bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimising HIV drug resistance testing laboratory networks in Kenya: insights from systems engineering modelling
Authors: Wang Yinsheng , Kingwara Leonard , Wagner Anjuli Dawn , Yongo Nashon , Hassan Shukri A , Liu Shan , Oyaro Patrick , Patel Rena C 
Published: April 2024

BackgroundHIV drug resistance (DR) is a growing threat to the durability of current and future HIV treatment success. DR testing (DRT) technologies are very expensive and specialised, relying on centralised laboratories in most low and middle-income countries. Modelling for laboratory network with point-of-care (POC) DRT assays to minimise turnaround time (TAT), is urgently needed to meet the growing demand.MethodsWe developed a model with user-friendly interface using integer programming and queueing theory to improve the DRT system in Kisumu County, Kenya. We estimated DRT demand based on both current and idealised scenarios and evaluated a centralised laboratory-only network and an optimised POC DRT network. A one-way sensitivity analysis of key user inputs was conducted.ResultsIn a centralised laboratory-only network, the mean TAT ranged from 8.52 to 8.55 working days, and the system could not handle a demand proportion exceeding 1.6%. In contrast, the mean TAT for POC DRT network ranged from 1.13 to 2.11 working days, with demand proportion up to 4.8%. Sensitivity analyses showed that expanding DRT hubs reduces mean TAT substantially while increasing the processing rate at national labs had minimal effect. For instance, doubling the current service rate at national labs reduced the mean TAT by only 0.0%–1.9% in various tested scenarios, whereas doubling the current service rate at DRT hubs reduced the mean TAT by 37.5%–49.8%. In addition, faster batching modes and transportation were important factors influencing the mean TAT.ConclusionsOur model offers decision-makers an informed framework for improving the DRT system using POC in Kenya. POC DRT networks substantially reduce mean TAT and can handle a higher demand proportion than a centralised laboratory-only network, especially for children and pregnant women living with HIV, where there is an immediate push to use DRT results for patient case management.
Mental health inequalities, challenges and support needs during COVID-19: a qualitative study of 14-to-25-year-olds in London
Authors: Lee Jasmine , Wong Keri Ka-Yee 
Published: April 2024

ObjectivesThe impact of the COVID-19 pandemic on adolescent’s mental health and relationships has received growing attention, yet the challenges and support needs of adolescents living in existing deprivation are not well understood. The current qualitative study, part of a broader project cocreating mental health and life-skill workshops with young people, documents adolescents’ lived experience and support needs 4 years on from the COVID-19 pandemic.Design20 semi-structured interviews and 6 focus groups were transcribed and thematically analysed in NVivo V.12 to inform codesigned workshops to support adolescents’ needs.SettingIslington borough in North London, United Kingdom.Participants20 adolescents aged 14–25 years (mean=18.3; 60% female, 60% white) from Islington with a history of difficulties (eg, mental health, deprivation, court order) were referred by Islington local authority teams to our study.ResultsThematic analyses revealed eight themes on adolescents’ COVID-19 experiences and five associated suggestions on ‘support needs’: health challenges and support; relationships and support; routines and support; educational challenges and learning support; inequality and support; distrust; loss of opportunities and grief.ConclusionsIn our qualitative study, adolescents spoke of positive reflections, challenges, and need for support 4 years on from the COVID-19 pandemic. Many adolescents shared their lived experiences for the first time with someone else and wished they would have the space and time to acknowledge this period of loss. Adolescents living with existing inequality and deprivation before the pandemic have reported sustained and exacerbated impacts during the pandemic, hence coproduced support for adolescents should be a priority.
Disparities in awareness and utilisation of National Essential Public Health Services between the floating population and the registered residents: a cross-sectional study in China
Authors: Wang Jin , Bai Lan , Xu Xinpeng 
Published: April 2024

