bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of behavior change and self-management theoretically-informed telehealth interventions for stroke secondary prevention: An overview of systematic reviews
Authors: da Cruz Peniche Paula , Faria Christina Danielli Coelho de Morais , Hall Patricia , Lennon Olive 
Published: April 2024

Introduction Despite the increased use of telehealth interventions, low-level evidence supports their use for behavior change and self-management in stroke secondary prevention. Therefore, this overview of systematic reviews (SRs) critically appraises and consolidates the evidence about theoretically-informed telehealth interventions in stroke secondary prevention. Methods Two phases were conducted independently by two reviewers. Phase-1 included SRs contemplating randomized controlled trials (RCTs) implementing telehealth interventions with individuals post-stroke, targeting cardiovascular events, risk-reducing health behaviors or physiological risk factors. Phase-2 interrogated RCTs from these SRs that implemented theoretically-informed interventions. Best-evidence synthesis of published meta-analyses and new meta-analyses of theoretically-informed interventions were conducted. GRADE evidence was applied. Results In Phase-1 (15 SRs), best-evidence synthesis identified telehealth interventions as effective in reducing recurrent angina and recurrent stroke rates (both with very low GRADE), improving medication adherence (low GRADE), physical activity participation (very low GRADE), and blood pressure targets (very low GRADE), reducing systolic blood pressure (SBP) (moderate GRADE) and low-density lipoprotein levels (very low GRADE). In Phase-2 (14 RCTs), new meta-analyses identified theoretically-informed telehealth interventions as effective in improving medication adherence (SMD: 0.38; 95%CI: 0.13–0.64; I²: 72%, low GRADE) and healthy eating (SMD: 0.38; 95%CI: 0.15–0.60; I²: 38%, low GRADE), and decreasing SBP (MD: −9.19; 95%CI: −5.49 to −12.89; I²: 0%, moderate GRADE). Discussion Telehealth demonstrates utility in stroke secondary prevention, notably in SBP reduction. High-quality RCTs are required given the lack of current evidence supporting theoretically-informed telehealth interventions addressing primary outcomes of secondary prevention, and the low certainty evidence identified for health behavior change.
“I have to charge my social battery”: Perspectives from autistic young adults on Quality of Life
Authors: Øverland Elisabeth , Hauge Åshild Lappegard , Orm Stian , Øie Merete Glenne , Skogli Erik Winther , Pellicano Elizabeth , Andersen Per Normann 
Published: April 2024

Several studies report on lower quality of life for autistic people when compared to non-autistic people. However, there are ongoing discussions about the conceptualization of quality of life for the autistic population. This qualitative study investigated self-perceived quality of life in the context of autistic young adults’ everyday lives. Participants (age range 21–29 years) were recruited from a 10-year follow-up study, Lillehammer Neurodevelopmental Follow-up Study, all diagnosed in childhood and adolescence. Fourteen individual in-depth interviews were conducted. When asked about what was important for having a good quality of life, our autistic participants described relationships to people and pets as important, as well as having meaningful activities. Specific interests had guided many to their choice of both academic and work career. Many also described obstacles in their environment that had influenced their quality of life negatively, such as being misunderstood by teachers and other professionals, being bullied, and sensory and emotional overload. Our findings indicate that those in supportive roles should provide help with establishing connections to activities and people/animals, as this seems to be essential for creating a good quality of life. Taking advantage of passions and interests can create opportunities for autistic people. Findings suggest that future research should address the communication barriers between autistic people and professionals that can lead to misunderstandings. Lay abstract In this study we have asked a group of autistic young adults to describe what is important for their quality of life. The 14 participants (aged 21–29 years) were recruited from a 10-year follow-up study of autistic people. During interviews, our participants described the importance of having relationships with family, friends and pets. Having meaningful activities and being able to immerse themselves in particular interests was also reported to be important for a good quality of life. Interests had also guided their choice of what to study and what to do for work. They also spoke of how communication problems with professionals, bullying and sensory and emotional overload could have a negative impact on quality of life. Future interventions should focus on how professionals can help autistic people to connect to people/animals and meaningful activities, as the participants described this as important for having a good quality of life. These findings may be helpful in enhancing how passions and interests can be seen as opportunities for both academic and work careers for autistic people. Future research and interventions should also look at the communication barriers between autistic people and professionals, and how two-way understanding can be improved.
Promotion of Muscle-Strengthening Activity Among Latina and Black/African American Women: A Review of Literature
Authors: Benitez Tanya J. , Brown Nashira , Marcus Bess , Sanchez Ashley , Von Ash Tayla , Joseph Rodney P. 
Published: April 2024

