bluuebunny/crossref_metadata_2025_split huggingface dataset:
Double burden of malnutrition among school-aged children and adolescents: evidence from a community-based cross-sectional survey in two Nigerian States
Authors: Adeomi Adeleye , Fatusi Adesegun , Klipstein-Grobusch Kerstin 
Published: July 2021

Background: Double burden of malnutrition (DBM) is the co-existence of overweight/obesity and undernutrition. Rising prevalence rates of childhood overweight/obesity in Nigeria have been reported, whilst undernutrition continues to be prevalent. This study aimed to estimate the prevalence and distribution of underweight, stunting, thinness, overweight/obesity, and DBM among school-aged children and adolescents in two Nigerian States. Methods: This was a community-based cross-sectional study carried out in Osun and Gombe States. A total of 1,200 children aged 6 – 19 years were recruited using multi-stage sampling technique. Weight, height and data on demographic, socio-economic, household/family characteristics of the children were collected using structured interviewer administered questionnaires. Nutritional status was calculated using the WHO 2007 reference values using BMI-for-age (thinness, overweight/obesity), height-for-age (stunting) and weight-for-age (underweight). DBM was described at the population and individual levels. Results: The mean age of the respondents was 11.6 ± 3.8 years. The overall prevalence rate of stunting was 34.9%, underweight was 13.5%, thinness was 10.3% and overweight/obese was 11.4% and 4.0% had individual level DBM, which typifies the DBM at individual and population levels. These rates differed significantly across demographic, socio-economic and household/family characteristics (p < 0.05). Gombe State, which is in the Northern part of Nigeria, had significantly higher burden of stunted, underweight and thin children than Osun State, while Osun State, in the Southern part of Nigeria, had a significantly higher burden of overweight/obesity. Conclusions: The study found evidence of DBM both at population and individual levels. The overall prevalence rates of stunting, underweight, thinness and overweight/obesity in this study were high, and they differed significantly across the demographic, socio-economic and household/family characteristics. There is the need for government and all other stakeholders to design nutritional educational programmes that will target both under- and over-nutrition among older children in the different contexts.
Screening for postoperative complications by continuous monitoring: protocol for the Biobeat-Postop cohort study
Authors: Paternot Alexis , Aegerter Philippe , Martin Aurélie , Ouattara Jonathan , Ma Sabrina , Adjavon Sherifa , Trillat Bernard , Alfonsi Pascal , Fischler Marc , Le Guen Morgan 
Published: July 2021

Background: Postoperative hypotension associated with postoperative morbidity and early mortality has been studied previously. Hypertension and other hemodynamic, respiratory, and temperature abnormalities have comparatively understudied during the first postoperative days. Methods: This bi-centre observational cohort study will include 114 adult patients undergoing non-cardiac surgery hospitalized on an unmonitored general care floor and wearing a multi-signal wearable sensor, allowing remote monitoring (Biobeat Technologies Ltd, Petah Tikva, Israel). The study will cover the first 72 hours after discharge of the patient from the post-anaesthesia care unit. Several thresholds will be used for each variable (arterial pressure, heart rate, respiratory rate, oxygen saturation, and skin temperature). Data obtained using the sensor will be compared to data obtained during the routine nurse follow-up. The primary outcome is hemodynamic abnormality. The secondary outcomes are postoperative respiratory and temperature abnormalities, artefacts and blank/null outputs from the wearable device, postoperative complications, and finally, the ease of use of the device. We hypothesize that remote monitoring will detect abnormalities in vital signs more often or more quickly than the detection by nurses’ routine surveillance. Discussion: A demonstration of the ability of wireless sensors to outperform standard monitoring techniques paves the way for the creation of a loop which includes this monitoring mode, the automated creation of alerts, and the sending of these alerts to caregivers. Trial registration: ClinicalTrials.gov, NCT04585178. Registered on October 14, 2020
The future of public health policymaking after COVID-19: a qualitative systematic review of lessons from Health in All Policies
Authors: Cairney Paul , St Denny Emily , Mitchell Heather 
Published: July 2021

