bluuebunny/crossref_metadata_2025_split huggingface dataset:
British Dietetic Association’s Obesity Specialist Group dietetic obesity management interventions in children and young people: review & clinical application
Authors: Stewart L. , Easter S. ,   the BDA’s Obesity Specialist Group
Published: November 2020

AbstractBackgroundDietitians play a vital role in the management of childhood obesity. To support that role the Obesity Specialist Group of the British Dietetic Association commissioned a review and clinical application paper. This current paper is a summary of that review document, which is available on the BDA’s website.MethodsThe initial sources of evidence were guidelines, published reviews and government guidance. Best practice advice was sought from networks including the BDA’s Obesity and Paediatric Specialists groups. The original document was reviewed by a review group and members of the Obesity and Paediatric Specialist group’s committees.ResultsThe overall aim of dietetic interventions in childhood weight management should be to deliver evidence based dietetic weight management care, which helps maintain positive lifestyle changes. To support this aim the review recommends the UK BMI cut off points in setting service referral and triaging criteria. Ensuring the whole child’s world is taken into account when undertaking assessment and throughout the programme process is essential. Dietitians working in this field require behavioural change skills, motivational techniques and the ability to communicate to children of differing ages and their parents. Knowledge of local child safe guarding procedures are necessary for all working in this field. Recommendations on basic and advanced skills required are specified.ConclusionsThis paper was written to compliment a full review document. The complexities around case management, child protection issues and competing family motivations require dietitians trained at undergraduate and postgraduate level to deliver high quality weight management and behavioural change.
Disability Law as an Academic Discipline: Towards Cohesion and Mainstreaming?
Authors: LAWSON ANNA 
Published: November 2020

AbstractThis article calls for a strengthening of Disability Law as an academic discipline and offers orientation for its future development. It argues that there is a need for enhanced cohesion among those already applying a critical disability perspective within disciplines such as Equality Law, Mental Health and Capacity Law, and Social Care and Protection Law and also for greater mainstreaming of this approach across the full breadth of sociolegal scholarship. The article is divided into three main sections. The first contextualizes Disability Law by reflecting on its relationship with other legal disciplines and broader pools of scholarship. The second focuses on issues of scope and structure. The third offers orientation for future Disability Law work by outlining four key cross‐cutting challenges with the potential to bring together scholars with expertise in different areas of substantive law.
Determinants of adherence to micronutrient powder use among young children in Ethiopia
Authors: Samuel Aregash , Brouwer Inge D. , Pamungkas Nindya P. , Terra Tosca , Lelisa Azeb , Kebede Amha , Osendarp Saskia J. M. 
Published: November 2020

AbstractIn Ethiopia, home fortification of complementary foods with micronutrient powders (MNPs) was introduced in 2015 as a new approach to improve micronutrient intakes. The objective of this study was to assess factors associated with intake adherence and drivers for correct MNP use over time to inform scale‐up of MNP interventions. Mixed methods including questionnaires, interviews and focus group discussions were used. Participants, 1,185 children (6–11 months), received bimonthly 30 MNP sachets for 8 months, with instruction to consume 15 sachets/month, that is, a sachet every other day and maximum of one sachet per day. Adherence to distribution (if child receives ≥14 sachets/month) and adherence to instruction (if child receives exactly 15[±1] sachets/month) were assessed monthly by counting used sachets. Factors associated with adherence were examined using generalized estimating equations. Adherence fluctuated over time, an average of 58% adherence to distribution and 28% for adherence to instruction. Average MNP consumption was 79% out of the total sachets provided. Factors positively associated with adherence included ease of use (instruction), child liking MNP and support from community (distribution and instruction) and mother's age >25 years (distribution). Distance to health post, knowledge of correct use (OR = 0.74, 95% CI = 0.66–0.81), perceived negative effects (OR = 0.73, 95% CI = 0.54–0.99) and living in Southern Nations, Nationalities and People Region (OR = 0.59, 95% CI = 0.52–0.67) were inversely associated with adherence to distribution. Free MNP provision, trust in the government and field staff played a role in successful implementation. MNP is promising to be scaled‐up, by taking into account factors that positively and negatively determine adherence.
Ultraprocessed food and chronic noncommunicable diseases: A systematic review and meta‐analysis of 43 observational studies
Authors: Lane Melissa M. , Davis Jessica A. , Beattie Sally , Gómez‐Donoso Clara , Loughman Amy , O'Neil Adrienne , Jacka Felice , Berk Michael , Page Richard , Marx Wolfgang , Rocks Tetyana 
Published: November 2020

