bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integrating lived experiences of out-of-hours health services for people with palliative and end-of-life care needs with national datasets for people dying in Scotland in 2016: A mixed methods, multi-stage design
Authors: Mason Bruce , Carduff Emma , Laidlaw Sheonad , Kendall Marilyn , Murray Scott A , Finucane Anne , Moine Sebastien , Kerssens Joannes , Stoddart Andrew , Tucker Sian , Haraldsdottir Erna , Ritchie Sir Lewis , Fallon Marie , Keen Jeremy , Macpherson Stella , Moussa Lorna , Boyd Kirsty 
Published: March 2022

Background: Unscheduled care is used increasingly during the last year of life by people known to have significant palliative care needs. Aim: To document the frequency and patterns of use of unscheduled healthcare by people in their last year of life and understand the experiences and perspectives of patients, families and professionals about accessing unscheduled care out-of-hours. Design: A mixed methods, multi-stage study integrating a retrospective cohort analysis of unscheduled healthcare service use in the last year of life for all people dying in Scotland in 2016 with qualitative data from three regions involving service users, bereaved carers and general practitioners. Setting: Three contrasting Scottish Health Board regions and national datasets for the whole of Scotland. Results: People who died in Scotland in 2016 ( n = 56,407) had 472,360 unscheduled contacts with one of five services: telephone advice, primary care, ambulance service, emergency department and emergency hospital admission. These formed 206,841 individual continuous unscheduled care pathways: 65% starting out-of-hours. When accessing healthcare out-of-hours, patients and carers prioritised safety and a timely response. Their choice of which service to contact was informed by perceptions and previous experiences of potential delays and whether the outcome might be hospital admission. Professionals found it difficult to practice palliative care in a crisis unless the patient had previously been identified. Conclusion: Strengthening unscheduled care in the community, together with patient and public information about how to access these services could prevent hospital admissions of low benefit and enhance community support for people living with advanced illness.
Area-Based Compassionate Communities: A systematic integrative review of existing initiatives worldwide
Authors: Quintiens Bert , D’Eer Louise , Deliens Luc , Van den Block Lieve , Chambaere Kenneth , De Donder Liesbeth , Cohen Joachim , Smets Tinne 
Published: March 2022

Background: Area-Based Compassionate Communities are community public health interventions which focus on the role of the community in palliative care provision. They apply a set of actions based on the Ottawa Charter for Health Promotion which aims to increase people’s control over their health. Aim: To review and compare Area-Based Compassionate Communities with respect to their contextual characteristics, development processes and evaluations. Design: A systematic integrative review with narrative synthesis. Registered in Prospero: CRD42020173406. Data sources: Five databases (Pubmed, Web of Science, PsycInfo, Embase and Scopus) were consulted, consisting of publications from 1999 onwards. This was supplemented with grey literature and author-provided documentation. Results: Twenty articles were drawn from the peer reviewed search, three from grey literature and two from author-provided documentation. Notwithstanding the substantial variation in what is reported, all Area-Based Compassionate Community initiatives focus on multiple action areas of the Ottawa Charter for Health Promotion. Variability in their contextual and developmental characteristics is high. Only a minority of initiatives have been evaluated and although conclusions are generally positive, what is evaluated often does not match their aims. Attaining support from policy makers can help in obtaining funding early in the project. Strengthening people’s social networks was a recurring community engagement strategy. Conclusions: While the concept of Area-Based Compassionate Communities is gaining momentum as a new paradigm for the creation of palliative care capacity across society, only a handful of initiatives have been described. The lack of formal evaluations of their envisaged health benefits indicates a pressing need for rigorous research about ongoing and future initiatives.
Association Between Hypertension Management Education and Multiple Healthy Behaviors: A Cross-Sectional Study
Authors: Kim Bomgyeol , Jang Sung-In , Kim Do Hee , Lee Sang Gyu , Kim Tae Hyun 
Published: March 2022

