bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transitions in Adolescent Boys and Young Men’s High-Risk Sexual Behaviour in India
Authors: Sharma Santosh Kumar , Vishwakarma Deepanjali 
Published: March 2020

Abstract
Background: The study aims to understand the transitions in adolescent boys and young men’s high-risk sexual behaviour in India using two rounds of Indian demographic health survey, NFHS-3 (2005-06) and NFHS-4 (2015-16). Methods: A total of 25,538 in NFHS-3 (2005-06) and 35,112 in NFHS-4 (2015-16) men were considered for the analysis. Men have been divided into two age groups as 15-19 years (adolescent) and 20-24 (young men) for comparison purposes. Descriptive and multivariate statistics have been used.Results: A significant decline was observed in the proportion of adolescent boys (from 11% to 8%) and young men (from 44% to 38%) among those who ever had sexual intercourse during the last decade. Adolescent boys and young men living in rural areas have also developed live-in-relationship as men belonging to urban areas over the last ten years. Adolescent boys having 10th and above years of education, residing in urban areas and belonging to the affluent class of households were more likely to engage in high-risk sexual activity than the young men in India. Conclusions: Findings conclude that early sexual debut and multi-partner sexual behaviour among adolescent boys put them at higher-risky sexual behaviour as compared to young men. Adolescent’s’ sexual behaviours have both short-term and long-term consequences, and interventions that focus on multiple domains of risk may be the most effective in helping to promote broad reproductive health among young adults.
Modifiable risk factors for non-communicable diseases among medical and non-medical University students in Dar es Salaam, Tanzania: A cross sectional study
Authors: Abdulbasat Suddeys , Kazaura Method 
Published: March 2020

Abstract
Background: Currently, non-communicable diseases (NCDs) are among the global health problems accounting for more than 70% of deaths. Yet, healthcare, workers, university and college students who are key educators to the public are at high risk of NCDs. The objective of this study was to assess modifiable risk factors for NCDs among medical and non-medical university students in Dar es Salaam, Tanzania.Methods: A cross-sectional study included respondents from six universities; split equally between medical and non-medical programmes. From universities with medical programmes, we randomly selected students in clinical track. We administered a modified WHO STEP-1 questionnaire to collect data on modifiable risk factors of NCDs.Results: A total of 574 students participated in the study. Of these, 315 (54.9%) undergraduates were in medical programmes. Few, 7 (3.1%), of the non-medical undergraduates and 14 (4.7%) of the non-medical undergraduates had none of the NCDs risk factors. The proportion of harmful alcohol consumption among medical and non-medical university students was 15 (4.8%) and 6 (2.3%) respectively. Students reporting sedentary lifestyle was significantly (p < 0.01) higher among non-medical undergraduates, 97 (37.5%), as compared to 82 (31.2%) students in non-medical universities. Undergraduates in non-medical programmes have 10% significantly increased prevalence ratio of high modifiable risk as compared to medical university students, (aPR=1.1, 95%CI: 1.0–1.2) independent of age and sex.Conclusion: Tobacco and armful alcohol consumption among students in medical and non-medical universities is low. Reported physical inactivity and unhealthy diet are high. We suggest broader communication strategies targeting university students in medical and non-medical programmes on dangers of NCDs and awareness of their modifiable risk factors.
Examining the association between HIV prevalence and socioeconomic factors among young people in Zambia: Do neighbourhood contextual effects play a role?
Authors: Nakazwe Chola , Fylkesnes Knut Martin , Michelo Charles , Sandøy Ingvild F. 
Published: March 2020