Latina and Black/African American (AA) women report disproportionately low levels of muscle-strengthening activities (MSA) and high rates of related chronic health conditions. Despite the health benefits of MSA, physical activity intervention research in these populations has focused mostly on increasing aerobic physical activity. The purpose of this review was to describe the current state of scientific literature on MSA interventions among Latina and Black/AA women. Two electronic databases, CINAHL and PubMed, were searched for studies published during the past 10 years. Studies were included in this review if they reported promotion of MSA, included at least 50% Latina and/or Black/AA women in their samples, and used an interventional design. Search procedures identified 8 unique interventions targeting MSA in Latina (n = 3) and Black/AA women (n = 5). Results revealed there is limited published research on MSA promotion among Latina and Black/AA women, especially on theory-based interventions that address psychosocial and behavioral influences of MSA, as well as assessment of MSA outcomes in these populations. This review highlights a critical need for research on culturally tailored behavioral interventions to reduce the low MSA in Latina and Black/AA women and provides future research directions on this topic.
Long-term limb salvage and functional outcomes for patients undergoing partial calcanectomy
Authors: Kostiuk Valentyna , Gazes Michael , Fereydooni Soraya , Chaar Cassius Iyad Ochoa , Guzman Raul J , Tonnessen Britt Hansen 
Published: April 2024

Introduction Partial calcanectomy (PC) can be performed to treat chronic heel ulcers in patients with calcaneal osteomyelitis. Patients undergoing PC often have multiple comorbidities, limited mobility, and face high risk of major limb amputation. This study examined the extent of vascular diagnostic testing and interventions as well as long-term outcomes in patients undergoing PC. Methods A retrospective analysis was performed on patients who underwent PC for non-healing calcaneal ulcer over a ten-year period. Demographics, comorbidities, vascular testing, and procedural data were recorded. Additional subgroup analysis was performed according to presence or absence of peripheral arterial disease (PAD). Primary outcomes were major limb amputation (above or below the knee) and mortality. Secondary outcomes included successful wound healing, time to complete wound healing, re-interventions, and change in ambulatory status. Results A total of 157 patients underwent partial calcanectomies on 162 limbs. 78.3% of patients had diabetes mellitus and 47.8% were diagnosed with PAD. Ankle brachial index with pulse volume recording (ABI/PVR) was performed for 46.5% (73/157) of patients, arterial duplex in 44.6% (70/157), and 19.7% (31/157) had a computed tomography angiogram. Lower extremity revascularization was performed in 28.4% of limbs (46/162). Independent ambulatory status was reported in 40.1% prior to PC and decreased to 17.9% by the time of last recorded follow-up ( p < .00001). Long-term amputation-free survival was significantly higher in patients without PAD at 7 years (78.4% vs 57.1%, p = .02). Multivariate logistic regression analysis demonstrated that PAD and end-stage renal disease (ESRD) increased the odds of major limb amputation (OR 3.5 and 2.8, respectively), whereas ESRD and adjuvant podiatric procedures were associated with increased mortality (OR 4.8 and 4.8, respectively). Conclusion Non-invasive vascular testing should be obtained in all patients undergoing PC, in order to stratify risk of amputation and identify candidates for revascularization. Over the long-term, patients undergoing PC face significant risk of prolonged wound healing, decline in ambulatory status, and major limb amputation.
Long-term safety and efficacy of zilucoplan in patients with generalized myasthenia gravis: interim analysis of the RAISE-XT open-label extension study
Authors: Howard James F. , Bresch Saskia , Farmakidis Constantine , Freimer Miriam , Genge Angela , Hewamadduma Channa , Hinton John , Hussain Yessar , Juntas-Morales Raul , Kaminski Henry J. , Maniaol Angelina , Mantegazza Renato , Masuda Masayuki , Nowak Richard J. , Sivakumar Kumaraswamy , Śmiłowski Marek , Utsugisawa Kimiaki , Vu Tuan , Weiss Michael D. , Zajda Małgorzata , Bloemers Jos , Boroojerdi Babak , Brock Melissa , de la Borderie Guillemette , Duda Petra W. , Vanderkelen Mark , Leite M. Isabel ,   the RAISE-XT Study Team*
Published: April 2024

