bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sex differences in at-risk drinking and associated factors–a cross-sectional study of 8,616 community-dwelling adults 60 years and older: the Tromsø study, 2015-16
Authors: Stelander Line Tegner , Høye Anne , Bramness Jørgen G. , Wynn Rolf , Grønli Ole Kristian 
Published: March 2022

AbstractBackgroundAlcohol consumption among older adults is on the rise, which may be an increasing public health concern. The proportion of older adults who drink above defined low-risk drinking limits, associated characteristics and the sex distribution of at-risk drinking vary across countries. The aims of this study were to (i) estimate the prevalence of at-risk drinking among older adults in Norway, (ii) investigate factors associated with at-risk drinking, and (iii) examine sex differences in alcohol consumption in the context of sociodemographic and selected health characteristics.MethodA cross-sectional study based on Tromsø 7 (2015–16), an ongoing population-based cohort survey. Data were retrieved from participants aged 60 and older (60-99 years) who answered questions about alcohol consumption (n= 8,616). Sex-stratified logistic regressions were used to assess the association between three at-risk drinking outcome variables, and sociodemographic and selected health characteristics. The outcome variables were operationalized using the Alcohol Use Disorders Identification Test (AUDIT), and Alcohol Consumption Questions (AUDIT-C), i.e. – cut off for at risk drinking, drinking any 6+ in the past year, and any alcohol problems.ResultsThe overall prevalence of at-risk drinking among those aged 60-99 years was equal in women and men; 44% and 46%, respectively. At-risk drinking was strongly associated with a higher level of education, with OR 2.65 (CI 2.28-3.10) in women and OR 1.73 (CI 1.48-2.04) in men.ConclusionsAlmost half of older adults in Norway exceeded sex- and older adult-specific at-risk drinking thresholds. Our findings suggest some differences in factors associated with at-risk drinking between women and men. Explicitly, at-risk drinking was associated with very good health, living with a spouse or partner, and having adequate social support in women, while it was associated with the use of sleeping pills in men. Our findings suggest that women exceed at-risk drinking thresholds with better health, while men exceed at-risk drinking thresholds regardless of good or poor health.
Factors predicting self-report adherence (SRA) behaviours among DS-TB patients under the “Integrated model”: a survey in Southwest China
Authors: Zhang Rui , Pu Jie , Zhou Jiani , Wang Qingya , Zhang Ting , Liu Shili , Wang Geng , Chen Yong , Liu Jiaqing , Hu Daiyu , Li Ying 
Published: March 2022

AbstractBackgroundChina is one of 30 countries with a high tuberculosis (TB) burden, and poor adherence to TB treatment is one of the biggest challenges for TB control. We aimed to explore the barriers and facilitators of treatment adherence among drug-sensitive tuberculosis (DS-TB) patients under the “Integrated model” in Western China, to provide evidence-based treatment and control regimens for DS-TB patients to improve adherence behaviours.MethodsBoth qualitative and quantitative research methods were used to explore the factors associated with self-reported adherence (SRA) behaviours. Questionnaire surveys with DS-TB patients and in-depth interviews with leaders from the Centers for Disease Control and Prevention (CDC) and community health sectors (CHCs), healthcare workers (HCWs) from CHCs, and DS-TB patients were conducted.ResultsA total of 459 eligible patients were included in the quantitative survey, and two patients and 13 healthcare providers were included in the in-depth interviews. The percentage of patients who experienced a missed dose, lack of follow-up sputum examination, and interrupted treatment were 19.0%, 11.3%, and 9.2%, respectively. Patients aged 20–39 had a higher risk of missed dose [OR (95% CI): 2.302 (1.001–5.305)] and a lower risk of interrupted treatment [OR (95% CI): 0.278 (0.077–0.982)] than patients more than 60 years. Patients who were of Han ethnicity (OR [95% CI]: 0.524 [0.301–0.912]) received psychological support (OR [95% CI]: 0.379 [0.144–0.998]) from their family and had a lower risk of missed doses. Patients who had drug side effects had a higher risk of interrupted treatment (OR [95% CI]: 2.587 [1.237–5.412]). Patients who possessed higher knowledge had a lower risk of lack of follow-up sputum examination [OR (95% CI): 0.817 (0.673–0.991)]. The results of the qualitative study also reported that patients’ poor TB knowledge was the main reason for their non-SRA behaviours.ConclusionsPatient-centred strategies should be implemented to improve health literacy and strengthen psychological support. More effective case management should be designed and implemented based on different patient characteristics to improve adherence behaviours in further studies.
Effect of later cord clamping on umbilical cord blood gas in term neonates of diabetic mothers: a randomized clinical trial
Authors: Shao Hailing , Lan Yehui , Qian Yiyu , Chen Ruyang , Peng Lingli , Hua Ying , Wang Xiaomei 
Published: March 2022

Abstract
Objective
To evaluate the effect of later cord clamping (LCC) on umbilical arterial blood gas in neonates of diabetic mothers.