Abstract
Background: Evidently, socioeconomic factors are strongly associated with HIV infection, however, the pattern of association varies. Understanding how these factors influence HIV infection can help public health authorities design targeted comprehensive prevention strategies. Methods: We used multi-level logistic regression models to examine the association of individual and neighbourhood level variables on HIV prevalence based on data from the 2013-14 Zambia Demographic and Health Survey, a population-based cross-sectional survey. The analysis was restricted to young people (15–24 years) with HIV serostatus results (n= 11,751). HIV serostatus was the outcome variable and socioeconomic status was measured by wealth, education and employment.Results: Overall, at individual level, an additional year of education was associated with 5% and 2% reduced odds of infection among young women and men, respectively. Conversely, relative wealth and employment were associated with increased odds of infection among women, while among men the socioeconomic factors were associated with reduced odds of HIV infection. Living in neighbourhoods with medium proportion employed residents and neighbourhoods with higher average level of education were associated with a tendency of higher odds of HIV infection. Thirty percent and 9% of the variation in HIV infection among young men and women, was attributed to neighbourhoods. Inclusion of individual variables to the intercept-only model accounted for 34.9% and 58.1% of the variance for men and women, and reduced the unexplained variance by an average of 17%. However, adding neighbourhood variables to the intercept-only model explained a relatively small part of the variance (0.04 for men and 0.06 for women), and adding the cluster variables to the individual variables only lead to a slight increase in R-squared (explained variance) (36.2% and 58.4%).Conclusion: Our study shows that individual-level socioeconomic factors are clearly associated with young people’s vulnerability to HIV infection in Zambia and that community level factors are less important than previous studies in selected areas of Zambia have indicated. However, the high neighbourhood variation among men, which was mostly unexplained, indicates that there are dynamics within communities, possibly affecting the way people interrelate, that can put them at increased risk.
Migrants’ and refugees’ health status and healthcare in Europe: A scoping literature review
Authors: Lebano Adele , Hamed Sarah , Bradby Hannah , Gil-Salmerón Alejandro , Durá-Ferrandis Estella , Garcés-Ferrer Jorge , Azzedine Fabienne , Riza Elena , Karnaki Pania , Zota Dina , Linos Athena 
Published: March 2020

Abstract
Background There is increasing attention paid to the arrival of migrants from outwith the EU region to the European countries. Healthcare that is universally and equably accessible needs to be provided for these migrants throughout the range of national contexts and in response to complex and evolving individual needs. It is important to look at the evidence available on provision and access to healthcare for migrants to identify barriers to accessing healthcare and better plan necessary changes. Methods This review scoped seventy seven papers from nine European countries (Austria, Cyprus, France, Germany, Greece, Italy, Malta, Spain, and Sweden) in English and in country-specific languages in order to provide an overview of migrants’ access to healthcare. The review aims at identifying what is known about access to healthcare and healthcare use of migrants and refugees in the EU member states. The evidence included documents from 2011 onward. Results The literature reviewed confirms that despite the aspiration to ensure equality of access to healthcare, there is persistent inequalities between migrants and non-migrants in access to healthcare services. The evidence shows unmet healthcare needs, especially when it comes to mental and dental health as well as the existence of legal barriers in accessing healthcare. Language and communication barriers, overuse of emergency services and underuse of primary healthcare services as well as discrimination are described. Conclusions The European situation concerning migrants’ and refugees’ health status and access to healthcare is heterogenous and it is difficult to compare and draw any firm conclusions due to the scant evidence. Different diseases are prioritised by different countries, although these priorities do not always correspond to the expressed needs or priorities of the migrants. Mental healthcare, preventive care (immunization) and long term care in the presence of a growing migrant older population are identified as priorities that deserve greater attention. There is a need to improve the existing data on migrants’ health status, needs and access to healthcare to be able to tailor care to the needs of migrants. To conduct research that highlights migrants’ own views on their health and barriers to access to healthcare is key.
A mixed methods approach to exploring the moderating factors of implementation fidelity of the integrated chronic disease management model in South Africa
Authors: Lebina Limakatso , Oni Tolu , Alaba Olufunke A. , Kawonga Mary 
Published: March 2020

