bluuebunny/crossref_metadata_2025_split huggingface dataset:
Persistent oral health inequality in children—repeated cross-sectional studies in 2010 and 2019
Authors: Blomma Caroline , Davidson Thomas , Gerdin Elisabeth Wärnberg , Bågesund Mats , Lyth Johan 
Published: December 2024

Abstract
Background and aim
Children growing up in vulnerable circumstances have a higher risk of caries experience. Tracking the development of caries in relation to socioeconomic variables over time is essential for fair resource distribution to groups with higher caries risk and to even out inequalities in oral health. The aim was therefore to analyse the association between 6-year-olds´ caries prevalence and socioeconomic variables at family and residential area levels in 2010 and 2019 as well as potential differences in the association between 2010 and 2019.

Methods
The study design is an epidemiological registry-based, repeated cross-sectional study based on caries data (grouped as 0, 1–3 and > 3 dmft) for the population of 6-year-olds in 2010 (n = 4,408, 95% coverage) and 2019 (n = 5,199, 94% coverage) in a Swedish region. Multiple socioeconomic variables for the children’s families and residential areas were retrieved from official registries. Multinomial logistic regression was performed at both levels to produce models for each level and studied year.

Results
The variables that explained most of the association between caries and socioeconomic variables were mainly the same over the years at both levels. At the family level, these were: maternal age when having their first child (explained most of the association in both years, at 30 and 35%, respectively); maternal age when having the child in the study group; parental employment; parental and child’s migration background; maternal educational level; form of housing; and financial assistance (only 2010). At the residential area level, these were: migration background (explained most of the association both years; 82 and 52%, respectively), educational level and number of persons per household. The association between socioeconomic variables and caries was consistently stronger for severe caries (dmft > 3) than moderate (dmft 1–3). Multiple socioeconomic risk variables meant an even greater likelihood of caries.

Conclusion
Over the studied years, variables related to socioeconomic vulnerability continued to be associated with caries in young children growing up under socially disadvantaged circumstances. Effective efforts for families living in socially vulnerable contexts are needed to achieve good and equal oral health, as is continued follow-up to evaluate whether the goal is reached.
Associations between violence in childhood, depression and suicide attempts in adolescence: evidence from a cohort study in Luwero district, Uganda
Authors: Akunzirwe Rebecca , Carter Daniel J. , Hanna Lauren , Zinke-Allmang Anja , Akim Aggrey , Datzberger Simone , Parkes Jenny , Knight Louise , Atuhaire Lydia , Nakuti Janet , Mirembe Angel , Allen Elizabeth , Naker Dipak , Devries Karen , Bhatia Amiya 
Published: December 2024

Abstract
Background
Many studies have documented an association between violence victimisation and poor mental health. However, few studies use longitudinal data from low- and middle-income countries with attention to how associations differ by experiencing specific types of violence or alongside different contexts of peer and family support. In this study, we quantify the association between experiences of violence in early adolescence and depression and suicide attempts in late adolescence and explore whether this association is modified by family and peer connectedness.

Methods
Data came from the Contexts of Violence Against Children (CoVAC) cohort study in Luwero District, Uganda, involving 2773 participants aged 11–14 years at Wave 1 (2014) and 15–18 years at Wave 2 (2018). Physical, sexual, and emotional violence were measured at Wave 1. Mental health outcomes, depression symptoms in the past two weeks, and lifetime suicide attempts were measured at Wave (2) We used logistic regression models, stratified by sex, to estimate adjusted odds ratios with an interaction term to test for effect modification by peer and family connectedness at Wave 1.

Findings
At Wave 1, the prevalence of any violence from any perpetrator was 90% (physical violence: 87%, physical violence excluding caning: 68%, sexual violence: 6.3%, emotional violence: 56.8%). At Wave 2, 13.3% of participants had scores indicative of depression and 4.3% reported ever attempting suicide. Physical violence excluding caning, emotional violence, and sexual violence during early adolescence increased the odds of depression and attempting suicide in late adolescence for both boys and girls. Experiencing any violence (including caning) in early adolescence was not associated with depression in late adolescence, including in sex-stratified models. Childhood experience of any violence was associated with a suicide attempt violence in early adolescence (aOR: 2.60; 95%CI: 1.08, 6.27). High peer support mitigated the effect of any violence and physical violence on depression.

