bluuebunny/crossref_metadata_2025_split huggingface dataset:
A public‐private partnership based model for regulating out‐of‐pocket expenditures to strengthen primary care system
Authors: Kumar Kaushal 
Published: July 2022

AbstractIn developing countries like India, the cost of health care is largely borne by patient out‐of‐pocket payments. Recent studies have reported that patients skip public‐funded clinics providing free consultation for distant private care providers. Some of the reasons identified for such behaviour include longer waiting times, perception regarding quality of care, etc. Therefore, optimal allocation of existing and new capacity is critical for a greater public interest. This article presents a decision‐making framework towards this intent for strengthening the existing government primary healthcare network. In this article, a mixed‐integer linear programing (MILP) model is developed for optimal reconfiguration of the existing government primary healthcare network to minimise patient out‐of‐pocket expenditures (OOPE). The model involves three types of facilities: Primary Health Centre (PHC), Community Health Centre (CHC), and Private OPD (outpatient department). Implementation of the proposed model can help in reducing out‐of‐pocket expenditures. The optimization model proposed in the article is unique as it incorporates for the first time, patient out‐of‐pocket expenditure, capacity reconfiguration, and public‐private partnership decisions in the primary healthcare system. A solution algorithm is also proposed for the optimization model. The model would be useful for theory development and also in policy‐making.
Perceptions toward the use of over‐the‐counter dietary supplements during the coronavirus disease 2019 pandemic: A cross sectional study of the general public in Jordan
Authors: Khasawneh Rawand A. , Al‐Shatnawi Samah F. , Alhamad Hamza , Kheirallah Khalid A. 
Published: July 2022

AbstractBackground and AimsOver‐the‐counter (OTC) dietary supplements gained popularity during the COVID‐19 pandemic as a preventive measure. Lack of complete understanding among the general population of the pathophysiologic mechanisms underlying the severity and progression of infection with coronavirus disease 2019 (COVID‐19) has further encouraged the use of supplements. The present study aimed to assess the perceptions of the general public toward the efficacy and safety of the use of OTC dietary supplements as immune enhancers during the COVID‐19 pandemic. The factors impacting these perceptions were also explored.MethodsThis was an online survey‐based, cross‐sectional study conducted in Jordan over 4 months. A validated survey which comprised 28 questions covering aspects related to the respondents’ demographic characteristics, their perceptions toward the efficacy of OTC dietary supplements and their awareness regarding the safety of popular OTC supplements and healthy dietary habits was used to collect responses. Associations between patient characteristics with perception and awareness were explored.ResultsA total of 1487 responses were included in the analysis. Ascorbic acid, zinc, and vitamin D were the most popular OTC supplements, as indicated by the percentages of users (48.8%, 38.6%, and 34.6%, respectively). Perceptions toward OTC supplement use were suboptimal, with a reported mean perception score of 27.82 ± 8.56 (range 0–45). The multivariate analysis showed that participants who were of older age (>65 years) (AOR = 6.29, 95% CI = 2.2–17.9), had an income level >1500 (AOR = 1.84, 95% CI = 1.80–3.56), and used chronic medications had better perceptions than did younger participants, those with no income, and non‐users of chronic medications, respectively. The mean safety awareness score was 5.36 ± 1.58 (maximum 7), with a significant direct relationship identified between perceptions and safety awareness scores (Spearman's correlation = 0.136, p < 0.001).ConclusionThis study highlighted the needs to organize educational campaigns that promote general public perceptions toward the safe use of OTC supplements to enhance immunity during COVID‐19.
Beyond treatment modalities: Clinical decisions and relational dynamics that facilitate change in group treatments
Authors: Aafjes‐van Doorn Katie , Horne Sarah 
Published: July 2022

