bluuebunny/crossref_metadata_2025_split huggingface dataset:
“The most culturally safe training I’ve ever had”: the co-design of a culturally safe Managing hepatitis B training course with and for the Aboriginal health workforce of the Northern Territory of Australia
Authors: Hosking Kelly , De Santis Teresa , Vintour-Cesar Emily , Wilson Phillip Merrdi , Bunn Linda , Gurruwiwi George Garambaka , Wurrawilya Shiraline , Bukulatjpi Sarah Mariyalawuy , Nelson Sandra , Ross Cheryl , Binks Paula , Schroder Phoebe , Davis Joshua S. , Taylor Sean , Connors Christine , Davies Jane ,   on behalf of the Hep B PAST partnership
Published: August 2023

Abstract
Background
The Aboriginal health workforce provide responsive, culturally safe health care. We aimed to co-design a culturally safe course with and for the Aboriginal health workforce. We describe the factors which led to the successful co-design, delivery, and evaluation of the “Managing hepatitis B” course for the Aboriginal health workforce.

Methods
A Participatory Action Research approach was used, involving ongoing consultation to iteratively co-design and then develop course content, materials, and evaluation tools. An Aboriginal and Torres Strait Islander research and teaching team received education in chronic hepatitis B and teaching methodologies. Pilot courses were held, in remote communities of the Northern Territory, using two-way learning and teach-back methods to further develop the course and assess acceptability and learnings. Data collection involved focus group discussions, in-class observations, reflective analysis, and use of co-designed and assessed evaluation tools.

Results
Twenty-six participants attended the pilot courses. Aboriginal and Torres Strait Islander facilitators delivered a high proportion of the course. Evaluations demonstrated high course acceptability, cultural safety, and learnings. Key elements contributing to success and acceptability were acknowledging, respecting, and integrating cultural differences into education, delivering messaging and key concepts through an Aboriginal and Torres Strait Islander lens, using culturally appropriate approaches to learning including storytelling and visual teaching methodologies. Evaluation of culturally safe frameworks and findings from the co-design process led to the creation of a conceptual framework, underpinned by meeting people’s basic needs, and offering a safe and comfortable environment to enable productive learning with attention to the following: sustenance, financial security, cultural obligations, and gender and kinship relationships.

Conclusions
Co-designed education for the Aboriginal health workforce must embed principles of cultural safety and meaningful community consultation to enable an increase in knowledge and empowerment. The findings of this research can be used to guide the design of future health education for First Nations health professionals and to other non-dominant cultures. The course model has been successfully transferred to other health issues in the Northern Territory.
How did the COVID-19 pandemic affect inpatient care for children in Germany? An exploratory analysis based on national hospital discharge data
Authors: Panteli Dimitra , Mauer Nicole , Tille Florian , Nimptsch Ulrike 
Published: August 2023

Abstract
Background
The delivery of health services around the world faced considerable disruptions during the COVID-19 pandemic. While this has been discussed for a number of conditions in the adult population, related patterns have been studied less for children. In light of the detrimental effects of the pandemic, particularly for children and young people under the age of 18, it is pivotal to explore this issue further.

Methods
Based on complete national hospital discharge data available via the German National Institute for the Reimbursement of Hospitals (InEK) data browser, we compare the top 30 diagnoses for which children were hospitalised in 2019, 2020, 2021 and 2022. We analyse the development of monthly admissions between January 2019 and December 2022 for three tracers of variable time-sensitivity: acute lymphoblastic leukaemia (ALL), appendicitis/appendectomy and tonsillectomy/adenoidectomy.

Results
Compared to 2019, total admissions were approximately 20% lower in 2020 and 2021, and 13% lower in 2022. The composition of the most frequent principal diagnoses remained similar across years, although changes in rank were observed. Decreases were observed in 2020 for respiratory and gastrointestinal infections, with cases increasing again in 2021. The number of ALL admissions showed an upward trend and a periodicity prima vista unrelated to pandemic factors. Appendicitis admissions decreased by about 9% in 2020 and a further 8% in 2021 and 4% in 2022, while tonsillectomies/adenoidectomies decreased by more than 40% in 2020 and a further 32% in 2021 before increasing in 2022; for these tracers, monthly changes are in line with pandemic waves.

