bluuebunny/crossref_metadata_2025_split huggingface dataset:
Systematic review of menstrual health and hygiene in Nepal employing a social ecological model
Authors: Sharma Aditi , McCall-Hosenfeld Jennifer S. , Cuffee Yendelela 
Published: June 2022

AbstractMenstrual health and hygiene are a major public health and social issues in Nepal. Due to inadequate infrastructure to provide education, healthcare, and communication as well as religious teachings, women and girls are excluded from participation in many activities of daily living and community activities during menstruation. Evidence based research addressing menstrual health and hygiene in Nepal is scares. The objective of this paper is to review the current state of knowledge on menstrual health and hygiene in Nepal through a socio-ecological perspective. This systematic review identifies knowledge gaps and targets for future research and interventions. Studies from Nepal that examined factors contributing to menstrual health and hygiene were identified through searches across six databases (Medline, CINAHL, Web of Science, PsychInfo, Nepal Journals Online and Kathmandu University Medical Journal) in January 2019. The SEM is a public health framework that describes how health is impacted at multiple levels including the individual, interpersonal, community, organizational and policy levels. Key themes were identified, and factors contributing to menstrual health and hygiene were categorized as per the level of socio-ecological model (SEM). After a comprehensive literature review, twenty peer-reviewed publications, published between 2003 and January 2019 were included in this review. Eighteen studies were descriptive and two were interventional. The main outcomes reported were reproductive health concerns and menstrual hygiene practices. Nine studies focused on knowledge, attitude, and practices regarding menstruation, seven studies highlighted reproductive health issues, three studies focused on prevalence of culturally restrictive practices, and one on school absenteeism and intimate partner violence. Lack of awareness regarding menstrual health and hygiene, inadequate WASH facilities, no sex education and culturally restrictive practices makes menstruation a challenge for Nepali women. These challenges have negative implications on women and girls’ reproductive as well as mental health and school attendance among adolescent girls. There are gaps in the evidence for high quality interventions to improve menstrual health and hygiene in Nepal. Future research and interventions should address needs identified at all levels of the SEM.
Brain microvascular endothelial cell dysfunction in an isogenic juvenile iPSC model of Huntington’s disease
Authors: Linville Raleigh M. , Nerenberg Renée F. , Grifno Gabrielle , Arevalo Diego , Guo Zhaobin , Searson Peter C. 
Published: June 2022

AbstractHuntington’s disease (HD) is an inherited neurodegenerative disease caused by expansion of cytosine–adenine–guanine (CAG) repeats in the huntingtin gene, which leads to neuronal loss and decline in cognitive and motor function. Increasing evidence suggests that blood–brain barrier (BBB) dysfunction may contribute to progression of the disease. Studies in animal models, in vitro models, and post-mortem tissue find that disease progression is associated with increased microvascular density, altered cerebral blood flow, and loss of paracellular and transcellular barrier function. Here, we report on changes in BBB phenotype due to expansion of CAG repeats using an isogenic pair of induced pluripotent stem cells (iPSCs) differentiated into brain microvascular endothelial-like cells (iBMECs). We show that CAG expansion associated with juvenile HD alters the trajectory of iBMEC differentiation, producing cells with ~ two-fold lower percentage of adherent endothelial cells. CAG expansion is associated with diminished transendothelial electrical resistance and reduced tight junction protein expression, but no significant changes in paracellular permeability. While mutant huntingtin protein (mHTT) aggregates were not observed in HD iBMECs, widespread transcriptional dysregulation was observed in iBMECs compared to iPSCs. In addition, CAG expansion in iBMECs results in distinct responses to pathological and therapeutic perturbations including angiogenic factors, oxidative stress, and osmotic stress. In a tissue-engineered BBB model, iBMECs show subtle changes in phenotype, including differences in cell turnover and immune cell adhesion. Our results further support that CAG expansion in BMECs contributes to BBB dysfunction during HD.
Effect of mobile-based cognitive behavior therapy (CBT) on lowering of blood lipid levels in atherosclerotic cardiovascular disease (ASCVD) patients: study protocol for a multicenter, prospective, randomized controlled trial
Authors: Hong Xu-Lin , Luan Yi , Liu Hong-Ying , Zhang Wen-Bin 
Published: June 2022