ObjectiveThere are differences between the floating population and the registered population in the awareness and use of the National Essential Public Health Services (NEPHS) due to the influence of China’s household registration system. The Equalization of Basic Public Health and Family Planning Services (EBPHFPS) policy aims to reduce disparities among populations by enhancing the migrant population’s access to basic public health services. The aim of this study is to examine the relationship between the EBPHFPS targeted at the floating population and the disparities in access to and utilisation of NEPHS between registered residents and the floating population.DesignA cross-sectional study.Setting8 cities (regions, autonomous prefectures) in China.Participants13 998 floating population and 14 000 registered residents in eight cities (regions, autonomous prefectures) were included in the analysis.Outcome measuresThree binomial variables, including awareness of NEPHS, acceptance of health education and establishment of health records, were used as outcome indicators to examine the relationship between the EBPHFPS and the disparities between the floating and registered populations.MethodsA linear regression model, fairness gap calculation and propensity score matching were used to explore the associations.ResultsThe areas that implemented EBPHFPS exhibited an 8.3% increase in awareness of the NEPHS (p<0.01) and a 4.0% increase (p<0.05) in the likelihood of individuals having received health education within the previous year compared with the areas without the policy implementation. In contrast to registered residents, however, the floating population still faces significant disparities in NEPHS awareness and utilisation. Compared with areas without the equalisation policy, the inequality of opportunity in health education of the floating population in implementation areas is significantly lower (p<0.01), whereas no significant difference is observed in the inequality of opportunity regarding NEPHS awareness among the floating population (p>0.1). The floating population in the pilot areas of the policy encountered greater disparities in the establishment of health records (p<0.01).ConclusionsPositive associations between the EBPHFPS policy and NEPHS awareness and utilisation among the floating population were demonstrated to some extent; however, the floating population was still confronted with a degree of inequality of opportunity. The government needs to develop target-oriented policies and a guaranteed mechanism to ensure access to NEPHS among the floating population.
Measurement properties of the Mental Health Literacy Scale (MHLS) validation studies: a systematic review protocol
Authors: ElKhalil Rouwida , AlMekkawi Mohamad , O'Connor Matt , Sherif Moustafa , Masuadi Emad , Ahmed Luai A , Al-Rifai Rami H , Belfakir Messaouda , Bayoumi Rasha , Elbarazi Iffat 
Published: April 2024

IntroductionMental Health Literacy (MHL) is important for improving mental health and reducing inequities in treatment. The Mental Health Literacy Scale (MHLS) is a valid and reliable assessment tool for MHL. This systematic review will examine and compare the measurement properties of the MHLS in different languages, enabling academics, clinicians and policymakers to make informed judgements regarding its use in assessments.Methods and analysisThe review will adhere to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology for systematic reviews of patient-reported outcome measures and the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis and will be presented following the Preferred Reporting Items for Systematic reviews and Meta-Analysis 2020 checklist. The review will be conducted in four stages, including an initial search confined to PubMed, a search of electronic scientific databases PsycINFO, CINAHL, Scopus, MEDLINE, Embase (Elsevier), PubMed (NLM) and ERIC, an examination of the reference lists of all papers to locate relevant publications and finally contacting the MHLS original author to identify validation studies that the searches will not retrieve. These phases will assist us in locating studies that evaluate the measurement properties of MHLS across various populations, demographics and contexts. The search will focus on articles published in English between May 2015 and December 2023. The methodological quality of the studies will be evaluated using the COSMIN Risk of Bias checklist, and a comprehensive qualitative and quantitative data synthesis will be performed.Ethics and disseminationEthics approval is not required. The publication will be in peer-reviewed journals and presented at national and international conferences.PROSPERO registration numberCRD42023430924.
Inter-facility transfers for emergency obstetrical and neonatal care in rural Madagascar: a cost-effectiveness analysis
Authors: Franke Mara Anna , Nordmann Kim , Frühauf Anna , Ranaivoson Rinja Mitolotra , Rebaliha Mahery , Rapanjato Zavaniarivo , Bärnighausen Till , Muller Nadine , Knauss Samuel , Emmrich Julius Valentin 
Published: April 2024

