bluuebunny/crossref_metadata_2025_split huggingface dataset:
Planning and optimising a digital intervention to reduce older adults' cognitive decline
Authors: Essery Rosie , Pollet Sebastien , Smith Kirsten A , Mowbray Fiona , Slodkowska-Barabasz Joanna , Denison-Day James , Hayter Victoria , Bradbury Katherine , Grey Elisabeth , Western Max J , Milton Alexander , Hunter Cheryl , Ferrey Anne E , Müller Andre Matthias , Stuart Beth , Mutrie Nanette , Griffin Simon , Kendrick Tony , Gudgin Bernard , Phillips Rosemary , Stokes Tom , Niven John , Little Paul , Yardley Lucy 
Published: March 2020

Abstract
BackgroundBy 2050 worldwide dementia prevalence is expected to triple, rising to 152 million. Affordable, scalable interventions are required to support protective behaviours such as physical activity, cognitive training and healthy eating. This paper outlines the development of ‘Active Brains’: a multi-domain digital behaviour change intervention to reduce cognitive decline amongst older adults, and key findings arising from this process.MethodsA theory-, evidence- and person-based approach to intervention development was undertaken. Scoping reviews and behavioural analysis contributed to intervention planning. Optimisation involved qualitative interviews with 52 older adults with higher and lower cognitive performance scores. Data were analysed thematically and informed changes.ResultsThe development process synthesised findings from planning and optimisation activities. Scoping reviews and qualitative interviews suggested that the same intervention content should be suitable for individuals with higher and lower cognitive performance. Qualitative findings revealed that maintaining independence and enjoyment motivated engagement in intervention-targeted behaviours, whereas managing ill health was a potential barrier. Social support for engaging in such activities could provide motivation, but was not desirable for all. These findings informed development of highly acceptable intervention content and functionality for target users.ConclusionsA digitally-delivered intervention with minimal support appears acceptable and potentially engaging to older adults with higher and lower levels of cognitive performance. As well as informing our own intervention, the insights obtained through our development process may be useful for others working with, and developing interventions for, older adults and/or those with cognitive impairment.
The Bat Meat Chain and Perceptions of the risk of contracting Ebola in the Mount Cameroon Region
Authors: Akem Efuet Simon , Pemunta Ngambouk Vitalis 
Published: March 2020

Abstract
Background Local people’s interaction with bats render them vulnerable to Ebola Virus Disease (EVD). This paper examines perceptions of risk involved in the hunting, handling, processing and consumption of bat meat in the Mount Cameroon region of Southwest Cameroon. It focuses on the myriad cultural beliefs, gendered patterns of activity and institutional arrangements in which the bat meat production chain is embedded. Methods We conducted 30 ethnographic interviews with a sample of purposively selected men and women involved in the bat meat trade. The interviews were tape recorded, transcribed verbatim and inductive analysis was performed on the data. Findings The findings suggests that more urban men than villagers and hunters consume bat meat. Different practices and behaviours expose the mostly uneducated, young, single men and women to the risk of Ebola infection depending on their differential level of intervention in the human-bat interaction and value chain linking hunters, sellers and customers. The killing of bats with the mouth during hunting expose hunters (young men) while the preparation of bat carcasses for consumption also put women, (mostly young and unmarried) at risk. Conclusions This study demonstrates that the complexity and nuances of gender, poverty and Ebola outcomes predispose some marginal groups to the risk of infection with zoonotic diseases. There is the need to improve public health intervention and health education among the rural masses in the Mount Cameroon region.
Reaching hard-to-reach men through home-based couple HIV testing among pregnant women and their male partners in Western Kenya: A qualitative study
Authors: Krakowiak Daisy , Makabong’o Pamela , Goyette Marielle , Kinuthia John , Osoti Alfred Onyango , Asila Victor , Gone Molly Ann , Mark Jennifer , Farquhar Carey 
Published: March 2020

