bluuebunny/crossref_metadata_2025_split huggingface dataset:
Associated adverse health outcomes of polypharmacy and potentially inappropriate medications in community-dwelling older adults with diabetes
Authors: Lu Lvliang , Wang Shuang , Chen Jiaqi , Yang Yujie , Wang Kai , Zheng Jing , Guo Pi , Cai Yunpeng , Zhang Qingying 
Published: November 2023

Aim: This study aimed to identify the association of chronic polypharmacy and potentially inappropriate medications (PIMs) with adverse health outcomes (AHOs) in community-dwelling older adults with diabetes in China.Methods: A 2-year retrospective cohort study was conducted using 11,829 community-followed older adults with diabetes and medical records from 83 hospitals and 702 primary care centers in Shenzhen, China. Chronic polypharmacy and PIMs were identified from prescription records using Beers’ criteria, and their associated AHO was analyzed using multivariable logistic regression analysis.Results: The prevalence of chronic polypharmacy and at least one PIM exposure was 46.37% and 55.09%, respectively. The top five PIMs were diuretics, benzodiazepines, first-generation antihistamines, sulfonylureas, and insulin (sliding scale). Chronic polypharmacy was positively associated with all-cause hospital admission, admission for coronary heart disease, admission for stroke, admission for dementia, and emergency department visits. Exposure to PIMs was positively associated with all-cause hospital admission, admission for heart failure (PIMs ≥2), admission for stroke (PIMs ≥3), emergency department visits, bone fracture, constipation, and diarrhea.Conclusion: Chronic polypharmacy and PIMs were prevalent in older adults with diabetes in Chinese communities. Iatrogenic exposure to chronic polypharmacy and PIMs is associated with a higher incidence of different AHOs. This observational evidence highlights the necessity of patient-centered medication reviews for chronic polypharmacy and PIMs use in older patients with diabetes in primary care facilities in China and draws attention to the caution of polypharmacy, especially PIM use in older adults with diabetes in clinical practice.
Deep incorporation of organic amendments into soils of a ‘Calardis Musqué’ vineyard: effects on greenhouse gas emissions, vine vigor, and grape quality
Authors: Schneider Nele , Islam Muhammad , Wehrle Ralf , Pätzold Stefan , Brüggemann Nicolas , Töpfer Reinhard , Herzog Katja 
Published: November 2023

BackgroundTraditional wine growing regions are increasingly endangered by climatic alterations. One promising approach to mitigate advancing climate change could be an increase of soil organic matter. Here, especially subsoils are of interest as they provide higher carbon storage potential than topsoils. In this context, vineyard subsoils could be particularly suitable since they are deeply cultivated once before planting and afterwards, left at rest for several decades due to the perennial nature of grapevines.MethodsFor this purpose, a biochar compost substrate and greenwaste compost were incorporated in up to 0.6 m depth before planting a new experimental vineyard with the fungus-resistant grapevine cultivar ‘Calardis Musqué’. The influence of this deep incorporation on greenhouse gas emissions and grapevine performance was evaluated and compared to a non-amended control using sensor-based analyses.ResultsIncreased CO2 emissions and lower N2O emissions were found for the incorporation treatments compared to the control, but these differences were not statistically significant due to high spatial variability. Only few plant traits like chlorophyll content or berry cuticle characteristics were significantly affected in some of the experimental years. Over the course of the study, annual climatic conditions had a much stronger influence on plant vigor and grape quality than the incorporated organic amendments.DiscussionIn summary, organic soil amendments and their deep incorporation did not have any significant effect on greenhouse gas emissions and no measurable or only negligible effect on grapevine vigor, and grape quality parameters. Thus, according to our study the deposition of organic amendments in vineyard subsoils seems to be an option for viticulture to contribute to carbon storage in soils in order to mitigate climate change.
An economic evaluation of restorative justice post-sentence in England and Wales
Authors: Grimsey Jones Frank , Jaffé Lucy , Harris Lucy , Franklin Jon , Allam Lisa , Shapland Joanna 
Published: November 2023

