bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stark choices: exploring health sector costs of policy responses to COVID-19 in low-income and middle-income countries
Authors: Torres-Rueda Sergio , Sweeney Sedona , Bozzani Fiammetta , Naylor Nichola R , Baker Tim , Pearson Carl , Eggo Rosalind , Procter Simon R , Davies Nicholas , Quaife Matthew , Kitson Nichola , Keogh-Brown Marcus R , Jensen Henning Tarp , Saadi Nuru , Khan Mishal , Huda Maryam , Kairu Angela , Zaidi Raza , Barasa Edwine , Jit Mark , Vassall Anna 
Published: December 2021

ObjectivesCOVID-19 has altered health sector capacity in low-income and middle-income countries (LMICs). Cost data to inform evidence-based priority setting are urgently needed. Consequently, in this paper, we calculate the full economic health sector costs of COVID-19 clinical management in 79 LMICs under different epidemiological scenarios.MethodsWe used country-specific epidemiological projections from a dynamic transmission model to determine number of cases, hospitalisations and deaths over 1 year under four mitigation scenarios. We defined the health sector response for three base LMICs through guidelines and expert opinion. We calculated costs through local resource use and price data and extrapolated costs across 79 LMICs. Lastly, we compared cost estimates against gross domestic product (GDP) and total annual health expenditure in 76 LMICs.ResultsCOVID-19 clinical management costs vary greatly by country, ranging between <0.1%–12% of GDP and 0.4%–223% of total annual health expenditure (excluding out-of-pocket payments). Without mitigation policies, COVID-19 clinical management costs per capita range from US$43.39 to US$75.57; in 22 of 76 LMICs, these costs would surpass total annual health expenditure. In a scenario of stringent social distancing, costs per capita fall to US$1.10–US$1.32.ConclusionsWe present the first dataset of COVID-19 clinical management costs across LMICs. These costs can be used to inform decision-making on priority setting. Our results show that COVID-19 clinical management costs in LMICs are substantial, even in scenarios of moderate social distancing. Low-income countries are particularly vulnerable and some will struggle to cope with almost any epidemiological scenario. The choices facing LMICs are likely to remain stark and emergency financial support will be needed.
Delivery of a multi-focus public health intervention in the paediatric emergency department: a feasibility and acceptability pilot study
Authors: Isba Rachel , Edge Rhiannon 
Published: December 2021

ObjectiveThe objective was to see if it was feasible and acceptable to deliver a brief public health intervention as part of an attendance at the paediatric emergency department (PED).DesignA feasibility and acceptability pilot design was used as there is no previous work done in this clinical area, population or using this approach in children and young people (CYP). Quantitative and qualitative data were collected. Follow-up was at 1 week and 1, 3 and 6 months.SettingThis pilot took place in a single PED in Greater Manchester, England.ParticipantsParticipants were CYP (under 16 years old) and their parents/carers, attending the PED during a 2-week recruitment period in September 2019.InterventionsThe intervention was a brief conversation with a Consultant in Paediatric Public Health Medicine, using Screening, Brief Intervention and Referral to Treatment. The intervention focused on vaccination, dental health, household smoking and frequent attendance.Primary and secondary outcome measuresThe primary outcome measure was information to support the effective development of a larger-scale study. Secondary outcomes were measures of health, again intended to provide additional information prior to a larger study.ResultsThirty CYP were recruited from 29 households. Sixty per cent of CYP triggered at least one screening question, most commonly household smoking and dental health. It was not possible to accurately assess frequent attendance and 97% of parents/carers stated that they thought their child or young person was fully vaccinated for their age, which is likely to be an over-estimate.ConclusionsIt is feasible to deliver a brief public health intervention in the PED and such an approach is acceptable to a variety of stakeholders including CYP, parents/carers and nursing staff. The pilot revealed issues around data quality and access. Future work will focus on vaccination and dental health.
Mixed-methods, descriptive and observational cohort study examining feeding and growth patterns among low birthweight infants in India, Malawi and Tanzania: the LIFE study protocol
Authors: Vesel Linda , Spigel Lauren , Behera Jnanindra Nath , Bellad Roopa M , Das Leena , Dhaded Sangappa , Goudar Shivaprasad S , Guruprasad Gowdar , Misra Sujata , Panda Sanghamitra , Shamanur Latha G , Vernekar Sunil S , Hoffman Irving F , Mvalo Tisungane , Phiri Melda , Saidi Friday , Kisenge Rodrick , Manji Karim , Salim Nahya , Somji Sarah , Sudfeld Christopher R , Adair Linda , Caruso Bethany A , Duggan Christopher , Israel-Ballard Kiersten , Lee Anne CC , Martin Stephanie L , Mansen Kimberly L , North Krysten , Young Melissa , Benotti Emily , Marx Delaney Megan , Fishman Eliza , Fleming Katelyn , Henrich Natalie , Miller Kate , Subramanian Laura , Tuller Danielle E , Semrau Katherine EA 
Published: December 2021