Background: Generalized myasthenia gravis (gMG) is a chronic, unpredictable disease associated with high treatment and disease burdens, with a need for more effective and well-tolerated treatments. Objectives: To evaluate the long-term safety, tolerability, and efficacy of zilucoplan in a mild-to-severe, acetylcholine receptor autoantibody-positive (AChR+) gMG population. Design: Ongoing, multicenter, phase III open-label extension (OLE) study. Methods: Eligible patients had completed a qualifying randomized, placebo-controlled phase II or phase III zilucoplan study and received daily, self-administered subcutaneous 0.3 mg/kg zilucoplan. The primary endpoint was incidence of treatment-emergent adverse events (TEAEs). Secondary efficacy endpoints included change from baseline in Myasthenia Gravis Activities of Daily Living (MG-ADL) score. Results: In total, 200 patients enrolled. At the cut-off date (8 September 2022), median (range) exposure to zilucoplan in RAISE-XT was 1.2 (0.11–4.45) years. Mean age at OLE baseline was 53.3 years. A total of 188 (94%) patients experienced a TEAE, with the most common being MG worsening ( n = 52, 26%) and COVID-19 ( n = 49, 25%). In patients who received zilucoplan 0.3 mg/kg in the parent study, further improvements in MG-ADL score continued through to Week 24 (least squares mean change [95% confidence interval] from double-blind baseline −6.06 [−7.09, −5.03]) and were sustained through to Week 60 (−6.04 [−7.21, −4.87]). In patients who switched from placebo in the parent study, rapid improvements in MG-ADL score were observed at the first week after switching to zilucoplan; further improvements were observed at Week 24, 12 weeks after switching (−6.46 [−8.19, −4.72]), and were sustained through to Week 60 (−6.51 [−8.37, −4.65]). Consistent results were observed in other efficacy endpoints. Conclusion: Zilucoplan demonstrated a favorable long-term safety profile, good tolerability, and sustained efficacy through to Week 60 with consistent benefits in a broad AChR+ gMG population. Additional long-term data will be available in future analyses. Trial registration: ClinicalTrials.gov identifier: NCT04225871 ( https://clinicaltrials.gov/ct2/show/NCT04225871 )
Reduced Efficacy of Glucagon-Like Peptide-1 Receptor Agonists Therapy in People With Type 1 Diabetes and Genetic Forms of Obesity
Authors: Klein Matthew P. , Akturk Halis Kaan , Snell-Bergeon Janet K. , Shah Viral N. 
Published: April 2024

Background: Once weekly Glucagon-Like Peptide-1 Receptor Agonists (GLP-1 RA) have been shown to improve glycemic outcomes and cause significant weight loss. However, 9% to 27% of individuals have little or no response to these drugs. In this article, we investigated the efficacy of GLP-1 RA therapy among adults with type 1 diabetes and obesity likely related to genetic mutations compared with obesity likely unrelated to genetic mutations. Methods: In this retrospective study, we compared body weight and glycated hemoglobin (HbA1c) change with the use of GLP-1 RA therapy (including a dual agonist, Tirzepatide) over six months among adults with type 1 diabetes and obesity likely (n = 11, median age 39.5 years with a median BMI of 43.0 kg/m2) versus unlikely related to genetic mutation(s) (n = 15, median age 45.8 years with a median BMI of 38.7 kg/m2). Results: Six months of GLP-1 RA treatment resulted in a numerically lower reduction of weight (−5.75 ± 9.46 kg vs −8.65 ± 9.36 kg, P = .44) and HbA1c (−0.28 ± 0.96% vs −0.43 ± 0.57%, P = .64) among individuals with obesity likely versus unlikely related to a genetic mutation(s), respectively. Fewer individuals with genetic obesity met goal weight loss ≥5% or HbA1c decrease ≥0.4% than did individuals with obesity unlikely related to a genetic cause (36.4% vs 80.0%, P = .04). Conclusions: The weight loss and glycemic lowering effects of GLP-1 RA therapy may be decreased in people with type 1 diabetes and obesity likely related to genetic causes. Further research is needed to understand GLP-1 RA mechanisms via energy regulating genes.
Pattern and determinants of health-related quality of life of adolescents with congenital heart disease in Cameroon: A single-center cross-sectional study
Authors: Kamdem Félicité , Meyanga Ngoah Jerrold , Nganou Gnindjio Chris Nadège , Mekoulou Ndongo Jerson , Ba Hamadou , Mouliom Sidick , Viché Lade , Ngoté Henri , Kenmegne Caroline , Tsague Kengni Hermann , Ndom Ebongue Marie Solange , Djibrilla Siddikatou , Bika Léle Elysée Claude 
Published: April 2024