SummaryThis systematic review and meta‐analysis investigated the association between consumption of ultraprocessed food and noncommunicable disease risk, morbidity and mortality. Forty‐three observational studies were included (N= 891,723): 21 cross‐sectional, 19 prospective, two case‐control and one conducted both a prospective and cross‐sectional analysis. Meta‐analysis demonstrated consumption of ultraprocessed food was associated with increased risk of overweight (odds ratio: 1.36; 95% confidence interval [CI], 1.23‐1.51;P< 0.001), obesity (odds ratio: 1.51; 95% CI, 1.34‐1.70;P< 0.001), abdominal obesity (odds ratio: 1.49; 95% CI, 1.34‐1.66;P< 0.0001), all‐cause mortality (hazard ratio: 1.28; 95% CI, 1.11‐1.48;P= 0.001), metabolic syndrome (odds ratio: 1.81; 95% CI, 1.12‐2.93;P= 0.015) and depression in adults (hazard ratio: 1.22; 95% CI, 1.16‐1.28,P< 0.001) as well as wheezing (odds ratio: 1.40; 95% CI, 1.27‐1.55;P< 0.001) but not asthma in adolescents (odds ratio: 1.20; 95% CI, 0.99‐1.46;P= 0.065). In addition, consumption of ultraprocessed food was associated with cardiometabolic diseases, frailty, irritable bowel syndrome, functional dyspepsia and cancer (breast and overall) in adults while also being associated with metabolic syndrome in adolescents and dyslipidaemia in children. Although links between ultraprocessed food consumption and some intermediate risk factors in adults were also highlighted, further studies are required to more clearly define associations in children and adolescents.Study registrationProspero ID: CRD42020176752.
Merit recruitment, tenure protections and public service motivation: Evidence from a conjoint experiment with 7,300 public servants in Latin America, Africa and Eastern Europe
Authors: Meyer‐Sahling Jan , Mikkelsen Kim Sass , Schuster Christian 
Published: November 2020

AbstractHow can governments manage civil servants to enhance public service motivation (PSM)? Despite the centrality of PSM in public administration research, the effects of management practices on PSM remain understudied. We address this gap through a conjoint experiment with 7,300 public servants in five countries in Africa, Latin America and Eastern Europe. Our experiment assesses two practices: merit‐based competitions for recruitment versus discretionary appointments; and permanent tenure versus temporary job contracts. We find that merit competitions are associated with greater PSM by respondents in four countries, yet have no significant effect in a fifth. Permanent contracts are associated with greater PSM (two countries), lower PSM (one country) and have no significant effect (two countries). The effects of personnel management practices thus appear to vary across contexts. A common practice in public administration research—generalizations about the effects of management practices from single‐country studies or cross‐country averages—requires rethinking.
Consensus recommendations for the use of retinoids in ichthyosis and other disorders of cornification in children and adolescents
Authors: Zaenglein Andrea L. , Levy Moise L. , Stefanko Nicole S. , Benjamin Latanya T. , Bruckner Anna L. , Choate Keith , Craiglow Brittany G. , DiGiovanna John J. , Eichenfield Lawrence F. , Elias Peter , Fleckman Philip , Lawley Leslie P. , Lewis Richard A. , Lucky Anne W. , Mathes Erin F. , Milstone Leonard M. , Paller Amy S. , Patel Sonali S. , Siegel Dawn H. , Teng Joyce , Tanumihardjo Sherry A. , Thaxton Lauren , Williams Mary L. ,   PeDRA Use of Retinoids in Ichthyosis Work Group
Published: November 2020

