bluuebunny/crossref_metadata_2025_split huggingface dataset:
&nbsp;Content Development for a Physical Activity and Sedentary Behaviour e-Learning Module for Early Childhood Education Students: A Delphi Study
Authors: Bruijns Brianne , Johnson Andrew M. , Tucker Trish 
Published: October 2020

Abstract
Background: Early childhood educators play a prominent role in promoting healthy activity behaviours in childcare. However, they have expressed that they lack the appropriate pre-service training to confidently lead physical activity (PA), and minimize sedentary behaviour (SB), in childcare. As such, the purpose of this Delphi study was to generate and reach agreement on content areas for inclusion in a PA and SB e-Learning module for Early Childhood Education (ECE) students.Methods: Purposeful sampling of Canadian/international researchers was used to form two expert panels: a PA/SB expert panel (n = 26), and a Canadian ECE panel. The PA/SB experts suggested their top 12 PA/SB topics for the module via online survey. These topics were then pooled to generate a list of 19 content areas. In a second online survey, both panels of experts rated the importance of each content area (0 = unimportant to 5 = very important). Mean ratings (M) were ranked separately for each panel, and then ratings were pooled to create an overall ranking of the 19 content areas. Inter-panel agreement of importance rankings was visually represented as a scatterplot and quantified using Spearman’s rho (rs).Results: The top-rated content area was Outdoor Play (M = 4.77 ± 0.64), followed by Benefits of PA in the Early Years (M = 4.75 ± 0.66), and Factors Influencing PA and SB in Childcare (M = 4.71 ± .74). Monitor PA and Sedentary Time Within Your Classroom had the lowest combined score (M = 3.77 ± 1.44). There was moderate-to strong inter-panel agreement for content area importance rankings (rs = 0.60, 95% CI: 0.20 to 0.83). The majority of the ECE expert panel considered this training important for ECE students (94.3%), aligning with ECE curriculum objectives (91.4%) and accreditation standards (78.8%), and complementary to the present ECE curriculum (88.6%).Conclusions: Providing PA and SB training to ECE students is a proactive way to ensure healthy movement behaviours are prioritized in childcare programming. With the PA/SB expert-developed content areas, and endorsement by the ECE expert panel, implementing this training within ECE programs is a necessary next step.
Women’s healthcare decision-making capacity and HIV testing in sub-Saharan Africa: a multi-country analysis of demographic and health surveys
Authors: Seidu Abdul-Aziz , Oduro Joseph Kojo , Ahinkorah Bright Opoku , Budu Eugene , Appiah Francis , Baatiema Linus , Ameyaw Edward Kwabena , Sambah Francis 
Published: October 2020

Abstract
Background Global commitment to stop Human Immunodeficiency Virus (HIV) and ensure access to HIV treatment calls for women empowerment, as these efforts play major roles in mother-to-child transmission. We explored the association between women’s healthcare decision-making capacity and HIV testing in sub-Saharan Africa (SSA). Methods We used data from the current Demographic and Health Surveys (DHS) conducted between January 1, 2010 and December 31, 2018 in 28 countries in SSA. At the descriptive level, we calculated the prevalence of HIV testing in each of the countries. This was followed by the distribution of HIV testing across the socio-demographic characteristics of women. Finally, we used binary logistic regression to explore the likelihood of HIV testing by women’s health care decision-making capacity and socio-demographic characteristics. The results were presented as Crude Odds Ratios (COR) and Adjusted Odds Ratios (AOR) with their corresponding 95% confidence intervals signifying precision. Statistical significance was set at p-value <0.05. Results We found that prevalence of HIV testing in the 28 SSA countries was 64.4%, with Congo DR having the least (20.2%) and the highest occurred in Rwanda (97.4%). Women who took healthcare decisions alone [COR=3.183, CI=2.880-3.519] or with their partners [COR=2.577, CI=2.335-2.844] were more likely to test for HIV, compared to those whose healthcare decisions were taken by others, and this persisted after controlling for significant covariates: [AOR=1.507, CI=1.321-1.720] and [AOR=1.518, CI=1.334-1.728] respectively. Conclusion SSA countries intending to improve HIV testing need to incorporate women’s healthcare decision-making capacity strategies. These strategies can include education and counselling. This is essential because our study indicates that the capacity of women to make healthcare decisions has an association with their decision to test for their HIV status.
Supporting mental health service users to stop smoking: findings from a process evaluation of the implementation of smokefree policies into two mental health trusts
Authors: Jones Susan E , Mulrine S. , Clements H. , Hamilton S. 
Published: October 2020

