bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analyzing Competitive Demands in Mountain Running Races: A Running Power-Based Approach
Authors: Rodríguez-Medina Juan , Carballo-Leyenda Belén , Gutiérrez-Arroyo Jorge , García-Heras Fabio , Rodríguez-Marroyo Jose A. 
Published: December 2024

Purpose: This study aimed to analyze the competitive demands of mountain running races of varying lengths. Methods: Sixty-six male athletes competed in Vertical race (∼3 km and ∼1000 m of total elevation change), Sky race (∼25 km and ∼3000 m of total elevation change), and SkyUltra race (∼80 km and ∼9000 m of total elevation change). Exercise intensity and competition load (TL) were assessed using running power, heart rate, and rating of perceived exertion (RPE). Results: The highest exercise intensity was observed in Vertical race (3.9 [0.4] W·kg−1, 93.6% [2.8%] HRmax, and 9.5 [0.7] RPE) compared to Sky race (3.5 [0.5] W·kg−1, 89.9% [2.4%] HRmax, and 8.5 [1.2] RPE), and SkyUltra (2.7 [0.6] W·kg−1, 73.4% [1.1%] HRmax, and 8.2 [1.1] RPE). Vertical races had the highest mean maximal power outputs for periods <10 minutes. They also had the highest proportion of time spent >5 W·kg−1 and the most time spent above the respiratory compensation threshold. The majority of time in SkyUltra was spent at low intensity. The highest TLs were observed in these races (6200.5 [708.0] kJ, 842.0 [35.7] AU for TLHR, and 4897.3 [940.7] AU for TLRPE). However, when normalized to competition time, the SkyUltra event showed the lowest values compared with the Vertical and Sky races (∼11 vs ∼14.5 kJ·min−1, ∼1.5 vs ∼2.5 AU·m−1 for TLHR). Conclusion: The results of this study expand knowledge about the effort demands of mountain races and demonstrate how these demands are affected by race duration. Additionally, the study highlights the potential use of running power for quantifying exercise in this sport.
Cost-effectiveness analysis of proactive home visits compared with site-based community health worker care on antenatal care outcomes in Mali: a cluster-randomised trial
Authors: Ogbuoji Osondu , Shahid Minahil , Zimmerman Armand , Liu Jenny X , Kayentao Kassoum , Whidden Caroline , Treleaven Emily , Traoré Coumba , Sogoba Mahamadou , Doumbia Saibou , Boettiger David Charles , Cissé Amadou Beydi , Keita Youssouf , Berthé Mohamed , Johnson Ari 
Published: December 2024

IntroductionDespite recommendations from the WHO, antenatal care (ANC) coverage remains low in many low-income and middle-income countries (LMICs). Community health workers (CHWs) can play an important role in expanding ANC coverage through pregnancy identification, provision of health education, screening for complications, delivery of therapeutic care and referral to higher levels of care. However, despite the success of CHW programmes in various countries, WHO has called for additional research to develop evidence-based models that optimise CHW service delivery and that can be replicated across geographies.MethodsThe ProCCM Trial was a cluster-randomised controlled trial to compare proactive home visits by CHWs (intervention, 69 village clusters) to the provision of CHW care at community fixed sites only (control, 68 village clusters) in the Bankass health district in Central Mali. In this study, we conducted a cost-effectiveness analysis of proactive CHW home visits in improving ANC utilisation, a secondary outcome of the ProCCM trial. We analysed five ANC outcomes: (1) number of ANC contacts, (2) at least one ANC contact, (3) at least four ANC contacts, (4) at least eight ANC contacts and (5) ANC initiated in the first trimester. We assumed two perspectives, a CHW programme’s and the Full ANC programme’s perspective, which included facility-based as well as community-based ANC. We estimated programme costs, incremental cost-effectiveness ratios (ICERs) and probabilities of the intervention being more cost-effective than the control at different willingness-to-pay (WTP) thresholds.ResultsProactive home visits were cost-saving from the CHW programme’s perspective (ICERs: −$21.39 to −$79.20 per ANC utilisation outcome) and from the Full ANC programme perspective (ICERs: −$1.70 to −$6.30 per ANC utilisation outcome) compared with the fixed-site CHW care. The likelihood of the intervention being more cost-effective than the control was 100% at WTP thresholds $0 per ANC utilisation outcome and between $12.5 and $50.00 per ANC utilisation outcome in the CHW- and Full ANC programme perspectives, respectively.ConclusionOur results provide evidence that proactive home visits produce more value per dollar spent as a means of improving the uptake of ANC services compared with fixed-site CHW services.Trial registration numberNCT02694055.
Inequalities in ownership and availability of home-based vaccination records in 82 low- and middle-income countries
Authors: Cata-Preta Bianca O , Santos Thiago M , Wendt Andrea , Arroyave Luisa , Mengistu Tewodaj , Hogan Daniel R , Barros Aluisio J D , Victora Cesar G , Danovaro-Holliday M Carolina 
Published: December 2024