Abstract
Background Globally only 79% of HIV positive adults know their status and men in sub-Saharan Africa are considered a particularly hard-to-reach population for HIV testing. Home-based HIV couple testing during the antenatal period is a safe and effective method that has been used to test male partners of pregnant women. The goal of this qualitative study was to identify elements that made couple testing successful and describe important characteristics of this home-based intervention from couples’ perspectives. Methods Couples who received scheduled home-based couple testing during pregnancy in Kisumu, Kenya, were purposively sampled based on HIV status from January to May 2015. An interviewer administered all of the in-depth interviews and two coders were directly involved in the data analysis and reconciled codes several times in the process. Results Twenty-one couples were enrolled: 9 concordant HIV-negative couples, 8 HIV discordant couples, 3 HIV concordant HIV-positive couples, and 1 whose concordance status was unknown. Median age at the time of home-based couple testing was 24 and 28 years for women and men, respectively. Median relationship duration was 3 years and couples had a median of two pregnancies. The major themes that emerged were that home-based couple testing 1) removed the female burden of requesting couple testing, 2) overcame logistical barriers associated with clinic-based testing, 3) encouraged participants to overcome their fear of testing and disclosure, 4) was preferred due to privacy in the home, and 5) provided quality time with the health advisors. Importantly, some women appreciated individual testing at the clinic before couple testing and some couples preferred skilled, anonymous health advisors delivering the intervention rather than known community health workers. Conclusions The results of this qualitative study suggest that home-based couple testing during pregnancy overcame many of the barriers that limit men’s access to and uptake of clinic-based testing. It encouraged participants to overcome their fear of testing and disclosure through a setting that afforded privacy and quality time with skilled health advisors. These qualitative results may help design effective partner and couple HIV testing programs in the antenatal setting and alongside or within other assisted partner notification services.
Analysis of the Association between environmental-meteorological factors and Acute Suppurative Otitis Media: Further Epidemiological Evidence from Lanzhou, Northwestern China
Authors: Wang Xinlan , Xu Baicheng , Tian Haiyue , Wang Jinyan , Xiang Dawei , Zhong Cuiping 
Published: March 2020

Abstract
Objective To investigate the possible associations, lag effects and pathogenic characteristics of urban air quality on acute suppurative otitis media (ASOM）in Lanzhou, a city in Northwestern China. Methods SPSS software was used to analyze Spearman correlation between ambient environment-meteorological factors and the daily number of patient ASOM visits. The GAM of time series was used to analyze the exposure -response curve, and R software was used to calculate RR.Using above results to discuss the relationship of air pollutions , meteorological factors and morbidity of ASOM. Results The number of patients with ASOM in 2014, 2015 and 2016 were 916, 875 and 1023 respectively. There was no significant difference in three years (P=0.85). The annual visits peaked in December, the lowest in August, followed by February, Summer was less than the other three seasons. The morbidity of ASOM had a largest peak within 14 years old (53.84%), and the number of male patients 1514 (53.6%) is 1.16 times that of female patients 1309 (46.4%). Spearman correlation analysis showed that the correlation between air pollutions and environmental variables. As for single-day lag effects , there were positive correlations between PM 2.5 , PM 10 , CO, NO 2 , SO 2 and the daily number of ASOM visits, but the correlation between O 3 and ASOM did not pass the significance test . As for multi-day lag effects, PM 2.5 , PM 10 , CO, NO 2 had lagging effects on the daily number of ASOM visits, but the correlation between SO 2 and O 3 did not pass the significant test. There was a positive correlation between ATM and the daily number of patient ASOM visits, and negative correlation between T and the daily number of patient ASOM visits ,while the correlation between W, RH and ASOM was weak. Conclusions The incidence of ASOM has obvious age and seasonal characteristics. There may be some correlation between environmental-meteorological factors and the incidence of ASOM. Therefore, it is of great significance to strengthen environmental control and public health strategy in order to reduce and prevent the occurrence of ASOM diseases.
Implementing a layperson post-crash first aid training programme in Tanzania: a qualitative study of stakeholder perspectives
Authors: Ndile Menti Lastone , Saveman Britt-Inger , Outwater Anne H , Mkoka Dickson A , Backteman-Erlanson Susann 
Published: March 2020

