bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changing the food environment in secondary school canteens to promote healthy dietary choices: a qualitative study with school caterers
Authors: Murphy Marie , Coffey Alice , Pallan Miranda , Oyebode Oyinlola 
Published: July 2024

Abstract
Background
Typical adolescent diets do not meet current dietary recommendations. There is a need to address these dietary patterns to reduce the risk of obesity and other diet-related diseases. Schools provide an opportune setting to do so, as students consume a substantial proportion of their daily dietary intake whilst at school. There is a developing evidence base on the use of choice architecture (food choice cues) to promote healthy eating in school contexts. It is necessary to understand the acceptability and feasibility of implementing such interventions. We aimed to explore these factors from the perspectives of secondary school caterers.

Methods
We conducted qualitative interviews with caterers from secondary schools across the West Midlands, UK and national/regional catering representatives. A semi-structured topic guide and visual aid were used to guide interviews. Interviews were recorded and transcribed. Framework analysis was conducted in NVivo v12.

Results
Twelve participants took part. Seven themes were identified and grouped into three categories: Acceptability (Suitability; Salient cues; Student engagement), Barriers (Catering decision drivers; Limits of influence), and Enablers (Perceived role; Opportunities). Caterers considered healthy food cues to be suited to adolescents as they require minimal reflective motivation. Salient cues included enhancing the placement, presentation and portability of healthy items, improving the dining environment and focusing pricing/incentive strategies on increased quantity. Student engagement was considered important. Some catering decision drivers conflicted with healthy food cues, and many felt that their role in healthy eating was limited due to the overwhelming influence of external food environments, adolescent resistance, and features of the secondary school canteen setting e.g. short duration of lunchtime, lack of space. However, caterers appeared motivated to implement healthy food cues and identified key opportunities for implementation, including integration into whole-school approaches to healthy eating.

Conclusions
Interventions using healthy food cues appeared acceptable to secondary school caterers, key potential implementers of these strategies. Future interventions could incorporate strategies relating to placement, presentation and pricing to prompt healthy selections, and actions to engage the student body and improve the dining environment. Evaluations should consider potential impacts upon food purchasing, consumption and waste to address caterers’ concerns about these issues.
Knowledge, attitudes, and practices related to soil-transmitted helminth infections among residents of Bata district, Equatorial Guinea; a cross-sectional study
Authors: Meñe Gertrudis Ribado , Dejon-Agobé Jean Claude , Angue Basilio Micha Aboho , Meñe Maximiliano Fero , Echube José Manuel Esara , Abdulla Salim , Adegnika Ayôla Akim 
Published: July 2024

Abstract
Background
Soil-transmitted helminth (STH) infection control remains a priority in endemic regions where local epidemiological data are needed for sustainable control strategies, particularly regarding population knowledge, attitudes, and practices (KAP). Our work assessed KAP toward STH infection and associated factors among residents of Bata district, Equatorial Guinea.

Methods
A community-based cross-sectional study was conducted among 14 randomly selected communities in the Bata district. Eligible participants were interviewed face-to-face using a standardized questionnaire. Participants aged under 18 years were interviewed in the presence of their parents or legal guardians. For participants aged less than ten, a simplified version of the main questionnaire was developed focusing on children’s practices toward STH and was administered to their parents or legal guardians.

