and their proxies regarding participating and data sharing. Furthermore, the robot had to be useful for the therapists and attendees. Ethical barriers were the deception and possible harm of the people with dementia or therapists. The focus group suggested 32 different applications. We implemented 13 applications that centered on the robot interacting with the people with dementia and lightening the workload off the therapists. The implemented applications were facilitated through utilizing existing hard- and software and building on applications. Barriers to implementation were due to hardware, software, or applications not fitting the scope of the project.DiscussionTo prevent barriers of robot employment in a group therapy for people with dementia, the robot’s applications have to be developed sufficiently for a flawless and safe use, the use of the robot should not cause irritation or agitation, but rather be meaningful and useful to its users. To facilitate the development sufficient time, money, expertise and planning is essential.
Awareness of Genitourinary Cancers Risk Factors—A 2024 Population-Based Cross-Sectional Study in Poland
Authors: Moczeniat Gabriela , Jankowski Mateusz , Duda-Zalewska Aneta , Gujski Mariusz 
Published: June 2024

ObjectiveThis study aimed to assess the awareness of genitourinary cancers risk factors among adults in Poland and to identify factors associated with public awareness of risk factors for genitourinary cancers.MethodsThis cross-sectional survey was carried out between 1 and 4 March 2024 in a nationwide sample of 2,165 adults in Poland. Quota sampling was used. Data were collected using computer-assisted web interview (CAWI) method.ResultsRegardless of the type of cancer (kidney, bladder, or prostate cancer), a family history of cancer was the most recognized risk factor indicated by over half of respondents. Over one-third were aware that chemical exposure increases the risk for bladder cancer (39.4%) or prostate cancer (34.2%). Smoking was recognized as a risk factor for kidney cancer by 40.6% of respondents. Female gender, having higher education, being occupationally active and the presence of chronic diseases were the most important factors (p &lt; 0.05) associated with a higher level of awareness of genitourinary cancers risk factors.ConclusionThis study revealed gaps in public awareness of genitourinary cancers risk factors among adults in Poland, especially lifestyle-related and workplace-related risk factors.
Total triage model in general practice: a systematic review of the opportunities and challenges
Authors: Rolfe Sam , Park Sophie , Yurtoglu Nesrin , Cooney Ciarón , Owen Emily 
Published: June 2024

BackgroundTotal triage (TT) has the potential to achieve more equitable access to primary care, to improve the overall quality of care, and enhance health outcomes. TT has gained increasing attention from the public, policymakers, and academics.AimTo examine relevant scientific literature regarding the implementation of TT, the reported opportunities and challenges for patients and staff, and implications for practice.MethodMedline, Embase, CINAHL, and Scopus were searched for articles and grey literature between 2013 and February 2023. Included documents described the implementation of TT during in-hours general practice and provided perspectives from patients/staff. Patients and stakeholders were involved throughout each stage of the review process. Findings were synthesised using a framework approach.ResultsIn total, 23 documents were included at full-text screening. Analysis highlights a range of TT approaches, sometimes conflating remote and TT systems. TT was seen to both increase and reduce workload. Consistently, patient and staff views worsened with TT use. TT can increase barriers to care access with potential to exacerbate inverse care laws across the UK. Critical knowledge gaps included patient co-production in TT systems and the role of reception teams to adapt systems to meet patients’ needs.ConclusionTT can influence patient access, safety, and equity. The approach may also generate profoundly different working styles for general practice. This review adds to current debates surrounding patient access and TT, and consequences for staff/patients. The findings can be used to aid practices when navigating the new GP contract and the implementation of new TT approaches.
Assessment and management of fracture risk in men with prostate cancer taking androgen deprivation therapy: a retrospective observational primary care database study
Authors: Huang Qizhi , Brown Janet , Mitchell Caroline 
Published: June 2024