Conclusions
Hospital care for critical and urgent conditions among patients under the age of 18 was largely upheld in Germany during the COVID-19 pandemic, potentially at the expense of elective treatments. There is an alignment between observed variations in hospitalisations and pandemic mitigation measures, possibly also reflecting changes in demand. This study highlights the need for comprehensive, intersectoral data that would be necessary to better understand changing demand, unmet need/foregone care and shifts from inpatient to outpatient care, as well as their link to patient outcomes and health care efficiency.
Piercing the veil on the functioning and effectiveness of district health system governance structures: perspectives from a South African province
Authors: Tshabalala Khanyisile , Rispel Laetitia C. 
Published: August 2023

Abstract
Background
Leadership and governance are critical for achieving universal health coverage (UHC). In South Africa, aspirations for UHC are expressed through the proposed National Health Insurance (NHI) system, which underscores the importance of primary health care, delivered through the district health system (DHS). Consequently, the aim of this study was to determine the existence of legislated District Health Councils (DHCs) in Gauteng Province (GP), and the perceptions of council members on the functioning and effectiveness of these structures.

Methods
This was a mixed-methods, cross-sectional study in GP’s five districts. The population of interest was members of existing governance structures who completed an electronic-self-administered questionnaire (SAQ). Using a seven-point Likert scale, the SAQ focuses on members’ perceptions on the functioning and effectiveness of the governance structures. In-depth interviews with the chairpersons of the DHCs and its technical committees complemented the survey. STATA® 13 and thematic analysis were used to analyze the survey data and interviews respectively.

Results
Only three districts had constituted DHCs. The survey response rate was 73%. The mean score for perceived functioning of the structures was 4.5 (SD = 0.7) and 4.8. (SD = 0.7) for perceived effectiveness. The interviews found that a collaborative district health development approach facilitated governance. In contrast, fraught inter-governmental relations fueled by the complexity of governing across two spheres of government, political differences, and contestations over limited resources constrained DHS governance. Both the survey and interviews identified gaps in accountability to communities.

Conclusion
In light of South Africa’s move toward NHI, strengthening DHS governance is imperative. The governance gaps identified need to be addressed to ensure support for the implementation of UHC reforms.
Food patch use of Japanese quail (Coturnix japonica) varies with personality traits
Authors: Li Chunlin , Zhang Xinyu , Cheng Lin , Zhang Baowei , Zhang Feng 
Published: August 2023

Abstract
Background
The classic optimal foraging theory (OFT) predicts animals’ food patch use assuming that individuals in a population use the same strategy while foraging. However, due to the existence of animal personality, i.e. repeatable inter-individual differences and intra-individual consistency in behaviours over time and/or across contexts, individuals often exhibit different behavioural strategies, challenging the basic assumptions of the OFT. Here, we tested whether personality traits (boldness and exploration in open arena) of Japanese quail (Coturnix japonica, 38 females and 34 males) influenced their patch use in two foraging experiments with different inter-patch distances (i.e. 2 m in Experiment 1 and 3 m in Experiment 2).

Results
The total feeding time and food intake of individuals did not differ between Experiment 1 and 2, but in both experiments, proactive (i.e. bolder and more explorative) individuals had longer feeding time and higher food intake than reactive individuals. In Experiment 1, proactive quails changed patches more frequently and had shorter mean patch residence time than reactive individuals, while the effects were not significant in Experiment 2. The quails reduced patch residence time along with feeding, and this trend was weakened in Experiment 2 which had longer inter-patch distance.

