bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing alcohol industry penetration and government safeguards: the International Alcohol Control Study
Authors: Leung June Yue Yan , Casswell Sally , Randerson Steve , Athauda Lathika , Banavaram Arvind , Callinan Sarah , Campbell Orfhlaith , Chaiyasong Surasak , Dearak Song , Dumbili Emeka W , Romero-García Laura , Gururaj Gopalkrishna , Kalapat Romtawan , Karki Khem , Karlsson Thomas , Kong Mom , Liu Shiwei , Maldonado Vargas Norman Danilo , Gonzalez-Mejía Juan Felipe , Naimi Timothy , Nthomang Keitseope , Oladunni Opeyemi , Owino Kwame , Herrera Palacio Juan Camilo , Phatchana Phasith , Pradhan Pranil Man Singh , Rossow Ingeborg , Shorter Gillian , Sibounheuang Vanlounny , Štelemėkas Mindaugas , Son Dao The , Vallance Kate , van Dalen Wim , Wettlaufer Ashley , Zamora Arianne , Jankhotkaew Jintana 
Published: November 2024

BackgroundThe alcohol industry uses many of the tobacco industry’s strategies to influence policy-making, yet unlike the Framework Convention on Tobacco Control, there is no intergovernmental guidance on protecting policies from alcohol industry influence. Systematic assessment of alcohol industry penetration and government safeguards is also lacking. Here, we aimed to identify the nature and extent of industry penetration in a cross-section of jurisdictions. Using these data, we suggested ways to protect alcohol policies and policy-makers from undue industry influence.MethodsAs part of the International Alcohol Control Study, researchers from 24 jurisdictions documented whether 22 indicators of alcohol industry penetration and government safeguards were present or absent in their location. Several sources of publicly available information were used, such as government or alcohol industry reports, websites, media releases, news articles and research articles. We summarised the responses quantitatively by indicator and jurisdiction. We also extracted examples provided of industry penetration and government safeguards.ResultsThere were high levels of alcohol industry penetration overall. Notably, all jurisdictions reported the presence of transnational alcohol corporations, and most (63%) reported government officials or politicians having held industry roles. There were multiple examples of government partnerships or agreements with the alcohol industry as corporate social responsibility activities, and government incentives for the industry in the early COVID-19 pandemic. In contrast, government safeguards against alcohol industry influence were limited, with only the Philippines reporting a policy to restrict government interactions with the alcohol industry. It was challenging to obtain publicly available information on multiple indicators of alcohol industry penetration.ConclusionGovernments need to put in place stronger measures to protect policies from alcohol industry influence, including restricting interactions and partnerships with the alcohol industry, limiting political contributions and enhancing transparency. Data collection can be improved by measuring these government safeguards in future studies.
Factors influencing the implementation of food fortification regulation among small and medium-scale corn millers in Dar es Salaam Tanzania: a qualitative study
Authors: Lema Dorice C , Mahiti Gladys Reuben , Sunguya Bruno F 
Published: November 2024

ObjectiveThe study aimed to explore factors influencing the implementation of food fortification regulation among corn millers in Dar es Salaam Tanzania.MethodsThis phenomenological qualitative study was conducted in Dar es Salaam, Tanzania among purposely interviewed corn millers. In-depth interviews conducted with nine corn millers were analysed using thematic analysis with the aid of N-Vivo software version 12.ResultsThe implementation of food fortification regulation among corn millers is influenced by access to knowledge and the right information, lack of consumers’ awareness, zero costs for the fortification of corn flour, and lack of punitive measures for non-compliance to the regulation.Conclusion and recommendationsLaxity in implementing food fortification as an important population-wide approach in addressing micronutrient deficiency is evident in Tanzania. This is triggered by non-punitive measures for non-compliance of the regulation among micro, small and medium-scale corn millers. Strengthening efforts to identify and implement measures against non-compliers, demand creation for fortified products through educational and advocacy interventions, and supportive supervision can help reach more than 90% of the population with fortified corn flour in Tanzania.
Effects of smartphone-based chatbot intervention to increase influenza and COVID-19 vaccine uptake among South Asian ethnic minorities in Hong Kong: protocol for a randomised waitlist-controlled trial
Authors: Wong Cho Lee , So Winnie Kwok Wei , Chan Carmen Wing Han , Choi Kai Chow , Li Huiyuan 
Published: November 2024

