bluuebunny/crossref_metadata_2025_split huggingface dataset:
Depression and determinants among diabetes mellitus patients in Ethiopia, a systematic review and meta-analysis
Authors: Tegegne Kirubel Dagnaw , Gebeyehu Natnael Atnafu , Kassaw Mesfin Wudu 
Published: March 2023

Abstract
Introduction
Primary studies have estimated the prevalence of depression and its determinants among diabetes patients. However, studies synthesizing this primary evidence are limited. Hence, this systematic review aimed to determine the prevalence of depression and identify determinants of depression among diabetes in Ethiopia.

Methods
This systematic review and meta-analysis included a search of PubMed, Google Scholar, Scopus, Science Direct, PsycINFO, and Cochrane library. Data were extracted using Microsoft Excel and analyzed using STATA statistical software (v. 14). Data were pooled using a random-effects model. Forest plots, and Egger’s regression test were all used to check for publication bias. Heterogeneity (I)2 was computed. Subgroup analysis was done by region, publication year, and depression screening instrument. In addition, the pooled odds ratio for determinants was calculated.

Results
Sixteen studies, including 5808 participants were analyzed. The prevalence of depression in diabetes was estimated to be 34.61% (95% CI: 27.31–41.91). According to subgroup analysis by study region, publication year, and screening instrument, the highest prevalence was observed in Addis Ababa (41.98%), studies published before 2020 (37.91%), and studies that used Hospital Anxiety and Depression Scale (HADS-D) (42.42%,) respectively. Older age > 50 years (AOR = 2.96; 95% CI: 1.71–5.11), being women (AOR = 2.31; 95% CI: 1.57, 3.4), longer duration with diabetes (above 5 years) (AOR = 1.98; 95% CI: 1.03–3.8), and limited social support (AOR = 2.37; 95% CI: 1.68–3.34), were the determinants of depression in diabetic patients.

Conclusion
The results of this study suggest that the prevalence of depression in diabetes is substantial. This result underscores the importance of paying particular attention to prevent depression among diabetes. Being older, not attending formal education, longer duration with diabetes, having comorbidity, and low adherence to diabetes management were all associated. These variables may help clinicians identify patients at high risk of depression. Future studies focusing on the causal association between depression and diabetes are highly recommended.
Burden of gastroesophageal reflux disease in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of disease study 2019
Authors: Li Na , Yang Wan-Li , Cai Mei-Hong , Chen Xiang , Zhao Ran , Li Meng-Ting , Yan Xia-Lin , Xue Li-Wei , Hong Liu , Tang Ming-Yu 
Published: March 2023

AbstractIntroductionFor effective preventive strategies against GORD (gastro-esophageal reflux disease), we assessed the GORD burden from 1990 to 2019.MethodsThe burden of GORD between 1990 and 2019 was evaluated globally, regionally, and nationally. Using ASIR (age-standardized incidence), ASYLDs (age-standardized years lived with disabilitys), we compared them to the GBD world population per 100,000. The estimates were based on 95% uncertainty intervals (UIs). The AAPC (average annual percent change) in incidence, YLDs, along with prevalence rates with associated 95% CIs were estimated.ResultsData to estimate the burden of GORD are scarce till now. The global ASIR of GORD in 2019 was 3792.79 per 100,000, an increase AAPC of 0.112% from 1990. The prevalence of GORD increased with a AAPC of 0.096% to 9574.45 per 100,000. Global ASYLDs in 2019 was 73.63, an increase AAPC of 0.105% from 1990. The GORD burden varies greatly depending on the development level and geographical location. USA demonstrated the most obvious decreasing trend in burden of GORD, while Sweden had an increasing trend. That the increase in GORD YLDs was mediated primarily by the growth and aging of population, was revealed by decomposition analyses. There was an inverse relationship between SDI (socio-demographic index) and GORD-burden. Frontier analyses revealed significant scope of improvement in the status of development at all levels.ConclusionGORD is a public health challenge, especially in Latin America. Some SDI quintiles had declining rates, while some countries experienced increased rates. Thus, resources should be allocated for preventative measures based on country-specific estimates.
Exploring culturally-preferred communication approaches for increased uptake of voluntary medical male circumcision (VMMC) services in rural Malawi
Authors: Mphepo Kent Yelemia G. , Muula Adamson Sinjani , Suzi Joel , Phuka Felix , Mfutso-Bengo Joseph 
Published: March 2023

