bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Relationship Between Policy Strength and Physical Activity Practices in Arizona Public Elementary Schools
Authors: Nam Kahyun , Wilson Kylie , Schulke Marissa , Kulinna Pamela Hodges , Poulos Allison 
Published: April 2023

Background: Many school-based physical activity statutes and regulations have been enacted, with the expectation that schools will comply. However, policy alone does not equate to implementation, and many policies fail for a variety of reasons. The purpose of the study was to determine whether the strength of reported state, district, and school-level physical activity policies were associated with reported recess, physical education, and other school-based physical activity practices at elementary schools in Arizona. Methods: A modified Comprehensive School Physical Activity Program (CSPAP) Questionnaire was administered to staff at elementary schools across Arizona (N = 171). Summative indices of the number of school physical activity policies and best practices at the state, district, and school levels were created. Relationships between policy strength and best practices were examined using linear regression analyses stratified by recess, physical education, and other school-based physical activity practices. Results: Stronger physical activity-related policies were associated with a greater number of recess (F1,142 = 9.87, P < .05), physical education (F4,148 = 4.58, P < .05, Adj. R2 = .09), and other school-based physical activity (F4,148 = 4.04, P < .05, Adj. R2 = .07) best practices at all levels while controlling for school-level demographic factors. Conclusions: The strength of policies may improve opportunities for comprehensive physical activity for children in schools. Strengthening policy language (eg, specifying duration and frequency) may contribute to better physical activity practices in schools, improving children’s health at the population level.
Beyond Individual Cognitions: Time for Intervention Science to Focus on Health Context and Audience
Authors: Chalabaev Aïna , Cheval Boris , Maltagliati Silvio , Saoudi Ilyes , Sniehotta Falko F. 
Published: April 2023

Intervention science faces a hazardous paradox: on the one hand, vulnerable populations (eg, patients, people from low socioeconomic background, older adults) are those for whom adoption of healthy behaviors is most urgent; on the other hand, behavior change models are less predictive, and interventions less successful, in these populations. This commentary presents 4 reasons that may explain this issue: (1) research mostly focuses on what causes behavior and how to change it, at the expense of investigating among whom and under what conditions models are valid; (2) models put an undue emphasis on individual cognitions; (3) most studies are not conducted on vulnerable populations; and (4) most researchers are from high-income countries. Several avenues are proposed to address this issue: (1) providing a central place to the context and audience in health behavior change modelization, through collaborations with researchers from other disciplines and countries, and with members of the targeted audience; (2) better reporting samples’ sociodemographic characteristics and increasing samples’ diversity; and (3) using more rigorous and innovative designs (eg, powered randomized controlled trials, N-of-1 trials, intensive longitudinal studies). In conclusion, it becomes urgent to change the way we do research: the social utility and credibility of intervention science depend on it.
P22 Implementing GREATix: learning from excellence in paediatric services
Authors: Barbour Emma , Murray Maeve 
Published: April 2023