Background: ‘Health in All Policies’ (HiAP) describes the pursuit of health equity. It has five main elements: treat health as a human right; identify evidence of the ‘social determinants’ of health inequalities, recognise that most powers to affect health are not held by health departments, promote intersectoral policymaking and collaboration inside and outside of government, and generate political will. Studies describe its potential but bemoan a major implementation gap. Some HiAP scholars learn from policymaking research how to understand this gap, but the use of policy theories is patchy. In that context, our guiding research question is:How does HiAP research use policy theory to understand policymaking?It allows us to zoom-out to survey the field and zoom-in to identify: the assumed and actual causes of policy change, and transferable lessons to HiAP scholars and advocates.Methods: Our qualitative systematic review (two phases, 2018 and 2020) identified 4972 HiAP articles. Of these, 113 journal articles (research and commentary) provide a non-trivial reference to policymaking (at least one reference to a policymaking concept). We use the 113 articles to produce a general HiAP narrative and explore how the relatively theory-informed articles enhance it.Results: Most articles focus on policy analysis (identifying policy problems and solutions) rather than policy theory (explaining policymaking dynamics). They report a disappointing gap between HiAP expectations and policy outcomes. Theory-informed articles contribute to a HiAP playbook to close that gap or a programme theory to design and evaluate HiAP in new ways. Conclusions: Few HiAP articles use policy theories for their intended purpose. Policy theories provide lessons to aid critical reflection on power, political dilemmas, and policymaking context. HiAP scholars seek more instrumental lessons, potentially at the cost of effective advocacy and research.
Review of a paediatric inflammatory bowel disease service during the pandemic and the impact of the CNS role
Authors: Lee Gemma , Kammermeier Jochen , Vora Rakesh , Mutalib Mohamed 
Published: July 2021

Background: Inflammatory bowel disease (IBD) is a chronic relapsing and remitting condition. The COVID-19 pandemic has severely disrupted provision of medical care across the world. IBD clinical nurse specialists (CNSs) played a pivotal role in the care of children with IBD during the pandemic national lockdown and in the recovery phase. This article aims to look at the impact of COVID-19 on the paediatric IBD service in one children's hospital and the effect on the IBD CNSs' workload. Method: A retrospective review of clinical notes and the service's IBD database from January 2019 to September 2020. Results: There was a significant increase in the number of email and telephone contacts to the IBD CNS team during lockdown. There was an increase in virtual clinics, and an increase in new IBD patients coming to the service, but a reduction in the number of face-to-face consultant clinics. Conclusion: COVID-19 has disrupted medical services to children with IBD and led to a reduction in face-to-face activities but has also led to a significant increase in virtual activities. CNSs have taken up a wider role to cover patient care during a time of both medical and nursing redeployment.
La difcultad de volver: exilio y flosofía en María Zambrano
Authors: Llevadot Pascual Laura 
Published: July 2021

Este trabajo ofrece una aproximación a la cuestión del exilio en el pensamiento de María Zambrano, en su triple dimensión de acontecimiento histórico, categoría existencial y concepto flosófico. Con el fn de comprender el concepto de exilio analiza su vínculo con dos fguras mayores del pensamiento creador de Zambrano: Antígona y El niño de Vallecas o el idiota.
Generation of wavelength-tunable optical vortices using an off-axis spiral phase mirror
Authors: Lee Dong-Ho , Kim Hong-Seung , Han Ilkyu , Bae Ji Yong , Yeo Woo-Jong , Jeong Seok Kyung , Jeon Minwoo , Choi Hwan-Jin , Kim Dong Uk , Lee Kye-Sung , Chang Ki Soo , Lee Wonkyun , Kim Geon Hee , Kim I Jong 
Published: July 2021