Conclusions
Findings highlight the importance of efforts to prevent violence and improve access to response and support services for violence and mental health for young people. Findings also underscore the important role friends and peer networks can play in mitigating the effects of violence as young people grow up.
Parents’ and informal caregivers’ experiences of accessing childhood vaccination services within the United Kingdom: a systematic scoping review of empirical evidence
Authors: Chisnall Georgia , Hersh-Toubia Samar , Mounier-Jack Sandra , Letley Louise , Chantler Tracey 
Published: December 2024

Abstract
Background
Despite repeated calls to action and considerable attention, childhood vaccination uptake has declined for a thirteenth consecutive year in the United Kingdom (UK). Increasingly, stakeholders are advocating for research which goes beyond vaccine hesitancy and explores service accessibility in greater depth. This scoping review aims to identify and critically assess how accessibility is being conceptualised and investigated with a view to informing future research. Research, that in turn, will dictate the interventions pursued to improve vaccination coverage.

Methods
A detailed search strategy was implemented across seven databases to identify research exploring parents’ experiences of accessing childhood vaccination services within the UK. The analysis explored the studies in relation to their conceptualisation of access, methodology, reported results, and recommendations for research or practice using a combination of descriptive qualitative content analysis, typologies, and frequency counts. Methods and reporting adhered to the ‘JBI Manual for Evidence Synthesis’ and the ‘Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews’.

Results
Forty-five studies were included in the analysis. Studies claimed to consider only attitudinal constructs (4%) or did not discuss access at all (33%) despite findings, in part, including access related issues. Remaining studies used the term access in passing or ambiguously (24%), distinguished between attitudes and access in-text (27%), and a minority of studies utilised a theoretical framework which acknowledged accessibility (13%). The focus on access to information (92% of studies) was disproportionately large compared to other domains of accessibility such as availability (11%), affordability (13%), and proximity (16%). Of the seven identified intervention studies, five were centred on information provision.

Conclusion
Accessibility is poorly conceptualised within most of the research conducted on childhood immunisation uptake within the UK. This, in part, is because exploring accessibility was not an explicit objective of many of the studies included in the review. It is vital that the accessibility of childhood vaccination services is given greater priority and appropriately defined in empirical research. Otherwise, researchers run the risk of limiting the scope of their findings based on their own conceptual ideas regarding the drivers of poor uptake rather than the lived reality of parents.
Community perceptions of health accountability meetings with local politicians to improve healthcare quality: a qualitative study in Western Uganda
Authors: Lee HaEun , Fiseha Neyat , Bateisibwa Jordan , Moyer Cheryl A. , Greenberg Joshua , Maffioli Elisa 
Published: December 2024

Abstract
Background
Lack of accountability within healthcare systems contributes to suboptimal healthcare quality and ultimately poor health outcomes, especially in low-income countries. In Uganda, our research team implemented a pilot project of quarterly health accountability meetings between community members and their local political leaders to discuss healthcare needs and strategies for quality improvement. In this study, we examine the community members’ understanding and perceptions of the health accountability meetings, as well as the perceived impact of the meetings on local healthcare services and community life.

Methods
We conducted a total of 12 focus group discussions (FGDs), half with men and half with women, in November 2022 across six randomly chosen communities out of the ten communities where health accountability meetings were held. We audio taped, transcribed, and translated all FGDs into English. We collected data on demographics, understanding of the meetings, and perceived changes within healthcare services and the community from 111 participants. Two researchers analyzed the data using an inductive thematic approach, generating five themes.

Results
We found the following themes: (1) increased inclusivity and promotion of bidirectional communication; (2) increased understanding of patient rights and practicing of collective empowerment by the community; (3) improved provider behavior; (4) enhanced relationships among politicians, community members, and healthcare providers; and (5) identified needs for future improvements.

Conclusion
Through this qualitative study, we found that the community members perceived the accountability meetings as beneficial in improving the local healthcare services and community life. The study demonstrates the need to prioritize the voices of local communities in efforts to address the accountability gaps, as well as the potential for utilizing the relationship between community members and politicians to address accountability shortfalls in other governmental functions beyond healthcare.

Trial registration
N/A.
Adaptation in adversity: innovative approaches to food security amidst COVID-19 in a remote First Nations community in Canada
Authors: Ahmed Fatima , Moriarity Robert J. , Spence Nicholas D. , Kataquapit Gisele , Sutherland Celine , Charania Nadia A. , Tsuji Leonard J. S. , Liberda Eric N. 
Published: December 2024