AimThe paediatric service is extremely good at reporting incidents through Datix system. These incidents are reviewed, learning is identified and then information disseminated, or even a change in practice takes place, all with the aim to improve things and prevent errors happening. A regular bulletin is prepared for the multidisciplinary paediatric team with the paediatric pharmacist involved in the medication section of this bulletin. There is no system within the Trust for reporting all the good things that are happening and it was felt that the department were missing out on learning from these. Learning from Excellence1is not new and numerous areas, both locally and nationally have introduced it in some form.The aim of this project is to identify and learn from everyday excellence as we currently learn from error via Datix, and to also improve staff morale. We wanted to have an anonymised way to let a colleague know they have done a great job. The ultimate goal would be to also interrogate and report findings.MethodA paediatric multidisciplinary oversight group was set up by the paediatric pharmacist and paediatric practice educator. A questionnaire was issued to paediatric staff, examining morale. Resources were developed to support reporting, data collection and nominee feedback. Following some meetings and discussions with the Trust IQI team, a GREATix reporting system was introduced into paediatrics. A pilot was initially carried out in one small area of paediatrics, a few changes were made and it was then introduced throughout the trust in paediatrics.Nominees are issued with a certificate and a letter from head of service and clinical director.ResultsOver the past 20 months there have been a total of 130 nominations to date. 20 themes have been coded including evidence of good teamwork and communication, putting the child and family at the centre of care and staff acting to positively affect patient safety or preserve further harm when an incident had occurred. There has been some feedback from nominees saying how delighted they were receiving the award, how it had made their day, and how grateful they are.ConclusionFor those staff who have received a nomination there has been some evidence of an increase in morale. There have been areas within paediatrics who have embraced this new system more than other areas. As an oversight group we need to highlight the process more. The plan would be to generate a bi-annual report for the paediatric service and present the learning Trust wide. We have supported other areas in the Trust to implement GREATix, including introducing it into the clinical pharmacy team. Our IQI team in the Trust are meeting with the small number of areas within the Trust who have implemented this and plan to look at the way forward as to how we can collaborate to introduce this further within the Trust.ReferenceKelly N, Blake S, Plunkett A. Learning from excellence in healthcare: a new approach in incident reporting.Arch of Dis Child2016;101:788–791.
P42 An audit to assess prescribing of paediatric CD TTOs
Authors: Junaid Ebraheem , Agudetse Audrey 
Published: April 2023

AimTo establish the root cause leading to an increased amount of time spent for a pharmacist to triage a paediatric controlled drug (CD) to take out (TTO) prescription.MethodMixed methods were used to collect data. Initially, raw data was collected over a period of three weeks to identify any CD TTO’s that required intervention from the pharmacist. We recorded if the correct CD TTO prescription template was being used, number of CD TTO prescriptions, clinically and legally correct and how long it took to complete the triage by the pharmacist (ward or dispensary based). The amount of raw data collected was not sufficient to establish an accurate picture of the problem. For this reason, we also collected data from the paediatric prescribing tests. The open book prescribing tests are completed by all new doctors coming in to the paediatric rotation. This is a scenarios-based test and question 10 of the test asks them to write out a CD TTO prescription using the CD TTO template. The answers to question 10 of the test were then audited.ResultsThe data that was collected shows that two thirds (67%) of prescribers failed to answer question 10 of the test (CD TTO question). This indicates an issue with CD TTO prescribing and the reasons why they failed to pass the question (i.e. legally and/or clinically incorrect). One of the reasons that may be a factor is the lack of CD TTO prescribing in paediatrics compared to adults (i.e. lack of practice/unfamiliarity). This may reduce their knowledge regarding CD TTO prescription requirements and thus confidence and competence in prescribing practice. It was also established that errors in relation to the dose and frequency were found to be the most frequent, which also suggests a lack of clinical knowledge and/or use of available resources. The causes of this can range from a lack of appropriate training to lack of self-checks and referring to the BNF and/or other prescribing guidelines. Furthermore, the live data (two CD TTOs audited) also showed that 50% of prescriptions written were not written on the CD TTO template, prompting the pharmacist to spend additional time triaging it. On average, it took 40 minutes to triage one CD TTO prescription.ConclusionsChanges are needed to address the issues that were found in this audit. Recommended immediate actions include making prescribers aware of where CD TTO templates can be found and implementing teaching sessions to improve clinical and legal knowledge of prescription writing. In the long term, it is recommended to add the CD TTO template to the back of the Child Health medication chart (like we have for the adult charts at our Trust). We are also considering creating a pocket guide on the correct prescribing of CD TTOs in consultation with doctors, nurses and pharmacists.
Improving coverage of antenatal iron and folic acid supplementation and malaria prophylaxis through targeted information and home deliveries in Côte d’Ivoire: a cluster randomised controlled trial
Authors: Koné Siaka , Probst-Hensch Nicole , Dao Daouda , Utzinger Jürg , Fink Günther 
Published: April 2023

