bluuebunny/crossref_metadata_2025_split huggingface dataset:
Housing First Combined with Suicide Treatment Education and Prevention (HOME + STEP): study protocol for a randomized controlled trial
Authors: Chavez Laura , Kelleher Kelly , Bunger Alicia , Brackenoff Brittany , Famelia Ruri , Ford Jodi , Feng Xin , Mallory Allen , Martin Jared , Sheftall Arielle , Walsh Laura , Yilmazer Tansel , Slesnick Natasha 
Published: June 2021

AbstractBackgroundYouth experiencing homelessness are at high risk for suicide, yet few studies have evaluated risk reduction interventions targeting suicidal ideation in this vulnerable population. A comprehensive approach to risk-reduction is needed that addresses basic needs and provides targeted interventions for those at highest risk. The protocol described builds on the design of the first randomized trial of Housing First (HF) for homeless youth. The primary objective is to determine whether housing combined with supportive services that include suicide screening and targeted psychotherapy (Cognitive Therapy for Suicide Prevention) is effective for reducing suicidal ideation and other secondary outcomes (depression and suicide attempts). Additionally, we will explore mediators of the treatment effect (housing stability and substance use) and determinants of implementation.MethodsYouth recruited to the HF trial will be randomized to HF + supportive services (n = 120), or supportive services alone (n = 120). The “Suicide Treatment Education and Prevention” (STEP) protocol will additionally screen youth in both arms at baseline and 3 months for suicidal ideation (SSI-W). Those who screen as moderate risk for suicide (SSI-W ≥ 10) will be offered CTSP, which includes up to 9 sessions over the first 6 months following enrollment. CTSP will be delivered in one-on-one sessions by a trained advocate. Research assessments will be collected to assess outcomes (including suicidal ideation) at baseline, 3, 6, 9 and 12 months. Qualitative interviews with subjects receiving CTSP and other stakeholders will explore implementation determinants.DiscussionThe study will fill an important gap in the literature about the added benefit of HF combined with supportive services including suicide screening and treatment for reducing suicidal ideation in homeless youth. With the urgent need to address both homelessness and suicide risk, evidence is needed about services that can be integrated into delivery settings for youth experiencing homelessness.Trial registrationNCT04135703. Date of registration: October 23, 2019.
Problems, policy and politics – perspectives of public health leaders on food insecurity and human rights in Australia
Authors: Godrich Stephanie L. , Barbour Liza , Lindberg Rebecca 
Published: June 2021

Abstract
Background
To achieve zero hunger targets set within the United Nations’ Agenda 2030, high-income countries such as Australia must reconsider current efforts to improve food security. This study aimed to; explore perspectives from public health nutrition experts on the usefulness of drawing on the international human right to food, and associated mechanisms, to address food insecurity; identify potential roles of key stakeholders in Australia to implement a rights-based approach; and examine barriers and enablers to achieving the right to food in Australia.

Methods
Qualitative in-depth interviews were conducted with key informants (> 10 years professional experience). Braun and Clarke’s (2006) six-phase approach to thematic analysis was employed to analyse data, using Kingdon’s multiple streams framework (1984) to examine interactive variables which affect policy-making processes.

Results
Thirty interviews took place, with most participants representing academia (n = 16), majority had 10–14 years of experience (n = 12) and almost one quarter (n = 7) were in senior leadership roles. Participants believed that framing food insecurity as a human rights issue could be effective when communicating with some audiences, however alternative rhetoric is more popular and potentially more effective. Citizens, government, food industry, non-profit sector, research/tertiary and legal institutions were described as playing critical roles. Barriers to progress were identified as lack of awareness and acknowledgement of the problem, prioritisation of the private sector, lack of political will and domestic laws, and an inefficient/ineffective charitable food sector. Participants identified various enablers and opportunities for implementing a rights-based approach such as grass-roots advocacy efforts to raise awareness of the issue, integrating human rights into government frameworks and community projects and the political will to support action aligned with sustainable development.

Conclusions
Human rights language and mechanisms have the potential to trigger genuine commitment to addressing food insecurity however should be used with caution. Australia’s public health workforce requires increased capacity to implement a human-rights approach and framing such efforts to align with sustainable development may achieve greater political action.