AbstractThis commentary on six articles comprising this Journal of Clinical Psychology: In Session issue on the therapeutic process in group psychotherapy brings together relevant clinical challenges and opportunities concerning the unique processes of change in group treatments. As illustrated by these six inspiring group therapy cases, therapy groups may vary widely in content and context. To balance the rich clinical illustrations of successful group treatments and the different theoretical formulations offered in these case studies, we highlight the processes that these treatments appear to have in common. Specifically, we describe the clinical considerations about the group format and the group members. We also reflect on the relational dynamics as they play out within the complex interplay between group leaders and group members; the facilitation of the corrective emotional experience as a change mechanism in group therapy, as well as the relational challenges and opportunities inherent in group treatments more generally. It is hoped that in this issue, clinicians will not only be inspired by the clinical description of successful change processes in group treatments but will also be reminded of the therapeutic nuances and opportunities of this multilayered treatment format.
Long‐term psychodynamic psychotherapy in a face‐to‐face versus videoconferencing setting: A single case study
Authors: Andreas Sylke , Gablonski Thorsten‐Christian , Tschacher Wolfgang , Gebhardt Albrecht , Rabung Sven , Schulz Holger , Kadur Jennifer 
Published: July 2022

AbstractObjectiveDue to the coronavirus pandemic and crisis, psychotherapists around the world were forced to switch to video‐ or tele‐based treatments overnight. To date, only a few studies on the effectiveness of video‐based psychodynamic psychotherapy via the Internet exist. Therefore, the goal of the present study was to examine symptom improvement, therapeutic relationship, nonverbal synchrony processes, and intersession processes within a systematic single case design and compare face‐to‐face to video‐based approaches in long‐term psychodynamic‐oriented psychotherapy.MethodsWe examined 85 sessions of a client with major depression whose psychodynamic psychotherapy changed from a face‐to‐face setting to a video‐based setting. Video recordings were analyzed using motion energy analysis, and nonverbal synchrony was computed using a surrogate synchrony approach. Time series analyses were performed to analyze changes in symptom severity, therapeutic relationship, and intersession processes.ResultsThe results showed that symptom severity improved descriptively, but not significantly, across the entire course of psychotherapy. There were significant differences, however, in the therapeutic relationship, intersession experiences, and synchronous behavior between the face‐to‐face and video‐based settings.ConclusionThe results indicate that the presented methodology is well situated to investigate the question whether psychodynamic psychotherapy in video‐based setting works in the sameway as in a face‐to‐face setting.
Multigenerational patterns of parenting‐at‐risk: A test of interpersonal specificity using copy process theory
Authors: Woehrle Petra L. , Critchfield Kenneth L. , Anolik Sarah , Bobal Carly , Pempek Tiffany A. , Skowron Elizabeth A. 
Published: July 2022

AbstractObjectivesThis study tests ways in which the perception of intergenerational continuity in parenting behaviors among child‐maltreatment (CM) and non‐CM families conform to Benjamin's (2006) Copy Process Theory, which considers three copy processes: Identification (be like him/her), Recapitulation (behave as if he/she is still present and in charge), and Introjection (treat myself as he/she treated me).MethodAcross two home visits and a laboratory session, 171 mothers of preschoolers (M = 3.7 years) completed the SASB Intrex Questionnaire relative to herself, her history with her parents, and her present relationship with her child.ResultsMothers' retrospective reports of her interactions with caregivers were correlated with the quality of self‐reported parenting processes in interactions with her preschooler. Analyses indicated high rates of intergenerational copying in both samples for each copy process. While copying in general was observed in nearly all mothers (roughly 80%−90%) and emphasized warm, securely attached patterns, the copying of hostility and/or lack of affiliation occurred in copied profiles for about one‐third of mothers. About the more problematic profiles, CM mothers tended to rate themselves as being in the child‐like position they experienced in their own childhood, with themes involving hostile control perceived from their child. By contrast, non‐CM mothers copied disaffiliative themes primarily in relation to themselves.ConclusionFindings verify that interpersonal patterns and internalized relational histories are important keys for understanding CM risk. The use of a method that offers interpersonal specificity at the level of individual profiles has application to clinical practice with at‐risk parents.
An umbrella review of systematic reviews of β‐hydroxy‐β‐methyl butyrate supplementation in ageing and clinical practice
Authors: Phillips Stuart M. , Lau Kyle J. , D'Souza Alysha C. , Nunes Everson A. 
Published: July 2022