IntroductionProtecting non-native ethnic minority groups against cocirculation of influenza and COVID-19 is crucial, and vaccination could be a viable option. Smartphone-based chatbots offer promising opportunities for improving vaccine knowledge and addressing barriers encountered by ethnic minorities. This trial aims to evaluate the effects of smartphone-based chatbot intervention on influenza and COVID-19 vaccine uptake, intention to receive vaccination and vaccine hesitancy among South Asian ethnic minorities in Hong Kong.Method and analysisAn assessor-blinded, cluster-randomised, waitlist-controlled trial will be conducted. This study consists of two phases. In phase I, a smartphone-based chatbot intervention will be developed, including designing a simple chatbot called ‘Ali’ to deliver prewritten educational text messages and vaccination reminders as well as respond to users’ questions, and on-demand option for communication with research assistants. An expert panel will be invited to review the designed chatbot, and pilot testing will be performed. In phase II, a total of 612 South Asians will be recruited from each of the six participating non-governmental community centres or ethnic minority associations. They will be randomly allocated to intervention (n=306) or waitlist control group (n=306). The intervention group will receive in-app notifications related to the education text messages and vaccination reminders via the smartphone-based chatbot twice a week for two weeks. The waitlist control group will receive usual care only. Evaluation will include vaccination uptake, intention to receive vaccination and vaccine hesitancy. Assessments will take place at baseline (T0), immediately postintervention (T1) and 3-month postintervention (T2).Ethics and disseminationThis study has been approved by the Joint Chinese University of Hong Kong-New Territories East Cluster Clinical Research Ethics Committee (CREC Ref. No.: 2021.688). The findings will be disseminated in peer-reviewed journals and through local or interventional conference presentations.Trial registration numberChiCTR2200061503.
Impact of the active job openings-to-applicants ratio on the number of ambulance dispatches in Japan, 2003-2021: a longitudinal ecological study
Authors: Kamikawa Yohei 
Published: November 2024

ObjectiveTo examine the contribution of the active job openings-to-applicants ratio, a macroeconomic indicator, to the number of ambulance dispatches.DesignLongitudinal ecological study.SettingJapan, between January 2003 and December 2021.ParticipantsAll ambulance dispatches.Primary and secondary outcome measuresThe contribution of the active job openings-to-applicants ratio in a month, adjusted by the number of older people, mean temperature and total population, to the number of ambulance dispatches in that specific month was examined and the primary model was compared to the conventional model considering only the older population, mean temperature, and total population.ResultsThere were 108 724 969 ambulance dispatches during this period. The active job openings-to-applicants ratio was significantly associated with the number of ambulance dispatches (the increase rate of monthly ambulance dispatches for 1% rise in the active job openings-to-applicants ratio, 1.00082; 95% CI 1.00052 to 1.00112). Additionally, the primary model effectively demonstrated better fitness to the actual trend than the conventional model (the quasi-likelihood under the independence model criteria were −2 626 817 720 and −2 626 775 185, respectively).ConclusionsThe number of ambulance dispatches was correlated with the active job openings-to-applicants ratio. Macroeconomic perspectives may be needed to address the issue of increasing ambulance dispatches.
Evaluating the effectiveness of the Smart About Meds (SAM) mobile application among patients discharged from hospital: protocol of a randomised controlled trial
Authors: Tamblyn Robyn , Habib Bettina , Buckeridge David L , Weir Daniala L , Frolova Elizaveta , Alattar Rolan , Rogozinsky Jessica , Beauchamp Caroline , Pupo Rosalba , Bartlett Susan J , McDonald Emily 
Published: November 2024

