bluuebunny/crossref_metadata_2025 huggingface dataset:
The Transformative power of friendships: Examining the relationships among friendship quality, self‐change, and well‐being
Authors: Yücel Emine , Dincer Duygu
Published: January 2024

Friendships are beneficial to a person's growth and well‐being. People in close relationships may experience four types of self‐change: self‐expansion, self‐pruning, self‐contraction, and self‐adulteration. The current cross‐sectional research sought to investigate whether these relational self‐change processes explain the links between friendship quality and well‐being in same‐sex best friendships. Study 1A (N = 187) adapted the Turkish Relational Self‐Change Scale to the friendship context and confirmed its psychometric adequacy in addressing friendship‐based self‐changes in Türkiye. Study 1B (N = 306) examined the links between different friendship functions and relational self‐changes, as well as whether relational self‐changes explain the link between friendship quality and ontological well‐being. Among the specific friendship functions, stimulating companionship and self‐validation were related to self‐expansion and self‐pruning, whereas reliable alliance was related to self‐contraction and self‐adulteration. Self‐adulteration also indirectly explained the relationship between friendship quality and ontological well‐being. Study 2 (N = 204) revealed that only self‐pruning explained the link between perceived friend responsiveness and overall well‐being. The contributions of friendships to self‐change and personal well‐being were discussed in light of the findings.
The “boy problem” in public policy
Authors: Holst Cathrine , Teigen Mari
Published: January 2024

The article investigates how gender differences in school performance are conceptualized in recent Swedish and Norwegian public commission reports against the backdrop of an increasing public focus on “problem boys” and boys' underachievement in school as a policy challenge. We found substantive country differences, despite regime similarities and the considerable level of gender equality norms and policy diffusion within the Nordic region. Whereas Swedish reports address gender differences in school performance and behavior equipped with radical feminist perspectives and theories of patriarchal oppression, Norwegian reports largely avoid explicit references to feminist theory and include analyses of the unfair burdens of boys in school and society. It is argued that the diverging approaches are connected to features of the commissions and of the wider knowledge regimes of the two gender equality forerunners, but also to historical differences in the ideological underpinnings of Swedish and Norwegian gender equality policy making.

Related Articles

Ireni‐Saban, Liza. 2013. “Give Me Children or Else I Die: The Politics and Policy of Cross‐Border Reproductive Care.” Politics & Policy 41(1): 5–38. https://doi.org/10.1111/polp.12004.

Svallfors, Stefan, Erica Falkenström, Corrie Hammar, and Anna T. Höglund. 2022. “Networked Reports: Commissioning and Production of Expert Reports on Swedish Health Care Governance.” Politics & Policy 50(3): 580–97. https://doi.org/10.1111/polp.12462.

Tusalem, Rollin F. 2022. “Does Gendered Representation in National Legislatures Promote Substantive Representation and Human Development? Evidence from the Developing World.” Politics & Policy 50(6): 1096–137. https://doi.org/10.1111/polp.12503.
Reduced reward responsiveness and depression vulnerability: Consideration of social contexts and implications for intervention
Authors: Kujawa Autumn
Published: January 2024

Depression is a prevalent, heterogeneous, and debilitating disorder that often emerges in adolescence, and there is a need to better understand vulnerability processes to inform more targeted intervention efforts. Psychophysiological methods, like event‐related potentials (ERPs), can offer unique insights into the cognitive and emotional processes underlying depression vulnerability. I review my and others' research examining ERP measures of reward responsiveness in youth depression and present a conceptual model of the development of low reward responsiveness, its role in depression vulnerability, and potential windows for targeted intervention. There is evidence that a blunted reward positivity (RewP) is observable in children at risk for depression, appears to be shaped in part by early social experiences, and predicts later depressive symptoms in combination with other risk factors like stress exposure. Further, a component consistent with RewP is reliably elicited in response to social acceptance feedback in computerized peer interaction tasks and demonstrates unique associations with social contextual factors and depressive symptoms, supporting the utility of developing psychophysiological tasks that may better capture youths' real‐world experiences and social risk processes. In addition, I address the translational implications of clinical psychophysiological research and describe a series of studies showing that a reduced RewP predicts greater reductions in depressive symptoms with treatment but is not modifiable by current treatments like cognitive behavioral therapy. Finally, I describe our preliminary efforts to develop a positive emotion‐focused intervention for the offspring of depressed mothers, informed by the RewP literature, and describe future directions for translating psychophysiological research to intervention and prevention.
Relative's suggestions for improvements in support from health professionals before and after a patient's death in general palliative care at home: A qualitative register study
Authors: Midlöv Elina Mikaelsson , Lindberg Terese , Skär Lisa
Published: January 2024

Introduction

The efforts of relatives in providing palliative care (PC) at home are important. Relatives take great responsibility, face many challenges and are at increased risk of poor physical and mental health. Support for these relatives is important, but they often do not receive the support they need. When PC is provided at home, the support for relatives before and after a patient's death must be improved. This study aimed to describe relatives' suggestions to improve the support from health professionals (HPs) before and after a patient's death in general PC at home.