IntroductionHome-based records (HBRs) are widely used for recording health information including child immunisations. We studied levels and inequalities in HBR ownership in low-income and middle-income countries (LMICs) using data from national surveys conducted since 2010.MethodsWe used data from national household surveys (Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS)) from 82 LMICs. 465 060 children aged 6–35 months were classified into four categories: HBR seen by the interviewer; mother/caregiver never had an HBR; mother/caregiver had an HBR that was lost; and reportedly have an HBR that was not seen by the interviewer. Inequalities according to age, sex, household wealth, maternal education, antenatal care and giving birth in an institutional setting were studied, as were associations between HBR ownership and vaccine coverage. Pooled analyses were carried out using country weights based on child populations.ResultsAn HBR was seen for 67.8% (95% CI 67.4% to 68.2%) of the children, 9.2% (95% CI 9.0% to 9.4%) no longer had an HBR, 12.8% (95% CI 12.5% to 13.0%) reportedly had an HBR that was not seen and 10.2% (95% CI 9.9% to 10.5%) had never received one. The lowest percentages of HBRs seen were in Kiribati (22.1%), the Democratic Republic of Congo (24.5%), Central African Republic (24.7%), Chad (27.9%) and Mauritania (35.5%). The proportions of HBRs seen declined with age and were inversely associated with household wealth and maternal schooling. Antenatal care and giving birth in an institutional setting were positively associated with ownership. There were no differences between boys and girls. When an HBR was seen, higher immunisation coverage and lower vaccine dropout rates were observed, but the direction of this association remains unclear.InterpretationHBR coverage levels were remarkably low in many LMICs, particularly among children from the poorest families and those whose mothers had low schooling. Contact with antenatal and delivery care was associated with higher HBR coverage. Interventions are urgently needed to ensure that all children are issued HBRs, and to promote proper storage of such cards by families.
Contribution of domestic animals’ feces to the occurrence of diarrhoea among children aged 6–48 months in Sidama region, Ethiopia: a laboratory-based matched case-control study
Authors: Gunsa Gorfu Geremew , Haddis Alemayehu , Ambelu Argaw 
Published: December 2024

BackgroundIn developing countries, due to improper management of domestic animals’ exposures, under-five (U5) children have been affected by diarrhoea. However, there is no evidence that shows the presence of diarrhoea-causing pathogens in the faeces of U5 children and animals residing in the same houses in the Sidama region, Ethiopia.MethodsA laboratory-based matched case-control study was conducted on children aged 6–48 months in the Sidama region of Ethiopia from February to June 2023. The study enrolled 113 cases, and 113 controls visited the selected health facilities during the study period. Faecal specimens from the case and control children and domestic animals were collected using transport media. Data were collected at children-residing homes by interviewing caretakers using the KoboCollect application. The presence of diarrhoea-causing pathogens (Campylobacteria, Escherichia coli, non-typhoidalsalmonella,ShigellaandCryptosporidium) was detected using culture media, biochemical tests, gram stain, catalase and oxidase tests. The diarrhoea risk factors were identified using conditional logistic regressions and the random forest method using R.4.3.2.ResultsOf the faecal specimens diagnosed, 250 (64.1%) tested positive for one or more pathogens. Faecal specimens from chickens tested more positive forE. coliandCampylobacteria. Of the pairs of faecal specimens taken from case children and animals living in the same house, 104 (92%) tested positive for one or more similar pathogens. Among the factors, disposing of animal waste in an open field, storing drinking water in uncovered containers, caretakers poor knowledge about the animals’ faeces as a risk factor for diarrhoea and ≤2 rooms in the living house were significantly associated with diarrhoea.ConclusionThe finding shows that diarrhoea-causing pathogens are transmitted from domestic animals’ faeces to children aged 6–48 months in the Sidama region. The improper management of animals’ faeces and related factors were the predominant risk factors for diarrhoea.
Components of cognitive–behavioural therapy for mitigating core symptoms in attention-deficit hyperactivity disorder: a systematic review and network meta-analysis
Authors: Matsumoto Kazuki , Hamatani Sayo , Kunisato Yoshihiko , Mizuno Yoshifumi 
Published: December 2024