IntroductionParticipation in restorative justice interventions post-sentence has been shown to reduce reoffending and mitigate harm to victims. Investment in, and access to, restorative justice remains limited in England and Wales. An economic model was developed to synthesize the available evidence in order to develop contemporary and robust estimates of the economic impact of investment in restorative justice interventions.MethodsThis research focused on direct and indirect restorative justice interventions for victims and offenders post-sentence in England and Wales. Included offences were those with an identifiable victim. A model was developed to estimate the social benefit–cost ratio of restorative justice, as well as the direct financial return to the criminal justice system. The modeled benefits of restorative justice included reductions in reoffending and direct wellbeing benefits for victims. It was not possible to incorporate direct wellbeing benefits for offenders due to evidence gaps.ResultsIn the model, 8% of referrals to restorative justice resulted in direct restorative justice interventions and 19% resulted in indirect Restorative justice interventions. The modeled cost of the restorative justice pathway per direct intervention was £3,394. The base case estimate for the social benefit–cost ratio of restorative justice was £14 per £1 invested, with a direct return to the criminal justice system of £4 as a result of substantial reductions in reoffending. Scenario analysis suggested a plausible range of £7 to £20 social benefit per £1 invested. Hypothetically, increasing the proportion of eligible cases referred for a restorative justice intervention from 15 to 40% could be associated with an increase in investment of £5 m, and benefits to the criminal justice system totaling £22 m, implying a net saving of £17 m.ConclusionThe research suggests that Restorative justice has the potential to yield a substantial social return on investment (SROI) and direct return on investment to the criminal justice system. The economic case for investment in restorative justice centers on identifying offenders with a high risk of offending and enabling them to participate in an intervention that has been repeatedly demonstrated to help them to change their behavior.
FDG-PET-based neural correlates of Addenbrooke’s cognitive examination III scores in Alzheimer’s disease and frontotemporal degeneration
Authors: Cabrera-Martín María Nieves , Nespral Pedro , Valles-Salgado Maria , Bascuñana Pablo , Delgado-Alonso Cristina , Delgado-Álvarez Alfonso , Fernández-Romero Lucía , López-Carbonero Juan Ignacio , Díez-Cirarda María , Gil-Moreno María José , Matías-Guiu Jorge , Matias-Guiu Jordi A. 
Published: November 2023

IntroductionThe Addenbrooke’s Cognitive Examination III (ACE-III) is a brief test useful for neuropsychological assessment. Several studies have validated the test for the diagnosis of Alzheimer’s disease (AD) and frontotemporal dementia (FTD). In this study, we aimed to examine the metabolic correlates associated with the performance of ACE-III in AD and behavioral variant FTD.MethodsWe enrolled 300 participants in a cross-sectional study, including 180 patients with AD, 60 with behavioral FTD (bvFTD), and 60 controls. An 18F-Fluorodeoxyglucose positron emission tomography study was performed in all cases. Correlation between the ACE-III and its domains (attention, memory, fluency, language, and visuospatial) with the brain metabolism was estimated.ResultsThe ACE-III showed distinct neural correlates in bvFTD and AD, effectively capturing the most relevant regions involved in these disorders. Neural correlates differed for each domain, especially in the case of bvFTD. Lower ACE-III scores were associated with more advanced stages in both disorders. The ACE-III exhibited high discrimination between bvFTD vs. HC, and between AD vs. HC. Additionally, it was sensitive to detect hypometabolism in brain regions associated with bvFTD and AD.ConclusionOur study contributes to the knowledge of the brain regions associated with ACE-III, thereby facilitating its interpretation, and highlighting its suitability for screening and monitoring. This study provides further validation of ACE-III in the context of AD and FTD.
Developing an innovative pediatric integrated mental health care program: interdisciplinary team successes and challenges
Authors: Schweitzer Jason , Bird Anne , Bowers Hilary , Carr-Lee Nicole , Gibney Josh , Schellinger Kriston , Holt Jasmine R. , Adams Devin P. , Hensler Domonique J. , Hollenbach Kathryn 
Published: November 2023

