bluuebunny/crossref_metadata_2025_split huggingface dataset:
Protocol for the CHINT study: a cross-sectional observational study of risk factors for cancer and other non-communicable diseases in the Chinese community of Milan
Authors: Avancini Alice , Baldassari Ivan , Gargano Giuliana , Lu Ming , Jing Hao , Zhao Hongwei , Zhang Ji , Sieri Sabina , Mussa Francesca Romana , Krogh Vittorio , Apolone Giovanni , Pala Valeria 
Published: January 2024

IntroductionThe Chinese community in Italy is the largest in Europe. The area of Milan hosts the largest Chinese Italian community—about 41 000 people. Since little is known of the health practices of Chinese persons in Italy, we designed the CHINT study (survey of risk factors for cancer and other non-communicable diseases (NCDs) in the Chinese community of Milan) to investigate lifestyle-related risk factors for these diseases in this community. We expect the study to reveal potentially unhealthy lifestyle behaviours that may be addressed in future prevention programmes.Methods and analysisThe CHINT study is a cross-sectional study on a sample of around 600 adults recruited from the Chinese community of Milan and surrounding areas. The non-random sample is clustered by age, sex, occupation and socioeconomic characteristics and is being recruited with the active cooperation of stakeholders within the Chinese community. The study employs face-to-face meetings, text messaging and WeChat. At the first recruitment meeting, participants’ physical measurements are taken and a lifestyle questionnaire is administered which enquires about physical activity, the consumption of salt, fruit and vegetables, tobacco and alcohol, and the presence of other risk factors for NCDs. A food frequency questionnaire is in preparation. By analysis of physical data and the results of the two questionnaires, the prevalence and distribution of NCD risk factors, and characteristics associated with these factors, will be identified. Factors associated with recruitment and compliance/retention will be investigated to identify predictors of willingness to participate future intervention studies.Ethics and disseminationThe study has been approved by the ethics committee of the Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy. All participants are required to provide written informed consent. Findings will be disseminated through peer-reviewed scientific publications, conferences and public meetings involving the Chinese community and the lay public.
Using electronic health records to enhance surveillance of diabetes in children, adolescents and young adults: a study protocol for the DiCAYA Network
Authors: Hirsch Annemarie G , Conderino Sarah , Crume Tessa L , Liese Angela D , Bellatorre Anna , Bendik Stefanie , Divers Jasmin , Anthopolos Rebecca , Dixon Brian E , Guo Yi , Imperatore Giuseppina , Lee David C , Reynolds Kristi , Rosenman Marc , Shao Hui , Utidjian Levon , Thorpe Lorna E 
Published: January 2024

IntroductionTraditional survey-based surveillance is costly, limited in its ability to distinguish diabetes types and time-consuming, resulting in reporting delays. The Diabetes in Children, Adolescents and Young Adults (DiCAYA) Network seeks to advance diabetes surveillance efforts in youth and young adults through the use of large-volume electronic health record (EHR) data. The network has two primary aims, namely: (1) to refine and validate EHR-based computable phenotype algorithms for accurate identification of type 1 and type 2 diabetes among youth and young adults and (2) to estimate the incidence and prevalence of type 1 and type 2 diabetes among youth and young adults and trends therein. The network aims to augment diabetes surveillance capacity in the USA and assess performance of EHR-based surveillance. This paper describes the DiCAYA Network and how these aims will be achieved.Methods and analysisThe DiCAYA Network is spread across eight geographically diverse US-based centres and a coordinating centre. Three centres conduct diabetes surveillance in youth aged 0–17 years only (component A), three centres conduct surveillance in young adults aged 18–44 years only (component B) and two centres conduct surveillance in components A and B. The network will assess the validity of computable phenotype definitions to determine diabetes status and type based on sensitivity, specificity, positive predictive value and negative predictive value of the phenotypes against the gold standard of manually abstracted medical charts. Prevalence and incidence rates will be presented as unadjusted estimates and as race/ethnicity, sex and age-adjusted estimates using Poisson regression.Ethics and disseminationThe DiCAYA Network is well positioned to advance diabetes surveillance methods. The network will disseminate EHR-based surveillance methodology that can be broadly adopted and will report diabetes prevalence and incidence for key demographic subgroups of youth and young adults in a large set of regions across the USA.
Effect of perceived injustice-targeted pain neuroscience education compared with biomedically focused education in breast cancer survivors: a study protocol for a multicentre randomised controlled trial (BCS-PI trial)
Authors: Roose Eva , Huysmans Eva , Leysen Laurence , Mostaqim Kenza , Van Wilgen Paul , Beckwée David , De Couck Marijke , Timmermans Annick , Bults Rinske , Nijs Jo , Lahousse Astrid 
Published: January 2024

