bluuebunny/crossref_metadata_2025_split huggingface dataset:
A single-arm pilot study: can a parental sleep intervention for sleep-disturbed young children in individual settings improve children’s sleep, crying, eating, and parental distress in mothers and fathers?
Authors: Schnatschmidt Marisa , Lollies Friederike , Schlarb Angelika A. 
Published: October 2022

AbstractBackgroundEarly sleep problems co-occur with crying, eating problems, and parental distress. This study investigates the impact of a parent-focused intervention to improve child sleep with the following aims: (1) To assess the impact on child sleep (sleep onset latency, frequency and duration of nighttime awakenings, frequency of bed-sharing, and nighttime food intake, total nighttime sleep duration, and sleep efficiency), child crying (frequency of crying episodes, of unexplained and unsoothable crying and of crying out of defiance), child eating difficulties, and parental distress of mothers and fathers. (2) To assess the maintenance of any changes in these areas longitudinally, at 3-month, 6-month, and 12-month follow-ups. (3) To explore at the within-subjects level, how children’s sleep, crying, eating, and parental distress changed together across all study measurement points.MethodsIn this single-arm pilot study, the parents of 60 children participated in six individual sessions of a parent-focused multimodal age-adjusted cognitive-behavioral intervention to improve child sleep. Parents of 39 children (46% girls, age in months M = 22.41, SD = 12.43) completed pre- and at least one measure after the intervention. Sleep diary, questionnaire for crying, feeding, sleeping, and parental stress index (short-form) were assessed pre, post, three, six, and 12 months after the intervention.ResultsSignificantly, sleep (decreased sleep onset latency, frequency, duration of nighttime awakenings, bed-sharing, nighttime food intake; increased total nighttime sleep duration, sleep efficiency), crying (reduced frequency of crying episodes, unexplained and unsoothable crying), and parental distress (reduced) changed, which remained partially stable over follow-up. The frequency of crying episodes decreased with fewer nighttime awakenings; morning crying with increased nighttime feeding; unexplained and unsoothable crying with higher sleep efficiency; crying due to defiance with more nighttime awakenings, sleep efficiency, and bed-sharing. Eating problems decreased with shorter night awakenings and time; maternal distress with fewer nighttime awakenings, paternal with less child’s nighttime feeding, unexplained and unsoothable crying, and time.ConclusionsA parental sleep intervention for sleep-disturbed young children could be promising to reduce children’s sleep problems, crying, eating problems and parental distress. Future studies should consider more personal contact during the follow-up to reduce the drop-out rate and a randomized-controlled design.Trial registrationThe study was retrospectively registered at the German Clinical Trials Register (ID: DRKS00028578, registration date: 21.03.2022).
Compared with dietary behavior and physical activity risk, sedentary behavior risk is an important factor in overweight and obesity: evidence from a study of children and adolescents aged 13–18 years in Xinjiang, China
Authors: Liu He , Bi Cunjian , Lin Hongniu , Ma Wei , Zhang Jie , Hu Yan-Yan , Liu Jing-Zhi 
Published: October 2022

Abstract
Background
Malnutrition or insufficient physical activity (PA) is a risk factor for obesity and chronic disease in children and adolescents. Affected by different economic circumstance, ethnic, dietary behavior, physical activity and other factors, children and adolescents in Xinjiang, China are facing a severe situation of overweight and obesity prevention and control. It is necessary to analyze the dietary behavior and physical activity of children and adolescents with different nutritional status and the relationship between them.

Methods
Using a stratified cluster sampling method in Xinjiang, China, 4833 middle school students aged 13–18 were selected., and tests for height and weight were conducted. Self-assessment questionnaires were completed for Dietary Behaviors, Physical Activity, and Sedentary Behaviors as well. Chi-square test, Logistic regression analysis and other methods were used to analyze the relationship between Dietary Behaviors, Physical Activity, Sedentary Behaviors and other health behavior risk factors and Weight and BMI.

Results
Children and adolescents aged 13–18 in Xinjiang, China, girls had a lower BMI compared with boys(19.49 VS. 20.41). The proportions of Underweight, Overweight and Obese among girls were lower (Underweight: 11.8 VS. 14.5; Overweight: 7.6 VS. 12.7; Obese 2.3 VS. 7.0).Boys with higher risk of sedentary had a 1.46-fold higher risk of developing Overweight/Obese than those with lower risk of sedentary (95%CI: 1.07–2.01).Girls with higher risky diet had a 1.56-fold higher risk of developing Underweight than those with lower risky diet (95%CI: 1.11–2.19). For all participants, the risk of Overweight/Obese in children and adolescents with higher risk of sedentary was 1.45 times more than that of children and adolescents with lower Risk sedentary (95%CI: 1.12 ~ 1.88). Overall, Weight had a significant correlation with PA risk (r = 0.076, P < 0.01) and sedentary behavior risk (r = 0.035, P < 0.05). BMI had a key correlation with PA risk (r = 0.064, P < 0.01) and sedentary behavior risk (r = 0.037, P < 0.05).