Purpose This study aimed to evaluate the association between hypertension management education and the adoption of multiple healthy behaviors. Design Cross-sectional study. Setting Data from the 2019 Community Health Survey in Korea. Subjects Of the 213,900 participants in the 2019 database, 89,773 (42.0%) were hypertensive and 124,127 (58.0%) were normotensive. Measures Secondary data analysis included a 1:1 computer-assisted personal interview. “Multiple healthy behaviors” included not smoking, not drinking excessively, and walking briskly. “Hypertension management education” referred to information on hypertension management that participants received from clinics, hospitals, and public health centers, outside consultation with a doctor. Analysis The association between hypertension management education and the adoption of multiple healthy behaviors was evaluated using multiple logistic regression. Results In total, 89,773 (42.0%) participants were hypertensive. Among 61,589 patients with diagnosed hypertension, only 7,719 (12.5%) received hypertension management education. Participants who received such education were more likely to adopt multiple healthy behaviors (odds ratio [OR] = 1.27, 95% confidence interval [CI]: 1.21–1.34) than their counterparts (OR = 0.91, 95% CI: 0.89–0.93). Participants with undiagnosed hypertension were least likely to adopt multiple healthy behaviors (OR = 0.89, 95% CI: 0.86–0.92). No causal relationships were ascertained because of the cross-sectional study design. Conclusions Education can improve the adoption of multiple healthy lifestyles among hypertensive patients. Patients should be encouraged to participate in hypertension management education.
Quality Improvement Interventions in the Delivery Room to Improve the Early Initiation of Breastfeeding in Healthy Neonates: A Tertiary Hospital-Based Study
Authors: Sisodia Pragati , Rathoria Richa , Singh Girjesh Kumar , Rathoria Ekansh , Bansal Utkarsh 
Published: March 2022

Background: The low-middle income countries continue to contribute to a high proportion of neonatal and child mortality globally. The reduction in mortality rates requires low-cost interventions such as early initiation of breastfeeding (EIBF). The study objective was to improve the rate of EIBF in all the healthy term newborns born in our institute from a baseline rate of 10% to at least 70% over 3 months through a quality improvement (QI) approach. Methods: This study was conducted in the labor room and operation theatre of a tertiary care center in Uttar Pradesh. All the healthy term mother-newborn pairs born in the study period were included and the Point Of Care Quality Improvement model was followed. After the baseline assessment of the problem, a QI team was formed which did the root-cause analysis and generated the change ideas to be implemented by small Plan-Do-Study-Act (PDSA) cycles initially then systematically expanded to the larger level. Outcome Measure: The effect of a PDSA cycle was measured by the percentage of newborns breastfed within the first hour of birth at the end of each cycle. Results: The EIBF improved from the baseline rate of 10% to 70.5% at the end of 5 PDSA cycles and was maintained at 70.7% during the sustainability phase. Conclusion: The QI approach can be utilized to improve EIBF, while the sustainability depends on continuous efforts like education programs, counselling, and supportive supervision. The inclusion of simulation-based training for staff can build confidence and improve results.
Function outperforms morphology in the assessment of muscular contribution to insulin sensitivity in premenopausal women
Authors: Wanger Lorena , Gar Christina , Rippl Michaela , Kern-Matschilles Stefanie , Potzel Anne , Haschka Stefanie , Seissler Jochen , Hesse Nina , Lechner Andreas 
Published: March 2022

Introduction Skeletal muscle contributes significantly to insulin sensitivity in humans. However, which non-invasive measurement best reflects this contribution remains unknown. Consequently, this paper compares morphologic and functional measurements. Research methods and design We conducted a cross-sectional analysis of 144 premenopausal women enrolled in the “Prediction, Prevention, and Sub-classification of Type 2 Diabetes” (PPSDiab) cohort study. For the analysis, we quantified insulin sensitivity by oral glucose tolerance testing and, in a subgroup of 30 women, euglycemic clamp. To assess skeletal muscle, we measured volume by magnetic resonance imaging, intramyocellular lipid content by magnetic resonance spectroscopy, and physical fitness by cardiopulmonary exercise testing. Results The mean age of the cohort was 35.7 ± 4.1 years and 94 participants (65%) had a history of gestational diabetes mellitus. Of the morphologic and functional muscle parameters, the maximum workload achieved during cardiopulmonary exercise testing associated most closely with insulin sensitivity (standardized beta = 0.39; p < .001). Peak oxygen uptake also demonstrated significant associations, whereas muscle volume and intramyocellular lipid content displayed none. Conclusion Functional measurements provided a better assessment of the muscular contribution to insulin sensitivity than morphologic measurements in premenopausal women. In particular, exercise testing rendered an easy and cost-effective method applicable in clinical settings and other human studies.
Endovascular Intervention for May-Thurner Syndrome in a Pregnant Patient with a Patent Foramen Ovale and Paradoxical Embolism
Authors: Bai Halbert , Cho Logan D. , Cooke Peter V. , Ting Windsor 
Published: March 2022