Trial registration
Ethics approval was received from the Deakin University Human Research Ethics committee (project ID HEAG 168_2018).
Influence of the request and purchase of television advertised foods on dietary intake and obesity among children in China
Authors: Xian Jinli , Zeng Mao , Cai Zhengjie , Xie Changxiao , Xie Yuqian , Sharma Manoj , Zhao Yong , Shi Zumin 
Published: June 2021

Abstract
Background
This study aims to examine the effects of the request and purchase of Television (TV) advertised foods on children’s dietary intake, overweight and obesity in China.

Methods
Data from 1417 children (aged 6–17 years) in the 2011 China Health and Nutrition Survey were analysed. The request and purchase of TV advertised foods were assessed through the frequency of children’s requests to purchase TV advertised foods and the frequency of parents’ purchases of these advertised foods, as well as the frequency of children’s purchases of TV advertised foods. The height and weight of children were measured. Logistic regression models were used to identify the associations between the request and purchase of TV advertised foods and overweight/obesity of children.

Results
The request and purchase of TV advertised foods were positively associated with children’s dietary intake of energy, protein, fat and carbohydrates. After adjusting for potential confounding factors, children’s request and purchase of TV advertised foods and parent’s purchase of TV advertised foods were positively associated with children’s overweight/obesity: odds ratio (OR) and 95% confidence interval (CI) for overweight/obesity were: 1.46 (1.01–2.11) for children purchasing advertised foods ≥1 time/week, 1.59 (1.15–2.18) for parents purchasing advertised foods for their children ≥1 time/week and 1.39 (1.00–1.95) for children requesting advertised foods ≥1 time/week.

Conclusions
The request and purchase of TV advertised foods are associated with children’s dietary intake. Moreover, the request and purchase of TV advertised foods can increase the risk of overweight and obesity of children. Health education involving children’s request and purchase of TV advertised foods and parents’ purchase of TV advertised foods should be considered in China.
Coping with migration-related stressors - a qualitative study of Nepali male labour migrants
Authors: Mak Joelle , Zimmerman Cathy , Roberts Bayard 
Published: June 2021

Abstract
Background
International labour migration has become a crucial livelihood strategy, especially in countries where decently paid employment opportunities are limited. Such opportunities come with many potential benefits but also many stressors that challenge migrants’ coping skills, especially when they are in a foreign environment away from their normal support network. This paper explores how labour migrants coped with migration-related stressors using a sample of male Nepali migrants.

Methods
Qualitative life histories were conducted in Kathmandu among returnee male migrants. Coping responses were categorised based Skinner and Zimmer-Gembeck’s coping typologies. The interview scripts were transcribed in Nepali and translated into English for analysis. Each interview script was open coded and then categorised according to the 12 core coping families. Data were analysed thematically to explore relationships across and within coping and stressors.

Results
Forty-two men were interviewed who mainly worked in low- and semi-skilled jobs in Malaysia, and the Gulf States. The coping strategies most commonly used belonged to the families of problem-solving, support-seeking, negotiation and helplessness. Men used these either individually or collectively with other migrants. Those who sought assistance from authorities or civil society organisations did not always receive the help needed and there were mixed messages as to when and what types of assistance were available. Some stressors involved multiple coping strategies simultaneously, others described changing strategies following unsuccessful earlier attempts. The coping families of helplessness and social isolation reflected migrants’ limited power in challenging certain stressors. The choice of coping strategies was also moderated by factors such as outstanding loans, language difficulties, or not wanting to cause their family distress. Some coping strategies used led to new stressors.