Methods
This prospective study included a group of 160 diabetic mothers (DM) whose neonates were randomized to immediate cord clamping (ICC) (≤ 15 s after birth) or LCC (≥ 30 s after birth), and a group of 208 non-diabetic mothers (NDM) whose neonates were randomized to ICC or LCC as a reference. Cord arterial pH, base excess (BE), bicarbonate (HCO3−), partial pressure of carbon dioxide (pCO2), partial pressure of oxygen (pO2), lactate, hemoglobin, hematocrit and glucose were compared among groups.

Results
In neonates of DM, there was no significant difference in cord arterial pH between the ICC and LCC group. LCC of ≥ 30 s decreased umbilical arterial HCO3− and BE and increased lactate (ICC versus LCC, HCO3−: 24.3 (22.7, 25.8) versus 23.7 (22.3, 24.7) mmol/L, P = 0.01; BE: -2.70 (-4.80, -1.50) versus − 3.72 (-5.66, -2.36) mmol/L, P = 0.006; lactate: 2.1 (1.6, 3.7) versus 2.7 (2.1, 4.3) mmol/L, P = 0.005), without the alterations of pCO2, pO2, hemoglobin, hematocrit and glucose. Similar results were found in neonates of NDM (ICC versus LCC, HCO3−: 24.3 (23.1, 25.7) versus 23.5 (22.3, 24.8) mmol/L, P = 0.01; BE: -2.39 (-3.73, -1.51) versus − 3.40 (-4.73, -1.91) mmol/L, P = 0.001; lactate: 2.2 (1.9, 3.3) versus 2.5 (2.0, 4.3) mmol/L, P = 0.01), except for the higher level of hemoglobin in the LCC group. The majority of diabetic mothers (ICC: 92.0%; LCC: 91.8%) had good blood glucose control. No differences were observed in acid-base status and glucose between neonates of DM and neonates of NDM in both ICC and LCC, but hemoglobin and hematocrit were elevated after ICC in neonates of DM compared to neonates of NDM.

Conclusions
Later cord clamping of ≥ 30 s resulted in a tendency towards metabolic acidosis of umbilical arterial blood in neonates of DM and NDM. Umbilical arterial blood gas parameters at birth were similar in neonates of DM and NDM.

Trial registration
ClinicalTrials.gov: NCT04369313; date of registration: 30/04/2020 (retrospectively registered).
The implementation of value-based healthcare: a scoping review
Authors: van Staalduinen Dorine J. , van den Bekerom Petra , Groeneveld Sandra , Kidanemariam Martha , Stiggelbout Anne M. , van den Akker-van Marle M. Elske 
Published: March 2022

Abstract
Background
The aim of this study was to identify and summarize how value-based healthcare (VBHC) is conceptualized in the literature and implemented in hospitals. Furthermore, an overview was created of the effects of both the implementation of VBHC and the implementation strategies used.

Methods
A scoping review was conducted by searching online databases for articles published between January 2006 and February 2021. Empirical as well as non-empirical articles were included.

Results
1729 publications were screened and 62 were used for data extraction. The majority of the articles did not specify a conceptualization of VBHC, but only conceptualized the goals of VBHC or the concept of value. Most hospitals implemented only one or two components of VBHC, mainly the measurement of outcomes and costs or Integrated Practice Units (IPUs). Few studies examined effects. Implementation strategies were described rarely, and were evaluated even less.

Conclusions
VBHC has a high level of interpretative variability and a common conceptualization of VBHC is therefore urgently needed. VBHC was proposed as a shift in healthcare management entailing six reinforcing steps, but hospitals have not implemented VBHC as an integrative strategy. VBHC implementation and effectiveness could benefit from the interdisciplinary collaboration between healthcare and management science.