Background Health-related quality of life (HRQoL) assessment is necessary for the management of patients with congenital heart diseases (CHD). No study has yet been reported on Cameroonian adolescents. The aim of this study was to evaluate the profile of and look for determinants of HRQoL in adolescents with CHD in Cameroon. Methods This was a cross-sectional study with prospective recruitment carried out on 71 adolescents diagnosed with CHD aged 12 to 18 years and recruited at the Douala General Hospital. Sociodemographic and clinical data were collected using a structured questionnaire. HRQoL was assessed using the pediatric quality of life inventory (PedsQL4.0) for child and parent reports. Multivariate linear regression was used to assess the determinants of HRQoL. Differences were considered significant for p < 0.05. Results Mean age of participants was 15 ± 2 years with 54.9% women. Mean physical and psychosocial functioning scores were 50.7 ± 13.9 and 60.5 ± 9.6 for parent report and 49.5 ± 13.4 and 59.1 ± 9.1 for child report respectively; with no significant difference according to gender. Distribution of functioning scores according to anatomical complexity showed no significant difference while it was lower in patients with a greater physiological severity and to those with no surgical intervention compared to the others. After multivariate adjustments, physiological stage 3 or 4 was negatively associated while cardiac intervention was positively associated with HRQoL. Conclusion CHD adolescents exhibit a low level of quality of life. Cardiac intervention positively affects HRQoL and should be targeted in the reduction of HRQoL burden from CHD in Cameroon.
A pilot randomised controlled trial exploring the feasibility and efficacy of a human-AI sleep coaching model for improving sleep among university students
Authors: Liu Jintana , Ito Sakura , Ngo Tra My , Lawate Ashwini , Ong Qi Chwen , Fox Tatiana Erlikh , Chang Si Yuan , Phung Duy , Nair Elizabeth , Palaiyan Malar , Joty Shafiq , Abisheganaden John , Lee Chuen Peng , Lwin May Oo , Theng Yin Leng , Ho Moon-Ho Ringo , Chia Michael , Bojic Iva , Car Josip 
Published: April 2024

Objective Sleep quality is a crucial concern, particularly among youth. The integration of health coaching with question-answering (QA) systems presents the potential to foster behavioural changes and enhance health outcomes. This study proposes a novel human-AI sleep coaching model, combining health coaching by peers and a QA system, and assesses its feasibility and efficacy in improving university students’ sleep quality. Methods In a four-week unblinded pilot randomised controlled trial, 59 university students (mean age: 21.9; 64% males) were randomly assigned to the intervention (health coaching and QA system; n = 30) or the control conditions (QA system; n = 29). Outcomes included efficacy of the intervention on sleep quality (Pittsburgh Sleep Quality Index; PSQI), objective and self-reported sleep measures (obtained from Fitbit and sleep diaries) and feasibility of the study procedures and the intervention. Results Analysis revealed no significant differences in sleep quality (PSQI) between intervention and control groups (adjusted mean difference = −0.51, 95% CI: [−1.55–0.77], p = 0.40). The intervention group demonstrated significant improvements in Fitbit measures of total sleep time (adjusted mean difference = 32.5, 95% CI: [5.9–59.1], p = 0.02) and time in bed (adjusted mean difference = 32.3, 95% CI: [2.7–61.9], p = 0.03) compared to the control group, although other sleep measures were insignificant. Adherence was high, with the majority of the intervention group attending all health coaching sessions. Most participants completed baseline and post-intervention self-report measures, all diary entries, and consistently wore Fitbits during sleep. Conclusions The proposed model showed improvements in specific sleep measures for university students and the feasibility of the study procedures and intervention. Future research may extend the intervention period to see substantive sleep quality improvements.
A Harmony-Based Approach to Student Diversity
Authors: Yiu Lisa 
Published: April 2024