IntroductionCoverage of antenatal iron and folic acid (IFA) supplementation and malaria chemoprophylaxis remains low in many low-income and middle-income settings. We assessed the effectiveness of personal information (INFO) sessions and personal information session plus home deliveries (INFO+DELIV) to increase coverage of IFA supplementation and intermittent preventive treatment in pregnancy (IPTp), and their effectiveness on postpartum anaemia and malaria infection.MethodsWe included 118 clusters randomised to a control (39), INFO (39) and INFO+DELIV (40) arm, in a trial conducted between 2020 and 2021 with pregnant women (age ≥15 years) in their first or second trimester of pregnancy in Taabo, Côte d’Ivoire. We used generalised linear regression models to assess intervention impact in postpartum anaemia and malaria parasitaemia, and displayed resulting estimates as prevalence ratios.ResultsOverall, 767 pregnant women were enrolled and 716 (93.3%) were followed up after delivery. Neither intervention had an impact on postpartum anaemia, with estimated adjusted prevalence ratios (aPRs) of 0.97 (95% CI 0.79 to 1.19, p=0.770) for INFO and 0.87 (95% CI 0.70 to 1.09, p=0.235) for INFO+DELIV. While INFO had no effect on malaria parasitaemia (aPR=0.95, 95% CI 0.39 to 2.31, p=0.915), INFO+DELIV reduced malaria parasitaemia by 83% (aPR=0.17, 95% CI 0.04 to 0.75, p=0.019). No improvements in antenatal care (ANC) coverage (aPR=1.05, 95% CI 0.81 to 1.36, p=0.692), IFA (aPR=2.00, 95% CI 0.89 to 4.46, p=0.093) and IPTp (aPR=1.03, 95% CI 0.87 to 1.21, p=0.728) compliance were found for INFO. INFO+DELIV increased ANC attendance (aPR=1.35, 95% CI 1.02 to 1.78, p=0.037) and compliance with IPTp (aPR=1.60, 95% CI 1.41 to 1.80, p<0.001) and IFA recommendations (aPR=7.06, 95% CI 3.68 to 13.51, p<0.001).ConclusionsINFO+DELIV can substantially increase compliance with IFA supplementation and improve malaria prevention. However, the increases in IFA supplementation are likely insufficient to address the prevalence of often severe anaemia in this population.Trial registration numberNCT04250428.
What is the role of primary care in the COVID-19 vaccine roll-out and the barriers and facilitators to an equitable vaccine roll-out? A rapid scoping review of nine jurisdictions
Authors: Aggarwal Monica , Kokorelias Kristina Marie , Glazier Richard H , Katz Alan , Shiers-Hanley Jessica E , Upshur Ross E G 
Published: April 2023

ObjectivesThis study aimed to: (1) examine the experience of nine global jurisdictions that engaged primary care providers (PCPs) to administer COVID-19 vaccines during the pandemic; (2) describe how vaccine hesitancy and principles of equity were incorporated in the COVID-19 vaccine roll-out strategies and (3) identify the barriers and facilitators to the vaccine roll-out.DesignRapid scoping review.Data sourcesSearches took place in MEDLINE, CINAHL, Embase, the Cochrane Library, SCOPUS and PsycINFO, Google, and the websites of national health departments. Searches and analyses took place from May 2021 to July 2021.ResultsSixty-two documents met the inclusion criteria (35=grey literature; 56% and 27=peer reviewed; 44%). This review found that the vaccine distribution approach started at hospitals in almost all jurisdictions. In some jurisdictions, PCPs were engaged at the beginning, and the majority included PCPs over time. In many jurisdictions, equity was considered in the prioritisation policies for various marginalised communities. However, vaccine hesitancy was not explicitly considered in the design of vaccine distribution approaches. The barriers to the roll-out of vaccines included personal, organisational and contextual factors. The vaccine roll-out strategy was facilitated by establishing policies and processes for pandemic preparedness, well-established and coordinated information systems, primary care interventions, adequate supply of providers, education and training of providers, and effective communications strategy.ConclusionsEmpirical evidence is lacking on the impact of a primary care-led vaccine distribution approach on vaccine hesitancy, adoption and equity. Future vaccine distribution approaches need to be informed by further research evaluating vaccine distribution approaches and their impact on patient and population outcomes.
Primary care provider interventions for addressing cancer screening participation with marginalised patients: a scoping review protocol
Authors: Ruco Arlinda , Cernat Alexandra , Calleja Sabine , Tinmouth Jill , Lofters Aisha K 
Published: April 2023