AbstractThe COVID-19 pandemic exacerbated food insecurity issues in geographically isolated communities, including Fort Albany First Nation (FAFN). This research examines FAFN’s adaptive strategies to improve food security, highlighting community resilience and leadership. Data were gathered through semi-structured interviews with 20 community members who were involved in the pandemic response, either as members of the pandemic committee or as managers of community programs. Thematic analysis revealed significant adaptation of existing programs and the establishment of new initiatives to address food security during the pandemic. Initiatives, such as the community garden and the Fort Albany Farmers Market were food security programs that existed prior to the pandemic, and despite labor shortages during the pandemic, logistical hurdles were addressed to maintain operations and enhance food distribution efficiency. New emergency food initiatives, backed by government support and community efforts, successfully delivered food to vulnerable households. Traditional subsistence activities, such as hunting and fishing, were essential for providing sustenance and strengthening community resilience. These adaptive strategies highlight the critical role of local leadership, community participation and ingenuity, and the utilization of Indigenous knowledge in overcoming food security challenges during crises. This paper underscores the need to support Indigenous food sovereignty and build resilient local food systems tailored to the unique needs of First Nations communities. The experiences of FAFN during the COVID-19 pandemic provide invaluable insights into the resilience and innovation required to improve food security in remote and vulnerable populations, emphasizing the need for sustained investment and policy support in these communities.
Predicting responsiveness to GLP-1 pathway drugs using real-world data
Authors: Zhu Xiaodong , Fowler Michael J. , Wells Quinn S. , Stafford John M. , Gannon Maureen 
Published: December 2024

Abstract
Background
Medications targeting the glucagon-like peptide-1 (GLP-1) pathway are an important therapeutic class currently used for the treatment of Type 2 diabetes (T2D). However, there is not enough known about which subgroups of patients would receive the most benefit from these medications.

Objective
The goal of this study was to develop a predictive model for patient responsiveness to medications, here collectively called GLP-1 M, that include GLP-1 receptor agonists and dipeptidyl peptidase-4 (DPP4) inhibitors (that normally degrade endogenously-produced GLP-1). Such a model could guide clinicians to consider certain patient characteristics when prescribing second line medications for T2D.

Methods
We analyzed de-identified electronic health records of 7856 subjects with T2D treated with GLP-1 M drugs at Vanderbilt University Medical Center from 2003–2019. Using common clinical features (including commonly ordered lab tests, demographic information, other T2D medications, and diabetes-associated complications), we compared four different models: logistic regression, LightGBM, artificial neural network (ANN), and support vector classifier (SVC).

Results
Our analysis revealed that the traditional logistic regression model outperforms the other machine learning models, with an area under the Receiver Operating Characteristic curve (auROC) of 0.77.Our model showed that higher pre-treatment HbA1C is a dominant feature for predicting better response to GLP-1 M, while features such as use of thiazolidinediones or sulfonylureas is correlated with poorer response to GLP-1 M, as assessed by lowering of hemoglobin A1C (HbA1C), a standard marker of glycated hemoglobin used for assessing glycemic control in individuals with diabetes. Among female subjects under 40 taking GLP-1 M, the simultaneous use of non-steroidal anti-inflammatory drugs (NSAIDs) was associated with a greater reduction in HbA1C (0.82 ± 1.72% vs 0.28 ± 1.70%, p = 0.008).

Conclusion
These findings indicate a thorough analysis of real-world electronic health records could reveal new information to improve treatment decisions for the treatment of T2D. The predictive model developed in this study highlights the importance of considering individual patient characteristics and medication interactions when prescribing GLP-1 M drugs.
Medical education videos – comparative analysis of sonography vs. clinical examination videos: user perception and educational value
Authors: Kuru Timur H. , Salem Johannes , Hircin Emrah , Siech Carolin , Moharam Nadim , Schoch Justine , Mattigk Angelika , Struck Julian , Borgmann Hendrik , Nestler Tim 
Published: December 2024

Abstract
Background
Video content has become an increasingly valuable tool in medical education, particularly for teaching hands-on skills like sonography and clinical examination. This study evaluates the satisfaction and content of sonography and clinical examination videos on the AMBOSS platform, a prominent medical education resource in Germany.

Objective
The goal of this study was to compare how effective and well-received sonography and clinical examination videos are on the AMBOSS platform. The study looked at aspects such as the medical and technical quality of the videos, their usefulness for learning, and overall user satisfaction.

Methods
Eighteen instructional videos were chosen and made accessible on the AMBOSS platform, grouped into sonography (n = 9) and clinical examination (n = 9) categories. Users were asked to voluntarily and anonymously fill out a questionnaire evaluating the videos. Over 49.5 months, data from 1,643,274 video views and 936 completed questionnaires were gathered.

Results
Clinical examination videos were watched significantly more often than sonography videos (86 vs. 14%). Both video types were highly rated in terms of medical and technical quality. However, sonography videos were judged superior in technical quality and clarity, whereas clinical examination videos were preferred for their medical quality and practical application. Feedback from users indicated a desire for more detailed annotations and clearer explanations.