Conclusions
Migrants need greater clarifications on their rights with respect to contract discrepancies, the types of support available, how and from whom to access them once in destination. Improvements to the support mechanisms migrants can access as well as strengthening migrant-led initiatives in destination countries to support labour migrants' in managing stressors are needed. These may contribute to reducing the experiences and impact of such stressors, which may ultimately lead to more successful migration outcomes. As labour migration from Nepal is likely to continue, government and CSOs need to ensure migrants have the support they need to cope with the challenges they may encountered along the way.
Awareness, knowledge and trust in the Greek authorities towards COVID-19 pandemic: results from the Epirus Health Study cohort
Authors: Kanellopoulou Afroditi , Koskeridis Fotios , Markozannes Georgios , Bouras Emmanouil , Soutziou Chrysa , Chaliasos Konstantinos , Doumas Michail T. , Sigounas Dimitrios E. , Tzovaras Vasilios T. , Panos Agapios , Stergiou Yiolanda , Mellou Kassiani , Papamichail Dimitrios , Aretouli Eleni , Chatzidimitriou Dimitrios , Chatzopoulou Fani , Bairaktari Eleni , Tzoulaki Ioanna , Evangelou Evangelos , Rizos Evangelos C. , Ntzani Evangelia , Vakalis Konstantinos , Tsilidis Konstantinos K. 
Published: June 2021

AbstractBackgroundTo assess the level of knowledge and trust in the policy decisions taken regarding the coronavirus disease (COVID-19) pandemic among Epirus Health Study (EHS) participants.MethodsThe EHS is an ongoing and deeply-phenotyped prospective cohort study that has recruited 667 participants in northwest Greece until August 31st, 2020. Level of knowledge on coronavirus (SARS-CoV-2) transmission and COVID-19 severity was labeled as poor, moderate or good. Variables assessing knowledge and beliefs towards the pandemic were summarized overall and by sex, age group (25–39, 40–49, 50–59, ≥60 years) and period of report (before the lifting of lockdown measures in Greece: March 30th to May 3rd, and two post-lockdown time periods: May 4th to June 31st, July 1st to August 31st). A hypothesis generating exposure-wide association analysis was conducted to evaluate the associations between 153 agnostically-selected explanatory variables and participants’ knowledge. Correction for multiple comparisons was applied using a false discovery rate (FDR) threshold of 5%.ResultsA total of 563 participants (49 years mean age; 60% women) had available information on the standard EHS questionnaire, the clinical and biochemical measurements, and the COVID-19-related questionnaire. Percentages of poor, moderate and good knowledge status regarding COVID-19 were 4.5, 10.0 and 85.6%, respectively. The majority of participants showed absolute or moderate trust in the Greek health authorities for the management of the epidemic (90.1%), as well as in the Greek Government (84.7%) and the official national sources of information (87.4%). Trust in the authorities was weaker in younger participants and those who joined the study after the lifting of lockdown measures (p-value≤0.001). None of the factors examined was associated with participants’ level of knowledge after correction for multiple testing.ConclusionsHigh level of knowledge about the COVID-19 pandemic and trust in the Greek authorities was observed, possibly due to the plethora of good quality publicly available information and the timely management of the pandemic at its early stages in Greece. Information campaigns for the COVID-19 pandemic should be encouraged even after the lifting of lockdown measures to increase public awareness.
Prevalence and risk factors for bone loss in rheumatoid arthritis patients from South China: modeled by three methods
Authors: Hu Zhuoran , Zhang Lei , Lin Zhiming , Zhao Changlin , Xu Shuiming , Lin He , Zhang Jiejing , Li Wenjie , Chu Yongliang 
Published: June 2021

Abstract
Background
To explore the prevalence of bone loss among patients with rheumatoid arthritis (RA) and healthy controls (HC) and further explored the risk factors for osteopenia and osteoporosis of RA patients.

Methods
A cross-sectional survey was undertaken in four hospitals in different districts in South China to reveal the prevalence of bone loss in patients. Case records, laboratory tests, and bone mineral density (BMD) results of patients were collected. Traditional multivariable logistic regression analysis and two machine learning methods, including least absolute shrinkage selection operator (LASSO) and random forest (RF) were for exploring the risk factors for osteopenia or osteoporosis in RA patients.

Results
Four hundred five patients with RA and 198 HC were included. RA patients had lower BMD in almost BMD measurement sites than healthy controls; the decline of lumbar spine BMD was earlier than HC. RA patients were more likely to comorbid with osteopenia and osteoporosis (p for trend < 0.001) in the lumbar spine than HC. Higher serum 25-hydroxyvitamin D3 level and using tumor necrosis factor inhibitor in the last year were protective factors; aging, lower body mass index, and increased serum uric acid might be risk factors for bone loss.