Abstract
Background: Life expectancy is 10-20 years lower among people with a severe mental health disorder. Most of these early deaths are due to chronic conditions, including cardiovascular and respiratory diseases. Smoking is a major risk factor for these conditions and introducing smokefree policies has been recommended to mental health service providers in England by the National Institute for Health and Care Excellence (NICE), in their Public Health Guideline 48: Smoking: acute, maternity and mental health services. This paper reports a process evaluation of introducing these policy recommendations, which were updated in 2013. Aim: To reflect on the process outcomes when introducing smokefree policies in National Health Service (NHS) Trusts providing mental health services in an English region. Method: Process data were collected through semi-structured interviews with staff (n=51), members of partnering organisations (n=5), service users (n=7) and carers (n=2) between November 2016 – April 2017. Normalization Process Theory (NPT) was used to design the data collection tools and analyse the data. A framework approach was taken with the analysis, using the four concepts of NPT: coherence, cognitive participation, collective action and reflexive monitoring. Results: The policy made sense to some staff, patients and carers (coherence) who ‘bought-into’ the idea (cognitive participation) but other participants disagreed. Although smokefree policies were operationalised (collective action), sometimes they were opposed. Progress was made, especially in some units, but continued to be resisted in others. Informal appraisal of progress (reflexive monitoring) presented a varied picture. Conclusion Some progress has been made in terms of changing an entrenched, smoking culture into one that is smokefree on Trust sites across the region. Perseverance and resourcing over the long-term is required to establish a non-smoking culture in on-site provision of mental health services.
How is migration background considered in the treatment and care of people? A comparison of national dementia care guidelines in Europe
Authors: Schmachtenberg Tim , Monsees Jessica , Hoffmann Wolfgang , Berg Neeltje van den , Stentzel Ulrike , Thyrian Jochen René 
Published: October 2020

Abstract
Background People with a migration background are vulnerable to dementia. Due to problems such as underdiagnosis or access barriers, the care of this population is a public health challenge in Europe. Many countries are issuing care guidelines, but a systematic overview of their references to migration groups is lacking. This study aims to analyze national dementia care guidelines regarding their focus on people with a migration background, what specific actions to ensure healthcare have been undertaken at the national level, and whether recommendations for action are made for this population.Methods This study is a systematic analysis of national dementia care guidelines of the EU and EFTA (European Free Trade Association) countries. Using the discourse analysis model by Keller (2011), 43 documents from 24 EU and 3 EFTA countries were systematically screened for migration references via keyword and context analysis. The content of the migration-related section was paraphrased, memos and comments were added, and the individual text passages were coded using the strategy of open coding.Results Twenty-seven of the 35 EU and EFTA countries have guidelines or similar documents on care for people with dementia, and twelve refer to migration. Norway, Sweden, and Northern Ireland refer to this topic in detail. The focus of the migration-related guidelines is on the early detection and diagnosis of dementia. The main message is that standardized diagnostic tools such as the MMSE (Mini-Mental State Examination) or the clock test are not suitable for linguistic minorities. Nine countries make recommendations for the care of people with a migration background and dementia, but only Norway, Sweden, and Denmark point to available healthcare services. A key recommendation is that the linguistic and cultural background of people should be considered when selecting diagnostic tests. Several countries refer to the validity of the RUDAS (Rowland Universal Dementia Assessment Scale) for migrants.Conclusions The topic of migration plays a subordinate role in the dementia care guidelines of European countries. Almost all countries lack appropriate diagnostic tools and healthcare services for people with a migration background. Consequently, this group is vulnerable to underdiagnosis and a lower level of care.
The origin and spread of CRF85_BC, driven by heterosexual transmission among older people in Sichuan, China
Authors: Su Ling , Feng Yi , Liang Shu , Zeng Yali , Li Yiping , Yang Hong , Li Ye , Wang Qiushi , Wei Dongbin , Yuan Dan , Lai Wenhong , Zhang Linglin 
Published: October 2020