Results
A total of 399 participants were included in the present analysis. Among them, 58% responded to the main questionnaire. The mean (± SD) age of participants aged 10 and over was 37.5 (± 22.2) years, and 60% of them were females, while the mean (± SD) age of those aged less than ten was 5.0 (± 2.5) years. The respondents’ overall knowledge, attitudes, and practices to STH were rated as bad (33%), very good (77%), and good (55%), respectively. Knowledge was significantly associated with education level (p = 0.04) with the knowledge level lower for participants with no formal education than for those with secondary/university education (β = -0.56, 95% CI: -1.00 – -0.12, p = 0.01); Appropriate attitudes level was significantly associated with occupation (p = 0.02) and education levels (p = 0.049) with the appropriate attitude level lower for students than for farmers/fishers (β = -1.24, 95% CI: -2.17—-0.32, p = 0.01) and for primary-level participants than for those with secondary/university education (β = -0.68, 95% CI: -1.23—-0.13, p = 0.02); while appropriate practice level were significantly associated with age (p = 0.01), occupation (p = 0.01), and education (p = 0.02), with the appropriate practices level increasing with age (β = 0.03, 95% CI: 0.005 – 0.05, p = 0.01) and lower in participants with no formal education than in those with secondary/university education (β = -1.19, -2.05 – -0.32, p = 0.007).

Conclusion
The present study revealed a lack of knowledge about STH in the study population, particularly regarding disease causes and transmission ways, highlighting the need for the implementation of integrated health education strategies, both at the community and school levels.
Rehabilitation in subjects with frozen shoulder: a survey of current (2023) clinical practice of Italian physiotherapists
Authors: Brindisino Fabrizio , Girardi Giuseppe , Crestani Mauro , Assenza Raffaele , Andriesse Arianna , Giovannico Giuseppe , Pellicciari Leonardo , Salomon Mattia , Venturin Davide 
Published: July 2024

Abstract
Objective
Frozen Shoulder (FS) is a musculoskeletal pathology that leads to disability, functional decline, and a worsening in quality of life. Physiotherapists are the primary professionals involved in the treatment of FS, and it is essential to determine if their practice aligns with evidence-based suggestions.

Aim
The aim is to assess the knowledge, skills, and operational strategies of Italian physiotherapists regarding FS and compare them with the existing literature.

Methods
A web-based, anonymous, and voluntary cross-sectional survey was developed and administered to Italian physiotherapists to evaluate their clinical practices.

Results
A total of 501 physiotherapists (38.5% female), completed the survey. More than half were under 35 years old (67.8%), declared working in private practice settings or being self-employed (57.1%), and were primarily engaged with musculoskeletal patients (81.8%). For subjects with FS at their first access, 21.4% identified X-rays as the most useful imaging technique to recognize pathologies beyond rehabilitation competence. In terms of general management, the majority reported working with an orthopaedic or physiatrist (47.5%) or in a multidisciplinary team (33.5%). Regarding manual therapy techniques, 63.3% of physiotherapists preferred intense degree mobilization, posterior direction, and moderate pain at the end of the range of motion for low irritable/high stiffness FS; however, there is a lack of consensus for managing very irritable/low stiffness FS. The majority of physiotherapists (57.7%) concurred that stretching improves the balance between metalloproteinase and its inhibitors. Additionally, 48.3% of physiotherapists selected mobile phone videos and messages to improve patients’ compliance with exercises at home and for motivational/educational purposes.

Discussion and Conclusion
The clinical practices of Italian physiotherapists in FS subjects sometimes deviate from evidence-based recommendations. While some discrepancies may be attributed to the existing uncertainties in the literature regarding knowledge and management strategies for FS patients, the authors recommend a stronger adherence to evidence-based practice.
Comparison of femoral tunnel position and knee function in anterior cruciate ligament reconstruction: a retrospective cohort study using measuring-fluoroscopy method versus bony marker method
Authors: Dong Yan , Gao Yang , Cui Peng , He Yuanming , Yao Guke 
Published: July 2024

Abstract
Background
Previous studies have shown that surgical technique errors especially the wrong bone tunnel position are the primary reason for the failure of anterior cruciate ligament (ACL) reconstruction. In this study, we aimed to compare the femoral tunnel position and impact on knee function during the ACL reconstruction using measuring combined with fluoroscopy method and bony marker method for femoral tunnel localization.