ContextThere is a substantial lack of inter-facility referral systems for emergency obstetrical and neonatal care in rural areas of sub-Saharan Africa. Data on the costs and cost-effectiveness of such systems that reduce preventable maternal and neonatal deaths are scarce.SettingWe aimed to determine the cost-effectiveness of a non-governmental organisation (NGO)-run inter-facility referral system for emergency obstetrical and neonatal care in rural Southern Madagascar by analysing the characteristics of cases referred through the intervention as well as its costs.DesignWe used secondary NGO data, drawn from an NGO’s monitoring and financial administration database, including medical and financial records.Outcome measuresWe performed a descriptive and a cost-effectiveness analysis, including a one-way deterministic sensitivity analysis.Results1172 cases were referred over a period of 4 years. The most common referral reasons were obstructed labour, ineffective labour and eclampsia. In total, 48 neonates were referred through the referral system over the study period. Estimated cost per referral was US$336 and the incremental cost-effectiveness ratio (ICER) was US$70 per additional life-year saved (undiscounted, discounted US$137). The sensitivity analysis showed that the intervention was cost-effective for all scenarios with the lowest ICER at US$99 and the highest ICER at US$205 per additional life-year saved. When extrapolated to the population living in the study area, the investment costs of the programme were US$0.13 per person and annual running costs US$0.06 per person.ConclusionsIn our study, the inter-facility referral system was a very cost-effective intervention. Our findings may inform policies, decision-making and implementation strategies for emergency obstetrical and neonatal care referral systems in similar resource-constrained settings.
Head impact differences in blind football between Rio 2016 and Tokyo 2020 Paralympic Games: video-based observational study
Authors: Tsutsumi Shogo , Sasadai Junpei , Maeda Noriaki , Tamura Yuki , Nagao Takumi , Watanabe Tomoya , Arima Satoshi , Kaneda Kazuki , Yoshimi Mitsuhiro , Mizuta Rami , Ishihara Honoka , Shimizu Reia , Fukui Kazuki , Tashiro Tsubasa , Komiya Makoto , Suzuki Akira , Urabe Yukio 
Published: April 2024

ObjectiveIn Tokyo 2020 Paralympic Games, there were the rule and goal size changes at the blind football competition. This study aimed to compare the scoring and head impact characteristics during blind football competition between the Rio 2016 and Tokyo 2020 Paralympic Games using the official videos.DesignVideo-based observational study.ParticipantsIn total, 36 blind football (men’s football 5-a-side) game videos were obtained from the official International Paralympic Committee.Primary and secondary outcome measuresHead impact was defined as the sudden contact of any object with the head. Videos were analysed to assess the number of scores and head impacts along with their corresponding details (ie, round, playing phase, scoring situation, impact situation, occurrence area, impact object, head impact site, fall and foul).ResultsThe total number of goals scored at the Tokyo 2020 Paralympic Games was nearly double that at the Rio 2016 Paralympic Games. Regarding head impacts, a total of 2036 cases (Rio 2016, n=1105; Tokyo 2020, n=931) were evaluated. Significant differences were observed in head impact characteristics between the Rio 2016 and Tokyo 2020 Paralympic Games among seven outcomes (round, scoring situation, impact situation, occurrence area, impact object, site of head impact and fall).ConclusionsCompared with the Rio 2016 Paralympic Games, the Tokyo 2020 Paralympic Games showed an increase in the number of points scored and different head impact characteristics.
Relationship among core competency, self-efficacy and transition shock in Chinese newly graduated nurses: a cross-sectional study
Authors: Tong Yahui , Wang Ting , Tong Shuping , Tang Zhaofang , Mao Lifen , Xu Lan , Shi Xiaoqing 
Published: April 2024