Abstract
Background: In low and middle-income countries (LMICs), laypersons play a significant role in providing initial care to injured victims of traffic accidents. Post-crash first aid (PFA) training programmes for laypersons have become an important response to addressing knowledge and skills gaps in pre-hospital care. However, little is known about factors influencing effective implementation of such programmes from stakeholders’ point of view. Therefore, this study aimed to explore views of stakeholders on potential factors that may facilitate or hinder successful implementation of a PFA training programme for lay persons. Methods: Twelve semi-structured qualitative interviews with leaders at a traffic police department and leaders of an association of city bus drivers, taxi drivers and motorcycle taxis in Tanzania were conducted. Interviews were audio-recorded and transcribed verbatim. A thematic analysis approach was used to identify themes and sub-themes. Results: Three themes pertaining to implementation of a PFA training programme were identified: Motivation for engaging in training, Constrains for engaging in training and Training processes. They consisted of a total of six sub-themes: “perceived benefits of first aid training” and “availability of incentives” were considered as facilitators to PFA training. “Availability of time to attend training” and “accessibility of training” were reported as a potential barriers to successful training. Finally, they felt that “methods of training delivery” and “availability of first aid training materials and equipment” could either facilitate or impede delivery of PFA training. Conclusion: This study highlights potential facilitators and barriers to implementing a PFA training programme for lay persons from the perspectives of leaders from police department and associations of city bus drivers, taxi drivers, and motorcycle taxis. This may be useful information for other stakeholders, and may enable government-level leaders and persons higher up in the health service hierarchy to take action to meet WHO recommendations for emergency pre-hospital care.
Cross-cultural validation of the Motivation to Change Lifestyle and Health Behaviours for Dementia Risk Reduction scale in the Dutch general population
Authors: Joxhorst Tessa , Vrijsen Joyce , Niebuur Jacobien , Smidt Nynke 
Published: March 2020

Abstract
BACKGROUND: This study aims to translate and validate the Motivation to Change Lifestyle and Health Behaviours for Dementia Risk Reduction (MCLHB-DRR) scale in the Dutch general population. METHODS: A random sample of Dutch residents aged between 30 and 80 years old were invited to complete an online questionnaire including the translated MCLHB-DRR scale. Exploratory and confirmatory factor analyses (EFA and CFA) were conducted to assess construct validity. Cronbach’s alpha was calculated to assess internal consistency. RESULTS: 618 participants completed the questionnaire. EFA and Cronbach’s alpha showed that four items were candidate for deletion. CFA confirmed that deleting these items led to an excellent fit (RMSEA = 0.043, CFI = 0.960, TLI = 0.951, χ²/df = 2.130). Cronbach’s alpha ranged from 0.69 to 0.93, indicating good internal consistency. CONCLUSION: The Dutch MCLHB-DRR scale demonstrated to have good validity to assess the health beliefs and attitudes towards dementia risk reduction.
Process evaluation of a national elderly nutrition care program in Iran: Perspectives of clients and providers
Authors: Kheirouri Sorayya , Alizadeh Mohammad , Foroumandi Elaheh , Khodayari-zarnaq Rahim 
Published: March 2020