AbstractThe compound β‐hydroxy‐β‐methyl butyrate (HMB) is proposed to increase or mitigate the loss of skeletal muscle and improve muscle function. We undertook a review of systematic reviews of HMB supplementation to promote gains or mitigate muscle loss in ageing and clinical populations. Following PRISMA guidelines, we searched for systematic reviews reporting the effect of HMB in our target populations. Dual‐energy X‐ray absorptiometry (DXA) measured lean soft‐tissue mass (LSTM) was accepted as a proxy for muscle. We identified 15 systematic reviews that met our inclusion criteria, which were independently evaluated. The methodological quality of the reviews was assessed using A Measurement Tool to Assess Systematic Reviews (AMSTAR), and standardized effectiveness statements were generated. Five of 15 studies found some evidence that HMB augmented LSTM; the remaining 10 studies reported some evidence favouring no difference (6/10 studies) or insufficient evidence to determine an effect (4/10 studies). Of the 12 studies that evaluated strength, 4/12 found some evidence, 5/12 found some evidence of no effect with one article finding some evidence in favour of patients in peri‐hospitalized and no evidence for those that are community‐dwelling, 4/12 had insufficient evidence to determine an effect, and 1/12 had insufficient evidence. No]study reported a positive effect of HMB on physical function; however, 2/10 studies found some evidence favouring no effect, and 7/10 studies reported insufficient evidence to determine an effect. The effectiveness of HMB supplementation in augmenting LSTM was heterogeneous, with most reviews finding no effect or inconclusive evidence to determine an effect. Most reviews concluded that HMB supplementation did not affect strength outcome measures or studies were inconclusive. The current evidence is insufficient to assess the impact of HMB supplementation on functional outcome measures. Our analysis shows minor, inconsistent support for HMB as part of an oral nutritional supplement or as a stand‐alone supplement (or combined with other amino acids) to increase or promote retention of LSTM, improve strength, and no evidence that it improves physical function in older persons or clinical populations.
A pretest‐posttest design to assess the effectiveness of an intervention to reduce HIV‐related stigma and discrimination in healthcare settings in Vietnam
Authors: Pollack Todd M. , Duong Hao Thi , Nhat Vinh Dang Thi , Phuong Do Thi , Thuy Do Huu , Nhung Vo Thi Tuyet , Uyen Nguyen Kieu , Linh Vuong The , Van Truong Nguyen , Le Ai Kim Anh , Ninh Nguyen Thi , Nguyen Asia , Canh Hoang Dinh , Cosimi Lisa A. 
Published: July 2022