BackgroundProstate Cancer (PCa) is the commonest cancer in the UK. Androgen deprivation therapy (ADT) is a mainstay of treatment. It increases fragility fractures causing a huge burden to patients and the NHS. As men live longer with PCa, many require prolonged ADT. Reducing fracture risks and improving cancer survivorship is becoming increasingly important. Primary care plays an important role.AimTo evaluate how fracture risk of PCa patients taking ADT (PCa-ADT) was assessed and managed in primary care.MethodA retrospective multi-practice database study. PCa patients were identified using SNOMED codes from five sociodemographically diverse practices (registered population 49 400). Data were extracted by hand-searching records, including hospital letters, and included: demographics; a 10-year fragility fracture score (FRAX); NOGG intervention threshold; DEXA requests; and use of bisphosphonates.ResultsOf the 261 PCa patients identified, 6% were Black African/Caribbean and 89% White British. Half had been prescribed ADT, 28% being current users. No fracture risk assessment was documented for any patients. ADT current users had significantly increased FRAX scores for both major osteoporotic fractures (MOF) (9.61%±1.12%) and hip fracture (HF) (5.30%±1.02%) compared with PCa patients without ADT (7.08%±0.57% [MOF] and 3.06%±0.46% [HF],P<0.001). For ADT current users, 39% showed intermediate fracture risk (NOGG amber), warranting a DEXA scan, with only 30% performed. Patients in more affluent areas received more DEXA scans and bisphosphonate treatment.ConclusionOsteoporosis is underdiagnosed and undertreated in men with PCa-ADT, especially in those with deprived backgrounds. There is an unmet need to manage the fracture prevention in this population.
A lack of sociodemographic participant diversity in endometriosis evidence risks unrepresentative clinical guidance: a structured review of the evidence contributing to a NICE guideline
Authors: Khan Zara , Vincent Katy , Rai Tanvi , Dixon Sharon 
Published: June 2024

BackgroundWomen who are black are less likely to be diagnosed with endometriosis than white women. There is no confirmed biological basis, so this likely represents structural barriers around health care. There is a lack of evidence exploring the interface between ethnicity and symptoms or experience of care and treatment.AimTo map recording of sociodemographic diversity in the evidence informing an endometriosis guideline.MethodInclusion of study setting, ethnicity, age, and socioeconomic status was documented within the evidence cited in National Institute for Health and Care Excellence (NICE) NG73 (2017)Endometriosis diagnosis and management. Included were 44 studies with 43 sample groups from the chapters: ‘Signs and Symptoms’, ‘Information and Support’, and ‘Diagnosis’. Data were extracted independently by two researchers.ResultsNo studies were conducted in primary care. The evidence cited in ‘Signs and Symptoms’ and ‘Diagnosis’ was exclusively from tertiary care. ‘Information and Support’ included 9/16 studies from tertiary care, and 7/16 recruited through community and advocacy networks. For ethnicity, 4/44 studies formally reported participant ethnicity (three from ‘Information and Support’, one from ‘Diagnosis’). In these, 93%, 90%, 60%, and 75% of participants were white/Caucasian (mean 79.5%). For age, 3/44 studies included adolescents. Many studies excluded women who were deemed outside reproductive age. For socioeconomic status, eight studies, all from ‘Information and Support’, reported socioeconomic status in some form. The majority of participants were tertiary educated.ConclusionThese results highlight the missing demographics within evidence cited in a national guideline for endometriosis. These align with documented inequities in diagnosis of endometriosis and warrant urgent attention.
Recommendations from evaluating the implementation of the ‘GP Daffodil Standards’ to support the provision of palliative and end-of-life care in primary care: a mixed-methods study
Authors: Sivell Stephanie , Price Delyth , Hope Isabel , Carson-Stevens Andrew 
Published: June 2024

