bluuebunny/crossref_metadata_2025_split huggingface dataset:
The duality of hope and challenges: a phenomenological study of first-year university students’ experiences in South Africa
Authors: Mason Henry D. 
Published: November 2024

IntroductionIn South Africa, access to higher education is viewed as a pathway to improved life chances. However, the transition from school to university is a stressful experience for students, marked by significant challenges. Although literature acknowledges these challenges, limited research has focused specifically on the role of hope during this period. Additionally, previous studies on hope have often utilized individualistic approaches, which may not fully capture the experience of students in collectivist cultures. This study addresses this gap by exploring hope from a culturally sensitive perspective within a collectivist context, aiming to understand how first-year South African university students experience hope during the transition to university.MethodsThis study employed Interpretative Phenomenological Analysis (IPA) to explore the lived experiences of hope among first-year South African university students during their transition to higher education. Twenty-two students participated in semi-structured interviews, allowing for an in-depth examination of their personal and cultural perspectives on hope and the challenges they faced. The data were analyzed iteratively, with strategies implemented to enhance trustworthiness and credibility, ensuring a thorough interpretation of students’ experiences.ResultsThe analysis yielded three main themes: (1) Affective and Social Duality: Students described mixed emotions and social challenges as they entered university, highlighting the dual nature of their experiences in adapting to a new environment. (2) Hope as a Multifaceted Concept: Hope was portrayed as a guiding force that helped students navigate periods of uncertainty. Participants described hope not just as a single idea but as a complex, evolving concept crucial to their resilience. (3) Beyond Academic Aspirations: Hope extended beyond academic success and was closely tied to personal fulfilment and the desire to contribute positively to society. This broader perspective on hope suggests that students’ aspirations were not confined to individual achievement but also included a sense of collective and societal impact.DiscussionThe study reveals that hope is a multidimensional construct that significantly influences students’ transitional experiences, extending beyond academic goals to include personal growth and societal contributions. This finding challenges the traditional, individualistic approaches to studying hope by highlighting the cultural relevance of collectivist values in shaping students’ experiences. The study underscores the need for culturally sensitive research and suggests that student support services should consider cultural contexts to address students’ unique challenges and aspirations better. Future research is recommended to explore hope across various cultural backgrounds to gain a more comprehensive understanding of its role in student development.
A policy brief: improving access and utilization of adolescent sexual and reproductive health services in Southern Ethiopia
Authors: Sidamo Negussie Boti , Abebe Kerbo Amene , Gidebo Kassa Daka , Wado Yohannes Dibaba 
Published: November 2024

BackgroundAdolescent sexual and reproductive health (ASRH) is fundamental to the overall wellbeing and development of young people. In Southern Ethiopia, adolescents face significant barriers to accessing and utilizing ASRH services: they include limited information, pervasive cultural stigma, and inadequate healthcare infrastructure. Addressing these barriers is critical to reducing unintended pregnancies, preventing sexually transmitted infections, and achieving national and international health objectives. Despite the existence of policies aimed at improving ASRH, these challenges persist, highlighting the urgent need for targeted policy reforms and effective implementation strategies to ensure a healthier future for adolescents in the region.Main findingsRecent research has identified substantial barriers to ASRH services in Southern Ethiopia. Key challenges include widespread gaps in knowledge, socio-cultural stigma, and strong influences from family and peers, compounded by limited service availability. The absence of adolescent-friendly care, coupled with insufficient outreach efforts, further restricts access. Healthcare providers also encounter significant obstacles, such as stigma, inadequate training, and a lack of institutional support, which undermine their ability to deliver effective services. Service utilization varies markedly based on geographic location, economic status, and educational attainment, with approximately half of adolescents lacking a comprehensive understanding of sexual and reproductive health and rights (SRHR). Moreover, persistent stigma, low levels of social support, and limited self-efficacy continue to hinder the uptake of these essential services.Policy implicationsTo improve ASRH services in Southern Ethiopia, a multi-faceted approach is imperative. Increasing public education through school programs and awareness campaigns can mitigate stigma and misinformation, fostering a more supportive environment. Initiatives such as providing transportation support and establishing mobile health clinics will significantly improve access for adolescents in underserved areas. Strengthening healthcare services by offering specialized training for providers and establishing adolescent-friendly clinics will elevate the quality of care. Engaging families, communities, and peer networks is essential for building a supportive framework that encourages adolescents to utilize SRH services. Finally, implementing skill-building and counseling programs will empower adolescents to make informed decisions regarding their sexual and reproductive health, ultimately contributing to improved health outcomes across the region.
Configurational analysis of ovarian cancer incidence in 30 provinces of China and its policy implications: a fuzzy-set qualitative comparative analysis approach
Authors: Shen Ying , Huang Zhenyu , Li Chan 
Published: November 2024