Conclusion
The findings underline the crucial role of video resources in medical education, particularly in teaching practical skills. To improve educational outcomes, it is important to tailor content to the specific needs of medical students and professionals, incorporate user feedback, and take advantage of technological advancements.
Improving event prediction using general practitioner clinical judgement in a digital risk stratification model: a pilot study
Authors: Parry Emma , Ahmed Kamran , Guest Elizabeth , Klaire Vijay , Koodaruth Abdool , Labutale Prasadika , Matthews Dawn , Lampitt Jonathan , Nevill Alan , Pickavance Gillian , Sidhu Mona , Warren Kate , Singh Baldev M. 
Published: December 2024

Abstract
Background
Numerous tools based on electronic health record (EHR) data that predict risk of unscheduled care and mortality exist. These are often criticised due to lack of external validation, potential for low predictive ability and the use of thresholds that can lead to large numbers being escalated for assessment that would not have an adverse outcome leading to unsuccessful active case management. Evidence supports the importance of clinical judgement in risk prediction particularly when ruling out disease. The aim of this pilot study was to explore performance analysis of a digitally driven risk stratification model combined with GP clinical judgement to identify patients with escalating urgent care and mortality events.

Methods
Clinically risk stratified cohort study of 6 GP practices in a deprived, multi-ethnic UK city. Initial digital driven risk stratification into Escalated and Non-escalated groups used 7 risk factors. The Escalated group underwent stratification using GP global clinical judgement (GCJ) into Concern and No concern groupings.

Results
3968 out of 31,392 patients were data stratified into the Escalated group and further categorised into No concern (n = 3450 (10.9%)) or Concern (n = 518 (1.7%)) by GPs. The 30-day combined event rate (unscheduled care or death) per 1,000 was 19.0 in the whole population, 67.8 in the Escalated group and 168.0 in the Concern group (p < 0.001). The de-escalation effect of GP assessment into No Concern versus Concern was strongly negatively predictive (OR 0.25 (95%CI 0.19–0.33; p < 0.001)).
The whole population ROC for the global approach (Non-escalated, GP No Concern, GP Concern) was 0.614 (0.592—0.637), p < 0.001, and the increase in the ROC area under the curve for 30-day events was all focused here (+ 0.4% (0.3–0.6%, p < 0.001), translating into a specific ROC c-statistic for GP GCJ of 0.603 ((0.565—0.642), p < 0.001).

Conclusions
The digital only component of the model performed well but adding GP clinical judgement significantly improved risk prediction, particularly by adding negative predictive value.
Changes in provision of extended community pharmacy services in Aotearoa New Zealand, 2018 to 2022
Authors: Officer Tara , McDonald Janet , Jeffreys Mona , Cumming Jacqueline , Russell Lynne , McKinlay Eileen , Kennedy Jonathan , Tanuvasa Ausaga Fa’asalele , Morris Caroline 
Published: December 2024

Abstract
Background
Recognition is growing of the contributions community pharmacists make to the primary health care team, as their role shifts from a traditional dispensing focus to greater emphasis on fully applying their clinical skills. Some extended pharmacist services (e.g., vaccinations) are becoming increasingly common in New Zealand (Aotearoa). Community pharmacies provided key services during the COVID-19 response.

Methods
An online survey was sent to community and intern pharmacists in 2022, regarding delivery of extended services and enablers and barriers to service provision, to look at changes since a 2018 survey. New questions were included regarding pharmacy services during the COVID-19 pandemic.
Descriptive analyses were conducted, and comparisons made between reported proportions in the 2018 and 2022 surveys. For questions related to attributes of pharmacies rather than pharmacists, we weighted the data by the inverse of the number of pharmacists in the pharmacy.

Results
A total of 64 pharmacists and 25 interns responded to the survey. The most common services for which pharmacists were accredited were the provision of the emergency contraceptive pill (95%), sildenafil (94%), trimethoprim (88%) and immunisations (80%). There was an increase from 2018 to 2022 in the proportion of pharmacists who were accredited to provide selected oral contraceptives and immunisations. As in 2018, interns showed strong interest in gaining accreditation for all extended services. Enablers and barriers to offering extended services did not change materially between 2018 and 2022, other than a greater proportion of pharmacists reporting that they were too busy dispensing to offer more services (an increase from 46 to 63%, P = 0.033). Almost all (98%) reported that “COVID increased the levels of stress at work”, 94% that “workload has increased”, and 90% that “home delivery services increased.” Sixty-nine percent of pharmacists and 73% of interns reported work stress negatively affecting their wellbeing.

Conclusions
Most pharmacists want to work at the top of their scope of practice and are accredited to offer a range of extended services. However, their ability to focus on more patient-facing roles continues to be constrained by the time they spend dispensing. Adequate remuneration for services provided remains a concern.