BackgroundThe ‘GP Daffodil Standards for Advanced Serious Illness and End of Life Care’ was launched by the Royal College of General Practitioners and Marie Curie in 2019 to support improvement of end-of-life care activity in primary care.AimTo undertake and independent evaluation of the implementation of the Daffodil Standards.MethodA multi-method evaluation, informed by Normalisation Process Theory. An online survey with GPs in the UK (Phase 1) and semi-structured interviews with a sub-sample of survey responders (Phase 2) were used to map end-of-life activities and understand the use of the standards. Illustrative case studies of good practice were used to outline recommendations to improve and sustain the implementation of the standards (Phase 3). Data were analysed both quantitatively (Phase 1: descriptive statistics) and qualitatively (Phases 2 and 3: framework analysis).ResultsFor the Phase 1 survey (n= 82) and Phase 2 semi-structured interviews (n= 8), results demonstrated the motivation to undertake end-of-life care activities and active use of the standards. GPs find it difficult to take this further because of limitations in resources and capacity. There is the indication that a misperception exists for both the purpose and role of the standards. For Phase 3, two case studies are complete, providing more in-depth practical insights into the planning, use, and implementation of the standards. All data collection stopped in December 2023.ConclusionFinal results were reported and best practice shared, along with recommendations to sustain the ongoing implementation of the Daffodil Standards.
The attitudes of general practices towards clinical research
Authors: Bond-Simmons James 
Published: June 2024

BackgroundDuring the financial year 2021/2022, the PANORAMIC study utilised the primary care setting to provide vital research into oral antivirals for COVID-19, recruiting more than 26 000 participants. Alongside the relentless work conducted by practices in supporting vaccine research, the number of GPs recruiting to National Institute for Health and Care Research (NIHR) portfolio studies in England remains consistently around 45% year on year despite the support offered by the NIHR. This figure varies across regions, falling to 23% in Greater Manchester, and rising to 95% in Northwest London, in 2022/2023. These figures suggest a regional inequality in access to potentially life-changing research from primary care providers.AimTo identify the barriers and challenges facing practices that reduce their likelihood of engaging in clinical research, as well as potential incentives and motivators that would support or encourage them to take part.MethodVarious factors must be considered as contributing to these figures, such as funding, regional deprivation, and the workload and workforce crisis; however, very little literature exists regarding GPs’ attitudes towards research that is backed by data. To address this, a series of online and face-to-face data collection activities will take place, in Greater Manchester, and later from a sample of the GPs across all NIHR regions.ResultsData collection to begin summer 2024.ConclusionKnowledge gained from these activities will help inform researchers and research organisations, such as the NIHR, to provide support and opportunities for GPs across England, ensuring that more of the population has access to clinical research opportunities through their GP.
Pharmacogenomics in primary care: a quality improvement project at Alconbury and Brampton surgeries 2019–2023
Authors: Bhimpuria Malav 
Published: June 2024

BackgroundTreatment of depression is common in primary care but not every antidepressant is effective in every patient. Adverse drug reactions are common, imposing a substantial burden on the patient and the NHS. Pharmacogenomics (PGx) utilises an individual’s genetic makeup to predict their response to medications. By tailoring prescriptions to a person’s genetic profile, PGx can significantly reduce adverse drug reactions, identify non-responders to medications, and enhance overall patient outcomes.AimTo see if PGx testing for antidepressants can be undertaken in general practice as part of ‘usual care’; to increase GP and patient awareness of PGx testing; to alter patient treatment according to the results of testing; and to sustain these changes at 4 years.MethodIn 2019, 23 patients were recruited by GPs at the surgery. They consented and had cheek swabs to check their genetic profile to common antidepressants. Results were reviewed at 1 week by the GP and patient, treatment changes made and reviewed again at 4 years.ResultsOn the CYP2D pathway, 19/23 patients were extensive (normal) metabolisers, one intermediate and two poor. These two had their treatments changed. At 4-year review 19/23 were on appropriate treatment (two had been stopped) but two had inappropriate drug treatment. On CYP2C19 pathway, 10/23 were normal metabolisers, eight intermediate, zero poor but five ultrarapid (they had their treatment changed). At 4-year review, 20/23 were on appropriate treatment (two stopped) and one inappropriate.ConclusionPGx testing works in primary care, improving patient outcomes sustainably.
Unveiling healthcare insights for patients and practitioners: a pilot study
Authors: Eastwood Zenahrai , Driessen Johannes 
Published: June 2024