Abstract
Background
In 2007 WHO and UNAIDS recommended communication interventions as a key strategy for creating demand for Voluntary Medical Male Circumcision (VMMC) in Southern Africa. In Malawi, VMMC communication interventions, implemented by health communication agencies, have effectively raised awareness of services. However, high awareness of VMMC has not resulted in increased uptake. Consequently, Malawi has achieved the lowest number of circumcisions in Southern Africa.

Methods
These researchers carried out a study among the traditionally circumcising Yaos of Mangochi in Southern Region and the non-circumcising Chewas in Central Region. Data were collected using FGDs, KIIs, IDIs, Life Histories and Participatory Rural Appraisal methods. Data were analyzed thematically.

Results
This study demonstrates two lessons. First, Laswell’s Theory, which has traditionally been used in politics, is relevant to the health sector where the message delivery continuum also needs to be clear on source, message, audience, channel and intended effects. Secondly, according to informants, allowing communities to give feedback to the VMMC messages delivered by health promoters is fundamental. Therefore, failure by Laswell Theory to emphasize on feedback compromises its efficacy. It weakens its ability to foster a common vision between the source and the audience which is prerequisite for behavioral change.

Conclusion
The study concluded that community engagement and interpersonal communication which provide room for real-time feedback in any communicative event are the most preferred communication interventions for VMMC services among Yaos and Chewas.
Life in lockdown: a qualitative study exploring the experience of living through the initial COVID-19 lockdown in the UK and its impact on diet, physical activity and mental health
Authors: Griffin Tania , Grey Elisabeth , Lambert Jeffrey , Gillison Fiona , Townsend Nick , Solomon-Moore Emma 
Published: March 2023

Abstract
Background
In response to the COVID-19 pandemic, the UK imposed a national lockdown prompting change to daily routines. Among behaviours impacted by the lockdown, diet and physical activity may be particularly important due to their association with mental health and physical health. The aim of this study was to explore people’s experiences of how lockdown impacted their physical activity, dietary behaviours and mental health, with a view to informing public health promotion.

Methods
This phenomenological qualitative study used semi-structured telephone interviews. Interviews were audio-recorded and transcribed verbatim. Thematic analysis was conducted, guided by the Framework Approach.

Results
Forty participants (28 female) completed an interview (mean duration: 36 min) between May and July 2020. The overarching themes identified were (i) Disruption (loss of routines, social interaction and cues to physical activity) and (ii) Adaptation (structuring the day, accessing the outdoor environment, finding new ways for social support). The disruption to daily routines altered people’s cues for physical activity and eating; some participants spoke of comfort eating and increased alcohol intake in the early days of lockdown, and how they consciously tried to change these when restrictions lasted longer than first anticipated. Others spoke of adapting to the restrictions using food preparation and meals to provide both routine and social time for families. Disruptions from the closure of workplaces resulted in flexible working times for some, allowing for physical activity to be built into the day. In later stages of restrictions, physical activity became an opportunity for social interaction and several participants reported intending to continue to replace sedentary means of socialising (e.g., meeting in cafes) with more active, outdoor activities (e.g., walking) once restrictions were lifted. Staying active and building activity into the day was seen as important to support physical and mental health during the challenging times of the pandemic.

Conclusions
Whilst many participants found the UK lockdown challenging, adaptations to cope with the restrictions presented some positive changes related to physical activity and diet behaviours. Helping people sustain their new healthier activities since restrictions have lifted is a challenge but presents an opportunity for public health promotion.
Sex differences in risk factors for metabolic syndrome in middle-aged and senior hospital employees: a population-based cohort study
Authors: Chang Hsu-Chieh , Wu Yi-Syuan , Tzeng Wen-Chii , Wu Hao-Yi , Lee Pai-Ching , Wang Wei-Yun 
Published: March 2023

Abstract
Background
Several cross-sectional studies have reported risk factors for metabolic syndrome (MetS). However, these studies did not focus on sex differences in middle-aged and senior populations or employ a longitudinal design. These study design differences are important, as there are sex differences in lifestyle habits associated with MetS, and middle-aged and senior individuals have increased MetS susceptibility. Therefore, the purpose of this study was to examine whether sex differences influenced MetS risk over a ten-year follow-up period among middle-aged and senior hospital employees.