AbstractIntroductionStigma and discrimination are important barriers to HIV epidemic control. We implemented a multi‐pronged facility‐level intervention to reduce stigma and discrimination at health facilities across three high‐burden provinces. Key components of the intervention included measurement of stigma, data review and use, participatory training of healthcare workers (HCWs), and engagement of people living with HIV and key populations in all stigma reduction activities.MethodsFrom July 2018 to July 2019, we assessed HIV‐related stigma and discrimination among patients and HCWs at 10 facilities at baseline and 9 months following an intervention. A repeated measures design was used to assess the change in stigma and discrimination among HCWs and a repeated cross‐sectional design assessed the change in stigma and discrimination experienced by PLHIV. HCWs at target facilities were invited at random and PLHIV were recruited when presenting for care during the two assessment periods. McNemar's test was used to compare paired proportions among HCWs, and chi‐square test was used to compare proportions among PLHIV. Mixed models were used to compare outcomes before and after the intervention.ResultsSemi‐structured interviews were conducted with 649 and 652 PLHIV prior to and following the intervention, respectively. At baseline, over the previous 12 months, 21% reported experiencing discrimination, 16% reported self‐stigma, 14% reported HIV disclosure without consent and 7% had received discriminatory reproductive health advice. Nine months after the intervention, there was a decrease in reported stigma and discrimination across all domains to 15%, 11%, 7% and 3.5%, respectively (all p‐values <0.05). Among HCWs, 672 completed the pre‐ and post‐intervention assessment. At baseline, 81% reported fear of HIV infection, 69% reported using unnecessary precautions when caring for PLHIV, 44% reported having observed other staff discriminate against PLHIV, 54% reported negative attitudes towards PLHIV and 41% felt uncomfortable working with colleagues living with HIV. The proportions decreased after the intervention to 52%, 34%, 32%, 35% and 24%, respectively (all p‐values <0.05).ConclusionsA multi‐pronged facility‐level intervention was successful at reducing healthcare‐associated HIV‐related stigma in Vietnam. The findings support the scale‐up of this intervention in Vietnam and highlight key components potentially applicable in other settings.
A qualitative study of how stigma influences HIV services for transgender men and women in Nigeria
Authors: Tun Waimar , Pulerwitz Julie , Shoyemi Elizabeth , Fernandez Anita , Adeniran Adepeju , Ejiogu Franklin , Sangowawa Olusegun , Granger Krista , Dirisu Osasuyi , Adedimeji Adebola A. 
Published: July 2022

AbstractIntroductionTransgender men and women in Nigeria experience many barriers in accessing HIV prevention and treatment services, particularly given the environment of transphobia (including harassment, violence and discrimination) and punitive laws in the country. HIV epidemic control in Nigeria requires improving access to and quality of HIV services for key populations at high risk, including transgender men and women. We assessed how stigma influences HIV services for transgender people in Lagos, Nigeria.MethodsIn‐depth interviews (IDIs) and focus group discussions were conducted with transgender men (n = 13) and transgender women (n = 25); IDIs were conducted with community service organization (CSO) staff (n = 8) and healthcare providers from CSO clinics and public health facilities (n = 10) working with the transgender population in March 2021 in Lagos. Content analysis was used to identify how stigma influences transgender people's experiences with HIV services.Results and discussionThree main findings emerged. First, gender identity disclosure is challenging due to anticipated stigma experienced by transgender persons and fear of legal repercussions. Fear of being turned in to authorities was a major barrier to disclose to providers in facilities not affiliated with a transgender‐inclusive clinic. Providers also reported difficulty in eliciting information about the client's gender identity. Second, respondents reported lack of sensitivity among providers about gender identity and conflation of transgender men with lesbian women and transgender women with being gay or men who have sex with men, the latter being more of a common occurrence. Transgender participants also reported feeling disrespected when providers were not sensitive to their pronoun of preference. Third, HIV services that are not transgender‐inclusive and gender‐affirming can reinforce stigma. Both transgender men and women spoke about experiencing stigma and being refused HIV services, especially in mainstream public health facilities, as opposed to transgender‐inclusive CSO clinics.ConclusionsThis study highlights how stigma impedes access to appropriate HIV services for transgender men and women, which can have a negative impact along the HIV care continuum. There is a need for transgender‐inclusive HIV services and competency trainings for healthcare providers so that transgender clients can receive appropriate and gender‐affirming HIV services.
Implications of intracellular protein degradation pathways in Parkinson's disease and therapeutics
Authors: K Amrutha , Mishra Amit , Singh Sarika 
Published: July 2022