IntroductionOvarian cancer is one of the three most common gynecological cancers, with the highest mortality rate among gynecological malignancies. Previous studies on the environmental and socioeconomic (ESE) factors that affect ovarian cancer incidence (OCI) have generally only considered the net effects of single variables, while the synergistic effects among multiple factors have yet to be explored.MethodsBased on a sample of 30 provinces in Mainland China, an ESE configuration model was constructed in this study, using a fuzzy-set qualitative comparative analysis approach to empirically explore the configuration effects of multiple ESE factors on OCI.Results(1) Education, marriage, income, insurance, urbanization, and environment alone do not constitute the necessary conditions for high or low OCI, indicating a need to comprehensively consider the configuration effects of these six conditions. (2) There are two configurations for high OCI: “configuration of environmental pollution under low socioeconomic development” and “configuration of insurance deficiency under high socioeconomic development.” (3) There are two configurations for low OCI: “configuration of insurance adequacy under low socioeconomic development” and “configuration of insurance adequacy under low urbanization.”ConclusionThe main contribution of this study is its focus on the configuration mechanism of ESE factors, enhancing understanding of the synergistic effects among the multiple factors that affect OCI. The study also provides valuable policy implications for decision-makers to formulate comprehensive health policies for the prevention and treatment of ovarian cancer.
Rapid methods for multi-level dissemination of neutralizing monoclonal antibody treatment for COVID-19 outpatients: designing for dissemination using the fit to context framework
Authors: Kwan Bethany M. , Sobczak Chelsea , Fish Lindsey E. , Ginde Adit A. , Grant Gillian , Hamer Mika K. , Leggott Kyle , Owen Vanessa , Reno Jenna , Shrader Justin , Whittington Lindsey , Jones Jenn L. , Koren Ramona , Begay Joel A. , Vinaithirthan Vall , Lum Hillary D. 
Published: November 2024

IntroductionThroughout the COVID-19 pandemic, there was an urgent need for the rapid and equitable translation of knowledge and effective treatments to reach vulnerable populations in response to the ever-shifting pandemic environment. The approval of neutralizing monoclonal antibodies (mAbs) for treatment of outpatient COVID-19 resulted in a need to rapidly design dissemination strategies to increase awareness and equitable access for community members and healthcare providers.Materials and methodsWe used the Fit to Context (F2C) Framework for Designing for Dissemination and Sustainability to (a) design products such as messages and materials, and (b) disseminate the products. We leveraged existing partnerships (e.g., community members, health system leaders, Regional Health Connectors, public health agencies, policymakers, and others) for activities including (a) advising on contextual implementation challenges and opportunities; (b) convening a stakeholder advisory panel; (c) rapid feedback on product reach and impact; and (d) serving as potential product adopters and distributors. We used concurrent data collection and co-design with rapid, iterative prototyping. We used real-world data to evaluate impact of D&amp;I strategies on mAb use in Colorado.ResultsMoving through the F2C Framework phases, we assessed mAb implementation and access barriers and facilitators, identified partner priorities, co-designed messages and materials for multiple audiences, and disseminated through audience-specific communication channels. An emphasis on equity led to tailoring materials to communities with lower health literacy, under- and uninsured groups, Spanish-speaking communities, Native American communities, and rural areas. Dissemination messages, materials, and distribution strategies were updated frequently based on emerging data on COVID-19 treatment effectiveness and availability. Real-world data revealed more than 400% increase in both referrals and number of unique referring providers, with the greatest impact on underserved communities. This was accomplished in under 9 months.ConclusionThe Fit to Context Framework for Designing for Dissemination and Sustainability is a novel process framework that can inform a rapid, iterative dissemination strategy. The COVID-19 pandemic presented an opportunity to learn better ways to speed translation of evidence to practice and enhance equitable access to evidence-based care. The mAb Colorado project demonstrated the importance of having strong community-academic-public health partnerships and leveraging existing capacity to enhance adoption and reach.
Health economic evaluation of structured education programs for patients with diabetes: a systematic review
Authors: Ye Caihua , Zhou Qiwei , Yang Wenfei , Tao Libo , Jiang Xinjun 
Published: November 2024