IntroductionAlmost half of patients discharged from hospital are readmitted or return to the emergency department (ED) within 90 days. Non-adherence to medication changes made during hospitalisation and the use of potentially inappropriate medications (PIMs) both contribute to postdischarge adverse events. We developed Smart About Meds (SAM), a patient-centred mobile application that targets medication non-adherence and PIMs use. This protocol describes a randomised controlled trial (RCT) to evaluate SAM.Methods and analysisA pragmatic, stratified RCT will evaluate SAM among 3250 adult patients discharged from hospital. At discharge, consenting participants will be randomised 1:1 to usual care or SAM. SAM integrates novel patient-centred features with pharmacist monitoring to manage non-adherence to new medication regimens. SAM also notifies patients of PIMs in their regimen, with advice to discuss with their physician.Following discharge, patients will be followed for 90 days to measure the primary composite outcome of ED visits, hospital readmissions and death. Secondary outcomes will include primary adherence to medication changes, secondary adherence to disease-modifying medications, patient empowerment and health-related quality of life.The primary outcome will be analysed according to intention-to-treat. Multivariable logistic regression will estimate differences between treatment groups in the proportion of patients experiencing the primary outcome and will assess modification of intervention effects by hospital, unit, age, sex and comorbidity burden. With a sample size of 3250, the study will have 80% power to detect a 5% absolute reduction in the primary outcome. Binary and continuous secondary outcomes will be assessed using multivariable logistic and linear regression, respectively.Ethics and disseminationThe Research Ethics Board of the McGill University Health Centre in Montréal, Canada has approved this study. Results will be submitted for publication in a peer-reviewed journal and presented at scientific conferences. If effective, SAM will be made available in app stores.Trial registration numberNCT05371548.
Qualitative exploration of awareness about risk factors and transformative behaviours among Pakistani patients with coronary artery disease
Authors: Barolia Rubina , Yaqoob Adnan , Ladak Laila , Khan Aamir Hameed , Pannu Furqan Yaqub 
Published: November 2024

ObjectivesTo explore patients’ awareness of risk factors for coronary artery disease (CAD) and experiences of the behavioural modifications, they made during their recovery through in-depth semistructured interviews.DesignQualitative exploration was undertaken as part of a larger project to answer the study questions.SettingParticipants were recruited from a public-sector tertiary care hospital in Lahore Pakistan.ParticipantsA total of 20 participants, men and women, who had more than 6 months of experience living with CAD, were recruited using a purposive sampling technique.ResultsThe data were organised and analysed using NVIVO software. An inductive coding approach was used to generate codes, categories and themes. Three themes emerged from participants’ data: lifestyle choices and behavioural factors, reflective awareness and lifestyle changes, holistic perspectives and health management.ConclusionsThe present study’s findings align with recent literature, emphasising the complex nature of risk factors contributing to heart disease. The participants’ understanding and behavioural changes show the importance of health awareness and preventive measures in reducing cardiovascular risks.
Qualitative study exploring reintegration of clinical trial participants with HIV to public health services in Johannesburg, South Africa
Authors: Nxumalo Sibongiseni Thandazani , Harris Bernice , Napoles Lizeka , Oladimeji Kelechi Elizabeth , Lalla-Edward Samanta Tresha 
Published: November 2024