Methods
This population-based and prospective cohort study enrolled 565 participants who did not have MetS in 2012 for a ten-year repeated-measurement analysis. Data were retrieved from the hospital’s Health Management Information System. Analyses included Student’s t tests, χ2 tests and Cox regression. P < 0.05 indicated statistical significance.

Results
Male middle-aged and senior hospital employees had an elevated MetS risk (hazard ratio (HR) = 1.936, p < 0.001). Men with more than four family history risk factors had an increased risk of MetS (HR = 1.969, p = 0.010). Women who worked shift duty (HR = 1.326, p = 0.020), had more than two chronic diseases (HR = 1.513, p = 0.012), had three family history risk factors (HR = 1.623, p = 0.010), or chewed betel nuts (HR = 9.710, p = 0.002) had an increased risk of MetS.

Conclusions
The longitudinal design of our study improves the understanding of sex differences in MetS risk factors in middle-aged and senior adults. A significantly elevated risk of MetS over the ten-year follow-up period was associated with male sex, shift work, the number of chronic diseases, the number of family history risk factors, and betel nut chewing. Women who chewed betel nuts had an especially increased risk of MetS. Our study indicates that population-specific studies are important for the identification of subgroups susceptible to MetS and for the implementation of hospital-based strategies.
Association between initial in-hospital heart rate and glycemic control in patients with acute ischemic stroke and diabetes mellitus
Authors: Kuo Ya-Wen , Lee Jiann-Der , Lee Chuan-Pin , Huang Yen-Chu , Lee Meng 
Published: March 2023

Abstract
Background
A high resting heart rate (HR) has been associated with an increased risk of diabetes mellitus. This study explored the association between initial in-hospital HR and glycemic control in patients with acute ischemic stroke (AIS) and diabetes mellitus.

Methods
We analyzed data from 4,715 patients with AIS and type 2 diabetes mellitus enrolled in the Chang Gung Research Database between January 2010 and September 2018. The study outcome was unfavorable glycemic control, defined as glycated hemoglobin (HbA1c) ≥ 7%. In statistical analyses, the mean initial in-hospital HR was used as both a continuous and categorical variable. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression analysis. The associations between the HR subgroups and HbA1c levels were analyzed using a generalized linear model.

Results
Compared with the reference group (HR < 60 bpm), the adjusted ORs for unfavorable glycemic control were 1.093 (95% CI 0.786–1.519) for an HR of 60–69 bpm, 1.370 (95% CI 0.991–1.892) for an HR of 70–79 bpm, and 1.608 (95% CI 1.145–2.257) for an HR of ≥ 80 bpm. Even after adjusting for possible confounders, the HbA1c levels after admission and discharge among diabetic stroke patients increased significantly in the subgroups with higher HRs (p < 0.001).

Conclusions
High initial in-hospital HR is associated with unfavorable glycemic control in patients with AIS and diabetes mellitus, particularly in those with an HR of ≥ 80 bpm, compared with those with an HR of < 60 bpm.
Simulation-based learning in palliative care in postgraduate nursing education: a scoping review
Authors: Skedsmo Karoline , Nes Andréa Aparecida Gonçalves , Stenseth Hege Vistven , Hofsø Kristin , Larsen Marie Hamilton , Hilderson Deborah , Smis Dieter , Hagelin Carina Lundh , Olaussen Camilla , Solberg Marianne Trygg , Bingen Hanne Maria , Ølnes Mia Alexandra , Steindal Simen A. 
Published: March 2023