Abstract
Background Chronic care models like the Integrated Chronic Disease Management (ICDM) model are innovative strategies to improve the efficiency and quality of care for patients with chronic diseases. However, there is a dearth of studies assessing the moderating factors of fidelity during the implementation of the ICDM model. The aim of this study is to identify moderating factors of implementation fidelity of the ICDM model. Methods This was a cross-sectional mixed method study conducted in two health districts in South Africa. The process evaluation and implementation fidelity frameworks were used to guide the assessment of moderating factors on the implementation fidelity of the ICDM model. A total of 30 healthcare workers from four clinics with different levels of implementation fidelity of the ICDM model were interviewed. Linear regression and descriptive statistics were used to analyse quantitative data while qualitative data were analysed thematically. Results The median age of participants was 36.5 (IQR: 30.8-45.5), and they had been in their roles for a median of 4.0 (IQR: 1.0 – 7.3)years. The moderating factors of implementation fidelity of the ICDM model were the existence of facilitation strategies (training and clinical mentorship); intervention complexity (healthcare worker, time and space integration); and participant responsiveness (observing operational efficiencies, compliance of patients and staff attitudes). One feature of the ICDM model that was said to compromise fidelity was the inclusion of tuberculosis patients in the same stream (waiting areas, consultation rooms) as other patients with non-communicable diseases and those with HIV/AIDS with no clear infection control guidelines. Participants also suggested that poor adherence to any one component of the ICDM model affected the implementation of the other components. Contextual factors that affected fidelity included supply chain management, infrastructure and adequate staff, and balanced patient caseloads. Conclusion There are multiple (context, participant responsiveness, intervention complexity and facilitation strategies) interrelated moderating factors of the implementation fidelity of the ICDM model. Augmenting some of the elements, like supply chain management and leadership support, could further improve the degree of fidelity during the implementation of the ICDM model.
Establishing a pain management program in cardiology: what we can learn from social marketing and normalization process theory Implementation of pain management in cardiology
Authors: Bode Kerstin , Doerschner Miriam , Bauer Yvonne , Hindricks Gerhard , Ali Haider 
Published: March 2020

Abstract
Background We analyzed how a pain management program (PMP) in a cardiology department of a high-volume center was implemented into daily practice. The results provide some very valuable insights into the dynamics of complex professional behavioral changes, including the barriers to and facilitators of such changes. Methodology The behavioral dynamics during the implementation of the PMP were analyzed using normalization process theory (NPT) because NPT reflects both individual and collective contributions. NPT elements were then studied in their relation to social marketing tools, especially the Cochrane Effective Practice and Organization of Care (EPOC) taxonomy. Where the EPOC tools did not wholly reflect the scope of the PMP, further marketing concepts were introduced. Results The frameworks used provided a useful structure to analyze the behavior change intervention, yielding insights into significant aspects of the change process (such as barriers and facilitators) at the level of the individual, within groups, and across the organization. By also integrating EPOC with NPT, we show how improvements in PMP tangibility can aid communication between PMP leaders and project participants. We also show how value can be co-created between the two groups. Conclusion Hospitals represent complex environments where effective behavior modification requires changes at many different levels. Nevertheless, we demonstrated, using NPT and the incorporation and adaptation of social marketing/EPOC tools, that an intervention designed to change behavior could succeed even in such extreme conditions.
The Impact of Legalization of Access to Recreational Cannabis on Canadian Medical Users with Cancer.
Authors: Hawley Philippa Helen , Gobbo Monica , Afghari Narsis 
Published: March 2020

Abstract
Background Canada legalized cannabis use for medical purposes in 1999. Legalization of cannabis for recreational purposes in October 2018 offered the opportunity to assess the impact of recreational legalization on cancer patients’ patterns of use to identify learning points that would be of use to other countries considering similar legislation. Method Two identical anonymous cross-sectional surveys were administered to cancer patients in British Columbia, 5 months apart (2 months before and 3 months following legalization), with the same eligibility criteria. The prevalence of medical cannabis use, the distribution of symptoms leading to use, the most common types of cannabis products and sources, reasons for stopping using cannabis, and barriers to access were assessed. Results The overall response rate was 27% with 821 and 852 individuals returning the first and second surveys respectively. Both cohorts were similar regarding participants’ characteristics, including age (median= 66yrs), gender (53% of participants were female), and education (one-third of participants had an education level of high school or less). Comparison of the two cohorts showed that legalization increased the prevalence of current cannabis use by 21% (23·1% to 29·1%, p-value 0·01). However, after legalization, Current Users reported more issues in getting cannabis (18% compared to 8%, p-value: <0·01). The most common barrier cited was lack of available preferred products, from closure of illegal dispensaries. Conclusions Results showed that legalization of access to cannabis for recreational purposes will have an unintended negative impact on those who use cannabis products for medical purposes. These should be anticipated and mitigated in the design and implementation of new legislation. Keywords Cannabis, Cancer, Survey, Symptom Management
A nanofiltration membrane prepared by PDA-C3N4 for removal of divalent ions
Authors: Bi Qiuyan , Zhang Chao , Liu Jiandong , Cheng Qi , Xu Shiai 
Published: March 2020