QuestionCognitive–behavioural therapy (CBT) is frequently implemented for individuals with attention-deficit hyperactivity disorder (ADHD). It is still unknown which specific components are effective, because CBT is a complex intervention with several components. The objective of this review was to assess the efficacy of CBT components for ADHD.Study selection and analysisBuilding on definitions of the components used in CBT strategies, we conducted network meta-analyses to evaluate the efficacy at both the treatment level (ie, combinations of these components) and the component level (ie, individual component). Primary outcome was treatment response of ADHD core symptoms. Secondary outcomes were total ADHD symptoms, inattention symptoms, hyperactivity-impulsivity symptoms and dropout from the treatment. We searched MEDLINE (via PubMed), Embase, PsycINFO, ClinicalTrials.gov and Cochrane Library for literature published up to 31 March 2022. This review included only randomised controlled trials.Findings43 trials with 3817 participants were included in the network meta-analyses. Third-wave therapy (OR=4.80, 95% credible interval (CrI) 2.50 to 9.10), behaviour therapy (OR=3.50, 95% CrI 1.70 to 7.30) and CBT (OR=3.10, 95% CrI 1.70 to 5.70) were treatments that demonstrated superior efficacy compared with placebo. The component-level analyses showed organisational strategies (incremental OR (iOR)=2.03, 95% CI 1.27 to 3.24) and third-wave components (iOR=1.95, 95% CI 1.30 to 2.93) were associated with increase in treatment response. Problem-solving techniques (incremental standardised mean difference=0.42, 95% CI 0.01 to 0.83) were associated with a reduction in inattention symptoms.ConclusionsOur findings suggest that the optimal treatment package for ADHD may include organisational strategies, third-wave components and problem-solving techniques.PROSPERO registration numberCRD42022323898.
Strategic interventions and a novel model for the integration of community pharmacy and primary care in Spain: qualitative insights
Authors: Piquer-Martinez Celia , Urionagüena Amaia , Benrimoj Shalom I. , Calvo Begoña , García-Cárdenas Victoria , Amador-Fernandez Noelia , Gastelurrutia Miguel A , Martinez Martinez Fernando 
Published: December 2024

ObjectivesTo explore the opinions and perceptions of key stakeholders on the integration between community pharmacy and primary care, within the Valencian Autonomous Community. Specific objectives include identifying strategic interventions to facilitate this integration. Additionally, the manuscript discusses the formulation of a novel model for the integration of community pharmacy and primary care.DesignQualitative, with data from five virtual focus groups (FG) and 12 semistructured interviews analysed thematically using NVivo and interventions prioritised through a virtual nominal group technique.SettingValencian Autonomous Community (Spain).ParticipantsFG involved community pharmacists (CP) and primary care stakeholders including general practitioners, primary care nurses, general practitioner pharmacists, social services managers and administrators. Interviewees were government representatives and professionals from organisations. Selection was through snowball sampling and invitations by Official Colleges of Pharmacists.ResultsFive themes emerged, revealing the multifaceted nature of integrating community pharmacies and primary care. ‘Integration’ was identified as an ambitious target, anchored in collaboration and communication efforts. The role of CP was particularly noted for their direct patient interaction and trust, vital in fostering medication adherence. Barriers like role ambiguity and regulatory environment were highlighted. Seven interventions were identified to enable integration, with three of them prioritised: ‘bidirectional communication’, ‘protocol standardisation’ and ‘multidisciplinary team strengthening’. These interventions, linked with prior components of health system integration, led to a pioneer integration model.ConclusionsRecognising stakeholder insights is essential in shaping workable, practical and adaptable models for integration. Tailoring these temporal models to stakeholders' immediate needs and strategic priorities may serve as effective starting points for integration. Support from professional bodies and proactive stakeholders’ engagement will optimise the integration success and its acceptance across healthcare levels.
Quality of care at childbirth during the COVID-19 pandemic in Belgium: a cross-sectional study based on WHO standards
Authors: Galle Anna , Berghman Helga , D’Hauwers Silke , Vaerewijck Nele , Valente Emanuelle Pessa , Mariani Ilaria , Bomben Arianna , delle Vedove Stefano , Lazzerini Marzia 
Published: December 2024