AbstractBackgroundNurses require advanced competence in palliative care, but they face wide variations in education and a shortage in opportunities for clinical placement. Simulation-based learning (SBL) can enable students to develop clinical skills, critical thinking and confidence. No scoping reviews to date have mapped the use of SBL in palliative care within postgraduate nursing education.MethodsThe aim of this scoping review was to systematically map published studies on the use of SBL in palliative care in postgraduate nursing education. A scoping review was conducted using Arksey and O’Malley’s (Int J Soc Res Meth 8(1):19–32, 2005) methodological framework. A systematic and comprehensive search of the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Education Resources Information Center (ERIC), Ovid MEDLINE, Ovid EMBASE, Allied and Complementary Medicine and PsycINFO was performed for studies published between January 2000 and April 2022. Two authors independently assessed papers for inclusion and extracted data. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. The protocol was registered on the Open Science Framework.ResultsThis review includes 10 studies. Three thematic groupings were identified: enhanced understanding of the importance of teamwork, interdisciplinarity and interpersonal skills; preparedness and confidence in one’s ability to communicate during emotionally challenging situations; and impact and relevance to one’s own clinical practice.ConclusionsThe use of SBL in palliative care in postgraduate nursing education seems to enhance students’ understanding of the importance of teamwork and interdisciplinarity. The review shows contradictory results regarding whether SBL in palliative care increases students’ confidence in their communication skills. Postgraduate nursing students experienced personal growth after participating in SBL. Because our findings indicate that limited research has been conducted within this field, future research should (1) explore postgraduate nursing students’ experiences with SBL in palliative care with a focus on more practical content such as symptom management, (2) examine the relevance and application of SBL in clinical practice, and (3) be reported in line with recommendations on the reporting of simulation research.
Prevalence and factors associated with condom use among sexually active young women in Haiti: evidence from the 2016/17 Haiti demographic and health survey
Authors: Jean Simon David , Paul Bénédique , Kiragu Ann , Olorunsaiye Comfort Z. , Joseph Fanor , Joseph Ghislaine , N’Gou M’Boh Delphin 
Published: March 2023

Abstract
Background
Young women in Haiti remain vulnerable to sexually transmitted infections and unintended pregnancy. However, little is known about condom use among this population. This study examined the prevalence and the factors associated with condom use among sexually active young women in Haiti.

Methods
Data from the 2016/17 Haiti demographic and health survey were used. The prevalence and the factors associated with condom use among sexually active young women in Haiti were assessed using descriptive statistics and binary logistic regression model.

Results
The prevalence of condom use was 15.4% (95% CI 14.0–16.8). Being teenage (AOR = 1.34; 95% CI: 1.04–1.74), living in urban areas (AOR = 1.41; 95% CI = 1.04–1.90), having higher education level (AOR = 2.39; 95% CI: 1.44–4.00), being in the middle or rich category of household wealth index (AOR = 2.32; 95% CI: 1.53–3.53 and AOR = 2.93; 95% CI: 1.90–4.52), having correct knowledge of ovulatory cycle (AOR = 1.65; 95% CI: 1.30–2.10), having 2–3 lifetime sexual partners and one lifetime sexual partner (AOR = 2.04; 95% CI: 1.36–3.06 and AOR = 2.07; 95% CI: 1.35–3.17) had significantly higher odds of using condom. In addition, sexually active young women whose last partner was their boyfriend (AOR = 4.38; 95% CI: 2.82–6.81), and those whose last partner was a friend/casual acquaintance/commercial sex worker (AOR = 5.29; 95% CI: 2.18–12.85) were associated with increased likelihood of using condom compared with their counterparts whose partner was their spouse.

Conclusion
The Haitian government as well as institutions involved in sexual health should consider these factors when designing sexual and reproductive health interventions targeting young women. More specifically, to increase condom use and reduce risky sexual behaviors, they should combine efforts to raise awareness and induce sexual behavioral changes at two levels. In the education system, they should reinforce sexual education in primary and secondary schools while paying special attention to rural areas. In the whole society, it is important to deepen efforts toward increased awareness on family planning and condom use, through mass media and local organizations including religious ones. Priority should be given to the poorer households, young people and women, and rural areas, in order to maximize reduction in early and unintended pregnancy, and sexually transmitted infections. Interventions should include a condom price subsidy and a campaign to destigmatize condom use which is actually a “male affair”.
Multidimensional evaluation of offline and online education in dermatology teaching during the COVID-19 pandemic in a chinese teaching hospital: a cross-sectional study
Authors: Wang Ben , Zhang Mi , Zhao Zhixiang , Huang Yingxue , Li Ji , Chen Xiang , Su Juan , Yi Mei 
Published: March 2023

Abstract
Background
The global spread of Coronavirus disease (COVID-19) has led to the use of online teaching methods in universities, but the effect of online education on dermatology teaching remains unclear.