Abstract
Background The rapid growth of Iran elderly population highlights the importance of more attention to nutritional needs of this age group. Process evaluation study on the nutritional part of the national Elderly-Integrated Care Program was conducted to examine degree of exposure and satisfaction of the targets with the program components, and assess the reach, delivery, fidelity, and external contexts of the program.Methods To evaluate perspectives of clients on elderly integrated nutrition care program (EINCP) implementation process, a self-administrated questionnaire was constructed, validated, and applied to 256 individuals with the age of above 60 years attending the program at 57 health care centers of Tabriz metropolitan area of East Azerbaijan province in Iran using convenience sampling method. Another valid questionnaire was also applied to investigate viewpoint of the perceptions of 76 staffs of these health care centers as the program providers around the EINCP.Results The reach rate of the clients was reported 20.0%. Delivery of the educational components to entire program providers was accomplished (100.0%); however, the delivery of some parts of the program to the clients had some main weaknesses. The fidelity of the program tools was considered inadequate from perspectives of both clients and providers. 77.5% of the clients had exposure to the program. Clients’ satisfaction rate was varied from 4.2 to 34.7% with various available services, but 42.8% of the clients had high satisfaction with overall parts of the EINCP. The program also suffered from some external contexts such as the lack of financial support of program providers.Conclusion The format of the EINCP and strategies related to recruitment of the clients should be improved in order to minimize the barriers highlighted in this study. The providers should focus on raising the compliance of clients to receive a higher reach rate. It is suggested that program planners add periodic monitoring and evaluation of the program.
Cardiovascular Disease Trends in Nepal - An Analysis of Global Burden of Disease Data 2017
Authors: Bhattarai Sanju , Aryal Anu , Pyakurel Manita , Bajracharya Swornim , Baral Phanindra , Citrin David , Cox Helen , Dhimal Meghnath , Fitzpatrick Annette , Jha Anjani Kumar , Jha Niharika , Karmacharya Biraj Man , Koju Rajendra , Maharjan Rashmi , Oli Natalia , Pyakurel Prajjwal , Sapkota Bhim Prasad , Shrestha Rajeev , Shrestha Soniya , Spiegelman Donna , Vaidya Abhinav , Shrestha Archana 
Published: March 2020

Abstract
Background Cardiovascular diseases (CVDs) are the leading cause of death and disease burden globally, disproportionately affecting low and middle-income countries. The continued scarcity of literature on CVDs burden in Nepal has thwarted efforts to develop population-specific prevention and management strategies. This article reports the burden of CVDs in Nepal including, prevalence, incidence, and disability basis as well as trends over the past two decades by age and gender. The findings from this study provide a base for public health priorities and for creating evidence-informed policies.Methods We used the Institute of Health Metrics and Evaluation (IHME)’s Global Burden of Diseases (GBD) database on cardiovascular disease mortality rates, prevalence, incidence, disability-adjusted life-years (DALYs), years of life lost (YLLs) and years lived with disability (YLDs) from Nepal to describe the most recent data available (2017) and trends by age, gender and year from 1990 to 2017. Tables, graphs and histograms are used to compare patterns and trends across all metrics. Data are presented as percentages or as rates per 100,000 population.Results In 2017, CVDs contributed to 26·9% of total deaths and 12·8% of total DALYs in Nepal. Ischemic heart disease and stroke were the predominant CVDs, contributing 16·4% and 7·5% to total deaths and 7·5% and 3·5% to total DALYs, respectively. Cardiovascular disease incidence and mortality rates have increased from 1990 to 2017, with the burden greater among males and among older age groups. The leading risk factors for CVDs were determined to be high systolic blood pressure, high low density lipoprotein (LDL) cholesterol, smoking, air pollution, a diet low in whole grains, and a diet low in fruit.Conclusion CVDs are a major public health problem in Nepal contributing to the high DALYs with unacceptable numbers of premature deaths. There is an urgent need to address the increasing burden of CVDs and their associated risk factors, particularly high blood pressure, body mass index (BMI) and unhealthy diet.
Association between malaria-related health service readiness and malaria mortality in under 5-year-old children in Burkina Faso
Authors: Millogo Ourohiré , Doamba Jean Edouard Odilon , Sié Ali , Utzinger Juerg , Vounatsou Penelope 
Published: March 2020