IntroductionCurrent treatments for pain in breast cancer survivors (BCSs) are mostly biomedically focused rather than biopsychosocially driven. However, 22% of BCSs with pain are experiencing perceived injustice, which is a known predictor for adverse pain outcomes and opioid prescription due to increased maladaptive pain behaviour. Educational interventions such as pain neuroscience education (PNE) are suggested to target perceived injustice. In addition, motivational interviewing can be an effective behavioural change technique. This trial aims to examine whether perceived injustice-targeted PNE with the integration of motivational interviewing is superior to biomedically focused pain education in reducing pain after 12 months in BCS with perceived injustice and pain. In addition, improvements in quality of life, perceived injustice and opioid use are evaluated, and a cost-effectiveness analysis will finally result in a recommendation concerning the use of perceived injustice-targeted PNE in BCSs with perceived injustice and pain.Methods and analysisThis two-arm multicentre randomised controlled trial will recruit female BCS (n=156) with pain and perceived injustice. Participants will be randomly assigned to perceived injustice-targeted PNE or biomedically focused pain education in each centre. Both interventions include an online session, an information leaflet and three one-to-one sessions. The primary outcome (pain), secondary outcomes (quality of life, perceived injustice and outcomes for cost-effectiveness analysis) and explanatory outcomes (pain phenotyping, sleep, fatigue and cognitive-emotional factors) will be assessed at baseline and at 0, 6, 12 and 24 months postintervention using self-reported questionnaires online. Treatment effects over time will be evaluated using linear mixed model analyses. Additionally, a cost-utility analysis will be done from a healthcare payer and societal perspective.Ethics and disseminationThe ethical agreement was obtained from the Main Ethics Committee (B.U.N.1432020000068) at the University Hospital Brussels and all other participating hospitals. Study results will be disseminated through presentations, conferences, social media, press and journals.Trial registration numberNCT04730154.
Sexual violence victimisation and response among university students in sub-Saharan Africa: a scoping review protocol
Authors: Mzilangwe Ester Steven , Chande Mallya Rehema , Lindkvist Marie , Kaaya Sylvia , Nkulu Kalengayi Faustine Kyungu 
Published: January 2024

IntroductionSexual violence (SV) is highly prevalent among university campuses across the globe, despite of several initiatives implemented to address it. Several studies have been published focusing on various aspects of SV on campuses. However, no review has been retrieved from the Joanna Briggs Institute (JBI) Database, Cochrane Library or Ovid examining evidence synthesis on prevalence, risk factors, victims and perpetrators, policies, laws and universities responses to SV in sub-Saharan Africa (SSA). This review aims to map the existing literature on SV victimisation among university students in SSA, related response strategies, and identify gaps in the evidence.Methods and analysisThis review will follow JBI guidelines and will be conducted from 1 July 2023 to 31 December 2023. A team of five reviewers will screen eligible documents and articles for relevance from various data sources including electronic databases such as MEDLINE, EMBASE, PsycINFO, CINAHL, Google Scholar, PubMed and websites for government and agencies. Standard information for each study will be collected and a common analytical framework for all the primary documents will be conducted.Ethics and disseminationThis review will involve analysis of published data only and therefore does not require ethics approval. The results will be published in a peer-reviewed journal.RegistrationThis review has been registered with the Open Science Framework.
The Brazilian COVID-19 vaccination campaign: a modelling analysis of sociodemographic factors on uptake
Authors: Li Sabrina L , Prete Carlos A , Zarebski Alexander E , de Souza Santos Andreza Aruska , Sabino Ester C , Nascimento Vitor H , Wu Chieh-Hsi , Messina Jane P 
Published: January 2024