AbstractTopical and systemic retinoids have long been used in the treatment of ichthyoses and other disorders of cornification. Due to the need for long‐term use of retinoids for these disorders, often beginning in childhood, numerous clinical concerns must be considered. Systemic retinoids have known side effects involving bone and eye. Additionally, potential psychiatric and cardiovascular effects need to be considered. Contraceptive concerns, as well as the additive cardiovascular and bone effects of systemic retinoid use with hormonal contraception must also be deliberated for patients of childbearing potential. The Pediatric Dermatology Research Alliance (PeDRA) Use of Retinoids in Ichthyosis Work Group was formed to address these issues and to establish best practices regarding the use of retinoids in ichthyoses based on available evidence and expert opinion.
Low dose oral corticosteroids, microneedling, and topical 5‐fluorouracil: A novel treatment for recalcitrant pediatric vitiligo
Authors: Marasca Claudio , Fabbrocini Gabriella , D’Andrea Mirella , Luciano Maria Antonietta , De Maio Gabriele , Ruggiero Angelo 
Published: November 2020

AbstractA 10‐year‐old boy was referred to our outpatient clinic with a 2‐year history of vitiligo minimally responsive to topical corticosteroids and phototherapy. Low dose oral corticosteroids were prescribed in combination with sessions of microneedling and 5‐fluourouracil 5% cream applied immediately after needling on a monthly basis. Repigmentation was initially noted after the first cycle at week 4. After 3 sessions of treatment (week 16), the patient showed a complete repigmentation of the knees.
Gerontocracy in a comparative perspective: Explaining why political leaders are (almost always) older than their constituents
Authors: Magni‐Berton Raul , Panel Sophie 
Published: November 2020

ABSTRACTGerontocracy, in its narrowest sense, refers to political systems ruled by elderly people, whether de jure or de facto. Although formal gerontocratic rules are progressively disappearing, contemporary political systems are still governed by individuals who are significantly older than the mean voter. This article reviews existing explanations for the prevalence of gerontocracy. To summarize main findings, gerontocracy cannot be explained by the leadership qualities of older rulers: aging leaders do not perform better in office and voters seem to be aware of it. Instead, existing research suggests that gerontocracy can be explained by strategic considerations. In autocracies, the selectorate tends to choose aging leaders in order to reduce their expected tenure length. In democracies, voters are more likely to select experienced candidates, which they expect to be more effective at advancing the interests of their constituency: this premium put on experience mechanically lengthens political careers and increases the age of the average politician. Finally, older voters, which participate more in politics, tend to prefer older politicians, because they (correctly) expect them to better defend their own interests.
Lifelong, universal Pneumocystis jirovecii pneumonia prophylaxis: Patient uptake and adherence after kidney transplant
Authors: Peterson Kathryn , Berrigan Liam , Popovic Katarina , Wiebe Christopher , Sun Siyao , Ho Julie 
Published: November 2020