Methods
A retrospective cohort study of patients undergoing ACL reconstruction using the bony marker method or measuring combined with fluoroscopy for femoral tunnel localization was conducted between January 2015 and January 2020. A second arthroscopic exploration was performed more than 1 year after surgery. Data regarding patient demographics, the femoral tunnel position, results of the Lysholm score, the International Knee Documentation Committee (IKDC) score, KT-1000 side-to-side difference, pivot shift grade, and Lachman grade of the knee were collected.

Results
A total of 119 patients were included in the final cohort. Of these, 42 cases were in the traditional method group, and 77 cases were in the measuring method group. The good tunnel position rate was 26.2% in the traditional method group and 81.8% in the measuring method group (p < 0.001). At the final follow-up, the Lysholm and IKDC scores were significantly greater in the measuring method group than the traditional method group (IKDC: 84.9 ± 8.4 vs. 79.6 ± 6.4, p = 0.0005; Lysholm: 88.8 ± 6.4 vs. 81.6 ± 6.4, p < 0.001). Lachman and pivot shift grades were significantly greater in the measuring method group (p = 0.01, p = 0008). The results of KT-1000 side-to-side differences were significantly better in the measuring method group compared with those in the traditional method group (p < 0.001).

Conclusions
The combination of the measuring method and intraoperative fluoroscopy resulted in a concentrated tunnel position on the femoral side, a high rate of functional success, improved knee stability, and a low risk of tunnel deviation. This approach is particularly suitable for surgeons new to ACL reconstructive surgery.
Comparison of immediate vs. delayed guided tissue regeneration in Infrabony defect of second molars after adjacent third molar extraction: a retrospective study
Authors: Tang Si-Min , Liu Di-Xin , Xiong Zi-Yun , Shao Yi-Qian , Jiang Jing , Chen Li , Xiong Qin , Wu Shuo-Yan , Xuan Dong-Ying 
Published: July 2024

Abstract
Background
The distal aspect of the second molar (d-M2) often exhibits infrabony defects due to the adjacent third molar. Although the defects can be treated by guided tissue regeneration (GTR) after removing the third molar, the optimal timing remains uncertain following third molar removal in clinical decision-making. This study aimed to compare delayed and immediate GTR treatments to assist in clinical decision-making.

Methods
D-M2 infrabony defects with a minimum 1-year follow-up were collected and divided into three groups: Immediate GTR group, which underwent third molar extraction and received GTR simultaneously; Delayed GTR group, which underwent delayed GTR at least 3 months after third molar extraction; and Control group, which underwent only scaling and root planing during third molar extraction. The clinical and radiographic parameters related to the infrabony defect before GTR and post-surgery were evaluated using the Kruskal-Wallis test or one-way ANOVA, followed by post-hoc Dunn’s test or the Bonferroni test for pairwise comparisons.

Results
A total of 109 d-M2 infrabony defects were assessed. No significant differences were found between the two GTR groups, although both of them showed significant reductions in infrabony defect depth: the immediate GTR group (2.77 ± 1.97 mm vs. 0.68 ± 1.03 mm, p < 0.001) and the delayed GTR group (2.98 ± 1.08 mm vs. 0.68 ± 1.03 mm, p < 0.001) compared to the control group.

Conclusion
GTR can effectively improve d-M2 infrabony defects when the third molar is removed, whether simultaneously or delayed. Patients may experience less discomfort with immediate GTR treatment as it requires only one surgery.
Experiences and perceptions of palliative care patients receiving virtual reality therapy: a meta-synthesis of qualitative studies
Authors: Huang Yufei , Deng Cunqing , Peng Meifang , Hao Yanping 
Published: July 2024

Abstract
Background
The combination of virtual reality (VR) and palliative care potentially represents a new opportunity for palliative care. Many previous studies have evaluated the application of VR therapy to patients with advanced disease receiving palliative care. However, patient-perspective reviews to comprehensively understand the actual experiences and feelings of patients and provide practical guidance for designing future studies are currently lacking. This review of qualitative evidence aimed to explore the experiences and perceptions of patients receiving VR therapy in palliative care.