Methods

This study had a qualitative descriptive design based on the data from open‐ended questions in a survey collected from the Swedish Register of Palliative Care. The respondents were adult relatives involved in general PC at home across Sweden. The textual data were analysed using thematic analysis.

Results

The analysis identified four themes: (1) seeking increased access to HPs, (2) needing enhanced information, (3) desiring improved communication and (4) requesting individual support.

Conclusions

It is important to understand and address how the support to relatives may be improved to reduce the unmet needs of relatives. The findings of this study offer some concrete suggestions for improvement on ways to support relatives. Further research should focus on tailored support interventions so that HPs can provide optimal support for relatives before and after a patient's death when PC is provided at home.
Ideological Disagreement and the Rejection of Laws by Italian Heads of State
Authors: Ceron Andrea
Published: January 2024

Heads of state in parliamentary democracies are usually perceived as neutral and non‐partisan political actors. However, they can make autonomous political choices, sometimes oriented by their own partisan preferences. Focusing on the Italian case, we analyze the propensity of the president of the Republic to publicly express political disagreement by rejecting the promulgation of laws. We contribute to the literature by creating and exploiting a new dataset, based on a content analysis of presidents' investiture speeches and New Year's Eve messages which maps the ideological position of Italian heads of state and their distance from the cabinet over more than 75 years (1946–2022). We show that such ideological distance increases the number of laws rejected by the president. This effect holds when controlling for the size and heterogeneity of the government coalition, as well as the state of the economy and the occurrence of crises.
Survey on the approach to antibiotic prophylaxis in liver and kidney transplant recipients colonized with “difficult to treat” Gram‐negative bacteria
Authors: Bonazzetti Cecilia , Rinaldi Matteo , Cosentino Federica , Gatti Milo , Freire Maristela Pinheiro , Mularoni Alessandra , Clemente Wanessa Trindade , Pierrotti Ligia Camera , Aguado Jose Maria , Grossi Paolo , Pea Federico , Viale Pierluigi , Giannella Maddalena ,   European Study Group of Infections in Immunocompromised Host
Published: January 2024

Background

Performance of active screening for multidrug‐resistant Gram‐negative bacteria (MDR‐GNB) and administration of targeted antibiotic prophylaxis (TAP) in colonized patients undergoing liver (LT) and/or kidney transplantation (KT) are controversial issues.

Methods

Self‐administered electronic cross‐sectional survey disseminated from January to February 2022. Questionnaire consisted of four parts: hospital/transplant program characteristics, standard screening and antibiotic prophylaxis, clinical vignettes asking for TAP in patients undergoing LT and KT with prior infection/colonization with four different MDR‐GNB (extended‐spectrum cephalosporin‐resistant Enterobacterales [ESCR‐E], carbapenem‐resistant Enterobacterales [CRE], multidrug‐resistant Pseudomonas aeruginosa [MDR‐Pa], and carbapenem‐resistant Acinetobacter baumannii [CRAb]).

Results

Fifty‐five respondents participated from 14 countries, mostly infectious disease specialists (69%) with active transplant programs (>100 procedures/year for 34.5% KT and 23.6% LT), and heterogeneous local MDR‐GNB prevalence from <15% (30.9%), 15%–30% (43.6%) to >30% (16.4%). The frequency of screening for ESCR‐E, CRE, MDR‐Pa, and CRAb was 22%, 54%, 17%, and 24% for LT, respectively, and 18%, 36%, 16%, and 11% for KT. Screening time‐points were mainly at transplantation 100%, only one‐third following transplantation. Screening was always based on rectal swab cultures (100%); multi‐site sampling was reported in 40% of KT and 35% of LT. In LT clinical cases, 84%, 58%, 84%, and 40% of respondents reported TAP for prior infection/colonization with ESCR‐E, CRE, MDR‐Pa, and CRAb, respectively. In KT clinical cases, 55%, 39%, 87%, and 42% of respondents reported TAP use for prior infection/colonization with ESCR‐E, CRE, MDR‐Pa, and CRAb, respectively.

Conclusion

There is a large heterogeneity in screening and management of MDR‐GNB carriage in LT and KT.

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Risk factors associated with severe dengue in Latin America: A systematic review and meta‐analysis
Authors: Paraná Victoria Cruz , Feitosa Caroline Alves , da Silva Greice Carolina Santos , Gois Luana Leandro , Santos Luciane Amorim
Published: January 2024

Objective

Severe dengue is a significant health problem in Latin America, with children being the most affected. Understanding risk factors for severe dengue is crucial for enhancing patient care. Therefore, this study aims to systematically review the literature to identify the risk factors associated with severe dengue in Latin America through systematic review and meta‐analysis.

Methods

PubMed, SciELO, LILACS and EMBASE databases were used to search for eligible scientific articles for the review. The outcomes considered were symptoms of severe dengue, hospitalisation and death. The Joanna Briggs Institute Critical Appraisal Checklist was used to assess the quality of the studies. Data analysis was performed using STATA v 13.0 software. The degree of heterogeneity between studies was quantified using the I2 measure, and statistically significant results were defined as those with p values <0.05.