AbstractIntroductionPneumocystis jirovecii pneumonia (PJP) is a significant cause of morbidity and mortality in transplant patients yet little is known about their adherence to prophylaxis. The goal of this study was to evaluate patient uptake and long‐term adherence after implementing universal, lifelong PJP prophylaxis.Materials and MethodsThis retrospective cohort study evaluated an adult kidney transplant program 18‐months after initiating trimethoprim‐sulfamethoxazole (TMP‐SMX) 80/400 mg thrice‐weekly following a cluster of PJP cases. The protocol incorporated multi‐modal patient education and drug tolerability strategies to improve adherence, including a modified re‐challenge strategy for TMP‐SMX intolerance. Adherence was independently confirmed by the transplant pharmacist and nurse for each patient, with an a priori target ≥ 75% population on prophylaxis.ResultsInitial uptake was high with 237/250 (94.8%) patients starting prophylaxis. Long‐term maintenance was high with 192/237 (81.0%) patients remaining on prophylaxis at 18‐months. Of the remaining 45 patients who initiated prophylaxis, 36/237 (15.2%) were non‐adherent and 9/237 (3.8%) discontinued prophylaxis by 18‐months. Reasons for non‐adherence included gastrointestinal upset, fear of drug reactions and cost; but the majority of reasons were not delineated by the patients (31/36, 86.1%). There was a statistically significant increase in serum creatinine 3.3 µmol/L (0.3‐6.3 µmol/L 95% CI) and potassium 0.08 mmol/L (0.03‐0.15 mmol/L 95% CI) in those prescribed TMP‐SMX with only 3/237 (1.3%) patients discontinuing TMP‐SMX for an increase in creatinine.ConclusionHigh rates of patient uptake (94.8%) and long‐term adherence (81.0%) were observed after implementing universal lifelong PJP prophylaxis. This may be due in part to the in‐depth patient education and drug tolerability strategies employed.
A common complaint… a rare disease!
Authors: Toner Mary-Beth , Molloy Seana , Mallett Peter , Thompson Andrew , Speirs Lynne 
Published: November 2020

A 2-year-old previously well child presented to the emergency department with temperatures and lethargy. He was pale and looked unwell. He received a fluid bolus and was commenced on intravenous ceftriaxone. Pus was discharging from his left ear with postauricular swelling and erythema. Given clinical concerns, urgent neuroimaging was arranged.Question 1What does the CT scan of head show (figure 1)?Figure 1Enhanced CT showing external and middle ear infection with skull base osteomyelitis.Acute subdural collectionAcute mastoiditis secondary to sinusitisEnhanced cerebral lesionsMeningitis with abscess formationMiddle ear infection with skull base osteomyelitisA subsequent MRI scan was performed (figure 2).Figure 2MRI shows thrombus in left jugular vein, and MRA demonstrates occlusion of left internal carotid artery secondary to carotid sheath infection.Question 2What do these two images show?Left jugular vein dissection with subdural haematomaLeft jugular vein thrombus and carotid artery occlusionPosterior fossa tumourRight sided posterior communicating artery aneurysmSkull base abscessQuestion 3What is the most likely diagnosis?Acute mastoiditis secondary to chronic sinusitisCerebral tuberculosis (TB)Hereditary thrombophilia (protein S deficiency)Lemierre’s syndromeNon-accidental head trauma (NAI)Question 4What is the most commonly identified organism in this syndrome?Candida albicansFusobacterium necrophorumHaemophilus influenzaStaphylococcus aureusStreptococcus pyogenesAnswers can be found on page XX.
Relation between opioid consumption and inclusion of opioids in 137 national essential medicines lists
Authors: Richards Georgia C , Aronson Jeffrey K , Heneghan Carl , Mahtani Kamal R , Koshiaris Constantinos , Persaud Nav 
Published: November 2020

IntroductionOpioids are deemed essential medicines by the World Health Organization (WHO). However, many countries have inadequate access to them. Whether including opioids in national essential medicines lists (EMLs) influences national opioid consumption has not been evaluated.MethodsWe conducted a cross-sectional study to determine whether the listing of opioids in national EMLs was associated with consumption. We quantified the numbers and types of all opioids included in 137 national EMLs, for comparison with opioids in the WHO’s Model List of Essential Medicines. Using the International Narcotics Control Board (INCB) consumption statistics for 2015–2017, we assessed the relation between annual mean opioid consumption (mg/person) and the numbers of opioids included in EMLs, controlling for region, population, healthcare expenditure, life expectancy, gross domestic product, human development and corruption.ResultsFive opioids were included in the 20th edition of the WHO’s Model List of Essential Medicines: codeine, fentanyl, loperamide, methadone and morphine. On average, countries’ lists included significantly (p<0.05) more opioids than the WHO’s Model List. However, there were wide variations in the numbers (median 6 opioids; IQR: 5–9) and types (n=33) of opioids included in national EMLs. Morphine (95%), fentanyl (83%) and codeine (69%) were the most commonly included opioids. Most national EMLs were out of date (median publication date: 2011, IQR: 2009–2013). After adjusting for country characteristics, there was no relation between mean opioid consumption and the number of opioids in EMLs.ConclusionsIncluding opioids in national EMLs was not associated with consumption. National EMLs should be regularly updated to reflect the availability of opioids and the populations’ needs for managing pain.
Economic costs of infertility care for patients in low-income and middle-income countries: a systematic review protocol
Authors: Njagi Purity , Groot Wim , Arsenijevic Jelena , Dyer Silke , Mburu Gitau , Kiarie James 
Published: November 2020