IntroductionEnding preventable deaths of newborns and children under 5 will not be possible without evidence-based strategies addressing the health and care of low birthweight (LBW, <2.5 kg) infants. The majority of LBW infants are born in low- and middle-income countries (LMICs) and account for more than 60%–80% of newborn deaths. Feeding promotion tailored to meet the nutritional needs of LBW infants in LMICs may serve a crucial role in curbing newborn mortality rates and promoting growth. The Low Birthweight Infant Feeding Exploration (LIFE) study aims to establish foundational knowledge regarding optimal feeding options for LBW infants in low-resource settings throughout infancy.Methods and analysisLIFE is a formative, multisite, observational cohort study involving 12 study facilities in India, Malawi and Tanzania, and using a convergent parallel, mixed-methods design. We assess feeding patterns, growth indicators, morbidity, mortality, child development and health system inputs that facilitate or hinder care and survival of LBW infants.Ethics and disseminationThis study was approved by 11 ethics committees in India, Malawi, Tanzania and the USA. The results will be disseminated through peer-reviewed publications and presentations targeting the global and local research, clinical, programme implementation and policy communities.Trial registration numbersNCT04002908and CTRI/2019/02/017475.
Non-invasive ventilation in the palliative care of patients with chronic obstructive pulmonary disease: a scoping review protocol
Authors: Steindal Simen A , Hofsø Kristin , Aagaard Hanne , Mariussen Kari L , Andresen Brith , Christensen Vivi L , Heggdal Kristin , Karlsen Marte-Marie Wallander , Kvande Monica E , Kynø Nina Margrethe , Langerud Anne Kathrine , Ohnstad Mari O , Sørensen Kari , Larsen Marie Hamilton 
Published: December 2021

IntroductionPatients with advanced chronic obstructive pulmonary disease (COPD) experience a great symptom burden. Breathlessness is a very frequently reported symptom that negatively affects all aspects of daily life and could lead to fear of dying. Non-invasive ventilation (NIV) could be an important palliative measure to manage breathlessness in patients with advanced COPD. We decided to conduct a scoping review to attain an overview of the existing research and to identify knowledge gaps. This scoping review aims to systematically map published studies on the use of NIV in the palliative care of COPD patients, including the perspectives and experiences of patients, families and healthcare professionals.Methods and analysisThis scoping review will employ the framework of Arksey and O’Malley. The reporting will be guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. A comprehensive and systematic search strategy will be developed in cooperation with an experienced librarian. Database searches will be conducted in AMED, PEDro, Embase, CINAHL, PsycInfo and MEDLINE in February 2021. Pairs of authors will independently assess studies’ eligibility and extract data using a standardised data-charting form. The data will be inductively summarised and organised thematically. The results will be discussed with an advisory board consisting of nurses and physicians from respiratory and intensive care units.Ethics and disseminationApproval for the workshop with the advisory board has been attained from the Norwegian Centre for Research Data (480222), and approval will be attained from the Personal Data Protection Officers of the participating hospitals. All advisory board participants will sign an informed written consent before participation. The results could contribute to developing the body of evidence on the use of NIV in the palliative care of COPD patients and serve to identify directions for future research.
Rabies mortality and morbidity associated with animal bites in Africa: a case for integrated rabies disease surveillance, prevention and control: a scoping review
Authors: Nyasulu Peter Suwirakwenda , Weyer Jacqueline , Tschopp Rea , Mihret Adane , Aseffa Abraham , Nuvor Samuel Victor , Tamuzi Jacques Lukenze , Nyakarahuka Luke , Helegbe Gideon Kofi , Ntinginya Nyanda Elias , Gebreyesus Melaku Tefera , Doumbia Seydou , Busse Reinhard , Drosten Christian 
Published: December 2021