Wavelength-tunable optical vortices with a topological charge equal to

l
=

1

of orbital angular momentum (OAM) were experimentally realized using a single off-axis spiral phase mirror (OSPM) with lasers of various visible-light wavelengths. Using an OSPM designed for 561 nm and an incidence angle of 45°, circular doughnut-shaped

l
=

1

optical vortices were obtained at 561, 473, and 660 nm by rotating the OSPM to modify the laser incidence angle. Wavelength-tunable

l
=

1

optical vortices were obtained at the respective incidence angles of 45°, 53.4°, and 33.7°, because the effective geometrical thickness of the OSPM, which determines the order of OAM, was identical at each wavelength. This flexible OSPM which operates over a wide wavelength range will provide continuously wavelength-tunable optical vortices for applications in the fields of advanced optics and photonics in which optical vortices with wide wavelength tunability are in demand.
“Chagas Express XXI”: A new ArtScience social technology for health and science education—A case study in Brazilian endemic areas of Chagas disease with an active search of chronic cases
Authors: Araujo-Jorge Tania C. , Ferreira Roberto R. , Rocha Rita C. M. , Vieira Thallyta M. , Costa Nancy D. , Santos Luzia L. , Silva Josefa O. , Mendes Marcelo O. , Almeida-Silva Juliana , Costa Erik J. , Mexas Rodrigo , Oliveira Jonathan G. , Suarez-Fontes Ana M. , Gonçalves Teresa C. M. , Lopes Catarina M. , Mello Marcio L. , Borges Cristina X. A. , Garzoni Luciana R. , Gibaldi Daniel , Lannes-Vieira Joseli , Vannier-Santos Marcos A. 
Published: July 2021

BackgroundChagas Disease (CD) affects 6–7 million people worldwide and is related to poverty-promoting conditions. Chronic asymptomatic cases are mostly invisible to health systems. Aiming (1) to translate CD discoveries into education/information practices to raise alertness and empowerment of affected people; and (2) to perform an active search of CD cases, articulating intersectoral actions to improve the access of infected people to the local health service for the treatment of CD; our research group developed and tested under field conditions as innovative social technology: an itinerant education interdisciplinary setting named “Chagas Express XXI” (CE21).MethodologyCE21 was created as an “imaginary train” with ~40 ArtScience workshops, games, laboratory activities and conversation circles. An entry/exit plus six activity modules combined associations of affected people, microscopic observations, One Health education, and wellness activities. CE21 was conceived as a social technology, since all the processes were co-created with CD patients and inter-sector local partners. Descriptive statistics showed quantitative data collected throughout the expeditions (CD knowledge, serological results). Qualitative data accessed the public perceptions about the education activities.Principal findingsCE21 was exhibited in local educational institutions (schools, universities) in four cities, engaging 2,117 people that evaluated the 41 activities carried out. Citizens and health professionals enjoyed acquisition of information related to blood, parasites, vectors, reservoirs, environmental changes, and social determinants of CD. Further, local legacies of 600 participants volunteer for health promotion groups and CD associations, local empowerment groups to fight for better health conditions, and 05 mural paintings. We observed that 81% of the participants ignored the possibility of treating CD while 52% of the participants requested a blood test for CD showing seropositivity in 20% of them.ConclusionsCE21 is a social technology potentially useful for health and science education and active search of asymptomatic CD chronic cases. Moreover, this technology may be adapted to understand and to cooperate in other potentially epidemic situations, especially NTDs related.
The introduction of a mandatory mask policy was associated with significantly reduced COVID-19 cases in a major metropolitan city
Authors: Scott Nick , Saul Allan , Spelman Tim , Stoove Mark , Pedrana Alisa , Saeri Alexander , Grundy Emily , Smith Liam , Toole Michael , McIntyre Chandini Raina , Crabb Brendan S. , Hellard Margaret 
Published: July 2021