Methods
This study was conducted in accordance with the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement guidelines. Ten databases, namely, PubMed, Web of Science, EBSCO, OVID MEDLINE, Scopus, John Wiley, ProQuest, CNKI, WANFANG DATA, and SinoMed, were searched, and qualitative and mixed studies from the establishment of each database to June 30, 2023 were included. The Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research was used to assess the quality of the included studies. The data included in the literature were analyzed and integrated by “thematic synthesis” to formalize the identification and development of themes.

Results
The nine selected studies altogether included 156 participants from seven hospice care facilities of different types and two oncology centers. Three key themes were identified: experiences of palliative care patients in VR therapy, the perceived value that palliative care patients gain in VR therapy, and perspectives of palliative care patients toward using VR therapy.

Conclusions
The patients’ feedback covered discomfort caused by VR devices, good sense of experiences, and situations that affected the interactive experience. Some patients were unable to tolerate VR therapy or reported newer forms of discomfort. The findings indicated that VR therapy may be an effective approach to relieve patients’ physical and psychological pain and help them gain self-awareness. Moreover, patients showed a preference for personalized VR therapy.
Utility of instant messaging application, WhatsApp, as a tool to augment post-graduate radiology education
Authors: Khan Sohail Ahmed , Shamim Shahid , Farooqui Waqas Ahmed , Sultan Rooha , Nisar Munizha , Adnan Noreen , Khan Ibrahim , Andani Hina 
Published: July 2024

Abstract
Background
Smart phone technology including different instant messaging applications like, WhatsApp, can be used for the development of radiological skills, reporting, and performance. To determine the utility, attitude, and outcome of WhatsApp for augmenting education in FCPS radiology residency program. To assess the opinion of radiology residents regarding WhatsApp as a tool to enhance postgraduate training.

Methodology
A mixed method (qualitative and quantitative) was conducted at Dow Institute of Radiology, Karachi, Pakistan. All FCPS Radiology residents were given a radiological case by principal investigator followed by residents’ response in 24 h. Key findings were shared by the mentor. Before and after the intervention of WhatsApp, all residents were evaluated with written and radiological imaging reporting exam. For quantitative analysis, a closed ended questionnaire was used containing information about total number of messages, images, webpage links shared, level of contribution (active/non-active), and utility (contribution in education related topic only). A feedback form with Likert scale was also got filled by all residents. For qualitative research, semi structured interviews (SSIs) were conducted.

Results
Median number of total images shared were 293 (IQR 1002 images), messages shared 110 (IQR), webpages shared were 54 webpages (61 webpages) and total contents shared by participants was 243 (544 contents). Active contributors showed better performance in utility, competency of contents and attitude towards using social media as a medium for learning. Comparison of written and OSCE results showed better performance after the intervention. Feedback form with Likert scale revealed that students responded positively regarding the shared learning content. Thematic analysis showed 52 codes and 16 themes.

Conclusion
In this research we have observed that WhatsApp is highly efficient and productive academic tool which can amplify postgraduate radiology education. Student’s narrative reflects that residents have found the missing link which can take them to radiological professional excellence through targeted high-profile learning outside lecture hall in time and place convenient motivational environment. Once it will be blended with existing teaching strategy, it can prove to be a game changer.
Predictors of grit among medical students: a study at a Malaysian Public University
Authors: Ibrahim Nurfauzani , Mohamad Mariam , Abdul-Razak Suraya , Mohamed-Yassin Mohamed-Syarif , Baharudin Noorhida 
Published: July 2024

Abstract
Background
Previous literature has demonstrated associations between grit and positive educational and psychological outcomes, such as higher academic grades, lower attrition rates in medical training, and protection from burnout. However, the predictors of grit have yet to be studied, particularly among medical students in Malaysia. This study aimed to determine the level of grit and its predictors among Malaysian medical students.