Trial registration
This scoping review was registered on Open Science Framework https://osf.io/jt4u7/ (OSF | The implementation of Value-Based Healthcare: a Scoping Review).
Development of a theory-informed questionnaire to assess the acceptability of healthcare interventions
Authors: Sekhon Mandeep , Cartwright Martin , Francis Jill J. 
Published: March 2022

Abstract
Background
The theoretical framework of acceptability (TFA) was developed in response to recommendations that acceptability should be assessed in the design, evaluation and implementation phases of healthcare interventions. The TFA consists of seven component constructs (affective attitude, burden, ethicality, intervention coherence, opportunity costs, perceived effectiveness, and self-efficacy) that can help to identify characteristics of interventions that may be improved. The aim of this study was to develop a generic TFA questionnaire that can be adapted to assess acceptability of any healthcare intervention.

Methods
Two intervention-specific acceptability questionnaires based on the TFA were developed using a 5-step pre-validation method for developing patient-reported outcome instruments: 1) item generation; 2) item de-duplication; 3) item reduction and creation; 4) assessment of discriminant content validity against a pre-specified framework (TFA); 5) feedback from key stakeholders.
Next, a generic TFA-based questionnaire was developed and applied to assess prospective and retrospective acceptability of the COVID-19 vaccine. A think-aloud method was employed with two samples: 10 participants who self-reported intention to have the COVID-19 vaccine, and 10 participants who self-reported receiving a first dose of the vaccine.

Results
1) The item pool contained 138 items, identified from primary papers included in an overview of reviews. 2) There were no duplicate items. 3) 107 items were discarded; 35 new items were created to maximise coverage of the seven TFA constructs. 4) 33 items met criteria for discriminant content validity and were reduced to two intervention-specific acceptability questionnaires, each with eight items. 5) Feedback from key stakeholders resulted in refinement of item wording, which was then adapted to develop a generic TFA-based questionnaire.
For prospective and retrospective versions of the questionnaire, no participants identified problems with understanding and answering items reflecting four TFA constructs: affective attitude, burden, perceived effectiveness, opportunity costs. Some participants encountered problems with items reflecting three constructs: ethicality, intervention coherence, self-efficacy.

Conclusions
A generic questionnaire for assessing intervention acceptability from the perspectives of intervention recipients was developed using methods for creating participant-reported outcome measures, informed by theory, previous research, and stakeholder input. The questionnaire provides researchers with an adaptable tool to measure acceptability across a range of healthcare interventions.
Effective anti-mycobacterial treatment for BCG disease in patients with Mendelian Susceptibility to Mycobacterial Disease (MSMD): a case series
Authors: Mahdaviani Seyed Alireza , Fallahi Mazdak , Jamee Mahnaz , Marjani Majid , Tabarsi Payam , Moniri Afshin , Farnia Parisa , Daneshmandi Zahra , Parvaneh Nima , Casanova Jean-Laurent , Bustamante Jacinta , Mansouri Davood , Velayati Ali Akbar 
Published: March 2022

Abstract
Background
Post-vaccination BCG disease typically attests to underlying inborn errors of immunity (IEIs), with the highest rates of complications in patients with Mendelian susceptibility to mycobacterial disease (MSMD). However, therapeutic protocols for the management of BCG-osis (disseminated) and persistent BCG-itis (localized) are still controversial.

Methods
Twenty-four Iranian patients with MSMD (BCG-osis or BCG-itis), followed from 2009 to 2020 in Tehran, were included in the study. Their medical records were retrospectively reviewed for demographics, clinical features, laboratory findings, and molecular diagnosis. The therapeutic protocol sheets were prepared to contain the types and duration of anti-mycobacterial agents.

Results
BCG disease either as BCG-itis (33.3%) or BCG-osis (66.7%) was confirmed in all patients by positive gastric washing test (54.2%), microbial smear and culture (58.3%), or purified protein derivative (PPD) test (4.2%). The duration between BCG-osis onset and MSMD diagnosis was 21.6 months.
All except three patients were initiated on second-line anti-mycobacterial agents with either a fluoroquinolone (levofloxacin: 15 mg/kg/day, ciprofloxacin: 20 mg/kg/day, ofloxacin: 15 mg/kg/day), aminoglycoside (amikacin: 10–15 mg/kg/day, streptomycin: 15 mg/kg/day), and/or macrolide (clarithromycin: 15 mg/kg/day) along with oral rifampin (10 mg/kg/day), isoniazid (15 mg/kg/day), and ethambutol (20 mg/kg/day). Three patients showed a clinical response to rifampin, despite in vitro resistance. Fourteen (58.3%) patients received also adjuvant subcutaneous IFN-γ therapy, 50 µ/m2 every other day. At the end of survey, most patients (n = 22, 91.7%) were alive and two patients died following BCG-osis and respiratory failure.