BackgroundWhilst evidence of use of face masks in reducing COVID-19 cases is increasing, the impact of mandatory use across a large population has been difficult to assess. Introduction of mandatory mask use on July 22, 2020 during a resurgence of COVID-19 in Melbourne, Australia created a situation that facilitated an assessment of the impact of the policy on the epidemic growth rate as its introduction occurred in the absence of other changes to restrictions.Methods and findingsExponential epidemic growth or decay rates in daily COVID-19 diagnoses were estimated using a non-weighted linear regression of the natural logarithm of the daily cases against time, using a linear spline model with one knot (lspline package in R v 3.6.3). The model’s two linear segments pivot around the hinge day, on which the mask policy began to take effect, 8 days following the introduction of the policy. We used two forms of data to assess change in mask usage: images of people wearing masks in public places obtained from a major media outlet and population-based survey data. Potential confounding factors (including daily COVID-19 tests, number of COVID-19 cases among population subsets affected differentially by the mask policy–e.g., healthcare workers) were examined for their impact on the results. Daily cases fitted an exponential growth in the first log-linear segment (k = +0.042, s.e. = 0.007), and fitted an exponential decay in the second (k = -0.023, s.e. = 0.017) log-linear segment. Over a range of reported serial intervals for SARS-CoV-2 infection, these growth rates correspond to a 22–33% reduction in an effective reproduction ratio before and after mandatory mask use. Analysis of images of people in public spaces showed mask usage rose from approximately 43% to 97%. Analysis of survey data found that on the third day before policy introduction, 44% of participants reported “often” or “always” wearing a mask; on the fourth day after, 100% reported “always” doing so. No potentially confounding factors were associated with the observed change in growth rates.ConclusionsThe mandatory mask use policy substantially increased public use of masks and was associated with a significant decline in new COVID-19 cases after introduction of the policy. This study strongly supports the use of masks for controlling epidemics in the broader community.
Historical trends in health care-related financial holdings among members of Congress
Authors: McCoy Matthew S. , Bonci Matthew , Joffe Steven , Kanter Genevieve P. 
Published: July 2021

Background
Revelations that some members of Congress, including members of key health care committees, hold substantial personal investments in the health care industry have raised concerns about lawmakers’ financial conflicts of interest (COI) and their potential impact on health care legislation and oversight.

Aims
1) To assess historical trends in both the number of legislators holding health care-related assets and the value and composition of those assets. 2) To compare the financial holdings of members of health care-focused committees and subcommittees to those of other members of the House and Senate.

Methods
We analyzed 11 years of personal financial disclosures by all members of the House and Senate. For each year, we calculated the percentage of members holding a health care-related asset (overall, by party, and by committee); the total value of all assets and health care-related assets held; the mean and median values of assets held per member; and the share of asset values attributable to 9 health asset categories.

Findings
During the study period, over a third of all members of Congress held health care-related assets. These assets were often substantial, with a median total value per member of over $43,000. Members of health care-focused committees and subcommittees in the House and Senate did not hold health care-related assets at a higher rate than other members of their respective chambers.

Conclusions
These findings suggest that lawmakers’ health care-related COI warrant the same level of attention that has been paid to the COI of other actors in the health care system.
Food insecurity during COVID-19 pandemic: A genuine concern for people from disadvantaged community and low-income families in Province 2 of Nepal
Authors: Singh Devendra Raj , Sunuwar Dev Ram , Shah Sunil Kumar , Sah Lalita Kumari , Karki Kshitij , Sah Rajeeb Kumar 
Published: July 2021

Background
Food insecurity is a serious social and public health problem which is exacerbated by the COVID-19 pandemic especially in resource-poor countries such as Nepal. However, there is a paucity of evidence at local levels. This study aims to explore food insecurity among people from the disadvantaged community and low-income families during the COVID-19 pandemic in Province-2 of Nepal.

Methods
The semi-structured qualitative interviews were conducted virtually among purposively selected participants (n = 41) from both urban and rural areas in eight districts of Province 2 in Nepal. All the interviews were conducted in the local language between July and August 2020. The data analysis was performed using thematic network analysis in Nvivo 12 Pro software.

Results
The results of this study are grouped into four global themes: i) Impact of COVID-19 on food security; ii) Food insecurity and coping strategies during the COVID-19 pandemic, iii) Food relief and emergency support during the COVID-19 pandemic, and iv) Impact of COVID-19 and food insecurity on health and wellbeing. Most participants in the study expressed that families from low socioeconomic backgrounds and disadvantaged communities such as those working on daily wages and who rely on remittance had experienced increased food insecurity during the COVID-19 pandemic. Participants used different forms of coping strategies to meet their food requirements during the pandemic. Community members experienced favouritism, nepotism, and partiality from local politicians and authorities during the distribution of food relief. The food insecurity among low-income and disadvantaged families has affected their health and wellbeing making them increasingly vulnerable to the COVID-19 infection.