ObjectivesTo examine quality of maternal and newborn care (QMNC) around childbirth in facilities in Belgium during the COVID-19 pandemic and trends over time.DesignA cross-sectional observational study.SettingData of the Improving MAternal Newborn carE in the EURO region study in Belgium.ParticipantsWomen giving birth in a Belgian facility from 1 March 2020 to 1 May 2023 responded a validated online questionnaire based on 40 WHO standards-based quality measures organised in four domains: provision of care, experience of care, availability of resources and organisational changes related to COVID‐19.Primary and secondary outcome measuresQuantile regression analysis was performed to assess predictors of QMNC; trends over time were tested with the Mann‐Kendall test.Results897 women were included in the analysis, 67% (n=601) with spontaneous vaginal birth, 13.3% (n=119) with instrumental vaginal birth (IVB) and 19.7% (n=177) with caesarean section. We found overall high QMNC scores (median index scores>75) but also specific gaps in all domains of QMNC. On provision of care, 21.0% (n=166) of women who experienced labour reported inadequate pain relief, 64.7% (n=74) of women with an instrumental birth reported fundal pressure and 72.3% (n=86) reported that forceps or vacuum cup was used without their consent. On experience of care, 31.1% (n=279) reported unclear communication, 32.9% (n=295) reported that they were not involved in choices,11.5% (n=104) stated not being treated with dignity and 8.1% (n=73) experienced abuse. Related to resources, almost half of the women reported an inadequate number of healthcare professionals (46.2%, n=414). Multivariable analyses showed significantly lower QMNC scores for women with an IVB (−20.4 in the 50th percentile with p<0.001 and 95% CI (−25.2 to −15.5)). Over time, there was a significant increase in QMNC Score for ‘experience of care’ and ‘key organisational changes due to COVID-19’ (trend test p< 0.05).Conclusions and relevanceOur study showed several gaps in QMNC in Belgium, underlying causes of these gaps should be explored to design appropriate interventions and policies.Trial registration numberNCT04847336.
Exploring residents’ perspectives on their professional identity in general practice residency in the Netherlands: a qualitative study
Authors: Al-Sabiry Miami , Slootweg Irene , Numans Mattijs E , van Mook Walther NKA , Barnhoorn Pieter 
Published: December 2024

ObjectivesEducational initiatives in residency may lack alignment with residents’ learning objectives. Furthermore, they may overlook residents’ struggle to find fulfilment in their work. Professional identity formation (PIF) is a conceptual lens through which to explore the alignment of educational initiatives with residents’ learning objectives. Few empirical studies have examined PIF in residency in general. PIF outcomes in general practice (GP) residency, from the perspective of residents, are poorly represented in the current literature. This study aimed to explore residents’ perspectives on their professional identity to inform PIF learning objectives in GP residency.DesignA qualitative descriptive study using a list of predetermined questions to guide focus group interviews.SettingData collection took place between winter and autumn 2019 at four GP training institutes across the Netherlands.Participants92 third (final) year GP residents participated in focus group interviews.ResultsResidents’ overall perspectives hinged on how to negotiate the endlessness of the profession. This endlessness was reported to manifest in four areas, namely, the GP: as an accessible healthcare provider, as a spider in the care-web, providing personalised care and maintaining a work–life balance.ConclusionsGP residents’ narratives highlighted an increasingly challenging profession and posited the importance of guided negotiation for their PIF. Deploying the concept of subjectification in residents’ guided negotiation of the profession’s endlessness possibly improves the supervisor–resident educational alliance. Furthermore, awareness of issues related to work–life balance and fostering residents’ sense of belonging and collegiality may contribute to improving their well-being and sense of fulfilment in their work.
Measuring technology-facilitated sexual violence and abuse: a scoping review protocol of existing measurements
Authors: Pak Sharon Hoi Lam , Choi Edmond Pui Hang , Wu Chanchan , Chau Pui Hing , Bradbury-Jones Caroline 
Published: December 2024