Abstract
Background：CRF_BC recombinants, including CRF07_BC and CRF08_BC, were considered the predominant subtypes in China. Since the discovery of HIV-1 circulating recombinant form CRF 85_BC in Southwest China in 2016, this BC recombinant forms had been reported in different regions of China. However, the history and magnitude of CRF85_BC transmission were still to be investigated. Method: We conducted the most recent molecular epidemiology of HIV-1 among newly reported HIV-1 infected patients in Sichuan in 2019 by sequencing and phylogenetic analysis of 1291 pol sequences. Then, we used maximum likelihood approach and the Bayesian Markov chain Monte Carlo (MCMC) sampling of pol sequences to reconstruct the phylogeographic and demographic dynamics of the CRF85_BC.Results: HIV-1 CRF85_BC (68/1291, 5.27%) became the fourth most prevalent strain revealing a significant increase in local population. CRF85_BC were only found in heterosexually infected individuals and the majority of CRF85_BC (95.45%) were circulating among the people living with HIV aged 50 years and over (PLHIV50+), suggesting a unique prevalent pattern. The founder lineages of CRF85_BC were likely to have first emerged in Yunnan, a province of Southwest China bordering Sichuan, in the early 2000s. It then spread exponentially to various places (including Guangxi, Sichuan, et al) and became endemic around 2008.6 (2006.7-2010.2) in Sichuan. Conclusion: Taken together, our ﬁndings on HIV-1 subtype CRF85_BC infections provided new insights into the spread of this virus and extended the understanding of the HIV epidemic in China.
Brazilian National Policy of Comprehensive Women’s Health Care and Mortality during Climacteric Period: Has Anything Changed?
Authors: Sorpreso Isabel Cristina Esposito , Figueiredo Francisco Winter dos Santos , Ramos José Lucas Souza , Zuchelo Lea Tami SuzuKi , Adami Fernando , Baracat Edmund Chada , Júnior José Maria Soares 
Published: October 2020

Abstract
Background: The National Policy for Integral Attention to Women’s Health Care (PNAISM) was implemented more than two decades ago, with the monitoring of potential benefits being explored. One of the life cycles of women contemplated in this health policy was the importance of health care during the climacteric. Prevention and health promotion actions carried out by the Brazil National Health System - Unified Health System and enshrined in health Brazilian policies for women. Thus, our purpose was to identify climacteric women’s main causes of death as well as the mortality trends of such causes, especially after PNAISM implementation. Methods: An ecological study was conducted from 2018–2019. Data were retrieved from the Brazilian Health Department by accessing the mortality information system of the National Health Information, divided into periods 1996–2004 and 2005–2016 to correspond with the implementation of the National Policy. The death records of Brazilian women aged 35 to 64 years who had a diagnosis were retrieved. Trends and differences between periods were evaluated using linear regression. The significance level was set at 5%. Results: The main causes of death in women from 1996 to 2016 were circulatory system diseases (29.39%, 736,972 deaths), neoplasms (26.17%, 656,385 deaths), respiratory system diseases (7.29%, 182,812 deaths), endocrine , nutritional and metabolic diseases (6.81%, 170,881 deaths), and external causes of morbidity and mortality (5.49%, 137,674 deaths). Mortality from circulatory system diseases was reduced following implementation of the PNAISM (β=-0.58; 95% CI -0.68 to -0.48; r²=0.93; p<0.001), but no significant changes were observed in mortality from neoplasms (β=0.07; 95% CI -0.01 to 0.15; r²=0.22; p=0.070).Conclusions: The leading causes of death during climacteric are circulatory system diseases, neoplasms, respiratory system diseases, nutritional, metabolic, and endocrine diseases, and external causes of morbidity and mortality, with no changes in neoplasms and respiratory system diseases. Thus, the analysis of women’s health indicators, such as mortality rates, is fundamental in order to enable the monitoring of benefits and results related to PNAISM as well as directing the design and implementation of other new health policies to be developed for women.
Inequality in health service utilization among migrant and local children: a cross-sectional survey of children aged 0–14 years in Shenzhen, China
Authors: Ke Xiatong , Zhang Liang , Li Zhong , Tang Wenxi 
Published: October 2020