ObjectiveDose shortages delayed access to COVID-19 vaccination. We aim to characterise inequality in two-dose vaccination by sociodemographic group across Brazil.DesignThis is a cross-sectional study.SettingWe used data retrieved from the Brazilian Ministry of Health databases published between 17 January 2021 and 6 September 2021.MethodsWe assessed geographical inequalities in full vaccination coverage and dose by age, sex, race and socioeconomic status. We developed a Campaign Optimality Index to characterise inequality in vaccination access due to premature vaccination towards younger populations before older and vulnerable populations were fully vaccinated. Generalised linear regression was used to investigate the risk of death and hospitalisation by age group, socioeconomic status and vaccination coverage.ResultsVaccination coverage is higher in the wealthier South and Southeast. Men, people of colour and low-income groups were more likely to be only partially vaccinated due to missing or delaying a second dose. Vaccination started prematurely for age groups under 50 years which may have hindered uptake in older age groups. Vaccination coverage was associated with a lower risk of death, especially in older age groups (ORs 9.7 to 29.0, 95% CI 9. 4 to 29.9). Risk of hospitalisation was greater in areas with higher vaccination rates due to higher access to care and reporting.ConclusionsVaccination inequality persists between states, age and demographic groups despite increasing uptake. The association between hospitalisation rates and vaccination is attributed to preferential delivery to areas of greater transmission and access to healthcare.
Is male gynaecomastia associated with an increased risk of death? A nationwide register-based cohort study
Authors: Bräuner Elvira V , Uldbjerg Cecilie , Lim Youn-Hee , Beck Astrid , Hueg Trine , Juul Anders 
Published: January 2024

ObjectiveRecent evidence supports that gynaecomastia may predict long-term morbidity, but evidence on the association with death and causes of death in males with gynaecomastia is lacking. The objective of this work is to estimate the risk of death in men diagnosed with gynaecomastia and evaluate whether this was conditional on underlying aetiologies of gynaecomastia.DesignA nationwide register-based cohort study.SettingNationwide Danish national health registries.ParticipantsMales were diagnosed with incident gynaecomastia (n=23 429) from 1 January 1995 to 30 June 2021, and each was age and calendar matched to five randomly population-based males without gynaecomastia (n=117 145).InterventionsNot applicable.Primary and secondary outcomesGynaecomastia was distinguished between maleswithout(idiopathic) and maleswitha known pre-existing risk factor. Cox regression models and Kaplan-Meier analyses estimated associations between gynaecomastia and death (all cause/cause specific).ResultsWe identified a total of 16 253 males withidiopathicgynaecomastia and 7176 with gynaecomastia anda known pre-existing risk factor. Of these, 1093 (6.7%) and 1501 (20.9%) died during follow-up, respectively. We detected a 37% increased risk of all-cause death in males with gynaecomastia in theentire cohort(HR 1.37; 95% CI 1.31 to 1.43). Death risk was highest in males diagnosed with gynaecomastia and aknown pre-existing risk factor(HR 1.75; 95% CI 1.64 to 1.86) compared with males withidiopathicgynaecomastia (HR 1.05; 95% CI 0.98 to 1.13). Specific causes of increased death were malignant neoplasms and circulatory, pulmonary and gastrointestinal diseases. Of the latter, an over fivefold risk of death from liver disease was detected (HR 5.05; 95% CI 3.97 to 6.42).ConclusionsMales diagnosed with gynaecomastia are at higher risk of death, observed mainly in males with a known pre-existing risk factor of gynaecomastia. These findings will hopefully stimulate more awareness among healthcare providers to potentially apply interventions that aid in alleviating underlying risk factors in males with this condition.
Role matters in understanding ‘quality’ in palliative care: a qualitative analysis of patient, caregiver and practitioner perspectives
Authors: Holdsworth Laura M , Giannitrapani Karleen , Gamboa Raziel C , O’Hanlon Claire , Singh Nainwant , Walling Anne , Lindvall Charlotta , Lorenz Karl 
Published: January 2024