ObjectivePeople living with HIV (PLHIV) are often recruited from primary healthcare clinics (PHC) into clinical trials. On trial completion, they are transferred back to the facility for continued care and support in managing their condition, potentially leading to better health outcomes. Because transferring PLHIV back to PHCs post-clinical trials may result in decreased access to specialised care or resources that were available during the trial, this study explored insights into challenges faced during reintegration from clinical trial settings into PHCs and antiretroviral therapy (ART) adherence post-clinical trials.DesignThis cross-sectional study was conducted using a qualitative research approach. Participants were recruited using purposive sampling.SettingThe study was conducted at the Ezintsha Research Centre in Johannesburg, South Africa, between November 2022 and February 2023.ParticipantsThe study population consisted of PLHIV who had participated in two clinical trials (DORA and ADVANCE) at the Ezintsha Research Centre in Johannesburg, South Africa.MethodsUsing a semistructured guide, 12 in-depth interviews were conducted with PLHIV until data saturation was reached. Data were then transcribed verbatim and analysed thematically with MAXQDA software.ResultsThe majority (n=8, 67%) of participants were female, and the average age of all participants was 40 (SD 7.2) years. Two main themes emerged: reintegration from clinical trials to public healthcare and barriers to ART adherence. These themes were further separated into seven subthemes, namely, negative attitude of healthcare workers, poor healthcare service delivery, poor communication to patients, waiting time at healthcare facilities, lack of privacy and confidentiality, mistakes in ART dispensing and bad reception at facilities post-clinical trials.ConclusionClinical trial sites should cultivate better stakeholder engagement with PHCs to facilitate a smoother transition of research participants, especially PLHIV, back into public healthcare for continued care.
Perspectives from clinicians from different levels of care in Maputo, Mozambique: qualitative study of the barriers to and facilitators of paediatric injury care in resource-poor hospital settings
Authors: Amado Vanda , Zandamela Americo , Couto Maria Tereza , Wallis Lee A , Laflamme Lucie 
Published: November 2024

ObjectivesProviding care for injured children is challenging in resource-poor settings. While checklists can assess local capacities and guide the setting of priorities for improvement, key insights can be gained from consultation with locally practising clinicians. This study aimed to highlight barriers to and facilitators of the delivery of paediatric injury care experienced by clinicians from hospitals at different levels of care in Maputo, Mozambique.DesignWe conducted semistructured individual qualitative interviews with clinical staff at four hospitals. Data were analysed using inductive content analysis.SettingThe study was conducted in four hospitals, each representing a specific level of care in Maputo, Mozambique.ParticipantsWe recruited clinicians (doctors, nurses and technicians) involved in paediatric injury care to be interviewed on-site (we target around 10 clinicians per hospital).ResultsFrom the 40 interviews conducted, four categories of barriers emerged: (1) prehospital care constraints, (2) shortage of child-appropriate resources, (3) inappropriate infrastructure for paediatric emergency care and (4) limited qualified staff available. By contrast, one category of facilitators stood out, namely that of cross-boundaries support and mentorship, between professionals and institutions.ConclusionFrom clinicians’ perspective, barriers to paediatric injury care are often similar across hospitals and professional groups, and they include the prehospital setting. Resource and infrastructure challenges were emphasized, as expected, and clinicians expressed a clear desire for knowledge and competence sharing.
Lived Experiences of Conscious Intubated Patients in the Intensive Care Units: A Qualitative Phenomenological Study in Iran
Authors: Nasiri Elhameh , Dashti Seemin , Karimollahi Mansoureh , Alefbaei Akram , Aghamohamamadi Delshad , Shahmari Mehraban 
Published: November 2024

ObjectiveMechanically ventilated patients experience significant suffering in intensive care units (ICUs). Recognising and understanding these patients’ distressing experiences can greatly improve the quality of care provided. This study aims to explore the lived experiences of conscious intubated patients in ICUs in Iran.DesignA qualitative study was conducted using an interpretative phenomenological approach. In-depth interviews served as the primary means of data collection. Subsequently, the collected data was analysed using the method of Diekelmannet al(1989).SettingThe study was conducted in the ICU.ParticipantsA purposive method was employed to select 13 patients who underwent conscious intubation for over 24 hours.ResultsThree main themes and seven subthemes emerged from the data analysis of the lived experience: (1) interpersonal discourse complexity (semantic misalignment and others’ impressionability), (2) sensory disquietude (pharyngeal discomfort, thirst beyond the quench and disgust with oral hygiene) and (3) resilient adaptation (emotional responses and coping strategies).ConclusionsThe findings of the lived experiences reveal a nuanced understanding of the intricate interplay between communication barriers, sensory discomfort and the adaptive capacities of conscious intubated patients in the ICU. This comprehensive analysis contributes to a deeper appreciation of their multifaceted experiences.
Evaluating the feasibility and attitudes towards SARS-CoV-2 self-testing in a rural population in Zimbabwe: a cross-sectional survey
Authors: Pfavayi Lorraine Tsitsi , Choto Emilia , Tagwireyi Paradzayi , Mduluza Takafira , Mutapi Francisca 
Published: November 2024