Abstract
Background: Shenzhen is characterized with the largest scale of migrant children among all the cities in China. Unequal access to health services among migrant and local children greatly affects health equity and has a profound impact on the quality of human capital. This study aimed to investigate differences in using community-based healthcare between local and migrant children and to identify the influencing factors in Futian District of Shenzhen. Methods: Households in 12 communities in Futian District of Shenzhen were randomly sampled. Children aged 0-14 years were investigated using self-administered questionnaire - the 2018 Survey of Health Service Needs of Chinese Residents. Differences in healthcare including physical examination, feeding guidance, development guidance, disease prevention guidance, injury prevention guidance, oral health guidance, and mental health guidance, were tested between local and migrant children. Binary logistic regressions were used in identifying potential influencing factors which affected the use in the above healthcare items. Results: A total of 936 participants from1512 families were sampled and 508 of them were included. Compared with local children, migrant children had less use of development guidance (OR=0.417, 95% CI: 0.279-0.624) and oral health care guidance (OR=0.557, 95% CI: 0.381-0.813). Children whose father received higher education level enjoyed a better use of disease prevention guidance as compared to whose father stopped at junior high school education or below (senior high vs junior high and below, OR=1.286, 95% CI: 0.791-2.090; bachelor and above vs junior high and below, OR=2.257, 95% CI: 1.417-3.595). Children whose fathers were blue-collar workers had less use of injury prevention guidance (OR=0.750, 95% CI: 0.334-1.684) and mental health guidance (OR=0.784, 95% CI: 0.295-2.080) as compared to whose father were white collar workers. Conclusions: Except feeding guidance, healthcare utilization were lower among migrant children than among local children. Generally, fathers have a stronger influence on children’s use of community-based healthcare than mothers do. The potential influence of fathers in promoting children’s healthcare use behaviors should be carefully considered, and fathers’ attention to children’s health should be increased.
Investigating the effect of social networking site use on mental health in an 18-34 year-old general population. A cross-sectional study using the 2016 Scania Public Health Survey.
Authors: Scott Emily Stella , Canivet Catarina A. , Östergren Per-Olof 
Published: October 2020

Abstract
Background: Social Networking Sites (SNS) are commonly used, especially by young adults. Their impact on mental health is unclear. Moreover, little is known about how social factors, e.g. Perceived Emotional Support (PES), may affect this association. Mental health issues are increasingly burdening the young generation and society as a whole. This study aims to investigate the association between frequency of SNS use and number of SNS contacts with the mental health of a young, Swedish population. Additionally, the potential effect modification of PES will be analysed in regard to these relationships.Method: This cross-sectional study applied logistic regression analyses to data on 1,341 participants (aged 18-34), retrieved from the Scania Public Health Survey (2016). Analyses were stratified by gender and the GHQ-12 scale assessed poor mental health. A 2-way interaction model was used to test for effect modification by PES regarding the association between SNS use and mental health.Results: Increased risk for poor mental health were found in women only. Using SNS almost hourly vs. less often resulted in an odds ratio (OR) of 1.66 (95% confidence interval (CI) = 1.16–2.38). The corresponding figures for having ≥600 contacts vs. ≤599 were (1.89; 1.21–2.97). Having low PES and using SNS almost hourly was associated with an OR of 3.12 (CI = 1.69–5.76; synergy index (SI) = 1.25). Low PES and ≥600 contacts resulted in an OR of 6.07 (CI = 1.73–21.33), whereby interaction was detected (SI = 2.88).Conclusion: Women, but not men, with frequent SNS use and a high number of SNS contacts were more likely to have poor mental health, which was exacerbated in women with low PES. Facilitating PES could be an approach for improving mental health among young adults. Future studies on the use of SNS should focus more on gender analyses.
NAMPT/SIRT2–mediated inhibition of the p53-p21 signaling pathway is indispensable for maintenance and hematopoietic differentiation of human iPS cells
Authors: Xu Yun , Nasri Masoud , Dannenmann Benjamin , Mir Perihan , Zahabi Azadeh , Welte Karl , Morishima Tatsuya , Skokowa Julia 
Published: October 2020