ObjectivesTo investigate how core competency and self-efficacy of newly graduated nurses affect their experience of transition shock, and to determine the relationship between these factors.DesignA cross-sectional study.Methods262 newly graduated nurses participated in a cross-sectional study by using demographic data, the transition shock scale, the competency inventory for registered nurses scale and the self-efficacy scale.ResultsAmong newly graduated nurses, the score of transition shock was 77.641±24.140, the score of core competency was 125 (109.5, 163.5) and the score of self-efficacy was 2.5 (2,3), all of which were at a moderate level. The core competency and self-efficacy of the newly graduated nurses had a negative impact on the transition shock (β=−0.151, p=0.026; β=−0.379, p<0.001). Additionally, self-efficacy played a mediating role in the relationship between core competency and transition shock, with a mediating effect accounting for 57.34% of the total effect.ConclusionsThe transition shock of newly graduated nurses was at a moderate level, with the highest level of transition shock occurring within the first year of employment. Self-efficacy plays a mediating role in the relationship between core competency and transition shock. Nursing managers should create standardised training for newly graduated nurses within the first year of employment to reduce their transition shock. This will help improve newly graduated nurses’ core competency, enhance self-efficacy and support the graduates. This will alleviate the impact of transition shock on newly graduated nurses, helping them transition smoothly and successfully.
Analysis on the willingness and influencing factors of choosing hospice care service institutions among among older people in Wuhu, China: a cross-sectional study
Authors: Yang Liu , Zhou Quan , Hong Ting , Zhang Lin , Che Hengying 
Published: April 2024

ObjectiveThe purpose of this study was to evaluate the inclination and determinants influencing the selection of hospice care service institutions among elderly individuals in China.DesignThe study conducted has a cross-sectional design.SettingThe study was conducted at four urban community centres in Wuhu, Anhui Province, China.ParticipantsThe sample consisted of 642 older adults, with ages ranging from 60 to over (mean age=71.03 years, SD=7.18).MethodThis study, based on the Anderson model, developed a questionnaire after conducting a preliminary survey and engaging in several group discussions. The final questionnaire encompassed the basic information, health status, attitude towards hospice care, choice of hospice care institutions and reasons of the older people. A regional population study was conducted using the Logistic regression model to estimate the ORs (OR) of influencing factors selected by hospice services.Results38.5% of respondents expressed their willingness to receive hospice care, while 22.3% were unwilling and 39.3% felt ambivalent towards it. The acceptance rate of older people in hospice care increases with higher levels of education and monthly income. 47.0% of older people opted for hospice care in a general hospital ward, indicating that demand for hospice services among older people in Wuhu City is primarily focused on such wards. The univariate analysis revealed significant differences in the willingness of older individuals to accept hospice care services based on gender, age, educational attainment and income levels. Regardless of the location of hospice care, older men had a lower likelihood of being willing to use hospice services compared with older women. The proportion of older women choosing a hospice ward or general hospital was 53.8%, which was higher than that of older men at 42.0%. The proportion of older men choosing a community health service institution was 31.6%, higher than 23.3% of women. The educational level differences significantly influence the older people’s inclination towards receiving hospice care.ConclusionWith the ageing population of Wuhu City on the rise, there is an increasing demand for hospice services. In their final journey, older individuals require multilevel hospice care services, which necessitates equipping general hospitals with hospice wards and using community health service centres to meet their specific needs.
Association between breast feeding and food consumption according to the degree of processing in Brazil: a cohort study
Authors: Abreu de Carvalho Carolina , Viola Poliana Cristina de Almeida Fonseca , Magalhães Elma Izze da Silva , Machado Soraia Pinheiro , Matijasevich Alicia , Menezes Ana Maria Baptista , Tovo-Rodrigues Luciana , Santos Ina S , Goncalves Helen , Wehrmeister Fernando C , Horta Bernardo Lessa , Moura da Silva Antônio Augusto 
Published: April 2024