IntroductionTechnology-facilitated sexual violence and abuse (TFSVA) refers to a range of behaviours in which digital technologies are used to facilitate both virtual and face-to-face sexual harm. The proliferation of smartphone usage and increasing internet penetration rates across the world have made it easier for individuals to become perpetrators and victims of TFSVA. Since empirical studies of TFSVA remain limited in the academic arena, and there is an absence of evidence to support the development of a standardised TFSVA measurement, this review aims to explore what TFSVA measurements are currently available and their potential use in measuring TFSVA.Methods and analysisThis scoping review will be structured according to the Joanna Briggs Institute recommended framework. Keywords related to ‘technology’, ‘sexual violence’ and ‘measure’ will be used. Any paper related to measurements of TFSVA will be included without limitation to any population or setting. A search will be conducted from database inception until May 2024 for published literature in English and Chinese electronic databases, which included PubMed, Embase, CINAHL, Scopus, ProQuest, Web of Science, Chinese National Knowledge Infrastructure, SinoMed, Index to Taiwan Periodical Literature and Ariti Library. Screening and study selection will be conducted by two independent reviewers. Data will be extracted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews Checklist. The PAGER (Patterns, Advances, Gaps, Evidence for practice and Research recommendations) Framework will be used to report the findings.Ethics and disseminationSince the scoping review methodology consists of reviewing and collecting data from publicly available materials, this study does not require ethics approval. This scoping review has the potential to serve as the most appropriate way to explore existing evidence related to this emerging phenomenon. The results of this review are expected to highlight various types of TFSVA measurement developed in different settings. Further work is required to develop measurements adapted for specific populations and tested to ensure acceptability and cultural competence. The results will be disseminated through a peer-reviewed publication and conference presentations.Review registrationThe protocol of this review was registered within the Open Science Framework (https://doi.org/10.17605/OSF.IO/Q5ETW) on 13 March 2024.
Mainstreaming control interventions for neglected tropical diseases into the health system: a scoping review protocol
Authors: Bilchut Awraris Hailu , Gebre Teshome , Seife Fikre , Enbiale Wendemagegn , Tamiru Adugna , Yohanes Tsegaye , Yohannes Amsayaw , Adane Yosef , Merdekios Behailu , Kebede Biruck , Kebede Fikreab , Deribe Kebede , Evans Jennifer , Burton Matthew J , Habtamu Esmael 
Published: December 2024

IntroductionThe WHO neglected tropical diseases (NTD) roadmap (2021–2030) proposed a shift in approach to addressing NTDs through accountability for impact, implementing integration across NTDs, mainstreaming in national health systems and ensuring country ownership. However, a major challenge has been the dearth of evidence on how to implement this shift in a resource-limited setting. The objective of this scoping review is to understand the extent and type of evidence on the mainstreaming or integration of programmes and/or interventions against NTDs into the national health system.MethodsResearch articles of any methodology, series, evaluations and reports published from 1995 in the English language on any peer-reviewed platforms, and WHO, universities and government or implementing partners websites that report and discuss mainstreaming or integration implementation practices or experiences of any interventions against NTDs into the health system will be included. The main databases searched on 30 October 2024 were Medical Literature Analysis and Retrieval System Online (Ovid), Embase (Ovid), Global Health (Ovid), Cochrane Database of Systematic Reviews and CENTRAL on the Cochrane Library (Wiley), and WHO Global Index Medicus. Following piloting, screening and data extraction will be undertaken independently by at least two people. Any disagreements that arise between the reviewers at each stage of the screening and selection process will be resolved through discussion, or with an additional reviewer/s. Thematic analysis will be conducted guided by the project INTEGRATE framework and the Primary Health Care Performance Initiative conceptual framework. Key information or evidence relevant to the mainstreaming of interventions against NTDs into the health system such as mainstreamed interventions and the level of health system where the mainstreaming occurred, the effectiveness of the mainstreaming, contextual differences in health system organisation between settings, and challenges and promising practices will be summarised.Ethics and disseminationEthical approval will not be sought as our review will only include published data. The findings will be published in a peer-reviewed journal and will be disseminated at national and international research and programme review platforms.