AbstractParkinson's disease (PD) pathology is the most common motor neurodegenerative disease that occurs due to the progressive degeneration of dopaminergic neurons of the nigrostriatal pathway of the brain. The histopathological hallmark of the disease is fibrillary aggregate called Lewy bodies which majorly contain α‐synuclein, suggesting the critical implication of diminished protein degradation mechanisms in disease pathogenesis. This α‐synuclein‐containing Lewy bodies are evident in both experimental models as well as in postmortem PD brain and are speculated to be pathogenic but still, the lineal association between these aggregates and the complexity of disease pathology is not yet well established and needs further attention. However, it has been reported that α‐synuclein aggregates have consorted with the declined proteasome and lysosome activities. Therefore, in this review, we reappraise intracellular protein degradation mechanisms during PD pathology. This article focused on the findings of the last two decades suggesting the implications of protein degradation mechanisms in disease pathogenesis and based on shreds of evidence, some of the approaches are also suggested which may be adopted to find out the novel therapeutic targets for the management of PD patients.
Effect of ElectroMagnetic interference from SmartPHone on cardiac ImplaNtable electronic device (EMI‐PHONE study)
Authors: Apakuppakul Sanatcha , Methachittiphan Nilubon , Apiyasawat Sirin 
Published: July 2022

AbstractBackgroundSmartphone can emit two types of electromagnetic waves, static field and dynamic field. Evidence showed the interference from phones to cardiac implantable electronic devices (CIEDs). The smartphones and CIEDs are reportedly better designed to reduce electromagnetic interference (EMI).Methods80 consecutive subjects with CIEDs were recruited and tested for EMI. Subject was tested with three different smartphones (Nokia 3310, Iphone 7, and Samsung 9S). Phone was attached to chest wall at 0 cm at generator site, at atrial lead level, and at ventricular lead level. During the tests, real‐time interrogations were performed to detect any EMI from smartphone in standby mode, and during calling‐in and out for 30 s. After the tests, post‐test interrogations were performed to detect any parameter change. Adverse events including pacemaker inhibition, false ICD shock, CIEDs device malfunction, and urgent electrophysiologist consultations were recorded.Results80 subjects (mean age 70.5‐year‐old, 50% male) recruited in the study, all completed the testing protocol. The most common type of CIEDs tested was pacemaker (N = 56, 70%), followed by ICD (N = 16, 20%), and CRT (N = 8, 10%). Most patients (N = 62, 77.5%) had more than one lead implanted. The mean year of implantation was 5.2±2.8 (devices were implanted from 2008 to 2019). Of all the tests performed, there was no EMI or adverse events observed.ConclusionCurrent generation of smartphones has no EMI effect on CIEDs in our study and can be used safely with less concern about adverse events including pacemaker inhibition, inappropriate ICD shock, and CIEDs device malfunction.
Understanding the association between clinical staging accuracy, treatment response, and survival among gastric cancer patients through Bayesian analysis
Authors: da Costa Wilson Luiz , Tran Cao Hop S. , Gu Xiangjun , Massarweh Nader N. 
Published: July 2022

AbstractBackgroundNeoadjuvant therapy (NAT) improves survival among patients with locally advanced gastric cancer (GC), but it remains unclear whether its benefit is contingent on treatment response.MethodsThis is a national cohort study of stage Ib‐III GC patients in the National Cancer Data Base (2006–2015) treated with upfront resection or NAT followed by surgery. Bayesian analysis was used for NAT patients to ascertain staging concordance and to account for down‐staging. We used multivariable Cox regression to evaluate the association between staging concordance, treatment, response to NAT, and survival.ResultsThe cohort included 13 340 patients treated at 1124 hospitals. Staging concordance ranged from 86.1% for cT3‐4N+ to 34.7% for cT2N0 patients. Relative to accurately staged patients treated with upfront surgery, NAT was associated with a decreased risk of death if there was disease down‐staging among those with cT1‐2N+ (hazard ratio [HR]: 0.43 [0.30–0.61]), cT3‐4N0 (HR: 0.69 [0.54–0.88]), and cT3‐4N+ (HR: 0.51 [0.48–0.58]) tumors, and in the absence of down‐staging among cT3‐4N+ patients (HR: 0.83 [0.74–0.92]). Conversely, NAT without down‐staging increased the risk of death among those with intermediate‐stage disease.ConclusionsNAT is associated with improved survival for GC, but it seems to be contingent on treatment response among patients with intermediate‐stage disease.