BackgroundThe benefits of breast feeding may be associated with better formation of eating habits beyond childhood. This study was designed to verify the association between breast feeding and food consumption according to the degree of processing in four Brazilian birth cohorts.MethodsThe duration of exclusive, predominant and total breast feeding was evaluated. The analysis of the energy contribution of fresh or minimally processed foods (FMPF) and ultra-processed foods (UPF) in the diet was evaluated during childhood (13–36 months), adolescence (11–18 years) and adulthood (22, 23 and 30 years).ResultsThose who were predominantly breastfed for less than 4 months had a higher UPF consumption (β 3.14, 95% CI 0.82 to 5.47) and a lower FMPF consumption (β −3.47, 95% CI −5.91 to −1.02) at age 22 years in the 1993 cohort. Exclusive breast feeding (EBF) for less than 6 months was associated with increased UPF consumption (β 1.75, 95% CI 0.25 to 3.24) and reduced FMPF consumption (β −1.49, 95% CI −2.93 to −0.04) at age 11 years in the 2004 cohort. In this same cohort, total breast feeding for less than 12 months was associated with increased UPF consumption (β 1.12, 95% CI 0.24 to 2.19) and decreased FMPF consumption (β −1.13, 95% CI −2 .07 to −0.19). Children who did not receive EBF for 6 months showed an increase in the energy contribution of UPF (β 2.36, 95% CI 0.53 to 4.18) and a decrease in FMPF (β −2.33, 95% CI −4 .19 to −0.48) in the diet at 13–36 months in the 2010 cohort. In this cohort, children who were breastfed for less than 12 months in total had higher UPF consumption (β 2.16, 95% CI 0.81 to 3.51) and lower FMPF consumption (β −1.79, 95% CI −3.09 to −0.48).ConclusionExposure to breast feeding is associated with lower UPF consumption and higher FMPF consumption in childhood, adolescence and adulthood.
Prospective diagnostic accuracy study of history taking and physical examination for adults with vertigo in general practice: study protocol
Authors: Ross Andrew , Leemeyer Anna-Marie Rebecca , Bruintjes Tjasse D , Cals Jochen W L , Bronstein Adolfo , van Leeuwen Roeland B , Lissenberg-Witte Birgit , van Vugt Vincent Alexander , Rutgers Sandra , Maarsingh Otto R 
Published: April 2024

IntroductionVertigo is a prevalent and burdensome symptom. More than 80% of patients with vertigo are primarily treated by their general practitioner (GP) and are never referred to a medical specialist. Despite this therapeutic responsibility, the GP’s diagnostic toolkit has serious limitations. All recommended tests lack empirical evidence, because a diagnostic accuracy study on vestibular disorders (‘How well does test x discriminate between patients with or without target condition y?’) has never been performed in general practice. The VERtigo DIagnosis study aims to fill this gap.Methods and analysisWe will perform a diagnostic accuracy study on vertigo of primary vestibular origin in general practice to assess the discriminative ability of history taking and physical examination. We will compare all index tests with a respective reference standard. We will focus on five target conditions that account for more than 95% of vertigo diagnoses in general practice: (1) benign paroxysmal positional vertigo, (2) vestibular neuritis, (3) Ménière’s disease, (4) vestibular migraine (VM) and (5) central causes other than VM. As these five target conditions have a different pathophysiology and lack one generally accepted gold standard, we will use consensus diagnosis as a construct reference standard. Data for each patient, including history, physical examination and additional tests as recommended by experts in an international Delphi procedure, will be recorded on a standardised form and independently reviewed by a neurologist and otorhinolaryngologist. For each patient, the reviewers have to decide about the presence/absence of each target condition. We will calculate sensitivity, specificity, predictive values, likelihood ratios and diagnostic ORs, followed by decision rules for each target condition.Ethics and disseminationThe study obtained approval from the Vrije Universiteit Medical Center Medical Ethical Review Committee (reference: 2022.0817—NL83111.029.22). We will publish our findings in peer-reviewed international journals.Trial registration numberISRCTN97250704.