ObjectiveThe objective of this scoping review was to map the current situation and available evidence and gaps on rabies morbidity, mortality, integrated rabies surveillance programmes, and existing prevention and control strategies in Africa.MethodsWe conducted a systematic scoping review following the Joanna Briggs methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews checklist. Medline, Embase, CINAHL (EBSCOHost), Scopus, Web of Science and rabies web conferences were used to search for peer-reviewed publications between January 1946 and May 2020. Two researchers reviewed the studies and extracted data based on author (year) and region, study design and data collection duration, participants/comparators, interventions, control conditions/exposures and outcomes (rabies mortality and morbidity) and key findings/gaps/challenges. The results were reported narratively using Arksey and O’Malley’s methodological framework.ResultsElectronic search yielded 2775 records, of which 43 studies were included. A total of 543 714 bite victims were censored through the included studies. Most of the victims were less than 15 years of age. The studies included rabies morbidity (21) and mortality (15) fluctuating in space and time across Africa depending on countries’ rabies prevention and control practices (16). Others were surveillance (nine studies); surveillance and prevention (five studies); management and control (seven studies); and surveillance, prevention and control (six studies). We found challenges in rabies reporting, existing dog vaccination programmes and post-exposure prophylaxis availability or compliance.ConclusionThis study found challenges for dog rabies control and elimination in Africa and the need for a policy to drive the goal of zero dog-transmitted rabies to humans by 2030.This is an open-access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build on this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated and the use is non-commercial (seehttp://creativecommons.org/licenses/by-nc/4.0/).
Scoping review protocol to understand the conceptualisation, implementation and practices of health promotion within the context of primary healthcare in Africa
Authors: Nkangu Miriam , Obegu Pamela , Asahngwa Constantine , Shiroya Veronica , Gobina Ronald , Agbaw-Ebai Fleur Pembe , Keboa Mark , Foretia Denis 
Published: December 2021

IntroductionThe ongoing COVID-19 pandemic has highlighted the importance of health promotion in empowering and sustaining communities, as well as the need to build resilient health systems and work collectively with other sectors to protect and promote health. The WHO has mainstreamed health promotion in the Global health agenda. However, the definition and practices of health promotion in Africa are not well understood and documented, with often, an interchangeable use of the concept of health promotion and health prevention. This scoping review is to explore how health promotion is defined and practised in Africa and identify gaps in its implementation within the framework of the Ottawa Charter.Methods and analysisThe scoping review will employ the approach described by Arksey and O’Malley in 2005. The approach consists of five stages: (1) formulating the research questions, (2) identifying relevant studies, (3) selecting eligible studies, (4) charting the data and (5) collating, summarising and reporting the results. This protocol employed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P). The review will apply the PRISMA extension for scoping reviews to present the results. The scoping review will adapt the five principles set forth in the Ottawa Charter to categorise the outcomes and uses its strategies to define the interventions. Data bases searched are Ovid Medline, Embase, Cochrane Library, CINAHL, SCOPUS, CABI, JBI Evidence Synthesis and grey literature. The database last searched was January 2021.Ethics and disseminationThis review does not require ethics approval. Our dissemination strategy includes peer review publication, policy brief, presentation at conferences and relevant stakeholders.
Alternatives to continuous positive airway pressure treatment in sleep apnoeas and hypopnoeas syndrome related to myofunctional and postural reeducation therapy: protocol for a systematic review
Authors: Guijarro-Herráiz Marta Maria , Arias-Palencia Natalia María , Lucas- de la Cruz Lidia , Guijarro-Herráiz Beatriz , Notario-Pacheco Blanca , Palomo-Carrión Rocio , García-Klepzig Jose Luis , Solera-Martínez Montserrat 
Published: December 2021