PurposeInspired by Kuan-Hsing Chen's “Asia as method,” this study investigates a multicultural approach to education. Using East Asia as the frame of reference, this study explores multiculturalism in middle school classrooms in Chinese Taiwan.Design/Approach/MethodsSemistructured interviews were conducted with principals, administrators, and teachers at a middle school known for its diversity work. Data were coded based on the conceptual framework and emergent themes analyzed using NVivo.FindingsFindings elucidate the harmony-oriented multicultural approach adopted by administrators and teachers to empower the youth to embrace their ethnic heritage. This approach was characterized by three Confucian-influenced features: whole-person development, strengthening of the collective school unit, and a school decision-making approach prioritizing “fairness.”Originality/ValueThis study investigates the multicultural responses of teachers and schools to student diversity through a nondeficit lens in East Asia, revealing the harmony-oriented practices adopted in this respect. In addition to establishing a foundation for East Asian scholars to explore how teachers respond to student diversity in their respective contexts through an asset lens, the findings of this study advance our understanding of how to recognize differences and maintain social cohesion.
Care for Staff: A Novel Technical Assistance Approach to Promote Occupational Mental Health Among Healthcare Workers in Lower and Middle Income Country Settings
Authors: Headrick Emily G. , McCarten-Gibbs Maggie , Coley Rachel , Avila Graciela , Mina Jerome , Villa Rea Celine , Fernando L. Harini 
Published: April 2024

Background: Healthcare workers (HCWs) in lower- and middle-income countries (LMICs) face unique, intersectional threats to their mental health at work. Despite the existence of recommendations for multi-tiered interventions to promote and protect occupational mental health for HCWs, there remain significant challenges to implementation worldwide. Methods: FHI 360, a global development organization, developed a novel technical assistance framework to accompany partners, including government and healthcare leaders to design, implement, improve, or evaluate any mental health and psychosocial support intervention. The EpiC Project, implemented by FHI 360, has utilized this framework in four countries (Vietnam, Philippines, Paraguay and Sri Lanka) specifically to guide the development of locally adapted occupational mental health interventions for HCWs. Findings: Each country applied this framework in various project cycle phases and in their unique local contexts; all countries reported positive developments in the advancement of their chosen interventions. Conclusions/Application to Practice: With the application of an adaptable, evidence-based technical assistance framework to guide collaborative consultation for project design, implementation, improvement, and/or evaluation, locally led teams pivoted from a solely “mental health” approach to more comprehensive, evidence-based interventions that framed mental health for HCWs as an occupational health priority. This allowed for teams advising interventions in LMICs to consider unique workplace, structural and policy-level factors rather than focusing solely on individual mental health strategies.
Experiences of social isolation and loneliness in middle-aged and older autistic adults
Authors: Stewart Gavin R. , Luedecke Emily , Mandy William , Charlton Rebecca A. , Happé Francesca 
Published: April 2024

Background Young autistic people often experience social isolation and loneliness. Despite social isolation and loneliness increasing in later life in non-autistic populations, no studies have examined whether middle-aged and older autistic adults are at an increased likelihood of these experiences. Methods 428 adults (autistic n = 265) aged 40–93 years (mean = 60.5 years) completed questionnaires related to social connectedness/isolation, loneliness, and mental health. Group differences and associations were examined. Results The autistic group was less socially connected and lonelier than the non-autistic group. While there were few gender differences in social connectedness, women were lonelier than men in both groups, including when controlling for age and mental health. Social connectedness decreased with age in both groups, loneliness only increased with age in the autistic group. For both social connectedness and loneliness, age associations were significantly stronger in men than women. Conclusions Autistic adults may be particularly susceptible to social isolation and loneliness in midlife and older age. While autistic women were lonelier than autistic men, autistic men may be at greater risk of increasing social isolation and loneliness with older age. This study highlights the need for evidence-based interventions to address social isolation and to reduce loneliness for autistic people as they age.