BackgroundDoctors in the UK experience significant heterogeneity in training. Whilst core curricula underpin specialty training, diversity in clinical attachments results in a heterogeneous knowledge base and variation in local practice. Some insights or practices, which have the potential to improve patient care, but which only exist anecdotally or in local rather than national guidance, remain undiscovered and underutilised.AimTo aggregate examples of such clinical insights; To assess the extent of recommendation and evidence for these insights; To raise awareness of underutilised clinical insights, to highlight areas for further study and dissuade the use of inappropriate or un-evidenced practices.MethodA qualitative survey seeking free text responses, open to all UK healthcare professionals, was disseminated opportunistically. Responses were recorded and the insights were assessed against the existing evidence base, cost and potential for harm.Results29 clinical insights were collated across multiple specialties. Some already formed part of national guidance, but appeared to be underutilised, while others appeared only in local or international guidance. Evidence for some insights was compelling, but often mixed, whilst almost all were rated as low cost and low risk.ConclusionWe uncovered a range of lesser-known clinical insights across a range of specialties, as well as some less well-evidenced practices. Many insights have the potential to positively impact patient care, particularly in general practice. There is a clear opportunity to draw attention to those insights which offer low-cost, low-risk and potentially effective treatments, whilst highlighting opportunities to further study less well-evidenced insights and practices.
أسباب ضعف الأسس النظرية في بحوث الاتصال الجماهيري: دراسة لاتجاهات أعضاء هيئة التدريس المتخصصين في مجال الإعلام بالمملكة العربية السعودية.
Authors: عبدالرزاق صالح العصماني  
Published: June 2024

استهدفت هذه الدراسة التصدي لأسباب ضعف الأسس النظرية في أبحاث الاتصال الجماهيري من خلال الإجابة على أربعة أسئلة رئيسية تتمثل في:
أ-	الأهمية التي يعطيها الباحث للإطار النظري عند اختياره السؤال وقيامه بالبحث العلمي.
ب-	تقييمه الشامل لنظريات الاتصال الجماهيري من حيث قدرتها على توجيه البحث العلمي وتطويره.
ت-	هل يرى الباحث (المبحوث في الدراسة ) أن هناك ضعفا في الأساس النظري لأبحاث الاتصال الجماهيري. وأخيرا
ث-	إذا كان هناك ضعف فما هي أبرز أسباب هذا الضعف؟
وقد كانت عينة الدراسة هي مجموعة من الباحثين وأساتذة الاتصال الجماهيري في الجامعات السعودية حيث تم جمع استجابات 30 مبحوثا (من هؤلاء الأساتذة) للتعرف على آرائهم واتجاهاتهم في الأسئلة المطروحة حيث أكد خمسة منهم أنهم يعطون أهمية أساسية للإطار النظري دائما وخمسة آخرون يعطون أهمية للإطار النظري أحيانا وهؤلاء يمثلون ثلث العينة أما العشرون الباقون فقد أكدوا أهم يعطون الإطار النظري أهمية ثانوية فقط سواء كان ذلك بصورة دائمة أو في بعض الأحيان وهذا يدعم الرأي القائل بعدم وجود اهتمام بالإطار النظري من قبل أكثر الباحثين. وحول تقييم الباحثين لنظريات الاتصال الجماهيري قال بعضهم (15 مبحوثا) إن هذه النظريات ضعيفة بينما قال عشرة منهم إنها جيدة فيما يرى خمسة آخرون فقط أنها ممتازة. وفيما يتعلق بالإجابة عن السؤال الثالث والرابع حول مرئيات المبحوثين فيما إذا كان هناك ضعف في الأساس النظري لأبحاث الاتصال وما هي تلك الأسباب فإن ثلثي المبحوثين (20 مبحوثا) أكدوا على ضعف حقيقي بينما يرى الثلث الآخر عدم وجود ذلك الضعف أساسا.
ويرى هؤلاء الذين أجابوا بنعم على وجود ضعف في الأسس النظرية أن هناك أسبابا عديدة حيث كان السؤال الرابع مفتوحا مما أدى إلى جمع تسعة عشر سببا من استجاباتهم يمكن تقسيمها إلى أسباب منهجية وأسباب بحثية وأسباب نظرية بالإضافة إلى أسباب عامة. وقد أكدت هذه الدراسة على ضرورة التعرف على الإطار النظري الذي يعمل الباحث من خلاله وذلك من خلال المداخل الرئيسية الخمسة وهي الوظيفة البنيوية، المذهب النشوئي، الصراع الاجتماعي، التفاعل الرمزي، والاتجاه النفسي حيث إن معظم الدراسات الإعلامية تندرج تحت هذه الأطر أو المداخل الخمسة.
مساهمة معلمي العلوم في تنمية الوعي البيئي لدى طلاب مرحلة التعليم الأساسي من وجهة نظر الطالب
Authors: علي بن هويشل الشعيلي  
Published: June 2024