Methods
A cross-sectional study was conducted among 123 medical students from a public university in Malaysia. Data on sociodemographic and educational characteristics were collected. The student’s personality traits were determined using the Big Five Inventory (BFI), while grit was assessed using the validated 7-item Short Grit Scale (Grit-S). Grit was expressed as a mean score, ranging from 1 (not at all gritty) to 5 (extremely gritty). Multiple linear regression was used to determine the association between the predictors (personality, sociodemographic and educational characteristics) and grit among these students.

Results
The mean grit score was 3.43 (SD 0.57). Based on the multiple linear regression analysis, the grit score was significantly predicted by three personality traits which were extraversion, b = 0.2 (95% CI: 0.07–0.32), agreeableness, b = 0.28 (95% CI: 0.12–0.44) and conscientiousness, b = 0.6 (95% CI: 0.42–0.77). A 1-point increase in the mean extraversion, agreeableness, and conscientiousness scores would independently increase these students’ mean grit scores by 0.2, 0.28, and 0.6, respectively. The sociodemographic and educational characteristics did not significantly predict grit among Malaysian medical students.

Conclusions
The mean grit score among Malaysian medical students is comparable to other medical students in Asia. Extraversion, agreeableness, and conscientiousness personality traits were associated with higher grit. As grit is a dynamic trait, appropriate interventions should be implemented to foster and increase it among these students.
WHO antenatal care policy and prevention of malaria in pregnancy in sub-Saharan Africa
Authors: Olapeju Bolanle , Bride Michael , Gutman Julie R. , Wolf Katherine , Wabwire Scolastica , Atobrah Deborah , Babanawo Felicia , Akrofi Otubea Owusu , Atta-Obeng Christian , Soro Benjamin Katienefohoua , Touré Fady , Shekarau Emmanuel , Hendrickson Zoé M. 
Published: July 2024

Abstract
Background
The WHO 2016 antenatal care (ANC) policy recommends at least eight antenatal contacts during pregnancy. This study assessed ANC8 uptake following policy implementation and explored the relationship between ANC attendance and intermittent preventive treatment in pregnancy (IPTp) coverage in sub-Saharan Africa following the rollout of the World Health Organization (WHO) 2016 ANC policy, specifically, to assess differences in IPTp uptake between women attending eight versus four ANC contacts.

Methods
A secondary analysis of data from 20 sub-Saharan African countries with available Demographic Health and Malaria Indicator surveys from 2018 to 2023 was performed. The key variables were the number of ANC contacts and IPTp doses received during a participant's last completed pregnancy in the past two years. Pooled crude and multivariable logistic regression models were used to explore factors associated with attendance of at least four or eight ANC contacts as well as receipt of at least three doses of IPTp during pregnancy.

Results
Overall, only a small proportion of women (median = 3.9%) completed eight or more ANC contacts (ANC8 +). Factors significantly associated with increased odds of ANC8 + included early ANC attendance (AOR: 4.61: 95% CI 4.30—4.95), literacy (AOR: 1.20; 95% CI 1.11—1.29), and higher wealth quintile (AOR: 3.03; 95% CI 2.67—3.44). The pooled estimate across all countries showed a very slight increase in the odds of IPTp3 + among women with eight (AOR: 1.06; 95% CI 1.00—1.12) compared to those with four contacts. In all but two countries, having eight instead of four ANC contacts did not confer significantly greater odds of receiving three or more doses of IPTp (IPTp3 +), except in Ghana (AOR: 1.67; 95% CI 1.38—2.04) and Liberia (AOR: 1.43; 95% CI 1.18—1.72).

Conclusion
Eight years after the WHO ANC policy recommendation, all countries still had sub-optimal ANC8 + coverage rates. This paper is a call to action to actualize the vision of the WHO and the global malaria community of a malaria free world. Policies to improve ANC and IPTp coverage should be operationalized with clear actionable guidance and local ownership. Study findings can be used to inform multi-level policy, programmatic, and research recommendations to optimize ANC attendance and malaria in pregnancy prevention, thus improving maternal and child health outcomes, including the reduction of malaria in pregnancy.