Results

Of the 1876 articles screened, 47 articles were included in the systematic review and 45 articles were analysed through meta‐analysis. Identified risk factors associated with severe dengue included secondary dengue infection, female sex, white or Caucasian ethnicity and specific signs and symptoms such as headache, myalgia and/or arthralgia, vomiting/nausea, abdominal pain or tenderness, diarrhoea, prostration, lethargy, fatigue or similar. For the death outcome, respiratory symptoms and age <18 years were identified as risk factors. On the other hand, in women, the diagnosis of positive tourniquet test, platelet count <100,000 per μL and symptoms of capillary fragility were associated with a lower probability of death. These data highlight the importance of early screening of patients, to identify possible haemorrhagic signs and reduce deaths from dengue. This study has limitations, including possible publication bias, heterogeneity of results and study design biases.

Conclusion

These findings are significant for shaping strategies, management approaches and identifying high‐risk groups, which will help establish future guidelines.
Construcción del Proyecto de Vida de Jugadores de Fútbol categoría juvenil. Un estudio de caso
Authors: Díaz-Rico María Elena , Gutiérrez-Rada Laura Vanessa
Published: January 2024

Objetivo. Indagar sobre los aspectos que inciden en la construcción del proyecto de vida de futbolistas de 17 años con aspiracionesde ser jugadores profesionales. Método. Estudio de enfoque cualitativo y descriptivo de corte transversal. Veinticinco jugadores defútbol de 17 años pertenecientes a un club deportivo de Cali, respondieron a una encuesta de datos sociodemográcos, se realizaronentrevistas semiestructuradas a los deportistas y al entrenador a cargo del proceso de formación. Resultados.Se encontró que elproyecto de vida de estos futbolistas estaba inuenciado por diversos factores de su contexto próximo, especialmente la familia y elclub deportivo. Conclusión. Los aspectos incidentes más importantes en la construcción del proyecto de vida de estos futbolistasson: su familia, los clubes deportivos a los que pertenecen, los entrenadores que han estado a cargo de su proceso deportivo, lacultura académica, las instituciones educativas y en cierta medida la empresa privada que proporciona patrocinios.Palabras clave: Elección profesional, autoconcepto, fútbol.
Dependence of Critical Stress Intensity Factor on Crack Depth From the Loading Boundary of Crystalline Silicon
Authors: Basu Ayan , Singh Gaurav
Published: January 2024

In the present work, an atomistic scale investigation is done on crystalline silicon to understand the effect of crack depth from the loading (pulling) boundary on the critical near-tip state of stress. For various depths of embedded cracks, the near-tip stress field has been calculated at the critical state just before the crack propagation initiation. This atomistically calculated stress field is found to be quite close to those found using continuum linear elasticity. Thereafter, the critical stress intensity factor (SIF) is calculated for all cases by fitting the atomistically calculated normal stress over inverse square-rooted distance from the crack tip. It has been found that the closer the crack is located to the loading boundary (i.e., lesser depth), the lower is the (locally calculated) critical SIF. This implies that it is easier to initiate crack propagation when the crack is located closer to the loading boundary. The claim is also strengthened by a similar observation of (globally calculated) boundary stresses at the critical state just before crack propagation initiation.
A Kinematics-Based Optimization Design for the Leg Mechanism of a Novel Earth Rover
Authors: Wu Yifan , Guo Sheng , Niu Lianzheng , Yang Xinhua , Zhao Fuqun , He Yufan
Published: January 2024

This paper proposes a general kinematic-based design method for optimizing the side-mounted leg mechanism of BJTUBOT, a novel multi-mission quadrupedal Earth rover. The focus issue lies in designing structural improvements that not only enhance its kinematic performance but also prevent singularity, all while meeting the demands for miniaturization and lightweight without deviating from the original leg design concept. To solve this issue, a novel 3-UPRU&PPRR mechanism is envisaged based on the original configuration. Around the unique structural features of this mechanism, its inverse kinematic solution and Jacobian matrix are calculated, and a coupled motion relation between a key limb and its moving platform (MP) is presented. In order to achieve singularity avoidance, some typical singularity configurations based on line geometry analysis are given. In accordance with this result, an initial configuration for multi-objective dimensional optimization is presented. To further enhance its kinematic performance, we introduce the use of the GCI (global conditional index) performance at extreme positions as one of the optimization criteria based on the NSGA-II (Non-dominated Sorting Genetic Algorithm) algorithm, and directly measuring the crowding distance using the position vector of the U (universal) joints on the moving platform. This optimized mechanism prototype is demonstrated in a single-leg Adams simulation, which exhibits good velocity mapping effects and displacement accuracy. Finally, a new BJTUBOT prototype was constructed based on the optimized leg, and its flexibility was tested with various classical forms of motions. The workflow in this paper significantly improves the leg performance under the current design needs.
One-Step Solving the Hand–Eye Calibration by Dual Kronecker Product
Authors: Wang Xiao , Song Hanwen
Published: January 2024