IntroductionThe main treatment for sleep apnoeas and hypopnoeas syndrome (SAHS) is continuous positive airway pressure (CPAP). However, patients sometimes do not adhere to the treatment protocol. Supplementary and complementary therapies have appeared as alternatives. Some of the therapies which are especially important are those related to myofunctional (MFT) and postural therapy (PT), as all of them are non-invasive, and their application is simpler than that of CPAP. We aim to present a protocol for a systematic review and meta-analysis for investigating new SAHS treatments, including the protocols and frequency of use and the effects they have on patient signs, symptoms and quality of life.Methods and analysisThe literature search will be conducted using the Cochrane, Web of Science, Medline (via PubMed) and Scopus databases, from January 2020 to December 2020. All types of studies written in English and Spanish that investigate the use of alternative SAHS treatments related to MFT, or more importantly, the combination of MFT and PRT, will be selected. To evaluate their quality, the Critical Appraisal Checklist for Analytical Cross-Sectional will be applied. The primary factor valued in the studies will be the inclusion of MFT and PT reeducation in the treatment. Subgroup analyses will be carried out evaluating the specific type of treatments chosen and the improvements or deteriorations in the level of health and quality of life in the patients. Finally, several patient-related outcomes, namely sleep quality, quality of life and sleep Apnoeas and Hypoapnoeas Index, will be examined.Ethics and disseminationIn this case, ethical approval is not necessary. The data used in the review will be exclusively obtained from published studies, implying there are no privacy concerns. The information obtained will be relevant to understand if the new treatments applied in SAHS are effective, and if postural and MFT therapy used together can be considered an appropriate approach to treat this disease.The results will be published in a peer-reviewed journal.
Mid-upper arm circumference for identifying adult overweight in large-scale population-based surveys: empirical evaluation using data of the EAT Addis study, Ethiopia
Authors: Shifraw Tigest , Selling Katarina , Worku Alemayehu , Berhane Hanna Yemane , Ekström Eva-Charlotte , Berhane Yemane 
Published: December 2021

ObjectivesThe present study evaluates body circumferences as a nutrition screening tool for women of reproductive age with children less than 5 years of age to improve the detection of overweight and obesity in a community setting.DesignThis study draws data from a community-based cross-sectional study conducted between July–August 2017 and January–February 2018 to account for seasonality in Addis Ababa, Ethiopia.SettingOne hundred and sixteen districts were included in Addis Ababa, Ethiopia.ParticipantsA total of 4914 women of reproductive age with children less than 5 years of age were participated in this study.Primary and secondary outcome measuresPrimary outcome measures included anthropometric indices. There were no secondary outcomes.ResultsThe optimal cut-off points to identify overweight women of reproductive age were >87.5 cm for waist circumference (WC), >31.7 cm for neck circumference (NC) and >28.0 cm for mid-upper arm circumference (MUAC) based on the highest corresponding Youden index. The area under the receiver operating characteristics curve was 0.92 (95% CI: 0.91 to 0.93) for WC, 0.83 (95% CI: 0.82 to 0.84) for NC and 0.91 (95% CI: 0.89 to 0.92) for MUAC.ConclusionsOur result shows that WC and MUAC are alternative tools to body mass index. Both WC and MUAC are effective in identifying overweight women. We recommend using MUAC in large-scale population-based assessments to identify overweight and obesity in low-income settings as it is logistically simpler and operationally feasible.
Expert elicitation on the relative importance of possible SARS-CoV-2 transmission routes and the effectiveness of mitigations
Authors: Freeman Alexandra LJ , Parker Simon , Noakes Catherine , Fitzgerald Shaun , Smyth Alexandra , Macbeth Ron , Spiegelhalter David , Rutter Harry 
Published: December 2021