Abstract
Background
Atherosclerotic cardiovascular disease (ASCVD) remains a major source of mortality in China. Convincing evidence has demonstrated that the reduction of low-density lipoprotein cholesterol (LDL-C) is correlated with lowering ASCVD risk. The efficacy of lifestyle management in lipid levels reduction has been confirmed in numerous studies. However, considering that low compliance to lifestyle management has limited the benefits of lowering lipid levels, cognitive behavior therapy (CBT) is proposed as a solution to improve clinical outcomes. The objective of this trial is to compare the LDL-C outcome in ASCVD patients receiving mobile device-based CBT to a control group, with both groups under standard pharmacological treatments.

Methods
This trial is designed as a multicenter, prospective randomized controlled trial with a 6-month follow-up. Mean LDL-C level and the percentage of different LDL-C levels, coefficient of variation of LDL, General Self-Efficacy Scale (GSEs), quality of life index (QL-index), etc., between the two groups at baseline, 1, 3, and 6 months will be measured.

Discussion
This trial should demonstrate that the implementation of mobile-based CBT intervention will be potentially effective in lowering LDL-C levels in ASCVD patients.

Trial registration
Chinese Clinical Trial Registry (ChiCTR2100046775) [registered: 2021/5/28].
Analyzing the current English language teaching materials in line with the academic and professional needs and interests of diploma theology students
Authors: Deressa Wakgari , Tefera Yohannes , Alemu Adege 
Published: June 2022

AbstractThe study analyzed the current English language teaching/learning materials in line with the academic and professional needs and interests of diploma theology students. The study was a descriptive survey that made use of a mixed-method approach. Thus, the researcher employed convergent parallel mixed method design. The data were collected using a questionnaire, interview, and content analysis. The participants of the study were second and third-year diploma theology students, former theology students, and English as a Foriegn Language instructors. All the students(112) were chosen using comprehensive sampling technique, and five former theology students who were working as priests and evangelists were chosen using the snowball technique to fill out the questionnaire. EFL teachers were also chosen for the interview. Additionally, the skills of three units of the current English language teaching materials were evaluated using the checklist. The reliability of the questionnaire were checked using Cronbach Alpha, and the quantitative data were analyised using SPSS version 22. The study revealed that both students and EFL teachers perceived the teaching materials as they less assist the students in their academic and professional contexts. Finally, the researcher recommended that preparing teaching materials that fit the needs and interests of the students.
Commonly occurring adversities in families as risk factors for developing psychosocial and psychiatric morbidities: evidence from general practice
Authors: Tendolkar Indira , Polat Talip , Peters Hans , Akkermans Reinier , van de Laar Floris 
Published: June 2022

Background
Childhood adversity may lead to mental and somatic complications throughout life. General practitioners are equipped to identify and manage adverse events in households. The relationship between adversities and psychiatric symptoms has not been studied in primary care.

Aims
We investigated the relationship of common adversities in families with respect to subsequent development of psychosocial and psychiatric problems in young children.

Method
We analysed data from seven general practices, including participants between 0 and 9 years of age. Adversity was defined as having a household member who was diagnosed with cancer, psychiatric disease or social problems. We compared these patients with controls matched for gender, age and general practice. The primary outcome was any new episode defined with a psychological and psychiatric label. Secondarily, the encounter rates at the general practices after adversity were analysed.

Results
Participants in both groups were followed for an average of 12 years, whereby patients with an adversity were more likely to develop psychiatric morbidities compared with matched references (odds ratio 1.38, 95% CI 1.12–1.68, P = 0.002), also revealing higher encounter rates at general practices. We found no statistically significant association between adversities in the family and increased psychosocial symptoms.