Hand–eye calibration is a typical research direction in robotics applications. The current methods can be divided into two categories according to whether the rotational and translational equations are decoupled for computation: two-step methods and one-step methods. Both one-step and two-step methods generally convert such problems to linear null space computations, which are implemented by the corresponding computational operators. Owing to the booming development of the rotation operators, the two-step methods have been more fully researched. However, due to the limitations of the research on computational operators integrating rotation and translation, the one-step methods still have much scope for research. Dual algebra, as effective mathematical entities for screws and wrenches, provides the theoretical basis for the development of the one-step methods for hand–eye calibration. In this paper, a computational operator for the dual matrices computation was first proposed, i.e., dual Kronecker product. Subsequently, a hand–eye calibration framework was proposed based on the dual Kronecker product, which allowed the screw motion to be represented as multiple dual vectors. Furthermore, the equivalence of this framework with the orthogonal-dual-tensor-based approach was derived, providing a more intuitive computational representation. The feasibility and superiority of the proposed computational framework were experimentally verified.
Beneficial and detrimental entanglement for quantum battery charging
Authors: Gyhm Ju-Yeon , Fischer Uwe R.
Published: January 2024

We establish a general implementation-independent approach to assess the potential advantage of using highly entangled quantum states between the initial and final states of the charging protocol to enhance the maximum charging power of quantum batteries. It is shown that the impact of entanglement on power can be separated from both the global quantum speed limit associated with an optimal choice of driving Hamiltonian and the energy gap of the batteries. We then demonstrate that the quantum state advantage of battery charging, defined as the power obtainable for given quantum speed limit and battery energy gap, is not an entanglement monotone. A striking example we provide is that, counterintuitively, independent thermalization of the local batteries, completely destroying any entanglement, can lead to larger charging power than that of the initial maximally entangled state. Highly entangled states can thus also be potentially disadvantageous when compared to product states. We also demonstrate that taking the considerable effort of producing highly entangled states, such as W or k-locally entangled states, is not sufficient to obtain quantum-enhanced scaling behavior with the number of battery cells. Finally, we perform an explicit computation for a Sachdev–Ye–Kitaev battery charger to demonstrate that the quantum state advantage allows the instantaneous power to exceed its classical bound.
Synthesis and characterization of low-friction W-V-N alloy coatings using reactive magnetron sputtering technique for tribological applications
Authors: Rao Akula Umamaheswara , Tiwari Sunil Kumar , Kharb Archana Singh , Sardana Neha , Chawla Vipin , Kumar Sanjeev , Saxena Vikas , Chawla Amit Kumar
Published: January 2024

In recent years, self-lubricating hard coatings have garnered significant interest across various industries such as cutting tools, molds, and manufacturing because of their ability to reduce friction and wear at high temperatures in dry-cutting applications. The present study focuses on synthesis of tungsten-vanadium-nitride (W-V-N) coatings using the reactive magnetron cosputtering technique in an Ar + N2 plasma gas environment. The coating microstructure, surface morphology, wetting behavior, and mechanical properties were characterized by grazing incidence x-ray diffraction, field-emission scanning electron microscopy, atomic force microscopy, energy-dispersive spectroscopy, and nanoindentation. Wear resistance properties of the prepared W-V-N alloy coatings were investigated using a ball-on-disk tribometer at two different temperatures. The findings indicate that all W-V-N coatings, regardless of the vanadium content, exhibit a face-centered cubic structure and form a solid solution of W-V-N. Among the coatings studied, W0.68V0.32N exhibited the highest hardness (14.25 GPa) and Young's modulus (257.53 GPa), as well as an excellent wear resistance. Increasing the vanadium content in the W-V-N coating led to a notable reduction in both the specific wear rate and friction coefficient. Moreover, this reduction was more pronounced with an increase in temperature during the wear test. Improvement in the wear properties can be attributed to the formation of Magnéli phases of vanadium oxides on the surface of the coatings. The ability of the W-V-N coating to reduce friction and wear, combined with its improved mechanical properties, makes it a promising candidate for solid lubricating coatings in tribological applications.
Utilitarianism, Sport Mega-Events, and Pandemic Protocols: A Case Scenario for Teaching Utilitarianism in Sport Ethics and Event Management
Authors: Provencio Chuck
Published: January 2024

Sport managers need to make decisions that have moral implications on a regular basis, and applying their theoretical knowledge to real-world scenarios is an essential skill in the field. Utilitarianism is a consequentialist ethical theory that focuses on maximizing the production of good. The purpose of this case is to provide students with the opportunity to learn about utilitarianism (including act and rule utilitarianism) and engage in class discussions surrounding the case of pandemic protocols in sport organizations. A brief and general overview of pandemic protocols used in the sport industry is provided alongside discussion questions designed to challenge students with the application of utilitarian principles to their decision making. The case also provides a teaching note with discussion topics and potential responses.
Nonsynchronous rotation of icy moon ice shells: The thermal wind perspective
Authors: Kang Wanying
Published: January 2024