Conclusion
Food insecurity among low-income and disadvantaged families was found to be a serious problem during the COVID-19 pandemic. The study suggests that the relief support plan and policies should be focused on the implementation of immediate sustainable food security strategies to prevent hunger, malnutrition, and mental health problems among the most vulnerable groups in the community.
Influence of a new botanical combination on quality of life in menopausal Spanish women: Results of a randomized, placebo-controlled pilot study
Authors: López-Ríos Laura , Barber Miguel A. , Wiebe Julia , Machín Rubén P. , Vega-Morales Tanausú , Chirino Ricardo 
Published: July 2021

Background
This study was designed to evaluate the beneficial effects of a botanical extract combination containing soy isoflavone extract (100mg), Aframomum melegueta seed dry extract (50 mg), and Punica granatum skin dry extract (100mg) on health-related Quality of Life in healthy Spanish menopausal women with hot flashes, anxiety, and depressive symptoms using the validated Cervantes Scale.

Methods and results
Fifty-seven outpatient women (45–65 years) with menstrual problems associated with climacteric syndrome were enrolled from April 2018 to April 2019 in the context of a prospective, placebo-controlled, double-blind study. Women were randomized to receive treatment with either the botanical combination (250 mg daily divided into two doses) or placebo for eight weeks. At the beginning and end of the study, health-related Quality of Life was assessed using the Cervantes Scale. Subjects treated with the botanical extract, compared to subjects in the placebo group, showed a significant improvement in the Global health-related Quality of Life score (38% [11.3–50.0]% vs. 18.8% [0–37.7]%; P = 0.04) on the Cervantes Scale and, specifically, in the menopause and health domain (13.6% [0–45.4]% vs. 40.7% [20.6–61.0]%; P = 0.05). By contrast, there were no significant changes in the psychic, sexuality, and couple relationship related domains of the Cervantes Scale. Patients who concluded the study did not report substantial side effects.

Conclusion
Short-term intake of the botanical combination improved the Global Quality of Life of climateric women, according to the Cervantes Scale. Since this is a pilot trial, results should be analysed with caution.

Trial registration
NCT04381026; ClinicalTrial.gov (retrospectively registered).
¿Hacia unas Nuevas Matemáticas?
Authors: Chamoso Sánchez José Mª , Rawson W.B. 
Published: July 2021

En la enseñanza de las Matemáticas se reconoce hoy en día que los estudiantes deben construir su propio conocimiento. Por consiguiente, el contenido matemático de lo que se enseña en el colegio es visto de forma diferente, más cercano a la vida ordinaria. Para ello se recomienda la utilización de materiales y diversos recursos para su mejor enseñanza-aprendizaje. Pero éstos no se tienen que convertir en un fin, sino que son un medio para adquirir el conocimiento. Además, la utilización de un recurso concreto sólo es aconsejable cuando se conoce profundamente, se piensa que es adecuado para lo que se pretende y, además, se sabe como utilizarlo en el contexto que nos encontramos.
Principios justificativos de la reforma educativa: su concreción en Cataluña
Authors: Sarramona Jaume 
Published: July 2021

La Reforma vigente en el sistema educativo español tiene en la Ley Orgánica de Ordenación General del Sistema Educativo (1990) se base legal fundamental. Esta Reforma ha supuesto una reordenación general del sistema, prolongando la escolaridad obligatoria común para todos los alumnos hasta los 16 años. Los principios que rigen la Reforma se pueden agrupar en los capítulos siguientes: autonomía, atención a los nuevos tiempos sociales y económicos, concepción sistémica de la educación y respuesta a la sociedad democrática presente y futura. Para dar respuesta este último punto, la Reforma se preocupa de la participación social en el sistema, de no discriminación, de la atención de los alumnos con dificultades y de la igualdad de oportunidades. La Reforma ha sido también una oportunidad para actualizar los principios psicopedagógicos que rigen el curriculum escolar, el cual se muestra abierto y flexible, para atender la diversidad de territorios y centros del conjunto del Estado. La transferencia del sistema educativo a los gobiernos de las respectivas Comunidades Autónomas hace que se produzcan variaciones entre los diversos territorios del Estado, según las propias necesidades culturales y lingüísticas, así como la importancia que los mismos gobiernos y la sociedad en general quiera otorgar a su educación. Se mantienen unas normas básicas comunes para todos.