Conclusions
The short- and long-term consequences of exposure to negative events in childhood are of great public health importance. Our data suggest screening more proactively for consequences of commonly occurring adversities in families, as they are a risk factor for subsequent psychiatric symptoms. Enhanced consultation frequency at general practitioners following adversities should be differentiated in more detail.
Antidepressant prescribing patterns in Australia
Authors: Malhi Gin S. , Acar Mustafa , Kouhkamari Mahsa H. , Chien Tzu Hsiang , Juneja Prabhjot , Siva Sinthuja , Baune Bernhard T. 
Published: June 2022

Background
The Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders (MDcpg2015 and MDcpg2020) provide evidence-based and consensus-based recommendations for managing mood disorders.

Aims
We examined Australian real-world prescribing habits to determine whether management in clinical practice aligned with MDcpg2015 recommendations.

Method
A retrospective analysis of a cohort of patients ≥16 years old who had been dispensed a Pharmaceutical Benefits Scheme (PBS)-listed antidepressant between July 2013 and June 2019 was conducted using Australian Commonwealth Department of Human Services PBS 10% sample data.

Results
Between July 2013 and June 2019, 239 944 patients in Australia commenced antidepressant treatment. Of these, 22% (52 694 patients) received a second treatment (a new class of treatment after a period of discontinuation or additional antipsychotic therapy) and 6% (15 741 patients) received a third treatment. Patients were initially prescribed primarily selective serotonin reuptake inhibitors (SSRIs; 52% of prescriptions) or tricyclic antidepressants (TCAs; 25%), even though TCAs are not recommended for first-line treatment. Fewer than one-quarter of patients were prescribed serotonin–noradrenaline reuptake inhibitors (13%) or other agents (10%). General practitioners (GPs) were more likely to initiate TCAs than psychiatrists (22% v. 7%).
Once initiated, the overall median time patients remained on treatment was 4.5 months; this was highest with SSRIs (5.8 months) and lowest with TCAs (0.9 months).

Conclusions
First-line prescribing broadly follows guidelines. GP and psychiatrist prescribing patterns differ, perhaps reflecting different patient groups and the need to tailor treatment to individuals. Future guidelines should aim to capture the different presentations and complexity of depression.
EDUCAÇÃO FINANCEIRA NAS DECISÕES DE POUPANÇA: UM ESTUDO DE CASO NA ESCOLA MUNICIPAL AUSÔNIO ARAÚJO EM CURRAIS NOVOS - RN
Authors: Carvalho Valdemir Galvao de , Lima Maria Olivia Caline de , Lima Maria Girliane Milena de , Alves Palloma Dejaíne Batista , Carvalho Beatriz Silva de 
Published: June 2022

O estudo verificou a influência do ensino da educação financeira nas decisões de poupança sobre o comportamento dos alunos das turmas do 5º ano da Escola Municipal Ausônio Araújo, por meio da implementação do projeto de extensão da Universidade Federal do Rio Grande do Norte, intitulado “Educação Financeira nas Escolas”. O universo compreende turmas do 5º ano, e a amostra foi composta por 180 alunos, sendo 45 participantes do projeto implementado nos anos de 2018, e 45 no ano de 2019, e um grupo de controle com 45 não participantes do projeto no ano de 2018, e 45 no ano de 2019. Para a análise dos dados, foi utilizado um questionário estruturado em escala de Likert e o teste de diferença de média não paramétrico de Wilcoxon. Os resultados sugerem que os grupos que participaram das aulas de educação financeira nos anos de 2018 e 2019 apresentaram um maior conhecimento em relação às respostas das proposições do que o grupo de controle. O projeto é relevante e contribui com a tomada de decisão referente à vida financeira dos alunos. Porém, em relação ao domínio das habilidades financeiras, os alunos apresentaram dificuldades e limitações para a tomada da decisão, evidenciando a importância de maior diálogo sobre o assunto no lar e nas relações interpessoais. Além disso, houve maior compromisso e iniciativa por parte do Ministério da Educação em relação à implementação efetiva da educação financeira nas escolas em âmbito nacional.
Association of fetal hydrocephalus with other embryological anomalies: A prenatal ultrasound-based study
Authors: Surti Ambreen , Usmani Ambreen , Javaid Quratulain , Shafique Sehrish 
Published: June 2022