BackgroundDiabetes structured education programs have been demonstrated to effectively improve glycemic control and self-management behaviors. However, evidence on the health economic evaluation of these programs is limited.ObjectivesTo systematically review the health economic evaluation of structured education programs for patients with type 1 and type 2 diabetes mellitus.MethodsThe English databases PUBMED, WEB OF SCIENCE, OVID, COCHRANE LIBRARY, EMBASE, and EBSCO, along with the Chinese databases CNKI, WANFANG, VIP, and SINOMED, were searched from their inception to September 2024. The quality of the literature was assessed using the CHEERS 2022 checklist. A descriptive analysis was performed on the studies included in the review, with all currencies converted to international dollars. An incremental cost-effectiveness ratio of less than one times the per capita GDP was considered highly cost-effective, while a ratio between one and three times the per capita GDP was considered cost-effective.ResultsA total of 28 studies from upper-middle-income and high-income countries were included. The average quality score of the included studies was 18.6, indicating a moderate level of reporting quality. Among these, eleven studies demonstrated that diabetes structured education programs were highly cost-effective and twelve were found to be cost-effective. In contrast, three studies were deemed not cost-effective, and two studies provided uncertain results. The ranges of the incremental cost-effectiveness ratios for short-term, medium-term, and long-term studies were − 520.60 to 65,167.00 dollars, −24,952.22 to 14,465.00 dollars, and −874.00 to 236,991.67 dollars, respectively.ConclusionThis study confirms the cost-effectiveness of structured education programs for diabetes and highlights their importance for patients with type 2 diabetes who have HbA1c levels exceeding 7% and are receiving non-insulin therapy. Additionally, the potential advantages of incorporating telecommunication technologies into structured diabetes education were emphasized. These findings offer valuable insights and guidance for decision-making in diabetes management and clinical practice, contributing to the optimization of medical resource allocation and the improvement of health status and quality of life for patients.
Knowledge of health risks, safety practices, acute pesticide poisoning, and associated factors among farmers in rural irrigation areas of northeastern Ethiopia
Authors: Keleb Awoke , Ademas Ayechew , Abebe Masresha , Berihun Gete , Desye Belay , Bezie Anmut Endalkachew 
Published: November 2024