Conclusions
We recommend the early instigation of second-line anti-mycobacterial agents in MSMD patients with BCG disease.
Novel bone morphogenetic protein 15 (BMP15) gene variants implicated in premature ovarian insufficiency
Authors: Afkhami Fatemeh , Shahbazi Shirin , Farzadi Laya , Danaei Shahla 
Published: March 2022

Abstract
Background
Bone morphogenetic protein 15 (BMP15) is expressed in oocytes and plays a crucial role in the reproduction of mono-ovulating species. In humans, BMP15 gene mutations lead to imperfect protein function and premature ovarian insufficiency. Here we investigated the BMP15 gene variants in a population of Iranian women with premature ovarian insufficiency. We conducted predictive bioinformatics analysis to further study the outcomes of BMP15 gene alterations.

Methods
Twenty-four well-diagnosed premature ovarian insufficiency cases with normal karyotype participated in this study. The entire coding sequence and exon-intron junctions of the BMP15 gene were analyzed by direct sequencing. In-silico analysis was applied using various pipelines integrated into the Ensembl Variant Effect Predictor online tool. The clinical interpretation was performed based on the approved guidelines.

Results
By gene screening of BMP15, we discovered p.N103K, p.A180T, and p.M184T heterozygous variants in 3 unrelated patients. The p.N103K and p.M184T were not annotated on gnomAD, 1000 Genome and/or dbSNP. These mutations were not identified in 800 Iranians whole-exome sequencing that is recorded on Iranom database. We identified the p.N103K variant in a patient with secondary amenorrhea at the age of 17, elevated FSH and atrophic ovaries. The p.M184T was detected in a sporadic case with atrophic ovaries and very high FSH who developed secondary amenorrhea at the age of 31.

Conclusions
Here we newly identified p.N103K and p.M184T mutation in the BMP15 gene associated with idiopathic premature ovarian insufficiency. Both mutations have occurred in the prodomain region of protein. Despite prodomain cleavage through dimerization, it is actively involved in the mature protein function. Further studies elucidating the roles of prodomain would lead to a better understanding of the disease pathogenesis.
Individuals who report having benefitted from dialectical behaviour therapy (DBT): a qualitative exploration of processes and experiences at long-term follow-up
Authors: Gillespie Conall , Murphy Mike , Kells Mary , Flynn Daniel 
Published: March 2022

AbstractBackgroundQualitative research in the area of DBT is limited, particularly at follow-up. The current study explored the follow-up experiences of individuals who previously received a diagnosis of borderline personality disorder and self-report having benefitted from DBT at the time of treatment.MethodsIndividuals who completed 12 months of standard DBT and were a minimum of two years post-completion were recruited. Individual semi-structured interviews were completed with a total of twelve participants.ResultsA thematic analysis generated three main themes which indicated that participants found DBT had a positive impact on their lives in the years after the programme and enabled further development; gave them control over their lives and the ability to manage setbacks and difficult situations; and contributed to healthier and more meaningful relationships with others.ConclusionsThe findings of this study indicated that DBT contributed positively to the participants’ lives and helped advance their recovery in the years after the programme.Despite the positive impact of DBT, participants required further support in the years following the intervention. Clinical and research implications of these findings are discussed.
Evaluasi Kompetensi Guru SMA di Manggelewa Dompu
Authors: Haryadi Didit , Islamiah Muarif 
Published: March 2022