Objective: To determine the incidence of fetal hydrocephalus in pregnant women and to identify the association of fetal hydrocephalus with other embryological anomalies.
Methods: This comparative cross-sectional study was conducted on 36 pregnant women at a private ultrasound clinic in Karachi over a period of eight months. The participants were divided into age groups, 21-30 years and 31-40 years. Toshiba APLIO 300 ultrasound machine was used to assess fetal age by measuring biparietal diameter (BPD) and femur length, whereas atrium of lateral ventricle was measured to diagnose fetal hydrocephalus.
Results: Twenty-two cases of fetal hydrocephalus were observed in maternal age of 21-30 years with a p-value of 0.011. Severe dilatation of ≥15mm was observed in 85.7% cases in age group of 31-40 years. Cranial anomalies were found in 20 cases with significant results while extracranial anomalies were observed in cases of severe dilatation only. Hydrocephalus was prevalent in male fetuses and was observed in 30 (83.33%) fetuses.
Conclusion: Most cases of fetal hydrocephalus were observed in women of younger age (p=0.011). Fetal hydrocephalus of severe type exhibiting ventricular dilatation >15mm was observed in fetuses of male gender.
doi: https://doi.org/10.12669/pjms.38.6.5223
How to cite this:Surti A, Usmani A, Javaid Q, Shafique S. Association of fetal hydrocephalus with other embryological anomalies: A prenatal ultrasound-based study. Pak J Med Sci. 2022;38(6):---------. doi: https://doi.org/10.12669/pjms.38.6.5223
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Role of Politics, Guilds and Pedagogy in defining Policies in Medical Education: The Pakistan Scenario
Authors: Baig Lubna , Ali Syeda Kauser , Sarfaraz Shaur 
Published: June 2022

Politics in education is not a new concept and has been a sore point of discussion between academia and policy makers. The politics of medical education has led to the formation of informal guilds that have taken control over medical education. Policy decisions concerning medical/dental education affecting the lives of the community, at large are implemented without giving due consideration to the pedagogy of medical education. This paper delves into the definitions of politics, pedagogy and guilds and with evidence identifies that major policy decisions in medical education are strongly influenced by politics. The paper will discuss that politics of medical education is not necessarily a bad thing if it ensures public safety and is based on best evidence medical education. In the same context the guilds formed for medical education reforms should uphold the principles of pedagogy.
doi: https://doi.org/10.12669/pjms.38.6.6057
How to cite this:Baig LA, Ali SK, Sarfaraz S. Role of Politics, Guilds and Pedagogy in defining Policies in Medical Education: The Pakistan Scenario. Pak J Med Sci. 2022;38(6):---------. doi: https://doi.org/10.12669/pjms.38.6.6057
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The puzzle of post-pandemic recovery, transatlantic relations and European solidarity
Authors: Czech Sławomir 
Published: June 2022

Motivation: The coronacrisis has highlighted the fragility of the highly interdependent world economic order. The economic recession following numerous lockdowns weakened the position of the West in the geopolitical arena. Thus economic recovery is a must, though its significance for the US and the EU differs considerably.
Aim: The paper aims to discuss the state and prospects of transatlantic relations in the era of new challenges posed in front of the US and the EU. We have selected two main issues: the incremental rivalry between the US and China, and the solidarity principle within the EU. The departure point for the analysis is the assumption that the tightening of economic cooperation between the US and the EU seems desired, but it might also lead to socioeconomic consequences questioning European solidarity in the long term. We employ the perspective of institutionalist political economy to understand the interplay between actors and the rules they create. We assume thus that actors pursue their goals, but must take various limitations into account. We also refer to the literature on economic policymaking and economic systems.
Results: Under possible regionalization of the world economy after the COVID-19 pandemic, transatlantic relations will be under pressure to generate growth. As far as the US is willing to embrace this imperative, the EU might face the dilemma between struggling for better economic performance and rebuilding solidarity between member countries.
How Employee Capital Plans qualify under the IORP II Directive
Authors: Jakubowski Sebastian 
Published: June 2022