IntroductionChildren and adolescents often do not receive mental healthcare when they need it. By 2021, the complex impact of the COVID-19 pandemic, structural racism, inequality in access to healthcare, and a growing shortage of mental health providers led to a national emergency in child and adolescent mental health in the United States. The need for effective, accessible treatment is more pressing than ever. Interdisciplinary, team-based pediatric integrated mental healthcare has been shown to be efficacious, accessible, and cost-effective.MethodsIn response to the youth mental health crisis, Rady Children’s Hospital-San Diego’s Transforming Mental Health Initiative aimed to increase early identification of mental illness and improve access to effective treatment for children and adolescents. A stakeholder engagement process was established with affiliated pediatric clinics, community mental health organizations, and existing pediatric integrated care programs, leading to the development of the Primary Care Mental Health Integration program and drawing from established models of integrated care: Primary Care Behavioral Health and Collaborative Care.ResultsAs of 2023, the Primary Care Mental Health Integration program established integrated care teams in 10 primary care clinics across San Diego and Riverside counties in California. Measurement-based care has been implemented and preliminary results indicate that patient response to therapy has resulted in a 44% reduction in anxiety symptoms and a 62% decrease in depression symptoms. The program works toward fiscal sustainability via fee-for-service reimbursement and more comprehensive payor contracts. The impact on patients, primary care provider satisfaction, measurement-based care, funding strategies, as well as challenges faced and changes made will be discussed using the lens of the Reach, Effectiveness, Adoption, Implementation and Maintenance framework.DiscussionPreliminary results suggest that the Primary Care Mental Health Integration is a highly collaborative integrated care model that identifies the needs of children and adolescents and delivers brief, evidence informed treatment. The successful integration of this model into 10 primary care clinics over 3 years has laid the groundwork for future program expansion. This model of care can play a role addressing youth mental health and increasing access to care. Challenges, successes, and lessons learned will be reviewed.
The role of the fronto-parietal network in modulating sustained attention under sleep deprivation: an functional magnetic resonance imaging study
Authors: Yao Linming , Wang Yajing , Gao Yanzhong , Gao Hongwei , Guo Xufeng 
Published: November 2023

ObjectiveThe intricate relationship between sleep deprivation (SD) and cognitive performance has long been a subject of research. Our study offers a novel angle by closely examining the neurobiological underpinnings of sustained attention deficits through the lens of the fronto-parietal network (FPN). Using state-of-the-art imaging techniques, we delve into the changes in spontaneous brain activity after SD and explore their associations with performance on the psychomotor vigilance task (PVT).MethodsWe conducted an elaborate investigation involving 64 healthy, right-handed participants who underwent resting-state functional MRI scans before and after experiencing 24 h of sleep deprivation. Employing sophisticated statistical analyses, we scrutinized the changes in fractional amplitude of low-frequency fluctuations (fALFF) through paired t-tests. Pearson correlation analyses were then applied to dissect the associations between these neurobiological shifts and behavioral outcomes in PVT.ResultsThe study yielded remarkable findings, revealing a dramatic decrease in fALFF values within critical areas of the FPN following SD. These alterations predominantly occurred in the frontal and parietal gyri and were inversely correlated with PVT performance metrics. Furthermore, we discovered that baseline fALFF values in the left dorsolateral prefrontal cortex (DLPFC) have the potential to serve as compelling neurobiological markers, with high discriminatory power in identifying individual responses to the adverse effects of SD on cognitive performance.ConclusionOur groundbreaking research underscores the pivotal role that the FPN plays in modulating attention and executive function, especially under the challenging conditions brought about by sleep deprivation. The findings offer critical insights that could shape the way we understand, assess, and potentially mitigate the cognitive impacts of SD, setting the stage for future research in this riveting domain.
Relationship of the SITLESS intervention on medication use in community-dwelling older adults: an exploratory study
Authors: Viegas Ruben , Alves da Costa Filipa , Mendes Romeu , Deidda Manuela , McIntosh Emma , Sansano-Nadal Oriol , Magaña Juan Carlos , Rothenbacher Dietrich , Denkinger Michael , Caserotti Paolo , Tully Mark A. , Roqué-Figuls Marta , Giné-Garriga Maria 
Published: November 2023