Abstract
In this study, a positively charged nanofiltration (NF) membrane was prepared by interfacial polymerization for separation of divalent cations, whereby a nanomaterial (modified graphitic carbon nitride (g-C3N4) with poly(dopamine), PDA-C3N4) was incorporated into the active layer of the NF membrane. PDA-C3N4 sheets were synthesized from g-C3N4 sheets prepared by thermal oxidation of melamine, and the preparation conditions of NF membrane were also optimized. The results show that the roughness of PDA-C3N4 embedded NF membrane decreases, and the hydrophilicity and the permeation increase. The membrane also shows high rejection for divalent cations (Mg2+, Ca2+, Ba2+, Cu2+ and Zn2+) but low rejection (36.8%) for monovalent cation (Li+), as well as good fouling resistance performance. The fabricated membrane has the potential for treatment of industrial wastewater.
Avaliação da qualidade da água superficial em bacias urbanas da Ilha do Maranhão
Authors: Costa de Jesus Veruska , Nébias Barreto Helen , Ribeiro Bezerra Amanda , Barra Amador Rafael 
Published: March 2020

O presente trabalho avalia a qualidade da água em duas microbacias urbanas (rios Urucutiua e Claro) situadas na Ilha do Maranhão, visando comparar os efeitos da urbanização e os impactos ambientais. Para isso, realizou-se análise laboratorial de parâmetros físico-químicos e microbiológicos de amostras de água superficial coletadas bimestralmente (2013-2014) em quatro pontos e; o mapeamento do uso e ocupação do solo das microbacias por meio do SIG ArcGIS, em recorte temporal (2007-2014) de imagens de satélite Quickbird. Os resultados indicaram, a contaminação em níveis elevados por microrganismos patogênicos em todas as amostras: Escherichia coli, na bacia do rio Urucutiua e; Escherichia coli, Proteus mirabilis, Proteus penneri, e Chromobacterium violaceum, na bacia do rio Claro. Os parâmetros físico-químicos mostraram acidez elevada em todas as amostras; Oxigênio Dissolvido abaixo do recomendado em 75% das amostras do rio Claro e 33% do rio Urucutiua; e Nitrogênio total acima do permitido em 91,7% das amostras. O uso do solo mostrou que a microbacia do rio Urucutiua sofreu as maiores alterações, com expressiva supressão da vegetação (71,6%, em 2007 e; 34,1% em 2014) e aumento das áreas de solo exposto, enquanto a bacia do rio Claro apresentou consolidação do processo de urbanização.
Organização espacial das caieiras e fornos de cal no campo calcário Aroeiras, municípios de Coreaú e Sobral (CE): passado e presente
Authors: Batista de Albuquerque Francisco Nataniel 
Published: March 2020

A apropriação dos elementos e aspectos da natureza dos geossistemas como recurso natural definem os sistemas ambientais e sua expressão geográfica, as organizações espaciais. Diante desse contexto, o presente artigo tem por objetivo analisar a organização espacial das caieiras e fornos de cal, unidades rudimentares e tradicionais de produção da cal, na paisagem do geossistema do campo calcário Aroeiras nos municípios de Coreaú e Sobral, região Noroeste do Estado do Ceará. A identificação das caieiras e fornos de cal se deu mediante análise de imagem de satélite e trabalho de campo no ano de 2015. Como resultado da pesquisa, foram identificadas 73 unidades de produção de cal, sendo 71 caieiras e 02 fornos de cal classificadas em ativas (19), desativadas (19) e destruídas (35) no campo Aroeiras e adjacências distribuídas pelo quadrilátero calcário delimitado pelos distritos de Aroeiras – Aprazível – São Joé do Torto – Ubaúna. As unidades produtivas estão organizadas espacialmente em 04 núcleos de produção e uma unidade isolada: Vila Basílio – Pau D’Arco, Queimadas – Visitação, Ubaúna – Campo do Meio, Ipu dos Lopes – Três Lagoas, São José do Torto e, Coreaú. Podemos concluir que apenas 1/3 das unidades estão em funcionamento, das quais 53% encontram-se no núcleo de produção Vila Basílio – Pau D’Arco ao longo de 14 km da rodovia CE-364 e cada vez mais distantes dos núcleos populacionais evidenciando um distanciamento dos núcleos populacionais e a concentração nos principais eixos rodoviários em função dos custos de transporte e da poluição causada pela combustão dos fornos às residências.
Use of bronchial blockers for thoracic surgery in pediatric oncology
Authors: Martynov L. A. , Matinyan N. V. , Kazantsev A. P. , Belousova E. I. 
Published: March 2020