Abstract
Background: Nicotinamide phosphoribosyltransferase (NAMPT) regulates cellular functions through the protein deacetylation activity of nicotinamide adenine dinucleotide (NAD+)-dependent sirtuins (SIRTs). SIRTs regulate functions of histones and none-histone proteins. The role of NAMPT/SIRTs pathway in the regulation of maintenance and differentiation of human induced pluripotent stem (iPS) cells is not fully elucidated.Methods: We evaluated the effects of specific inhibitors of NAMPT-, or SIRT2 on the pluripotency, proliferation, survival and hematopoietic differentiation of human iPS cells. We also studied the molecular mechanism downstream of NAMPT/SIRTs in iPS cells.Results: We demonstrated that NAMPT is indispensable for the maintenance, survival and hematopoietic differentiation of induced pluripotent stem (iPS) cells. We found that inhibition of NAMPT or SIRT2 in iPS cells induces p53 protein by promoting its lysine acetylation. This leads to activation of the p53 target, p21, with subsequent cell cycle arrest and induction of apoptosis in iPS cells. NAMPT and SIRT2 inhibition also affect hematopoietic differentiation of iPS cells in an embryoid body (EB)-based cell culture system.Conclusions: Our data demonstrate the essential role of the NAMPT/SIRT2/p53/p21 signaling axis in the maintenance and hematopoietic differentiation of iPS cells.
Breastfeeding knowledge of mothers in protracted crises: The Gaza Strip example
Authors: Iellamo Alessandro , Monaghan Emily , Moghany Samar AL , Latham Jonathan , Nassereddin Nihal 
Published: October 2020

Abstract
Background: The protection, promotion and support of breastfeeding is the most effective intervention to prevent child morbidity and mortality in all contexts, especially in humanitarian crisis. During the Palestine-Israel conflict that started in the middle of the 20th century, healthcare services are understaffed and lack basic resources, with frequent power cuts and stock-outs of essential drugs and equipment. This case study seeks to answer the questions: (1) How does the protracted crisis in Gaza affect the breastfeeding practices of the most vulnerable population; and (2) What is the role that midwives can play in improving breastfeeding practices?A mixed method (qualitative and quantitative) study was used to collect data. A total of 1044 respondents had a child less than 24 months at the time of the study. A total of 62.75 percent practice early initiation of breastfeeding and 42 percent confirmed that their new-borns were given liquids other than breast milk during the first three days of life. Fifty percent of mothers addressed breast milk insufficiency by drinking additional fluids and 40 percent by using infant formula. More than 50% of women said that they received most breastfeeding information during antenatal care visits. Only 18% of women said that they received breastfeeding information during contact with health professionals throughout labour, delivery, and subsequent post-natal care visits. Many mothers during the FGDs confirm using milk to top up or replace breast milk even if they know how important breastfeeding is for the childrenDiscussion: This study confirms the need to a) adapt the IYCF-E operational guidance in the Gaza strip and b) include breastfeeding counselling in the pre-service and in-service training for midwives. For vulnerable populations in humanitarian contexts, the impact of this cannot be underestimated. Conducting research in humanitarian settings is particularly challenging. The experience included integration and linkage with security officers on the ground, co-ordination with authorities and communities, supportive supervision during data collection, allocation of buffer days in-country and remote assistance to data collection teams Conclusions: This research focuses on a protracted emergency in insecure populated areas. The uncertain security situation, meant that the team adopted a flexible approach. Lessons learned throughout this exercise included the importance of a) allocating additional research time, to account for potential interruption b) daily coordination with security officers to ensure safe access to localities c) identification of extra sites, in case escalation of conflict d) training of additional enumerators in case conflict escalation e) negotiation with authorities to ensure compliance with requirements.