BackgroundSedentary behavior (SB) and physical activity (PA) interventions in older adults can improve health outcomes. Problems related with aging include prevalent comorbidity, multiple non-communicable diseases, complaints, and resulting polypharmacy. This manuscript examines the relationship between an intervention aiming at reducing SB on medication patterns.MethodThis manuscript presents a local sub-analysis of the SITLESS trial data on medication use. SITLESS was an exercise referral scheme (ERS) enhanced by self-management strategies (SMS) to reduce SB in community-dwelling older adults. We analyzed data from the ERS + SMS, ERS and usual care (UC) groups. Patient medication records were available at baseline and at the end of the intervention (4-month period) and were analyzed to explore the effect of SITLESS on medication patterns of use.ResultA sample of 75 participants was analyzed, mostly older overweight women with poor body composition scores and mobility limitations. There was a significant reduction of 1.6 medicines (SD = 2.7) in the ERS group (p &lt; 0.01), but not in the UC or ERS + SMS groups. Differences were more evident in medicines used for short periods of time.ConclusionThe findings suggest that an exercise-based program enhanced by SMS to reduce SB might influence medication use for acute conditions but there is a need to further investigate effects on long-term medicine use in older adults.
Effects of COVID-19 pandemic on provision and use of maternal health services in Allada, southern Benin: a local health system perspective
Authors: Akpi Éric , Vigan Armelle , Boyi Hounsou Christelle , Gandaho Marlène , Houngbo Gisèle , Gryseels Charlotte , Dossou Jean-Paul , Delvaux Thérèse 
Published: November 2023

ObjectiveTo assess the effects of the COVID-19 pandemic on the provision and use of maternal health services in southern Benin from a local health system perspective.MethodsWe conducted a qualitative study from April to December 2021 in a health district in southern Benin. We interviewed health workers involved in antenatal, delivery, postnatal and family planning care provision, alternative and spiritual care providers, administrative staff of the district hospital, community health workers, adolescents and women who had given birth in the past six weeks in public health centers were interviewed. The World Health Organization health systems building blocks framework was used to guide the thematic analysis from a local health system perspective.ResultsThe COVID-19 pandemic changed the lines of command and the institutional arrangements in the local health systems leadership; it put the interpersonal relationships in the health care provision team under stress and reduced the overall revenues of the district hospital. The motivation of allopathic health workers was undermined. Communities underutilized maternal health services in the COVID-19 period. Plausible causes included negative patient perceptions of COVID-19 measures taken at the public health facility level as well as well as fear of being forcibly vaccinated against COVID-19 in the health facilities.ConclusionIn times of health crises, appropriate local health system governance that integrates providers’ concerns into effective guidelines is critical to reach and maintain a sufficient level of work motivation to ensure quality maternal health services.
Association between activities of daily living and depressive symptoms among older adults in China: evidence from the CHARLS
Authors: Liu Haixia , Ma Yang , Lin Lin , Sun Zekun , Li Zeyu , Jiang Xinxin 
Published: November 2023

ObjectiveThe limitation of activities of daily living (ADL) affects the mental health of older adults. We distinguished activities of daily living into basic activities of daily living (BADL) and instrumental activities of daily living (IADL) and aimed to explore the relationship between the two limitations and depressive symptoms among Chinese older adults by using nationally representative cross-sectional data.MethodsData from the China Health and Retirement Longitudinal Study (CHARLS, wave 4) were used, and 9,789 older adults aged 60 years and above were screened. The 10-item Center for Epidemiologic Studies Depression (CES-D-10) scale was used to measure the depressive symptoms of older adults, and a 12-item scale for ADL was used to estimate functional limitations. Generalized linear mixed-effect models were employed to examine the relationship between BADL/IADL and depressive symptoms among older adults.ResultsThe prevalence of high-risk depression among older adults was 43.5%, and the rates of limitation in BADL and IADL were 19.02 and 25.29%, respectively. The prevalence of high-risk depression significantly differed among subgroups of smoking, drinking, chronic diseases, duration of sleep, having social activities or not, and the type of medical insurance. Older adults with limited BADL or IADL were at a higher risk of depression than those without limitations of BADL or IADL; BADL (OR-adjusted = 2.71; 95% CI: 2.40–3.06) and IADL (OR-adjusted = 2.68; 95% CI: 2.41–2.98) had various influences on the risk of depression in older adults.ConclusionADL was a related factor in the risk of depression among older adults in China. BADL and IADL had different effects on the risk of depression, suggesting that older adults with physical function limitations might be more likely to suffer from depression.
Parental acceptance of silver fluoride as a treatment option for carious lesions among South African children with special health care needs
Authors: Potgieter N. , Noordien N. , Mulder R. , Peck C. , Groisman S. 
Published: November 2023