Abstract
Background: The Service Availability and Readiness Assessment (SARA) surveys generate data on the readiness of health facility services. We constructed a readiness index related to malaria services and determined the association between health facility malaria readiness and malaria mortality in children under the age of 5 years in Burkina Faso.Methods: Data on malaria-related visits and associated deaths in under 5-year-old children were extracted from the national Health Management Information System (HMIS) in Burkina Faso. Bayesian geostatistical models with variable selection were fitted to malaria mortality data. The most important facility readiness indicators related to general and malaria-specific services were determined. Multiple correspondence analysis (MCA), applied to the selected indicators, was used to construct a composite facility readiness score based on multiple factorial axes. Geostatistical models were employed to characterise the geographical distribution of facility malaria readiness. The analysis was carried out separately for 112 medical centres (“health facility order 1”; HF1) and 546 dispensaries (HF2).Results: The composite readiness score explained 30% and 53% of the original indicators for HF1 and HF2, respectively. Mortality rate ratio (MRR) was by 59% (MRR = 0.41, 95% Bayesian credible interval (BCI): 0.19-0.91) lower in the high readiness group of HF2, compared to the low readiness group. HF1 readiness was not related to malaria mortality.Conclusion: Performant health services in resource-constrained settings are associated with lower malaria mortality rates. To accelerate progress towards malaria elimination in low-resource settings, appropriate funding should be made available to strengthen health systems.
Social, economic and family factors associated with binge drinking in Spanish adolescents
Authors: Vargas-Martínez Ana Magdalena , Trapero-Bertran Marta , Mora Toni , Lima-Serrano Marta 
Published: March 2020

Abstract
Background: The main aim of this study was to determine the socioeconomic and family factors associated with binge drinking in Spanish adolescents who participated in a web-based computer intervention for the prevention of binge drinking known as Alerta Alcohol. Methods: Longitudinal analyses were carried out in a sample of Andalusian adolescents aged 15 to 19 enrolled in public schools, which was part of a two-arm cluster randomized controlled trial. Panel count data and the following econometric procedures were used: negative binomial, a two-part model and a finite mixture model. A total of 1,247 subjects in the pre-intervention period, with an average age of 16.8 years, plus 612 adolescents in the follow-up period, were included in the analysis. Results: In relation to findings, being older (≥ 17 years old), having more pocket money and higher family alcohol consumption were associated with greater binge drinking. By contrast, subjects who completed the questionnaire on Wednesday, Thursday or Friday, further from the previous weekend, indicated a lower number of occasions of binge drinking. Conclusions: Our results suggest the need to include families, especially parents and siblings, in interventions aimed at preventing alcohol use among adolescents, given the association shown between both weekly pocket money or availability of money to adolescents, family alcohol consumption and binge drinking. Given the findings with regard to age, future research aimed at intervening in early adolescence to prevent binge drinking would be justified.
Building Towards Common Psychosocial Measures in U.S. Cohort Studies: A Qualitative Assessment of Principal Investigators’ Views regarding the Role of Spirituality in Human Health
Authors: Shields Alexandra E. , Balboni Tracy 
Published: March 2020

Abstract
Background. The goal of this study was to understand prospective cohort Principal Investigators’ (PIs’) attitudes regarding the importance of religion and spirituality (R/S) on disease etiology in order to identify barriers and opportunities for greater inclusion of these domains in high-quality epidemiological research.Methods. One-hour, semi-structured qualitative interviews were conducted with 20 PIs representing 24 National Institutes of Health (NIH)-funded prospective cohort studies in the US, collectively capturing health data on 1 in 100 Americans. Sample size was calculated to achieve thematic saturation.Results. The majority of PIs we interviewed saw R/S as a potentially important area to investigate to better understand disease etiology, but some were unsure about the mechanisms through which R/S can impact health and how to translate this knowledge into public health interventions. PIs identified 5 key areas that are lacking in current R/S research that need to be addressed in future research to convince them of collecting more R/S measures in their cohorts: (1) high-quality, prospective studies; (2) examining a plausible biological mechanism; (3) commonly collected, well-validated R/S measures; (4) addressing bias against R/S research; and (5) NIH funding for R/S research.Conclusions. Results of this study provide a roadmap for future R/S research investigating the impact of R/S on disease etiology in the context of U.S. prospective cohort studies. Such research could provide potentially important information concerning how to address existing health disparities in the U.S.