Conclusions
RA patients were more prone and earlier to have bone loss than HC. More attention should be paid to measuring BMD in RA patients aging with lower BMI or hyperuricemia. Besides, serum vitamin D and all three measurement sites are recommended to check routinely. TNFi usage in the last year might benefit bone mass.
Two-stage exchange Arthroplasty for knee Periprosthetic joint infection exhibit high infection recurrence rate in patients with chronic viral hepatitis
Authors: Chen Jui-ping , Chang Chih-hsiang , Lin Yu-chih , Lee Sheng-hsun , Shih Hsin-nung , Chang Yuhan 
Published: June 2021

Abstract
Background
Currently, there is little evidence about the outcome of two-stage exchange arthroplasty for the treatment of knee periprosthetic joint infection (PJI) in patients with chronic viral hepatitis. To evaluate it, we set the primary outcome as infection recurrence, and the secondary outcome as the difference between patients diagnosed with hepatitis B virus or hepatitis C virus.

Patients and methods
Between June, 2010 and December, 2016, 172 patients with knee PJIs were treated with two-stage exchange arthroplasty at our institute. Treatment success was defined using Delphi-based consensus. These patients were further divided into groups with or without chronic hepatitis. Variables were analyzed, including age, sex, comorbidities, microbiology, and operative methods. Minimum follow-up was 12 months (mean, 35 months; range, 12-85 months).

Results
Of the 172 knee PJI patients, 25 were identified with chronic hepatitis. The infection recurrence rate in the hepatitis group (28%, 7 in 25) was significantly higher than that in the non-hepatitis group (9.5%, 14 in 147), p = 0.017. However, there was no significant difference in the infection recurrence rates between patients with HBV (24%, 4 in 16) and HCV (33.3%, 3 in 9). Regarding the outcomes of patients with infection recurrence, 4 of the non-hepatitis patients were treated with the debridement, antibiotic treatment, irrigation, and retention of prosthesis (DAIR) procedure, with a success rate of 75%. The other 17 patients (7 with hepatitis and 10 without) were treated with repeated two-stage exchange arthroplasty with 100% infection elimination rate until the final follow-up.

Conclusions
Knee PJI patients with chronic hepatitis have higher infection recurrence rate after two-stage exchange arthroplasty (28%).
Multiple drilling is not effective in reducing the rate of conversion to Total hip Arthroplasty in early-stage nontraumatic osteonecrosis of the femoral head: a case-control comparative study with a natural course
Authors: Liu Zunhan , Yang Xuetao , Li Yuhan , Zeng Wei-Nan , Zhao Enze , Zhou Zongke 
Published: June 2021

Abstract
Background
To determine whether multiple drilling is effective in postponing the need for total hip arthroplasty (THA) in early-stage nontraumatic osteonecrosis of the femoral head (ONFH).

Methods
We identified 514 patients who were diagnosed with early-stage ONFH between January 2008 and December 2018. One hundred ninety-six patients underwent multiple drilling, and 318 patients had a natural course of progression. One hundred fifty-nine patients were selected for each group after case-control matching for preoperative demographics and modified Ficat and Arlet stage. The rates of THA conversion were compared. We also performed Cox regression to identify risk factors associated with THA conversion in patients who underwent multiple drilling.

Results
Kaplan-Meier survivorship with an endpoint of THA for nontraumatic reasons were not significantly different between the multiple drilling group (75.6, 95% confidence interval 67.8–83.4%) and the natural course group (72.2, 95% confidence interval 64.8–79.6%) at 5 years (log-rank, P = .191). In the Cox regression model, a larger extent of necrotic lesion, bone marrow edema (BME), and higher postoperative work intensity significantly increased the risk of THA conversion (P < .05). Among patients treated with autogenous bone grafting, there was a lower risk of failure in patients with necrotic lesion less than 15% (P < .05).

Conclusions
Multiple drilling is not effective in reducing the rate of THA conversion in early-stage nontraumatic ONFH. The risk of conversion to THA after multiple drilling is increased by a larger extent of necrotic lesion, presence of BME, and higher postoperative work intensity in patients with early-stage ONFH.