Conclusions
The above results suggest that personality traits affect animals’ patch use, while the effects might be weakened with longer inter-patch distance. Our study highlights that animal personality should be considered when investigating animals’ foraging behaviours because individuals may not adopt the same strategy as previously assumed. Furthermore, the interaction between personality traits and inter-patch distances, which is related to movement cost and capacity of information gathering, should also be considered.
Nerve excitability test and lead toxicity: a case-control study
Authors: Chien Chung-Yao , Wang Jung-Der , Lin Chou-Ching 
Published: August 2023

Abstract
Background
Although conventional electrophysiological parameters have been proposed as clinical indicators for monitoring lead neuropathies, their correlations with blood lead level are weak. In this study, we investigated the applicability of nerve excitability tests (NETs) to evaluate lead intoxication.

Methods
Fourteen workers who were exposed to lead with an elevated blood level ranging from 17.8 to 64.9 µg/dL and 20 healthy controls with similar ages and body heights were enrolled. Both workers and controls underwent nerve conduction studies (NCSs), motor evoked potentials (MEPs) with transcranial magnetic stimulation (TMS), and NETs.

Results
NCSs showed prolonged distal latencies and decreased motor nerve conduction velocity of median nerves in the workers but without significant correlation to blood lead level (BLL). Significantly prolonged MEP latency was observed in the workers (+ 6 ms). NETs demonstrated hyperpolarized resting membrane potentials in stimulus-response curves and changes in the property of potassium channels under a hyperpolarized current in threshold electrotonus, implying that lead hyperpolarized nerves by interfering with potassium channels. NETs also showed a better correlation with BLL than conventional electrophysiological parameters.

Conclusions
Axonal hyperpolarization and central conduction delay are more apparently reflecting elevated BLL than NCS. NET may have the potential for early detection of lead neuropathy.
A cluster randomised controlled trial, process and economic evaluation of quality improvement collaboratives aligned to a national audit to improve the care for people with diabetes (EQUIPD): study protocol
Authors: Sykes Michael , Copsey Bethan , Finch Tracy , Meads David , Farrin Amanda , McSharry Jenny , Holman Naomi , Young Bob , Berry Alex , Ellis Kat , Moreau Lauren , Willis Thomas , Alderson Sarah , Girling Melissa , O’Halloran Elaine , Foy Robbie 
Published: August 2023

Abstract
Background
People with type 1 diabetes and raised glucose levels are at greater risk of retinopathy, nephropathy, neuropathy, cardiovascular disease, sexual health problems and foot disease. The UK National Institute for Health and Care Excellence (NICE) recommends continuous subcutaneous ‘insulin pump’ therapy for people with type 1 diabetes whose HbA1c is above 69 mmol/mol. Insulin pump use can improve quality of life, cut cardiovascular risk and increase treatment satisfaction. About 90,000 people in England and Wales meet NICE criteria for insulin pumps but do not use one. Insulin pump use also varies markedly by deprivation, ethnicity, sex and location. Increasing insulin pump use is a key improvement priority.
Audit and feedback is a common but variably effective intervention. Limited capabilities of healthcare providers to mount effective responses to feedback from national audits, such as the National Diabetes Audit (NDA), undermines efforts to improve care. We have co-developed a theoretically and empirically informed quality improvement collaborative (QIC) to strengthen local responses to feedback with patients and carers, national audits and healthcare providers. We will evaluate whether the QIC improves the uptake of insulin pumps following NDA feedback.

Methods
We will undertake an efficient cluster randomised trial using routine data. The QIC will be delivered alongside the NDA to specialist diabetes teams in England and Wales. Our primary outcome will be the proportion of people with type 1 diabetes and an HbA1c above 69 mmol/mol who start and continue insulin pump use during the 18-month intervention period. Secondary outcomes will assess change in glucose control and duration of pump use. Subgroup analyses will explore impacts upon inequalities by ethnicity, sex, age and deprivation. A theory-informed process evaluation will explore diabetes specialist teams’ engagement, implementation, fidelity and tailoring through observations, interviews, surveys and documentary analysis. An economic evaluation will micro-cost the QIC, estimate cost-effectiveness of NDA feedback with QIC and estimate the budget impact of NHS-wide QIC roll out.