هدفت هذه الدراسة إلى التعرف على مدى مساهمة معلمي العلوم في تنمية الوعي البيئي لدى طلاب مرحلة التعليم الأساسي، من وجهة نظر الطلاب في سلطنة عمان، وتكونت عينة الدراسة من 340 طالبا وطالبة ممن يدرسون في الصفين السابع والثامن الأساسيين في محافظة مسقط والمنطقة الداخلية بالسلطنة، وقام الباحث بإعداد استبانة تألفت من 57 فقرة تم توزيعها في ثلاثة مجالات: المعرفي، والوجداني، والمهاري. وتم التأكد من صدق الأداة بعرضها على مجموعة من المحكمين، كما تم حساب الاتساق الداخلي للأداة باستخدام معادلة ألفا كرونباخ ووجد معامل الثبات مساويا (0,93).
وأظهرت نتائج الدراسة ما يلي:
-	كانت مساهمة معلمي العلوم في إكساب طلابهم الوعي البيئي بشكل عام فوق المتوسط.
-	جاء المجال المعرفي في المرتبة الأولى في تقديرات الطلاب في اكتسابهم الوعي البيئي من معلميهم يليه المجال الوجداني في المرتبة الثانية والمجال المهاري في المرتبة الثالثة.
-	وجود فروق ذات دلالة إحصائية عند مستوى (a=0,05) تُعزى للجنس في المجال المعرفي لصالح الطالبات، وعدم وجود فروق دالة إحصائيا تُعزى للجنس في المجالين المعرفي والمهاري.
-	عدم وجود فروق ذات دلالة إحصائية عند مستوى (a=0,05) تُعزى للمنطقة التعليمية.
-	وجود فروق ذات دلالة إحصائية عند مستوى (a=0,05)تُعزى للصف الدراسي في المجال المعرفي لصالح طلاب الصف الثامن الأساسي، وعدم وجود فروق دالة إحصائيا تُعزى للصف الدراسي في المجالين المعرفي والمهاري.
وفي ضوء نتائج الدراسة قدم الباحث عددا من التوصيات.
اتجاهات طلبة جامعة البلقاء التطبيقية نحو نظام التقييم القائم على العلامات بالرموز
Authors: مظهر محمد عطيات  , حمد صالح الدعيج  , عماد محمد السلامة  
Published: June 2024

هدفت هذه الدراسة إلى تقصي اتجاهات طلبة جامعة البلقاء التطبيقية نحو نظام العلامات بالرموز؛ ولتحقيق هذا الغرض اختيرت عينة مكونة من (1760) طالباً وطالبة بالطريقة العشوائية العنقودية من مجتمع الدراسة، طبق عليهم مقياس اتجاهات مكون خمسين فقرة، من نوع ليكرت ذي التدريج الخماسي، هذا وقد أظهرت الدراسة إلى النتائج التالية:
-	اتجاهات الطلبة بشكل عام نحو نظام العلامات بالرموز كانت سلبية.
-	لم تختلف اتجاهات الطلبة نحو نظام العلامات بالرموز باختلاف الجنس.
-	اختلفت اتجاهات الطلبة نحو نظام العلامات بالرموز باختلاف التخصص.
-	اختلفت اتجاهات الطلبة نحو نظام العلامات بالرموز باختلاف المستوى الدراسي.