ObjectivesTo compare the discussions from two panels on the concept of palliative care quality for patients with advanced cancer, exploring the priorities reflected in each group’s perspectives.DesignWe convened two RAND-UCLA appropriateness panel discussions on palliative care quality in advanced cancer. Discussions were audio-recorded and transcribed verbatim. Panel transcripts were analysed thematically using a matrix approach to examine perceptions and experiences of quality.SettingDiscussions were framed within the context of advanced cancer care and palliative care.ParticipantsThe patient–caregiver panel had 9 patients with current or a history of cancer and caregivers, and the practitioner panel had 10 expert practitioners representing fields of oncology, primary care, social work, palliative care, nursing, pain management and ethics.ResultsOur analysis identified three thematic categories for understanding quality common across both groups and nine subthemes within those categories. At the highest level, quality was conceived as: (1) the patient and caregiver experience of care, (2) technical competence and (3) the structure of health system. Among the subthemes, four were present in only one of the two group’s discussions: ‘purpose and action’ was specific to the patient–caregiver panel, whereas ‘adhering to best medical practice’, ‘mitigating unintended consequences and side effects’, and ‘health system resources and costs’ were specific to the practitioner panel.ConclusionsWhile both panels aligned on the three key domains of quality, the particular dimensions through which they perceived quality varied in relation to their experience and role as a professional provider of care versus recipient of healthcare services. These differences suggest the importance of adopting a collaborative approach to quality measurement and improvement so that the values of all interested parties are represented in improvement efforts.
Thematic analysis to explore patients’ experiences with long COVID-19: a conceptual model of symptoms and impacts on daily lives
Authors: Rofail Diana , Somersan-Karakaya Selin , Choi Julia Y , Przydzial Krystian , Zhao Yuming , Hussein Mohamed , Norton Thomas D , Podolanczuk Anna J , Mylonakis Eleftherios , Geba Gregory P 
Published: January 2024

ObjectivesThere is limited qualitative research on patients’ experiences with long COVID-19, and how specific symptoms impact their daily lives. The study aimed to understand patients’ lived experiences of long COVID-19 and to develop a conceptual model representing the symptoms and their impact on overall quality of life.SettingQualitative study consisting of a comprehensive literature review, and in-depth clinician and patient semistructured interviews.ParticipantsForty-one adult patients with long COVID-19, of whom 18 (44%) were recruited through Regeneron Pharmaceuticals’s clinical trials and 23 (56%) through recruitment agencies; 85.4% were female and 73.2% were White. Five independent clinicians treating patients with long COVID-19 were interviewed. Concept saturation was also assessed.Primary and secondary outcomesInterview transcripts were analysed thematically to identify concepts of interest spontaneously mentioned by patients, including symptoms and their impacts on daily life, to guide the development of the conceptual model.ResultsFindings from the literature review and clinician and patient interviews resulted in the development of a conceptual model comprising two overarching domains: symptoms (upper respiratory tract, lower respiratory tract, smell and taste, systemic, gastrointestinal, neurocognitive and other) and impacts (activities of daily living, instrumental activities of daily living, physical impacts, emotional, social/leisure activities and professional impacts). Saturation was achieved for the reported impacts. The symptoms reported were heterogenic; neurocognitive symptoms, such as numbness, ringing in ears, haziness, confusion, forgetfulness/memory problems, brain fog, concentration, difficulties finding the right word and challenges with fine motor skills, were particularly pertinent for several months.ConclusionThe conceptual model, developed based on patient experience data of long COVID-19, highlighted numerous symptoms that impact patients’ physical and mental well-being, and suggests humanistic unmet needs. Prospective real-world studies are warranted to understand the pattern of long COVID-19 experienced in larger samples over longer periods of time.
Exploring the motivation of self-directed learning of hospital pharmacists: a multicentre qualitative study
Authors: Wang Xiangyu , Wen Linlin , Fu Hang , Yin Zhao 
Published: January 2024