Discussion
Our study responds to a need for more head-to-head trials of different ways of reinforcing feedback delivery. Our findings will have implications for other large-scale audit and feedback programmes.

Trial registration
ISRCTN82176651 Registered 18 October 2022.
Screening for late-onset Pompe disease in Internal Medicine departments in Spain
Authors: López-Rodríguez Mónica , Torralba-Cabeza Miguel Angel , de Pedro Iván Pérez , Rivera Alberto , Gil Roi Suarez , Gómez-Belda Ana , de la Peña Jose Luis Patier , de los Santos Moreno Alberto , Selva-O’Callaghan Albert , Gárate Igor Gómez , García Andrés González , Hurtado Roberto , de Ureta Pablo Tutor , Barba-Romero Miguel Ángel , Milisenda José C. , Grau-Junyent Josep M. ,   POMPE study group
Published: August 2023

Abstract
Background
The screening of high-risk populations using dried blood spots (DBS) has allowed the rapid identification of patients with Pompe disease, mostly in Neurology departments. The aim of the study was to determine the prevalence of late-onset Pompe disease (LOPD) among patients not previously diagnosed or tested for this entity despite presenting possible signs or symptoms of the disease in Internal Medicine departments in Spain.

Methods
This epidemiological, observational, cross-sectional, multicenter study included a single cohort of individuals with clinical suspicion of LOPD seen at Internal Medicine departments in Spain. The diagnosis of LOPD was initially established on the basis of the result of DBS. If decreased enzyme acid-alpha-1,4-glucosidase (GAA) activity was detected in DBS, additional confirmatory diagnostic measurements were conducted, including GAA activity in lymphocytes, fibroblasts, or muscle and/or genetic testing.

Results
The diagnosis of LOPD was confirmed in 2 out of 322 patients (0.6%). Reasons for suspecting LOPD diagnosis were polymyositis or any type of myopathy of unknown etiology (in one patient), and asymptomatic or pauci-symptomatic hyperCKemia (in the other). The time between symptom onset and LOPD diagnosis was 2.0 and 0.0 years. Both patients were asymptomatic, with no muscle weakness. Additionally, 19.7% of the non-LOPD cases received an alternative diagnosis.

Conclusions
Our study highlights the existence of a hidden population of LOPD patients in Internal Medicine departments who might benefit from early diagnosis and early initiation of potential treatments.
Seawater-Mixed Lightweight Aggregate Concretes with Dune Sand, Waste Glass and Nanosilica: Experimental and Life Cycle Analysis
Authors: Sikora Pawel , Afsar Levent , Rathnarajan Sundar , Nikravan Morteza , Chung Sang-Yeop , Stephan Dietmar , Abd Elrahman Mohamed 
Published: August 2023

AbstractThe use of alternative and locally available materials is encouraged in the construction industry to improve its sustainability. Desert regions with shortages in freshwater and river sand as fine aggregates in concrete have to search for alternative materials such as seawater, dune sand, and waste glass powder to produce lightweight concretes. The potential negative effects of adding these alternative materials can be reduced by adding nanosilica to the cementitious system at very low quantities. This study evaluates the feasibility of using these alternative materials and nanosilica (NS) in producing lightweight aggregate concretes (LWACs). A systematic study was carried out to understand the synergistic effect of nanosilica and seawater in improving the hydration characteristics of the developed cementitious systems. Also, the effect of these alternative materials on the fresh properties of the cementitious system was assessed by slump flow tests. The evolution of compressive strength at early ages was investigated after 2, 7, and 28 days of moist curing and an improvement in the strength development in concretes with seawater was observed. Furthermore, the integrity of the developed LWACs was analyzed using oven-dry density, thermal conductivity, water porosity and shrinkage measurements. Moreover, the capillary porosity and sorptivity measurements revealed the denser microstructure in the nano-modified seawater lightweight concretes. In the end, the life-cycle assessment study calculated the benefit of alternative materials in terms of carbon footprint and water consumption. As an outcome, a sustainable solution for producing LWACs containing seawater, dune sand or glass powder was proposed.
The need to increase antimicrobial resistance surveillance among forcibly displaced persons (FDPs)
Authors: Yusuff Sodiq Inaolaji , Tajudeen Yusuf Amuda , Oladunjoye Iyiola Olatunji , Oladipo Habeebullah Jayeola , Bolarinwa Olufunmilayo Victoria , Popoola Olalekan Tolulope , Ahmed Abdulhakeem Funsho , Olana Matifan Dereje 
Published: August 2023