May-Thurner syndrome (MTS) is a known structural risk factor for deep vein thrombosis (DVT) and embolism. In patients with a patent foramen ovale (PFO), emboli originating from the deep veins are able to paradoxically reach the systemic circulation via the PFO, consequently resulting in transient ischemic attacks (TIA) or stroke. We report the case of a 31-year-old pregnant woman, with a recent history of TIA, who presented with chronic bilateral numbness, pain, and swelling in the lower extremities. On imaging, she was found to have a PFO and MTS. Her pregnancy was subsequently terminated. This decision was made independently by the patient. Her care team did not advise her to terminate her pregnancy as there was no specific medical reason to do so. However, the patient was in significant physical pain and distress and ultimately was not comfortable continuing with the pregnancy. This highlights the complex, multifactorial decision-making process that pregnant patients with comorbid health conditions undertake. The patient then underwent transcatheter PFO closure and stents were placed bilaterally in the left and right common iliac veins. Following the stent procedure, lower extremity symptoms swiftly resolved, allowing the patient to significantly improve her ability to ambulate. There have been no signs of TIA since her procedures, and her venous symptoms have been stable. In patients with TIA or stroke from a paradoxical embolism, MTS should be considered as a potential etiology. Endovascular intervention to treat the underlying MTS should also be considered to decrease the risk of recurrent DVT and embolism.
Mapping Healthcare Spaces: A Systematic Scoping Review of Spatial and Behavioral Observation Methods
Authors: Lipson-Smith Ruby , McLaughlan Rebecca 
Published: March 2022

Objective: To provide a taxonomy of spatial observation methods that are commonly used in healthcare environments research and to describe their relative success. Background: Spatial observation is a valuable but resource intensive research method that is often used in healthcare environments research, but which frequently fails to deliver conclusive results. There is no existing catalog of the different spatial and behavioral observation methods that are used in healthcare design research and their benefits or limitations. Methods: The review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Ten key databases were searched, and articles were screened by both authors. Results: Across 67 included studies, 79 observation methods were reported. We categorized those into four, distinct methodological approaches, outlining the benefits, limitations, and suitability of each for obtaining different types of results. Common limitations included difficulty generalizing to other contexts and a lack of detailed description during data collection which led to key environment variables not being recorded. More concrete conclusions were drawn when observation methods were combined with complimentary methods such as interview. Conclusions: The relative success of spatial observation studies is dependent on the fit of the method selected relative to the research question, approach, and healthcare setting; any complimentary methods delivered alongside it; and the analysis model employed. This article provides researchers with practical advice to guide the appropriate selection of spatial observation methods.
Physical activity domains, levels, and health-related quality of life among Nigerian adolescents during the coronavirus disease 2019 pandemic
Authors: Ugwueze Fabian Chibunine , Agbaje Olaoluwa Samson 
Published: March 2022

Introduction: The coronavirus disease 2019 pandemic spurred unprecedented public health measures to curb its spread. Such measures might have negatively impacted adolescents’ participation in physical activity and health-related quality of life. However, the evidence is unclear in Nigerian adolescents. This study assessed the physical activity domains, levels, and health-related quality of life in Nigerian adolescents during the coronavirus disease 2019 pandemic. Methods: The sample consisted of 430 students in public secondary schools in Nsukka, Enugu State. The students were randomly selected to participate in the cross-sectional study between November 2020 and April 2021. The Demographic Profile Form, International Physical Activity Questionnaire, Short Form-36 Health Survey, and Perceived Susceptibility to coronavirus disease 2019 Infection Questionnaire were used for data collection. Descriptive statistics, Chi-square test, independent-samples t-test, univariate ANOVA, and multiple linear regressions were conducted using SPSS version 25. Results: The mean score of total physical activity (MET-min/week) was 1651.3 ( SD = 842.18). The mean overall score of health-related quality of life was 78.30 ( SD = 16.43). The mental health component of health-related quality of life showed that adolescents had poor mental health status. Female adolescents had higher mean scores in physical component summary ( M = 83.03; SD = 27.36) and mental component summary ( M = 51.19; SD = 8.69) than the male adolescents, physical component summary ( M = 69.0; SD = 21.65) and mental component summary ( M = 46.15; SD = 10.71). Conclusion: The findings showed a significant positive association among gender, class of study, parental type, perceived susceptibility to coronavirus disease 2019, and physical activity domains, levels, and health-related quality of life. In addition, boys had a higher mean score of total physical activity (MET-min/week) than the girls. More girls were less active than the boys. However, concerning the health-related quality of life, girls had higher mean scores in physical component summary and mental component summary than boys. Physical activity interventions that specifically target female adolescents’ physical activity participation are needed. Also, mental health interventions are needed to improve the mental health status of adolescents, especially boys in the post–coronavirus disease 2019 era.
The experiences of community-dwelling individuals with newly diagnosed type-2 diabetes in using patient-reported outcomes in a municipal setting
Authors: Eriksen Jeppe , Bygholm Ann , Nielsen Signe Hudtloff , Bertelsen Pernille 
Published: March 2022