The ice shells of icy satellites have been hypothesized to undergo nonsynchronous rotation (NSR) under the influence of tidal torques and/or ocean currents. In this work, the author proposes that the thermal wind relationship can be combined with geostrophic turbulence theory to predict ocean stress onto the ice shell inside the tangent cylinder. High-resolution numerical simulations validate the prediction within a factor of 2. For the prediction to be valid, the rotation effect must dominate (Rossby number < 1), and the upper ocean should be stratified. The latter can be achieved with sufficiently large ice thickness variations [the threshold for Europa is O(100) m]. Using this framework, once the ice rheology, thickness variations and NSR rate are determined, one may be able to estimate the ocean overturn timescale and put constraints on the ocean vertical diffusivity or the heat flux originating from the silicate core.
Could PLATELIA Toxo IgM be the new gold standard for the serological diagnosis of congenital toxoplasmosis: a French multicenter study
Authors: Arkhis Safya , Rouges Celia , Dahane Naïma , Guegan Hélène , Yéra Hélène , Robert-Gangneux Florence
Published: January 2024

This study will help clinical microbiologists to chose an alternative serological method for the neonatal diagnosis of congenital toxoplasmosis, once the gold standard technique ISAGA will be withdrawn next year.
Inequalities in use of hospitals for childbirth among rural women in sub-Saharan Africa: a comparative analysis of 18 countries using Demographic and Health Survey data
Authors: Straneo Manuela , Hanson Claudia , van den Akker Thomas , Afolabi Bosede B , Asefa Anteneh , Delamou Alexandre , Dennis Mardieh , Gadama Luis , Mahachi Nyika , Mlilo Welcome , Pembe Andrea B , Tsuala Fouogue Jovanny , Beňová Lenka
Published: January 2024

Introduction

Rising facility births in sub-Saharan Africa (SSA) mask inequalities in higher-level emergency care—typically in hospitals. Limited research has addressed hospital use in women at risk of or with complications, such as high parity, linked to poverty and rurality, for whom hospital care is essential. We aimed to address this gap, by comparatively assessing hospital use in rural SSA by wealth and parity.

Methods

Countries in SSA with a Demographic and Health Survey since 2015 were included. We assessed rural hospital childbirth stratifying by wealth (wealthier/poorer) and parity (nulliparity/high parity≥5), and their combination. We computed percentages, 95% CIs and percentage-point differences, by stratifier level. To compare hospital use across countries, we produced a composite index, including six utilisation and equality indicators.

Results

This cross-sectional study included 18 countries. In all, a minority of rural women used hospitals for childbirth (2%–29%). There were disparities by wealth and parity, and poorer, high-parity women used hospitals least. The poorer/wealthier difference in utilisation among high-parity women ranged between 1.3% (Mali) and 13.2% (Rwanda). We found use and equality of hospitals in rural settings were greater in Malawi and Liberia, followed by Zimbabwe, the Gambia and Rwanda.

Discussion

Inequalities identified across 18 countries in rural SSA indicate poor, higher-risk women of high parity had lower use of hospitals for childbirth. Specific policy attention is urgently needed for this group where disadvantage accumulates.
An interpretative phenomenological analysis of the lived experience of people with multimorbidity in low- and middle-income countries
Authors: Tran Phuong Bich , Ali Ayaz , Ayesha Rubab , Boehnke Jan R , Ddungu Charles , Lall Dorothy , Pinkney-Atkinson Victoria J , van Olmen Josefien
Published: January 2024

People living with multimorbidity (PLWMM) have multiple needs and require long-term personalised care, which necessitates an integrated people-centred approach to healthcare. However, people-centred care may risk being a buzzword in global health and cannot be achieved unless we consider and prioritise the lived experience of the people themselves. This study captures the lived experiences of PLWMM in low- and middle-income countries (LMICs) by exploring their perspectives, experiences, and aspirations.

We analysed 50 semi-structured interview responses from 10 LMICs across three regions—South Asia, Latin America, and Western Africa—using an interpretative phenomenological analysis approach.

The bodily, social, and system experiences of illness by respondents were multidirectional and interactive, and largely captured the complexity of living with multimorbidity. Despite expensive treatments, many experienced little improvements in their conditions and felt that healthcare was not tailored to their needs. Disease management involved multiple and fragmented healthcare providers with lack of guidance, resulting in repetitive procedures, loss of time, confusion, and frustration. Financial burden was exacerbated by lost productivity and extreme finance coping strategies, creating a vicious cycle. Against the backdrop of uncertainty and disruption due to illness, many demonstrated an ability to cope with their conditions and navigate the healthcare system. Respondents’ priorities were reflective of their desire to return to a pre-illness way of life—resuming work, caring for family, and maintaining a sense of independence and normalcy despite illness. Respondents had a wide range of needs that required financial, health education, integrated care, and mental health support.

In discussion with respondents on outcomes, it appeared that many have complementary views about what is important and relevant, which may differ from the outcomes established by clinicians and researchers. This knowledge needs to complement and be incorporated into existing research and treatment models to ensure healthcare remains focused on the human and our evolving needs.
Understanding the factors affecting global political priority for controlling sexually transmitted infections: a qualitative policy analysis
Authors: Wu Dadong , Low Nicola , Hawkes Sarah J
Published: January 2024

Introduction

Sexually transmitted infections (STIs) are a significant public health challenge, but there is a perceived lack of political priority in addressing STIs as a global health issue. Our study aimed to understand the determinants of global political priority for STIs since the 1980s and to discern implications for future prioritisation.