ObjectivesThe widespread adoption of self-testing for SARS-CoV-2 has proven effective in curbing the virus’ spread, particularly in Western countries. However, significant knowledge gaps persist regarding the feasibility, acceptance and factors influencing the uptake of self-testing in low-resource areas, notably rural Africa. Our aim was to assess the willingness and capability of rural Zimbabwean participants to self-diagnose COVID-19 using rapid lateral flow tests (LFTs) and adhere to post-positive test guidelines. Additionally, we aimed to identify barriers to self-testing uptake and reasons for non-compliance with follow-up actions.Design and settingWe conducted a cross-sectional survey in Shamva District, Zimbabwe.ParticipantsA total of 120 villagers aged 18 years and above participated. We employed a questionnaire to gather data on participants' attitudes towards self-testing for SARS-CoV-2 using LFTs, along with their knowledge, attitudes and practices regarding COVID-19.Primary outcomesincluded the likelihood of self-testing, the ability and accuracy of self-testing, adherence to post-test guidelines and socio-demographic factors influencing these responses.ResultsAmong the 120 participants, 108 (90%) expressed willingness to use LFTs for self-testing. The subset unwilling to self-test belonged to a religious sect historically opposed to Western medicine. All self-tests yielded valid results, as confirmed by the appearance of control lines on the LFT. Participants demonstrated the ability to interpret their results accurately without assistance and expressed willingness to adhere to post-test guidelines. Questionnaire responses indicated a preference for self-testing due to its ease, lack of pain, convenience and confidentiality. Moreover, participants exhibited a high level of knowledge about COVID-19.ConclusionThis study underscores the acceptability and feasibility of SARS-CoV-2 LFT self-testing in rural settings, suggesting its potential as an additional public health measure for epidemics and pandemics in low-resource areas.
Does intermittent nutrition enterally normalise hormonal and metabolic responses to feeding in critically ill adults? A protocol for the DINE-Normal proof-of-concept randomised parallel-group study
Authors: Beattie Clodagh Emer , Thomas Matt , Borislavova Borislava , Smith Harry A , Ambler Michael , White Paul , Hayes Kati , Milne Danielle , Ramesh Aravind V , Gonzalez Javier T , Betts James A , Pickering Anthony E 
Published: November 2024

IntroductionOver half of patients who spend >48 hours in the intensive care unit (ICU) are fed via a nasogastric (NG) tube. Current guidance recommends continuous delivery of feed throughout the day and night. Emerging evidence from healthy human studies shows that NG feeding in an intermittent pattern (rather than continuous) promotes phasic hormonal, digestive and metabolic responses that are important for effective nutrition. It is not yet known whether this will translate to the critically ill population. Here, we present the protocol for a proof-of-concept study comparing diurnal intermittent vs continuous feeding on hormonal and metabolic outcomes for patients in the ICU.Methods and analysisThe study is a single-centre, prospective, randomised, open-label trial comparing intermittent enteral nutrition with the current standard practice of continuous enteral feeding. It aims to recruit participants (n=30) needing enteral nutrition via an NG tube for >24 hours who will be randomised to a diurnal intermittent or a continuous feeding regimen with equivalent nutritional value. The primary outcome is peak plasma insulin/c-peptide within 3 hours of delivering the morning intermittent feed on the second study day, compared with that seen in the continuous feed delivery group at the same time point. Secondary outcomes include feasibility, tolerability, efficacy and metabolic/hormonal profiles.Ethics and disseminationWe obtained ethical approval from the Wales Research Ethics Committee 3 prior to data collection (reference 23/WA/0297). We will publish the results of this study in an open-access peer-reviewed journal.Trial registration numberNCT06115044.