Objective The aim of this study was to examine the experiences of citizens with newly diagnosed type-2 diabetes when using a newly developed and implemented patient-reported outcome (PRO) questionnaire as part of clinical practice in a municipal setting. Specifically, the citizens’ experiences in completing the PRO questionnaire and using the PRO data in consultations were examined. Methods The study was based on participant observations and semi-structured interviews and conducted at the Centre for Diabetes in Copenhagen and online. Participants were recruited deliberately to represent different cases of citizens with type-2 diabetes. Ten citizens were observed during consultation with an healthcare professional (HCP) and subsequently interviewed. The interviews were recorded as audio or video and transcribed verbatim. A thematic analysis was performed on the basis of previously described guidelines. Results The PRO instigated reflections and enlightened citizens on disease-specific matters and motivated citizens to engage in self-management activities. During the citizen-HCP consultations, the PRO data prepared the actors before the meeting and enabled structured, effective and relevant conversations. However, the PRO questionnaire lacked response options, triggered citizen concerns about future health conditions and made them unsure if their answers were correct and aware that they lacked disease-specific knowledge. The experiences were linked to the citizens' situation as newly diagnosed with type-2 diabetes. Conclusion The informants found the PRO questionnaire and data meaningful and useful. However, adjustments are needed if the PRO instrument is to resemble the disease situation of citizens with newly diagnosed type-2 diabetes.
“I am chatbot, your virtual mental health adviser.” What drives citizens’ satisfaction and continuance intention toward mental health chatbots during the COVID-19 pandemic? An empirical study in China
Authors: Zhu Yonghan , Wang Rui , Pu Chengyan 
Published: March 2022

Introduction In order to address the psychological problems during the COVID-19 pandemic, mental health chatbots have been extensively used by public sectors. According to Theory of Consumption Values, this paper proposed an analytical framework to investigate the determinants behind users’ satisfaction and continuance intention toward mental health chatbots. Methods The empirical study was conducted through an online survey, facilitated by the use of questionnaire posted on the WeChat platform. Seven-point Likert scale and closed-ended questions were employed. Totally 371 valid samples were collected. The research data was tested via the partial least squares structural equation modeling. Gender, age, and income were included as control variables. Results Analysis of samples collected from 371 Chinese users suggested that personalization (functional value), enjoyment (emotional value), learning (epistemic value), and the condition of the COVID-19 pandemic (conditional value) have positive influences on user satisfaction and continuance intention, but such effects were weak. The findings also revealed that user satisfaction has weakly positive impact on continuance intention. However, voice interaction (functional value) was an insignificant predictor of user satisfaction and continuance intention. Discussion This study developed a critical perspective on the role of Theory of Consumption Values in the context of mental health chatbot usage, while Theory of Consumption Value has been increasingly employed to explain the use of AI-based public services. Thus, this research devotes to the enhancement of theoretical frameworks regarding the usage of mental health chatbots.
Implications of a Diabetic Foot Xerosis Treatment With an Emulsion Containing the Plant-Based Anionic Phospholipids
Authors: Glonek Thomas , Greiner Jack V. , Oliver Paula J. , Baker Terrance L. 
Published: March 2022

Purpose: This study compares and contrasts a skin cream containing plant-based anionic polar phospholipid (APP) technology with a mineral oil hydrocarbon (petrolatum)-based (MHB) skin cream technology in the treatment of skin xerosis (dryness) in diabetic feet. Skin cream with APP technology promotes phospholipid absorption, reparation of intercellular lamellae, and organization of water promoting hydration; whereas skin cream with mineral hydrocarbon-based (MHB) technology principally covers skin, preventing dehydration. Methods: Subjects (n = 54) with diagnoses of diabetes mellitus and foot skin dryness were studied using a multicenter, double-blind, masked-study design. An emulsion cream containing 0.05% APP in triglycerides (APP preparation) was compared to MHB skin cream, Eucerin® (MHB preparation) applied topically to skin of the feet. Graded measurements were recorded on 4 efficacy variables including dryness, erythema, fissures, and itching and neurovascular assessments. Implications of the plant-based and mineral-based skin creams in the context of skin xerosis are contrasted. Results: APP and MHB preparations were similar in effectiveness and safety. There was no significant difference among any of the 4 efficacy variables ( P < .5) including neurovascular measurements. The APP preparation is absorbed into the skin, whereas the MHB skin cream leaves detectable residues after each application. Conclusion: Although the APP and MHB preparations were not significantly different in effectiveness and safety, distinctively, application of the APP skin cream preparation absorbed into the skin leaving no discernible residue in contrast to the MHB preparation leaving residues potentiating textile damage. Both of these technologies function in the hydration of skin; however, they differ in their modes of action. The plant-based APP preparation functions actively by phospholipid and triglyceride absorption, reparation of skin lamellae, and in the consequent delivery and organization of waters of hydration in skin. The MHB preparation functions passively, hydrating the skin it covers by sealing the skin against dehydration.