BackgroundPesticide exposure is a major public health issue among farmers affecting make it their health, economic stability, and agricultural productivity. This study aimed to investigate the magnitude and determinants of farmers’ knowledge of health risks, safety practices, and acute pesticide poisoning in the South Wollo Zone, Ethiopia.MethodsA community-based cross-sectional study was conducted in the South Wollo Zone’s irrigation areas from July to August 2022. Using a multistage sampling technique, five out of ten irrigation districts were randomly selected, and three kebeles (the smallest administrative unit) from each district (15 total) were chosen based on intensive irrigation activities. A proportional sample size was allocated across the selected kebeles according to the number of farmers. Trained data collectors conducted face-to-face interviews using a pretested structured questionnaire. Crude and adjusted odds ratios with 95% confidence intervals at a p-value of 0.05 identified statistically significant factors.ResultThe study found that 55.2% of farmers had below mean knowledge of health risks, 63.7% practiced below mean safety practices, and 47.9% experienced acute pesticide poisoning. Significant factors for below mean knowledge included no formal education (AOR = 2.32; 95% CI: 1.27–4.23) and lack of pesticide training (AOR = 2.07; 95% CI: 1.33–3.21). Below mean safety practices were associated with age &gt; 47 years (AOR = 2.07; 95% CI: 1.06–4.04), below mean retailer actions (AOR = 1.97; 95% CI: 1.34–2.89), and below mean attitude (AOR = 1.79; 95% CI: 1.23–2.62). Acute pesticide poisoning was significantly associated with over 10 years of exposure (AOR = 4.34; 95% CI: 2.55–7.39), below mean knowledge (AOR = 2.17; 95% CI: 1.23–2.62), lack of training (AOR = 3.73; 95% CI: 2.33–5.98), and below mean safety practices (AOR = 4.40; 95% CI: 2.86–6.78).ConclusionFarmers’ knowledge of health risks and safety practices was not satisfactory. Low educational status, lack of training, and minimal government involvement were associated with below mean knowledge. Below mean knowledge and below mean safety practices, low education, lack of training, and minimal government involvement were associated with acute pesticide poisoning. Young farmers, limited retailer involvement, and below mean attitudes contribute to unsafe practices.
Fatigue among children and adolescents with acquired brain injury in a specialized neurorehabilitation setting
Authors: Proschowsky Marie-Louise Smidt , Reimers Sofie Hur , Granhøj Anette 
Published: November 2024

IntroductionWe investigated the fatigue experienced in children and adolescents with acquired brain injury (ABI) undergoing neurorehabilitation.MethodsFatigue was assessed using the pediatric quality of life inventory™ (PedsQL™). Multidimensional Fatigue Scale in 38 participants aged 2–19 years with ABI. Data were collected at enrollment and discharge, either from the participants themselves or their parents. The causes of ABI, including stroke, infection, tumor, and traumatic brain injury), were compared.ResultsParticipant-reported fatigue levels significantly decreased over time (p = 0.005), whereas parent-reported fatigue levels did not show a significant change. Fatigue levels varied by ABI cause, with stroke-associated fatigue having the least impact and infection-related fatigue showing the greatest impact.ConclusionThis study highlights the importance of individualized assessments that consider varying etiological factors and advocates for tailored interventions. Further research is needed to fully understand the long-term impacts of fatigue in this population.
Masticatory performance and masticatory behavior in individuals with eating disorders: a pilot study
Authors: Kumar Abhishek , Munirji Linda , Langlet Billy , Bostanci Nagihan , Grigoriadis Anastasios 
Published: November 2024

AimThe brief report aims to evaluate masticatory performance and components of chewing behavior in people with anorexia nervosa and compare it with a reference group of individuals with no history of eating disorders.Material and methodsEighteen women participated in the study: nine with anorexia nervosa (age 20.2 ± 5.9) and nine as controls in a reference group without anorexia nervosa (age 23.6 ± 0.9). Masticatory performance was assessed with a food comminution test. The participants also ate (chewed and swallowed) a second test food while their jaw movements were recorded to evaluate their chewing behavior. The number of comminuted pieces during the food comminution test, chewing cycles, chewing duration, and components like occlusal, and jaw opening/closing duration, were evaluated.ResultsIn comparison to the reference group the anorexia nervosa patients performed poorly in the food comminution test (P = 0.007), and also chewed the test food significantly longer (P = 0.004) and with significantly more chewing cycles (P = 0.014). The results also showed a significantly longer jaw-closing duration in the anorexia nervosa group compared to the reference group (P = 0.021). However, there were no significant differences in either the jaw opening or the occlusal duration between the two groups.ConclusionOverall, the results of the study indicate that the anorexia nervosa group shows signs of poor masticatory performance and altered chewing behavior compared to the reference group of individuals with no history of eating disorders.
Quality of life, anxiety, and depression improve at one-year after liver transplantation in patients with advanced liver disease
Authors: Cordoba-Alvarado Rosana , Romero-Fonnegra Valentina , Cortes-Mejia Nicolas , Bejarano-Ramirez Diana Fernanda , Maldonado-Hoyos Valentina , Sanchez-Garcia Sandra Janeth , Vera-Torres Alonso 
Published: November 2024