Methods

Through semistructured interviews from July 2021 to February 2022, we engaged 20 key stakeholders (8 women, 12 men) from academia, United Nations agencies, international non-governmental organisations, philanthropic organisations and national public health agencies. A published policy framework was employed for thematic analysis, and findings triangulated with relevant literature and policy documents. We examined issue characteristics, prevailing ideas, actor power dynamics and political contexts.

Results

A contrast in perspectives before and after the year 2000 emerged. STI control was high on the global health agenda during the late 1980s and 1990s, as a means to control HIV. A strong policy community agreed on evidence about the high burden of STIs and that STI management could reduce the incidence of HIV. The level of importance decreased when further research evidence did not find an impact of STI control interventions on HIV incidence. Since 2000, cohesion in the STI community has decreased. New framing for broad STI control has not emerged. Interventions that have been funded, such as human papillomavirus vaccination and congenital syphilis elimination have been framed as cancer control or improving newborn survival, rather than as STI control.

Conclusion

Globally, the perceived decline in STI control priority might stem from discrepancies between investment choices and experts’ views on STI priorities. Addressing STIs requires understanding the intertwined nature of politics and empirical evidence in resource allocation. The ascent of universal health coverage presents an opportunity for integrated STI strategies but high-quality care, sustainable funding and strategic coordination are essential.
Perineural injections of incobotulinumtoxin-A for diabetic neuropathic pain of the lower extremities: protocol for a phase II, single-centre, double-blind, randomised, placebo-controlled trial (the PINBOT study)
Authors: Klee Marc , Hørmann Thomsen Trine , Enggaard Thomas Peter , Bitsch Martin Sabro , Simonsen Louise , Jensen Rigmor Højland , Biering-Sørensen Bo
Published: January 2024

Introduction

Diabetic neuropathic pain (DNP) is a debilitating complication affecting 15–20% of people with diabetes and is a predictor of depression, poor sleep and decreased quality of life. Current pharmacological treatments are often insufficient and have significant side-effects. Subcutaneous or intradermal botulinumtoxin-A (BonT-A) is an effective and safe treatment for neuropathic pain but is limited by the need to cover the entire affected area with injections. For large cutaneous areas, infiltration of the sensory nerve supply with BonT-A could provide similar effects, with a single injection. We aim to investigate the safety, efficacy, and effects on quality of life, physical activity, depressive symptoms and activities of daily living of perineural injections of BonT-A in patients with DNP of both lower extremities.

Methods

This study is a double-blind, randomised, placebo-controlled clinical trial. 80 participants with moderate to severe DNP of both legs will be randomised 1:1 to receive injections of either 100 units incobotulinumtoxin-A or a saline placebo around each distal sciatic nerve for two cycles of 12 weeks. Average daily pain scores will be recorded once a day from 1 week prior to the first treatment and through the entire study period. Primary outcomes are differences between groups in daily and weekly mean pain scores. Secondary outcomes are levels of physical activity, depression scores, health-related quality of life, activities of daily living, sensory profiles and motor function, recorded at baseline, 4, 12, 16 and 24 weeks. The use of rescue medication and adverse events will be recorded throughout the study period.

Ethics and dissemination

The study is approved by the Danish Committee on Health Research Ethics and the Danish Medicines Agency. EU-Clinical Trial Information System (EU: 2022-500727-68-01), clinicaltrials.gov (ID:NCT05623111). Results will be published in peer-reviewed journals in open-access formats and data made available in anonymised form.

Trial registration number

NCT05623111.
Disruption of diabetes and hypertension care during the COVID-19 pandemic and recovery approaches in the Latin America and Caribbean region: a scoping review protocol
Authors: Jabakhanji Samira Barbara , Ogungbe Oluwabunmi , Angell Sonia Y , Appel Lawrence , Byrne David , Mehta Roopa , McCaffrey John , Rosman Lori , Gregg Edward W , Matsushita Kunihiro
Published: January 2024

Introduction

The COVID-19 pandemic significantly disrupted primary healthcare globally, with particular impacts on diabetes and hypertension care. This review will examine the impact of pandemic disruptions of diabetes and hypertension care services and the evidence for interventions to mitigate or reverse pandemic disruptions in the Latin America and Caribbean (LAC) region.

Methods and analyses

This scoping review will examine care delivery disruption and approaches for recovery of primary healthcare in the LAC region during the COVID-19 pandemic, focusing on diabetes and hypertension awareness, detection, treatment and control. Guided by Arksey and O’Malley’s scoping review methodology framework, this protocol adheres to the Joanna Briggs Institute guidelines for scoping review protocols and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance for protocol development and scoping reviews. We searched MEDLINE, CINAHL, Global Health, Embase, Cochrane, Scopus, Web of Science and LILACS for peer-reviewed literature published from 2020 to 12 December 2022 in English, Spanish or Portuguese. Studies will be considered eligible if reporting data on pandemic disruptions to primary care services within LAC, or interventions implemented to mitigate or reverse pandemic disruptions globally. Studies on COVID-19 or acute care will be excluded. Two reviewers will independently screen each title/abstract for eligibility, screen full texts of titles/abstracts deemed relevant and extract data from eligible full-text publications. Conflicts will be resolved through discussion and with the help of a third reviewer. Appropriate analytical techniques will be employed to synthesise the data, for example, frequency counts and descriptive statistics. Quality will be assessed using the Newcastle Ottawa Quality Assessment Scale.