Providing dental care for children with neurological special health care needs, including Down syndrome, Cerebral palsy and Autism spectrum disorders, is challenging. They often require repeat exposure to sedation or general anaesthesia for routine dental care. 51 parents of children with special needs completed a questionnaire regarding the acceptance of Silver Fluoride as a treatment option.BackgroundSilver Diamine Fluoride has become popular as a minimally invasive treatment option for providing oral health care to young or uncooperative children. Silver Fluoride (SF) is a newer development with similar but improved properties. The aim was to determine the acceptance of SDF/SF as treatment option for Children with Special Health Care Needs (CSHCN), including Down Syndrome, Autism Spectrum Disorder and Cerebral Palsy.Methods51 Parents of CSHCN completed a questionnaire on the overall acceptance of SF; aesthetic concerns related to the location of application; the use of SDF as an alternative to general anesthesia; and the composition of SF.ResultsThe use of SF on posterior teeth were more acceptable (70.59%) as opposed to its application to anterior teeth (50.98%). Parents generally agreed/ strongly agreed to the use of SF to reduce infection and pain (82%); to avoid treatment under GA (26.70%); and to avoid an injection (78%). 64% of parents indicated their agreement in using SF because it has a reduced cost when compared to a conventional restoration. Majority of parents were in agreement to use SF even if it contains Fluoride (84%) and Silver (78%).ConclusionThe use of SF, as treatment option for caries, was well accepted by South African parents of CSHCN. Shared decision making should be applied when considering SF as treatment option for CSHCN.
Coping strategies for handling stress and providing mental health in elite athletes: a systematic review
Authors: Nuetzel Barbara 
Published: November 2023

BackgroundThe combination of stressors unique to the athletic context plus the sensitive developmental phase that elite athletes go through during their peak performance may increase the athletes’ vulnerability to mental health decrements. To emphasize the necessity to raise elite athletes' awareness of health risks, it seems to be essential to teach them coping skills to handle stress and to make affected athletes aware of how to recognize, evaluate, and articulate potential risks to their health.ObjectiveThis systematic review analyzes coping strategies used by elite athletes to deal with stress and the effect of these strategies on mental health to identify gaps that future research could prioritize.MethodsThe current review analyzes studies containing quantitative, qualitative, and mixed data and results, all of them focusing on coping strategies to deal with stress and the effect of coping strategies on elite athletes' mental health. Literature search for this systematic review took place between August and October 2023 and included the use of 3 electronic databases: PubMed, PsychINFO, SPORTdiscus.ResultsThere were initially 5,705 hits from 3 electronic databases, hand search and from a complementary search in Google Scholar. After the screening process and quality appraisal 30 studies were included. The analyzed study results point to a broad spectrum of coping categories, elite athletes make use of to deal with stressful situations. The results of this review underpin the necessity that especially young athletes being confronted with a wide range of stressors, need to be taught mental skills to cope with these stressors. In addition, teaching coaches and teammates about social support seemed to decrease elite athletes' stress reactions, such as anxiety or depressive symptoms.ConclusionCoping in elite sporting settings is very complex and dynamic. There is evidence of coping being effective to buffer stress, but the interrelationships between stressor, appraisal of the stressor, application of a corresponding coping strategy and its effect especially in terms of mental health outcomes is still unclear because of lacking intervention-based study designs.