BackgroundLiver transplantation (LT) improves survival in end-stage liver disease. Several reports have addressed the impact of LT on patients’ lives, beyond purely medical outcomes. Although the quality of life and mental health have been demonstrated to improve with this procedure, such studies are still missing in Latin America.MethodsPatients who received LT at the Fundación Santa Fe de Bogotá between 2017 and 2019 were assessed for quality of life (QoL), anxiety, and depression and they were followed up for one year after the procedure. Pre-transplant data were gathered at inclusion on the waiting list, while post-transplant data at 3- and 12 months after LT. European Quality of Life-5 Dimensions (EQ-5D) and European Quality of Life-Visual Analog Scale (EQ-VAS) instruments were used to evaluate QoL. The Hospital Anxiety and Depression Scale (HADS) was used for evaluating anxious and depressive symptoms.Results115 recipients met the inclusion criteria. Mean pre-transplant EQ-VAS was 70.78, rising to 87.16 and 92.56 at 3- and 12-months, respectively. Improvements in all EQ-5D dimensions were found in response to LT. According to the HADS questionnaire, anxiety was reduced by 2.35 points and depression by 1.63 points after LT.Conclusionin the short term, LT is a successful strategy for enhancing QoL, anxiety, and depression in patients with liver disease. Long-term benefits must be assessed.
Surgical vs. nonoperative treatment for acute Achilles' tendon rupture: a meta-analysis of randomized controlled trials
Authors: Fan Lei , Hu Yunan , Zhou Leng , Fu Weili 
Published: November 2024

BackgroundAcute Achilles tendon rupture (AATR) is common among young individuals. There are various management options available, including conservative treatment, open surgical repair, and minimally invasive treatments. However, the optimal treatment approach remains controversial.PurposeIn this study, we conducted a thorough analysis of the existing literature to compare the clinical outcomes of surgical and nonoperative treatments for patients with AATR by conducting a meta-analysis of randomized controlled trials.Study designMeta analysis; Level of evidence, 1.MethodsEligible trials randomly assigned adults with AATR to surgical or conservative treatment and assessed by three independent reviewers. We searched in PubMed, Embase, and The Cochrane Library. The assessment of risk of bias was conducted by entering the data from each included study into the Revman computer program. Extracted data were meta-analyzed. Heterogeneity was evaluated using the I2 test. Pooled results were expressed as odds ratios, risk ratios (OR), and mean differences (MD).ResultsThe meta-analysis included a total of 14 studies and 1,399 patients, with 696 patients receiving surgical intervention and 703 patients undergoing non-surgical treatment. The follow- up duration ranged from 12 to 30 months. The surgical group was found to have a significantly lower re-rupture rate (OR: 0.30, 95% CI: 0.18–0.54; P &lt; 0.00001), but also had a higher risk of other complications (OR: 3.28, 95% CI: 1.56–6.93, P = 0.002). The surgical group also had significantly abnormal calf (OR: 0.45, 95% CI: 0.26–0.76, P = 0.03). There was no statistically significant difference between the two groups in terms of returning to sports, ATRS, abnormal motion of foot and ankle, unable heel-rise, and torque for plantar flexion.ConclusionThe meta-analysis results indicate that surgical intervention for AATR is associated with a lower re-rupture rate, but a higher risk of other complications. Our assessment of life-quality and functional outcomes also suggests that surgery leads to significantly better outcomes in terms of sick leave, abnormal calf, and torque for plantar flexion. Based on these findings, we recommend that surgery is a preferable option for patients who have a higher risk of re-rupture and require a quick rehabilitation.