AbstractAntimicrobial resistance (AMR) poses a significant threat to human health as 4.95 million deaths were associated with bacterial AMR in 2019 and is projected to reach 10 million by 2050. To mitigate AMR, surveillance is an essential tool for determining the burden of AMR and providing the necessary information for its control. However, the global AMR surveillance is inadequate and particularly limited among forcibly displaced persons (FDPs) despite having higher risks of harboring these pathogens. Predisposing factors among this group include poor living conditions, limited access to treatment and diagnostic tests, and inadequate trained health professionals in refugee camps. Strengthening AMR surveillance among FDPs would address the identified gaps and facilitate formulation and implementation of evidence-based policies on AMR control and prevention response. This article provides information on the growing population of FDPs, factors contributing to the AMR burden and AMR surveillance gaps in FDPs and highlighted recommendations for control.
Self-reported interoception, worries and protective behaviors during the COVID-19 pandemic: a longitudinal study
Authors: Vig Luca , Ferentzi Eszter , Köteles Ferenc 
Published: August 2023

Abstract
Background
Protective behaviors were essential for minimizing the spread of the virus during the coronavirus disease 2019 (COVID-19) pandemic. It is often assumed that awareness of bodily sensations (interoception) can improve decision-making and facilitate adaptive behavior.

Objective
This paper investigates cross-sectional and longitudinal relationships between different aspects of self-reported interoception, trait anxiety, COVID-related worry, and health protective behaviors.

Methods
The study was conducted on a community sample of 265 adults. The two data collection phases took place online, before (baseline) and during the second wave of the COVID-19 pandemic in Hungary.

Results
Contrary to our expectations, neither cross-sectional nor longitudinal associations were found between protective behaviors and indicators of self-reported interoception. However, worry at baseline predicted protective behaviors during the second wave, even after controlling for socio-economical characteristics and protective behaviors at baseline.

Conclusion
Our results highlight the adaptivity of health-related worry when behavioral steps to avoid threats are known and available. Also, higher level of perceived interoception did not appear to be health protective under these circumstances.
Using social presence theory to predict online consumer engagement in the emerging markets
Authors: Yeboah Abraham , Agyekum Ofosu , Owusu-Prempeh Vida , Prempeh Kwadwo Boateng 
Published: August 2023

Abstract
The purpose of this paper was to contribute to the dimension of online consumer engagement in the emerging markets. The study is based on the social presence theory factors. The study evaluated 443 data sets obtained through a standardized Qualtrics online survey to examine social presence theory to predict online consumer engagement in the emerging markets. The study employed AMOS v24 with the covariance-based structural equation modelling technique to investigate the relationship between social context, online communication, interactivity, privacy and online consumer engagement. The study also assessed social gratification as a mediator in the relationship between online communication and online consumer engagement. Furthermore, the study evaluated technology gratification as a moderator of interaction effect in the relationship between online communication and online consumer engagement. The study results showed that the effect of social context was not significant. In contrast, online communication, interactivity and privacy’s effects on online consumer engagement were significant. The social gratification as a mediator and technology gratification as a moderator were significant towards online consumer engagement. This paper is pioneering in that it generates the effects of social presence theory factors and some intervening variables in the context of online consumer engagement in the emerging markets at the micro-level. This area is relevant to scholars, marketing and brand practitioners in digital consumer social behaviour.