Trial registration
The trial was registered in the Chinese Clinical Trial Registry (ChiCTR2000035180) dated 2 August 2020.
Exercise training using hybrid assistive limb (HAL) lumbar type for locomotive syndrome: a pilot study
Authors: Miura Kousei , Koda Masao , Tamaki Kazuhiro , Ishida Masatoshi , Marushima Aiki , Funayama Toru , Takahashi Hiroshi , Noguchi Hiroshi , Mataki Kentaro , Yasunaga Yoshihiro , Kawamoto Hiroaki , Sankai Yoshiyuki , Matsumura Akira , Yamazaki Masashi 
Published: June 2021

Abstract
Background
With a rapidly aging population in Japan, locomotive syndrome is becoming an increasingly serious social problem. Exercise therapy using the lumbar type HAL, which is a wearable robot suit that can assist voluntary hip joint motion, would be expected to cause some beneficial effects for people with locomotive syndrome. The purpose of this study was to assess whether the deterioration of low back pain and any other adverse events would occur following HAL exercise therapy. Moreover, the changes of motor ability variables were evaluated.

Methods
We enrolled 33 participants (16 men, 17 women) with locomotive syndrome in this study. They received exercise training (sit-to-stand, lumbar flexion-extension, and gait training) with HAL (in total 12 sessions). We assessed the change of low back pain (lumbar VAS). More than 50% and 25 mm increase compared to baseline was defined as adverse events. One-leg standing time (OLST), 10-m walking test (10MWT), Timed Up and Go test (TUG), 1-min sit-to-stand test (1MSTS), FIM mobility scores and EQ-5D were measured.

Results
Of the 33 participants, 32 (16 men, 16 women) (97.0%) completed all 12 exercise training sessions using the lumbar type HAL. One woman aged 82 years withdrew because of right upper limb pain after the second session regardless of the use of HAL. There was no participant who had deterioration of low back pain. Any other adverse events including external injuries and/or falling, skin disorders, uncontrollable cardiovascular or respiratory disorders, and other health disorders directly related to this exercise therapy did not occur. Several outcome measures of motion ability including OLST, TUG and 1MSTS, EQ VAS and lumbar pain improved significantly after this HAL training.

Conclusions
Almost all patients with locomotive syndrome completed this exercise training protocol without any adverse events related to HAL. Furthermore, balance function variables including OLST, TUG and 1MSTS improved after this HAL exercise therapy even though mobility function variables including 10MWT and FIM mobility scores did not show any significant change. These findings suggest that the exercise therapy using the lumbar type HAL would be one of the options for the intervention in locomotive syndrome.
The predictive value of high school grade point average to academic achievement and career satisfaction of dental graduates
Authors: Al-Asmar Ayah A. , Oweis Yara , Ismail Noor H. , Sabrah Alaa H. A. , Abd-Raheam Islam M. 
Published: June 2021

AbstractBackgroundIn a country where admission to dental schools is based solely on the cognitive abilities of students, the aim of the study was to investigate the correlation between high school grade point average and graduating academic achievement for dental students; moreover, determine whether a correlation exists between dental students’ graduating academic achievement and their career choices and job satisfaction.MethodsA five-year retrospective cohort study was conducted at the University of Jordan, involving (828) dental graduates first enrolled between 2010 and 2014. Correlations comparing high school grade point average and graduating academic achievement were done for the total sample composed of (736) students. A short survey was constructed to assess the career choices and job satisfaction for recently graduated dentists and correlate them with their graduating academic achievement.ResultsStatistically significant but weak positive correlation (0.3) was found between high school grade point average and graduating academic achievement for dental students (p ≤ 0.05). Statistically significant correlations were found between graduating academic achievement and career choices and job satisfaction.ConclusionThe significant positive correlation between the high school grade point average and graduating academic achievement of our dental students indicate that our school admission system depending on high school grade point average is a valid system. There was a significant negative correlation between the graduating academic achievement and both the career choices and job satisfaction among fresh graduate dentists in Jordan. This information is required to update the dental school admissions procedures in response to the changing dental educational landscape.