Ethics and dissemination

No ethics approval was needed as this is a scoping review of published literature. Results will be disseminated in a report to the World Bank and the Pan American Health Organization, in peer-reviewed scientific journals, and at national and international conferences.
Abdominal massage for chronic constipation in the elderly: a systematic review and meta-analysis protocol
Authors: Yuan Qiang , Wang Xiaoyan , Zhou Li , Li Chuan , Lu Qunwen , Wang Haozhong , Luo Jian
Published: January 2024

Introduction

Chronic constipation (CC) is a highly prevalent health challenge that is particularly challenging to treat in elderly patients. Although lifestyle guidance and laxative therapy often yield positive outcomes, patients occasionally struggle with maintaining dietary control. Therefore, identifying an economical and safe alternative therapy to the existing treatment methods documented in the international literature is necessary. This systematic review and meta-analysis aims to evaluate the efficacy and safety of abdominal massage in elderly patients with CC to provide a basis for future mechanistic research.

Methods and analysis

Electronic searches will be conducted to identify clinical randomised controlled trials in various databases, including Web of Science, PubMed, Cumulated Index to Nursing and Allied Health Literature, Cochrane Library, Embase, Airiti Library, Chinese National Knowledge Infrastructure Databases, Chinese Science and Technology Periodical Database (VIP), Chinese Biomedical Literature Database and Wan Fang Database. Relevant data will be extracted, and a meta-analysis will be conducted using Reviewer Manager V.5.4. Quality and risk assessments of the included studies will be performed, and the outcome indicators of the trials will be observed. This review will evaluate abdominal massage as a treatment option for relieving symptoms and improving quality of life in elderly patients with CC. Moreover, it will provide additional insights for clinical treatment and mechanistic studies. The search will be performed following the publication of this protocol (estimated to occur on 30 December 2023).

Ethics and dissemination

As this is a literature review, ethics approval will not be required. We will disseminate the findings of this study to publications in peer-reviewed journals as well as presentations at relevant national and international conferences.

PROSPERO registration number

CRD42023408629.
Association of habitual physical activity with depression and anxiety: a multicentre cross-sectional study
Authors: Liu Sitong , Mei Yunting , Huang Li , Liu Xudong , Xi Yuandi
Published: January 2024

Objective

Despite the known benefits of physical activity, the effect of habitual physical activity (HPA) on depression and anxiety remains unclear. This study aimed to investigate the association of HPA with the risk of depression and anxiety among Chinese adults, with the consideration of disease severity.

Methods

The participants in this multicentre cross-sectional study were from the nationwide survey of the psychology and behaviour of Chinese residents. Depression and anxiety were measured using the nine-item Patient Health Questionnaire and seven-item Generalised Anxiety Disorder scale. HPA was assessed by the short form of the International Physical Activity Questionnaire. Crude and adjusted ORs with their 95% CIs were estimated by using ordinal logistic regression.

Results

Of the 19 798 participants, 3901 (19.7%) had anxiety and 8914 (45.02%) had depression. Compared with inactive participants, depression risk in individuals reporting low, median and high volume HPA was reduced by 23% (OR 0.77, 95% CI 0.66 to 0.89), 21% (OR 0.79, 95% CI 0.68 to 0.90) and 13% (OR 0.87, 95% CI 0.78 to 0.98), respectively, after adjustment for confounder. No significant association of HPA with anxiety risk was observed.

Conclusion

Participation in HPA, whether low, median or high volume, was associated with a lower risk of depression compared with inactive participation, while no significant association was observed between HPA and anxiety.
Vaccine hesitancy among physicians: a qualitative study with general practitioners and paediatricians in Austria and Germany
Authors: Wojczewski Silvia , Leitner Katja M , Hoffmann Kathryn , Kutalek Ruth , Jirovsky-Platter Elena
Published: January 2024

Objective

This study aims to understand reasons for vaccine hesitancy (VH) among general practioners (GPs) and paediatricians. We aim to analyse how and when the healthcare workers (HCWs) developed vaccine-hesitant views and how they transfer these to patients.

Design and setting

Semistructured interviews with vaccine-hesitant GPs and paediatricians were conducted in Austria and Germany using an explorative qualitative research design.

Participants

We contacted 41 physicians through letters and emails and 10 agreed to participate, five were male and five female.

Data collection and analysis

Ten interviews were recorded, transcribed verbatim and anonymised. The material was analysed inductively following a grounded theory approach with open coding using the software atlas.ti.