IntroductionInfertility, a condition of the reproductive system, affects millions of individuals and couples worldwide. Despite infertility treatment’s existence, it is largely unavailable and inaccessible in low/middle-income countries (LMICs) due to the prohibitive costs compounded by an absence of financing. Previous systematic reviews have shown that there is scanty information in LMICs on out-of-pocket (OOP) payments for infertility treatment. This protocol outlines the methodological approach and analytical process to appraise the extent of economic burden due to payments for infertility care services in LMICs.Method and analysisUsing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach, we will primarily search for articles indexed in PubMed, Web of Science, Cumulative Index of Nursing and Allied Health Literature, EconLit and PsycINFO databases. Grey literature from relevant organisations’ virtual libraries shall also be searched. Backward and forward searches on the articles selected will also be done. Quantitative studies on infertility treatment costs from LMICs across the world regions within the last 20 years will be considered. The primary outcome of interest shall include OOP payments, catastrophic health expenditure and direct costs for infertility services. Conversely, informal payments and indirect costs related to infertility treatments shall be considered as secondary outcomes. Integrated quality Criteria for Review Of Multiple Study designs will be used to assess the quality of the studies included in the review. Meta-analysis shall be considered if sufficient studies identified are homogenous in characteristics. Also, the review shall analyse the average cost of infertility treatment against the respective countries’ economic indicators like gross domestic product per capita if data permit.Ethics and disseminationResearch and ethics approval will not be required given this will be a review of published articles on the subject. The findings shall be disseminated through publication in a peer-reviewed journal and presentation to the WHO and its partners.PROSPERO registration numberCRD42020199312.
On Architectural Support for Instruction Set Randomization
Authors: Christou George , Vasiliadis Giorgos , Papaefstathiou Vassilis , Papadogiannakis Antonis , Ioannidis Sotiris 
Published: November 2020

Instruction Set Randomization (ISR) is able to protect against remote code injection attacks by randomizing the instruction set of each process. Thereby, even if an attacker succeeds to inject code, it will fail to execute on the randomized processor. The majority of existing ISR implementations is based on emulators and binary instrumentation tools that unfortunately: (i) incur significant runtime performance overheads, (ii) limit the ease of deployment, (iii) cannot protect the underlying operating system kernel, and (iv) are vulnerable to evasion attempts that bypass the ISR protection itself.
To address these issues, we present the design and implementation of ASIST, an architecture with both hardware and operating system support for ISR. ASIST uses our extended SPARC processor that is mapped onto a FPGA board and runs our modified Linux kernel to support the new features. In particular, before executing a new user-level process, the operating system loads its randomization key into a newly defined register, and the modified processor decodes the process’s instructions with this key. Besides that, ASIST uses a separate randomization key for the operating system to protect the base system against attacks that exploit kernel vulnerabilities to run arbitrary code with elevated privileges. Our evaluation shows that ASIST can transparently protect both user-land applications and the operating system kernel from code injection and code reuse attacks, with about 1.5% runtime overhead when using simple encryption schemes, such as XOR and Transposition; more secure ciphers, such as AES, even though they are much more complicated for mapping them to hardware, they are still within acceptable margins,with approximately 10% runtime overhead, when efficiently leveraging the spatial locality of code through modern instruction cache configurations.