ObjectivesTo help people make decisions about the most effective mitigation measures against SARS-CoV-2 transmission in different scenarios, the likelihoods of transmission by different routes need to be quantified to some degree (however uncertain). These likelihoods need to be communicated in an appropriate way to illustrate the relative importance of different routes in different scenarios, the likely effectiveness of different mitigation measures along those routes, and the level of uncertainty in those estimates. In this study, a pragmatic expert elicitation was undertaken to supply the underlying quantitative values to produce such a communication tool.ParticipantsTwenty-seven individual experts from five countries and many scientific disciplines provided estimates.Outcome measuresEstimates of transmission parameters, assessments of the quality of the evidence, references to relevant literature, rationales for their estimates and sources of uncertainty.Results and conclusionThe participants’ responses showed that there is still considerable disagreement among experts about the relative importance of different transmission pathways and the effectiveness of different mitigation measures due to a lack of empirical evidence. Despite these disagreements, when pooled, the majority views on each parameter formed an internally consistent set of estimates (for example, that transmission was more likely indoors than outdoors, and at closer range), which formed the basis of a visualisation to help individuals and organisations understand the factors that influence transmission and the potential benefits of different mitigation measures.
Continuity of care, measurement and association with hospital admission and mortality: a registry-based longitudinal cohort study
Authors: Hetlevik Øystein , Holmås Tor Helge , Monstad Karin 
Published: December 2021

ObjectiveTo assess whether continuity of care (COC) with a general practitioner (GP) is associated with mortality and hospital admissions for older patients We argue that the conventional continuity measure may overestimate these associations. To better reflect COC as a GP quality indicator, we present an alternative, service-based measure.DesignRegistry-based, population-level longitudinal cohort study.SettingLinked data from Norwegian administrative healthcare registries, including 3989 GPs.Participants757 873 patients aged 60–90 years with ≥2 contacts with a GP during 2016 and 2017.Main outcome measureAll-cause emergency hospital admissions, emergency admissions for ambulatory care sensitive conditions, and mortality, in 2018.ResultsWe assessed COC using the conventional usual provider of care index (UPCpatient) and an alternative/supplementary index (UPCGP list) based on the COC for all other patients enlisted with the same preferred GP.For both indices, the mean index score was 0.78. Our model controls for demographic and socioeconomic characteristics, prior healthcare use and municipality-fixed effects. Overall, UPCGP listshows a much weaker association between COC and the outcomes. For both indices, there is a negative relationship between COC and hospital admissions. A 0.2-point increase in the index score would reduce admissions for ambulatory care sensitive conditions by 8.1% (CI 7.1% to 9.1%) versus merely 1.9% (0.2% to 3.5%) according to UPCpatientand UPCGP list, respectively. Using UPCGP list, we find that mortality is no longer associated with COC. There was greater evidence for an association between COC and all-cause admissions among patients with low education.ConclusionsA continuity measure based on each patient’s contacts with own preferred GP may overestimate the importance of COC as a feature of the GP practice. An alternative, service-based measure of continuity could be suitable as a quality measure in primary healthcare. Facilitating continuity should be considered a health policy measure to reduce inequalities in health.