ObjectiveSelf-directed learning (SDL) has been embraced by the medical community as a core professional competency, with motivation considered a crucial component of SDL. However, little is known about how hospital pharmacists perceive motivation in SDL in the workplace. This study aimed to examine the intrinsic and external motivation of hospital pharmacists in SDL.DesignThis study employed a multicentre qualitative design, which lasted 13 months from May 2020 to June 2021. The interviews were audiorecorded, transcribed verbatim and analysed in NVivo V.12.0. Thematic analysis method was used to analyse the data.SettingThe study took place in nine public hospitals located in urban areas of Henan Province.ParticipantsSixteen hospital pharmacists were enrolled from the pharmacy departments of the sample hospitals, using a purposive sampling method.ResultsSixteen one-on-one semistructured interviews were conducted, identifying intrinsic and extrinsic motivation in SDL for hospital pharmacists in the workplace. Intrinsic motivation includes curiosity and interest, achievement, self-efficacy and personal growth. Extrinsic motivation includes a more comprehensive set of elements, such as interpersonal motivations, work-related motivations and career-related motivations.ConclusionsPersonal interests, the influence of surrounding individuals (directly or indirectly), work-related requirements and pressures, and professional development requirements and pressures are the main intrinsic or extrinsic motivations for SDL among hospital pharmacists in China. Future research may focus on these aspects to enhance the SDL competence of hospital pharmacists and other medical personnel.
Promoting maternal-child health by increasing breastfeeding rates: a National Canadian Baby-Friendly Initiative Quality Improvement Collaborative Project
Authors: LeDrew Michelle , Benoit Britney , O'Grady Kathleen , Ustianov Jennifer , Edwards Candi , Gallant Claire , Loring Sally , Clément Louise , Aziz Khalid , Green Marina , O’Sullivan Pam , Nickel Nathan Christopher 
Published: January 2024

While breastfeeding has long been an important, globally recognized aspect of population health, disparities exist across Canada. The Baby-Friendly Initiative (BFI) is a WHO/UNICEF best-practice program that helps ensure families receive evidence-based perinatal care and is associated with improved breastfeeding rates. However, <10% of hospitals in Canada are designated as ‘Baby-Friendly’.The Breastfeeding Committee for Canada (BCC) aimed to increase the number of hospitals that moved towards BFI designation by implementing a National BFI Quality Improvement Collaborative Project. Key activities included (1) implementing and evaluating the BFI Project with 25 hospital teams across Canada and (2) making recommendations for scaling up BFI in Canada.As of December 2023, three hospitals in the BFI Project have attained designation and six have started the official process towards designation with the BCC. Breastfeeding initiation rates remained high and stable (>80%); however, breastfeeding exclusivity rates did not meet targets. All BFI care indicators improved across participating facilities. All skin-to-skin indicators improved, with rates of immediate and sustained skin-to-skin meeting targets of >80% for vaginal births. BFI care indicators of documented assistance and support with breastfeeding within 6 hours of birth, rooming-in and education about community supports also met target levels. Leadership buy-in, parent partner engagement and collaborative activities of workshops, webinars and mentoring with BFI Project leadership were viewed as valuable.This BFI Project demonstrated that hospitals could successfully implement Baby-Friendly practices in various Canadian settings despite challenges introduced by the COVID-19 pandemic. Indicators collected as part of this work demonstrate that delivery of Baby-Friendly care improved in participating facilities. Sustainability and scaling up BFI implementation in both hospitals and community health services across Canada through implementation of a BFI Coach Mentor Program is ongoing to enable continued progress and impact on breastfeeding and maternal-child health.