Introduction. Treatment of children with mediastinal and lung tumors is an urgent problem in both surgery and anesthesiology. Main goal is to grant optimal conditions for the surgery – collapse of the lung on the side of the operation, while maintaining adequate oxygenation and efficient transport of oxygen to the tissues. The choice of devices for carrying out one-lung ventilation (OLV) is the most important factor determining the safety of the patient.Aim of the study. To increase the efficiency and safety of anesthesia for thoracic surgeries in children due to the use of bronchial blockers (BB) for one-lung ventilation (OLV). Materials and methods. 92 surgeries were performed (49 – thoracoscopic, 43 – thoracotomies) in 11–17 years old 92 patients. Patients were randomly divided into two groups: BB group (n = 56) – OLV was performed using bronchial blocker; double-lumen tubes (DLT) group (n = 36) – OLV was performed using a DLT. Ventilation parameters, hemodynamics, the incidence of complications in the perioperative and postoperative periods were recorded.Results. A much less prolonged lungs separation time in BB group was found compared to the DLT group (65.32 ± 17.32 sec versus 99.0 ± 9.03 sec respectively, p < 0.0001) and a lower frequency of repositioning (0.2 ± 0.4 and 0.57 ± 0.51 respectively, p = 0.04). In patients with BB, less complications were recorded, such as postoperative aphonia and sore throat.Conclusion. BB demonstrate efficacy and safety in OLV management for thoracic surgeries in pediatric oncology. They provide faster lungs separation time than DLT, irrespective of the side of the surgery, allow complete collabation of the lung with a less frequent need for repositioning. The introduction of a new method of OLV with the use of BB in children is associated with reduction of the length of stay of patients in the intensive care unit during the postoperative period due to the reduction in complications such as trauma of the main bronchi, aphonia and sore throat.
Relation of Steatosis to Neurocognitive Function in People Living with HIV
Authors: Marić Daniela , Brkić Snežana , Ignjatović Vojislava Bugarski , Nikolaševic Željka , Ilić Dalibor , Vujanović Miloš , Drvendžija Zorka , Galić Biljana Srdić 
Published: March 2020

Background:
In HIV negative population metabolic syndrome and steatosis are related
to poorer neurocognitive (NC) performance. We investigated if similar relation exists in people living
with HIV (PLWH).

Methods::
We included male PLWH aged 20-65, with undetectable viral load for at least 6 months.
Data on levels of education, anthropometric measurements, CD4 levels, ART, markers of metabolic
syndrome, smoking and concurrent treatment were collected from database. Concentrations of
TNF-α and IL-6 were measured. An ultrasound was used to establish the presence of steatosis, visceral
fat thickness and carotid intima media thickness. An extensive NC assessment was done by an
experienced neuropsychologist. Cognitive domains were defined as executive functions, divergent
reasoning, visuo-constructional abilities, delayed recall and working memory and learning and were
measured using a battery of 12 tests.

Results:
88 PLWH were included (mean age 39,9 years), 51% on PIs, 46% on NNRTI; 20,4% had
metabolic syndrome, 42% patients had steatosis. Weak but statistically significant negative correlations
were found between the presence of metabolic syndrome, steatosis and VFT and cognitive
domains (divergent reasoning, delayed recall and working memory). Poorer perfomrance in the
domains of divergent reasoning and in the working memory were found in participants with steatosis
(p=0,048 and 0,033 respectively).

Conclusion:
Although the sample size was relatively small, our results show consistent correlations
between the observed neurocognitive variables and metabolic parameters. As central obesity is one
of the contributors to NCI, it would be one of the modifiable factors to prevent further neurocognitive
decline.