Methods
We designed a multi-dimensional teaching evaluation form for data collection, student teaching feedback evaluation, and assessed the scores of final theoretical and clinical skill tests, to compare the effective difference between online and offline teaching of dermatology.

Results
A total of 311 valid questionnaires of medical undergraduates were collected, 116 of which were enrolled for offline learning, and 195 for online learning. The average score of final theoretical test in the online teaching group had no significant difference compared with that in the offline teaching group (75.33 ± 7.37 vs.75.63 ± 7.51, P = 0.734). However, both scores of skin lesion recognition test and medical history collection test in the online teaching group were significantly lower than that in the offline teaching group (6.53 ± 0.86 vs. 7.10 ± 1.11, P < 0.001; 6.70 ± 1.16 vs. 7.62 ± 0.85, P < 0.001). Additionally, the scores of understanding skin lesions in the online teaching group were significantly lower than that in the offline group (P < 0.001), and the scores of overall understanding of skin diseases and evaluating their learning mode in the online teaching group also decreased (P < 0.05). Among the 195 students enrolled in the online learning group, 156 students (80.0%) recognized that the time of offline teaching should be increased.

Conclusions
Both online and offline education can be used in dermatology theory teaching, but online education is less efficient in skin lesion and practical skills learning. More online teaching software with skin diseases characteristic should be developed to improve the online teaching effect.
Perceived impacts of COVID-19 responses on routine health service delivery in Liberia and UK: cross-country lessons for resilient health systems for equitable service delivery during pandemics
Authors: Alhassan Yussif , Zaizay Zeela , Dean Laura , McCollum Rosalind , Watson Victoria , Kollie Karsor , Piotrowski Helen , Hastie Olivia , Parker Colleen , Dacombe Russell , Theobald Sally , Taegtmeyer Miriam 
Published: March 2023

Abstract
Background
COVID-19 has caused significant public health problems globally, with catastrophic impacts on health systems. This study explored the adaptations to health services in Liberia and Merseyside UK at the beginning of the COVID-19 pandemic (January–May 2020) and their perceived impact on routine service delivery. During this period, transmission routes and treatment pathways were as yet unknown, public fear and health care worker fear was high and death rates among vulnerable hospitalised patients were high. We aimed to identify cross-context lessons for building more resilient health systems during a pandemic response.

Methods
The study employed a cross-sectional qualitative design with a collective case study approach involving simultaneous comparison of COVID-19 response experiences in Liberia and Merseyside. Between June and September 2020, we conducted semi-structured interviews with 66 health system actors purposively selected across different levels of the health system. Participants included national and county decision-makers in Liberia, frontline health workers and regional and hospital decision-makers in Merseyside UK. Data were analysed thematically in NVivo 12 software.

Results
There were mixed impacts on routine services in both settings. Major adverse impacts included diminished availability and utilisation of critical health services for socially vulnerable populations, linked with reallocation of health service resources for COVID-19 care, and use of virtual medical consultation in Merseyside. Routine service delivery during the pandemic was hampered by a lack of clear communication, centralised planning, and limited local autonomy. Across both settings, cross-sectoral collaboration, community-based service delivery, virtual consultations, community engagement, culturally sensitive messaging, and local autonomy in response planning facilitated delivery of essential services.

Conclusion
Our findings can inform response planning to assure optimal delivery of essential routine health services during the early phases of public health emergencies. Pandemic responses should prioritise early preparedness, with investment in the health systems building blocks including staff training and PPE stocks, address both pre-existing and pandemic-related structural barriers to care, inclusive and participatory decision-making, strong community engagement, and effective and sensitive communication. Multisectoral collaboration and inclusive leadership are essential.