IntroductionCancer screening is an integral component of primary care, and providers can play a key role in facilitating screening. While much work has focused on patient interventions, there has been less attention on primary care provider (PCP) interventions. In addition, marginalised patients experience disparities in cancer screening which are likely to worsen if not addressed. The objective of this scoping review is to report on the range, extent and nature of PCP interventions that maximise cancer screening participation among marginalised patients. Our review will target cancers where there is strong evidence to support screening, including lung, cervical, breast and colorectal cancers.Methods and analysisThis is a scoping review conducted in accordance with the framework by Levacet al. Comprehensive searches will be conducted by a health sciences librarian using Ovid MEDLINE, Ovid Embase, Scopus, CINAHL Complete and the Cochrane Central Register of Controlled Trials. We will include peer-reviewed English language literature published from 1 January 2000 to 31 March 2022 that describes PCP interventions to maximise cancer screening participation for breast, cervical, lung and colorectal cancers. Two independent reviewers will screen all articles and identify eligible studies for inclusion in two stages: title and abstract, then full text. A third reviewer will resolve any discrepancies. Charted data will be synthesised through a narrative synthesis using a piloted data extraction form informed by the Template for Intervention Description and Replication checklist.Ethics and disseminationSince this is a synthesis of digitally published literature, no ethics approval is needed for this work. We will target appropriate primary care or cancer screening journals and conference presentations to publish and disseminate the results of this scoping review. The results will also be used to inform an ongoing research study developing PCP interventions for addressing cancer screening with marginalised patients.
Exploring gender dysphoria and related outcomes in a prospective cohort study: protocol for the Swedish Gender Dysphoria Study (SKDS)
Authors: Özel Fatih , Indremo Malin , Karamanis Georgios , Elofsson Ulf , Beckman Ulrika , Fazekas Attila , Frisén Louise , Isaksson Magnus , Sandström Lotta , Thelin Nils , Tivesten Åsa , Wahlberg Jeanette , Skalkidou Alkistis , Bodlund Owe , Papadopoulos Fotios C 
Published: April 2023

IntroductionThere has been a drastic increase in the reported number of people seeking help for gender dysphoria in many countries over the last two decades. Yet, our knowledge of gender dysphoria and related outcomes is restricted due to the lack of high-quality studies employing comprehensive approaches. This longitudinal study aims to enhance our knowledge of gender dysphoria; different aspects will be scrutinised, focusing primarily on the psychosocial and mental health outcomes, prognostic markers and, secondarily, on the underlying mechanisms for its origin.Methods and analysisThe Swedish Gender Dysphoria Study is an ongoing multicentre longitudinal cohort study with 501 registered participants with gender dysphoria who are 15 years old or older. Participants at different phases of their clinical evaluation process can enter the study, and the expected follow-up duration is three years. The study also includes a comparison group of 458 age- and county-matched individuals without gender dysphoria. Data on the core outcomes of the study, which are gender incongruence and experienced gender dysphoria, body satisfaction and satisfaction with gender-affirming treatments, as well as other relevant outcomes, including mental health, social functioning and life satisfaction, are collected via web surveys. Two different research visits, before and after starting on gender-affirming hormonal treatment (if applicable), are planned to collect respective biological and cognitive measures. Data analysis will be performed using appropriate biostatistical methods. A power analysis showed that the current sample size is big enough to analyse continuous and categorical outcomes, and participant recruitment will continue until December 2022.Ethics and disseminationThe ethical permission for this study was obtained from the Local Ethical Review Board in Uppsala, Sweden. Results of the study will be presented at national and international conferences and published in peer-reviewed journals. Dissemination will also be implemented through the Swedish Gender Dysphoria Study network in Sweden.
Brain responses to food viewing in women during pregnancy and post partum and their relationship with metabolic health: study protocol for the FOODY Brain Study, a prospective observational study
Authors: Lesniara-Stachon Anna , Quansah Dan Yedu , Schenk Sybille , Retsa Chrysa , Halter Ryan J , Murray Micah M , Lacroix Alain , Horsch Antje , Toepel Ulrike , Puder Jardena J 
Published: April 2023