Kualitas kompetensi guru dapat mempengaruhi kualitas pendidikan. Adapun tujuan dari penelitian ini adalah (1) untuk mengetahui Kompetensi Pedagogik (2) untuk mengetahui kompetensi sosial (3) untuk mengetahui kompetensi kepribadian dan (4) untuk mengetahui kompetensi profesional Guru di SMA Negeri 1 Manggelewa.
Penelitian ini merupakan jenis penelitian Evaluasi. Penelitian evaluasi di gunakan karena di dalam penelitian memuat evaluasi yang berkaitan kompetensi guru di SMA Negeri 1 Manggelewa. subjek penelitian adalah Guru di SMA Negeri 1 Manggelewa yang berjumlah 20 orang. Teknik pengumpulan data berupa Angket dengan skala likert 1 sampai dengan 4 dan dibantu wawancara untuk mendapatkan informasi awal atau kondisi empiris sekolah. Teknik analisis data yang digunakan adalah deskriptif kuantitaf dengan menggunakan analisa deskriptik atau statistik deksriptik. Cara menarik kesimpulan adalah dengan melihat hasil dari tiap komponen dan membandingkan dengan tabel presentase dari bukunya Prof. Sugiyono sehingga dapat ditarik kesimpulan tiap kompenen atau Kompetensi kurang baik atau sangat baik
Dari penelitian dapat di simpulkan (1) Kompetensi Pedagogik di SMA Negeri 1 Manggelewa sangat baik berdasarkan deskripsi data yang sudah dilakukan dengan presentase 85 % (2) Kompetensi Sosial di SMA Negeri 1 Manggelewa sangat baik berdasarkan deskripsi data yang sudah dilakukan dengan presentase 88 % (3) Kompetensi Kepribadian di SMA Negeri 1 Manggelewa sangat baik berdasarkan deskripsi data yang sudah dilakukan dengan presentase 88 % (4) Kompetensi Profesional di SMA Negeri 1 Manggelewa sangat baik berdasarkan deskripsi data yang sudah dilakukan dengan presentase 85 %. Secara keseluruhan Kompetensi Guru di SMA Negeri 1 Manggelewa sangat baik.
Evaluation of a nurse-led intervention to improve adherence to secondary prevention of rheumatic heart disease
Authors: Thomas Nisha , Kaur Sukhpal , Saxena Anita 
Published: March 2022

Background/Aims Rheumatic heart disease is a major health concern in India. Secondary prevention following acute rheumatic fever can prevent disease escalation, but adherence rates are often low. This study evaluated whether a nurse-led intervention could effectively increase adherence rates to secondary prevention and reduce rheumatic symptoms in this patient group. Methods A total of 60 patients were randomly assigned to either an intervention or control group. The control group received standard treatment, while the intervention group received a 25-minute education session with a nurse, along with text message or phone call reminders before they were due for treatment. Participants also completed a rheumatic morbidity index scale survey over 12 months to record their symptoms. A two-way sample t-test was used to compare adherence rates and symptom incidence in both groups. Results Patients in the intervention group had significantly better adherence rates to their medication, receiving 11–17 of the total 18 injections over the 12-month period, compared to 6–12 in the control group. They were also less likely to experience symptoms of rheumatic heart disease or require emergency hospitalisation. Conclusions A nurse-led intervention is an effective method of reducing pressure on hospital services and increasing treatment adherence among patients receiving secondary prevention treatment for rheumatic heart disease.
Association between the Orthopaedic Trauma Society classification of open fractures and economic costs
Authors: Png May Ee , Petrou Stavros , Bourget-Murray Jonathan , Knight Ruth , Trompeter Alex J. , Costa Matt L. 
Published: March 2022

AimsThe aim of this study was to investigate the relationship between the Orthopaedic Trauma Society (OTS) classification of open fractures and economic costs.MethodsResource use was measured during the six months that followed open fractures of the lower limb in 748 adults recruited as part of two large clinical trials within the UK Major Trauma Research Network. Resource inputs were valued using unit costs drawn from primary and secondary sources. Economic costs (GBP sterling, 2017 to 2018 prices), estimated from both a NHS and Personal Social Services (PSS) perspective, were related to the degree of complexity of the open fracture based on the OTS classification.ResultsAdjusted mean total NHS and PSS costs were £13,785 following treatment of complex fractures and £3,550 following treatment of simple fractures, where the open fracture wound is closed at the end of the first wound debridement, generating a mean difference of £10,235 (95% confidence interval £8,074 to £12,396).ConclusionFollowing previous work correlating clinical outcomes with the OTS classification of open fractures, this study suggests that the new OTS classification also correlates with economic costs estimated from alternative study perspectives. Cite this article: Bone Joint J 2022;104-B(3):408–412.