Results

Key themes that were identified were education and career path, understanding of medicine and medical profession, experiences with vaccines, doctor–patient interactions and continuous education activities and the link to VH. GPs and paediatricians’ vaccine-hesitant attitudes developed during their medical training and, in particular, during extracurricular training in homeopathy, which most of the participants completed. Most participants work in private practices rather than with contracts with social insurance because they are not satisfied with the health system. Furthermore, they are critical of biomedicine. Most of the interview partners do not consider themselves antivaccination, but are sceptical towards vaccines and especially point out the side effects. Most do not vaccinate in their practices and some do only occasionally. Their vaccine-hesitant views are often fostered through respective online communities of vaccine-hesitant HCWs.

Conclusions

More studies on a connection between complementary medicine and vaccine-hesitant views of HCWs are needed. Education about vaccines and infectious diseases among healthworkers must increase especially tailored towards the use of internet and social media. Physicians should be made aware that through time and empathy towards their patients they could have a positive impact on undecided patients and parents regarding vaccine decisions.
Protocol of an individual participant data meta-analysis to quantify the impact of high ambient temperatures on maternal and child health in Africa (HE2AT IPD)
Authors: Lakhoo Darshnika Pemi , Chersich Matthew Francis , Jack Chris , Maimela Gloria , Cissé Guéladio , Solarin Ijeoma , Ebi Kristie L , Chande Kshama S , Dumbura Cherlynn , Makanga Prestige Tatenda , van Aardenne Lisa , Joubert Bonnie R , McAllister Kimberly A , Ilias Maliha , Makhanya Sibusisiwe , Luchters Stanley
Published: January 2024

Introduction

Globally, recognition is growing of the harmful impacts of high ambient temperatures (heat) on health in pregnant women and children. There remain, however, major evidence gaps on the extent to which heat increases the risks for adverse health outcomes, and how this varies between settings. Evidence gaps are especially large in Africa. We will conduct an individual participant data (IPD) meta-analysis to quantify the impacts of heat on maternal and child health in sub-Saharan Africa. A detailed understanding and quantification of linkages between heat, and maternal and child health is essential for developing solutions to this critical research and policy area.

Methods and analysis

We will use IPD from existing, large, longitudinal trial and cohort studies, on pregnant women and children from sub-Saharan Africa. We will systematically identify eligible studies through a mapping review, searching data repositories, and suggestions from experts. IPD will be acquired from data repositories, or through collaboration with data providers. Existing satellite imagery, climate reanalysis data, and station-based weather observations will be used to quantify weather and environmental exposures. IPD will be recoded and harmonised before being linked with climate, environmental, and socioeconomic data by location and time. Adopting a one-stage and two-stage meta-analysis method, analytical models such as time-to-event analysis, generalised additive models, and machine learning approaches will be employed to quantify associations between exposure to heat and adverse maternal and child health outcomes.

Ethics and dissemination

The study has been approved by ethics committees. There is minimal risk to study participants. Participant privacy is protected through the anonymisation of data for analysis, secure data transfer and restricted access. Findings will be disseminated through conferences, journal publications, related policy and research fora, and data may be shared in accordance with data sharing policies of the National Institutes of Health.

PROSPERO registration number

CRD42022346068.
Effects of retirement on inpatient healthcare utilisation: an observational study in China
Authors: Ye Xin , Li Wentao , Wang Yanshang , Hu Mingzheng , Zhu Dawei , Shi Xuefeng , He Ping
Published: January 2024

Objective

Previous studies have presented mixed evidence on retirement and inpatient healthcare utilisation. We aimed to examine the causal effect of retirement on inpatient healthcare utilisation in China and explore the heterogenous effects of sex, disease types and ways of hospital admission.

Design

This was a retrospective observational study from the electronic medical record at 376 tertiary hospitals in China between 2013 and 2018.

Setting

Nationwide data from China.

Participants

We included the male sample aged between 50 and 70, and the female sample aged between 40 and 60 and with basic medical insurance system or public medical insurance. Observations with total expenditures per visit at the top or bottom 1% were excluded.

Primary and secondary outcome measures

Inpatient expenditures per visit and inpatient days per visit.

Methodology

We examined the effects by a non-parametric fuzzy regression discontinuity design, exploiting the mandatory retirement age as a source of exogenous variation in retirement status.

Results

Retirement reduced drug expenditures (β=−467.46, p<0.05) and inpatient days per visit (β=−0.99, p<0.05). The mitigation effect was concentrated on people admitted into hospital due to chronic diseases (β=−551.28, p<0.05 for drug expenditures; β=−1.08, p<0.05 for inpatient days per visit) and people admitted into hospital through outpatient services (β=−353.75, p<0.001 for drug expenditures). For males, retirement significantly reduced diagnostic tests expenditures (β=−302.38, p<0.05) and drug expenditures (β=−728.31, p<0.05). Retirement significantly reduced inpatient days per visit (β=−1.13, p<0.05) for females.

Conclusion

The empirical findings suggested that retirement may lead to a reduction in inpatient healthcare utilisation, which underlined the importance for policy-makers to consider the externalities of retirement policies on inpatient healthcare utilisation.