IntroductionFood cravings are common in pregnancy and along with emotional eating and eating in the absence of hunger, they are associated with excessive weight gain and adverse effects on metabolic health including gestational diabetes mellitus (GDM). Women with GDM also show poorer mental health, which further can contribute to dysregulated eating behaviour. Food cravings can lead to greater activity in brain centres known to be involved in food ‘wanting’ and reward valuation as well as emotional eating. They are also related to gestational weight gain. Thus, there is a great need to link implicit brain responses to food with explicit measures of food intake behaviour, especially in the perinatal period. The aim of this study is to investigate the spatiotemporal brain dynamics to visual presentations of food in women during pregnancy and in the post partum, and link these brain responses to the eating behaviour and metabolic health outcomes in women with and without GDM.Methods and analysisThis prospective observational study will include 20 women with and 20 without GDM, that have valid data for the primary outcomes. Data will be assessed at 24–36 weeks gestational age and at 6 months post partum. The primary outcomes are brain responses to food pictures of varying carbohydrate and fat content during pregnancy and in the post partum using electroencephalography. Secondary outcomes including depressive symptoms, current mood and eating behaviours will be assessed with questionnaires, objective eating behaviours will be measured using Auracle and stress will be measured with heart rate and heart rate variability (Actiheart). Other secondary outcome measures include body composition and glycaemic control parameters.Ethics and disseminationThe Human Research Ethics Committee of the Canton de Vaud approved the study protocol (2021-01976). Study results will be presented at public and scientific conferences and in peer-reviewed journals.
Primary healthcare needs and service utilisation of people with disability: a data linkage protocol
Authors: Douglas Jacinta , Winkler Di , McLeod Adam , Oliver Stacey , Gardner Karina , Supple Jamie , Pearce Christopher 
Published: April 2023

IntroductionGeneral practitioners (GPs) play a crucial role in the early management and treatment of the comorbidities and complications experienced by people with disability. However, GPs experience multiple constraints, including limited time and disability-related expertise. Knowledge gaps around the health needs of people with disability as well as the frequency and extent of their engagement with GPs mean evidence to inform practice is limited. Using a linked dataset, this project aims to enhance the knowledge of the GP workforce by describing the health needs of people with disability.Methods and analysisThis project is a retrospective cohort study using general practice health records from the eastern Melbourne region in Victoria, Australia. The research uses Eastern Melbourne Primary Health Network (EMPHN)-owned de-identified primary care data from Outcome Health’s POpulation Level Analysis and Reporting Tool (POLAR). The EMPHN POLAR GP health records have been linked with National Disability Insurance Scheme (NDIS) data. Data analysis will involve comparisons across disability groups and the rest of the population to explore utilisation (eg, frequency of visits), clinical and preventative care (eg, cancer screening, blood pressure readings) and health needs (eg, health conditions, medications). Initial analyses will focus on NDIS participants as a whole and NDIS participants whose condition is either an acquired brain injury, stroke, spinal cord injury, multiple sclerosis or cerebral palsy, as classified by the NDIS.Ethics and disseminationEthics approval was obtained from the Eastern Health Human Research Ethics Committee (E20/001/58261), and approval for the general collection, storage and transfer of data was from the Royal Australian College of General Practitioners National Research Ethics and Evaluation Committee (protocol ID: 17-088). Dissemination mechanisms will include the engagement of stakeholders through reference groups and steering committees, as well as the production of research translation resources in parallel with peer-reviewed publications and conference presentations.