Motivation: The pension system in Poland is undergoing another major reform. Between 2019 and 2021 Employee Capital Plans (ECP) are being implemented. This common system of voluntary pension savings schemes is a new element of the third pillar. The purpose of the ECP is to cover the majority of employees and to provide additional pension security for the large part of the labour force in Poland. Since Poland is still implementing the reform, and the system is still quite young, the research background is limited.
Aim: This article tries to provide deeper, both legal and economic, analysis of the ECP. On the legal ground, it considers whether ECP provide “cover against biometric risk” or “guarantees a given level of benefits” for the purposes of Article 13(2) of EU Directive 2016/2341 (the “IORP II Directive”). If no such cover and no such guarantee are provided, then an ECP scheme is not required to comply with the technical provisions, buffer, and other funding requirements applicable to an IORP which is classified as a “regulatory own fund” in Article 15 of the IORP II Directive. From the economic perspective, the purpose of the article is to answer the question of how much the ECP members are covered against the risk of longevity. To achieve the research objective the method of critical legal dogmatics and the economic analysis of law method are employed.
Results: The article explores how the ECP schemes are classified under the IORP II Directive. It also answers the question of how much the ECP members are covered against the risk of longevity. The main finding of this analysis is that the ECP, as a defined contribution plan, does not protect participants from either biometric risk or asset value declines.
Determinants of digital financial exclusion as a barrier to the adoption of mobile banking services in Poland
Authors: Solarz Małgorzata , Adamek Jacek 
Published: June 2022

Motivation: the contemporary phenomenon of financial exclusion, in the sphere of its reasons, consequences and activities aimed at its reduction can be connected, e.g., with using new technologies and financial innovations. The new dimension of such exclusion is created by the digital financial exclusion developed through a diverse set of behavioral, environmental and demographic factors. Their identification and analysis has become an essential activity influencing, e.g., the effectiveness of selective choice and application of proper tools to reduce this exclusion.
Aim: identification and assessment of the determinants related to digital financial exclusion as a barrier in the adoption of mobile banking services, considered from the perspective of their impact on the segmentation of the analysed population.
Results: the ranking, identified by the authors, regarding the importance of predictors indicated that the dependent variable — Y (i.e. people who have an online bank account classified based on the mobile forms of its use) is most influenced by the generation factor — X4 (1.0), followed by: personal innovativeness — X2 (0.92), digital skills — X1 (0.90) and the perceived risks of new technologies — X3 (0.66).
Mental well-being in young people with psychiatric disorders during the early phase of COVID-19 lockdown
Authors: Orfeuvre Emilie , Franck Nicolas , Plasse Julien , Haesebaert Frédéric 
Published: June 2022

Background
Mental health and well-being were seriously impacted by the COVID-19 lockdown especially among young people and people with psychiatric disorders. This study aimed to identify factors associated with well-being in young people with psychiatric disorders, during early phase of COVID-19 lockdown in France.

Methods
A national cross-sectional online study started on the 8th day of COVID-19 lockdown in France (during March 25–30, 2020). We included young people aged from 16 to 29 who responded to the questionnaire, living and being confined in France, with past or current psychiatric treatment. The questionnaire was accessible online and explored demographics and clinical factors, well-being, stress, situation during lockdown. Well-being was measured by the Warwick-Edinburg Mental Well-Being Scale (WEMWBS). Simple and multiple linear regression analyses were carried out.

Results
439 individuals were included with 262 (59.7%) previously treated and 177 (40.3%) currently treated. WEMWBS total score were 42.48 (9.05). Feeling of useful was the most affected dimension. Well-being was positively correlated with: currently working on site, physical activity, abilities to cope with difficulties, family and social supports (p<0.05). It was negatively correlated with: elevated stress level, anxious ruminations, dissatisfaction with information, difficulties to sleep or reorganize daily life, feeling supported by medicines (p<0.05). No individual factor was correlated with well-being. The stepwise linear multivariate model had simple R2 coefficient of determination of 0.535.

Conclusion
In the specific population of young people with psychiatric disorders, factors associated with well-being at early stage of lockdown were mainly psychosocial and related to brutal disorganisation of daily life.