Conclusions
The detection rate of Underweight among children and adolescents aged 13–18 in Xinjiang, China is higher, while the detection rate of Overweight and Obese is lower than that of the whole country. Static behavior was an important factor affecting the occurrence of Overweight and Obese in children and adolescents, and the performance of boys was more obvious than that of girls.The results further improve the data on the weight status of Chinese children and adolescents and their influencing factors, and call on Chinese society and schools to continue their efforts to prevent and reduce malnutrition and obesity among children and adolescents in Xinjiang.
Association of maternal characteristics with child feeding indicators and nutritional status of children under-two years in Rural Ghana
Authors: Nsiah-Asamoah Christiana , Adjei George , Agblorti Samuel , Doku David Teye 
Published: October 2022

AbstractBackgroundOptimal nutrition during the first two years of a child’s life is critical for the reduction of morbidity and mortality. In Ghana, majority of children miss out on optimal nutrition and only few (13%) of children receive a Minimum Acceptable Diet (MAD). Several studies have investigated the influence of community-level factors on infants and young children feeding (IYCF) practices. However, little is known about the influence of maternal factors on IYCF practices in rural settings. Therefore, this study assessed the influence of maternal factors on the feeding indicators and nutritional status of children aged 6–23 months in two administrative districts in Ghana.MethodsData were collected among 935 mothers who had children aged 6–23 months and accessed 21 Child Welfare Clinics within the study area. The study involved a face- to-face interview using structured questionnaires to capture maternal characteristics, dietary intake and anthropometric measurements of children. Multivariate logistic regression was used to study the association between maternal factors and child nutrition outcomes (MAD, dietary diversity score (DDS) and anthropometric indicators) using Stata 16.0 software.ResultsBeing employed (AOR = 3.07, 95% CI: 1.71—5.49,p < 0.001) and attaining secondary or higher education (AOR = 2.86, 95% CI: 1.42—5.78,p = 0.003) were significant predictors of children receiving MAD. Similarly, having an average decision-making autonomy increased the child’s odds of receiving MAD (AOR = 1.68, 95% CI: 1.02—2.76,p = 0.040). Children of mothers who attained secondary or a higher level of education (AOR = 0.59, 95% CI: 0.36 -0.97,p = 0.040) and those whose mothers were employed (AOR = 0.71, 95% CI: 0.47—1.07,p = 0.043) were associated with a reduced risk of underweight and stunting respectively. Children of mothers with average financial independence status were more likely to receive diversified meals (AOR = 1.55, 95% CI: 1.01–2.38,p = 0.045).ConclusionsHigh educational level and being employed have positive influence on MAD, stunting and underweight of children. High decision-making power and average financial independence of mothers are good predictors of children receiving MAD. Family planning, women empowerment in decision-making, providing employment opportunities for mothers and promoting girl-child education are recommended.
Determinants of access to hemodialysis services in a metropolitan region of Brazil
Authors: de Oliveira Soares Ana Cristina , Cattafesta Monica , Paixão Mirian Patrícia Castro Pereira , dos Santos Neto Edson Theodoro , Salaroli Luciane Bresciani 
Published: October 2022

Abstract
Introduction
The increasing prevalence of chronic kidney disease has made it a public health issue. Research on access to hemodialysis services is fundamental for appropriate and assertive approaches to the disease. This study analyzed the factors that influence access to hemodialysis services, from the dimensions of availability, accessibility, and acceptability.

Methods
This was a cross-sectional census epidemiological study involving 1024 individuals in the Metropolitan Region of Brazil in 2019. Data were analyzed using multinomial logistic regression.

Results
Factors that increase the chance of belonging to the lowest level of access were: age group from 30 to 59 years (OR 2.16, IC95% 1.377–3.383), female (OR 1.74, IC95% 1.11–2.72), and lower income or equal to two minimum wages (OR 1.80, IC95% 1.17–2.76); the factors medium coverage of the family health strategy or the gateway to public health policy in Brazil (OR 0.54, 95%CI 0.29–0.99), no previous conservative treatment (OR 0.59, 95%CI 0.38–0.91), lack of paid work (OR 0.35, 95%CI 0.15–0.85), retirement/sick leave (OR 0.27, 95%CI 0.12–0.64), and self-assessment of health status as bad or very bad (OR 0.62, 95%CI 0.40–0.96) reduced the chance of belonging to the lowest access level.

Conclusion
Access to hemodialysis services in a metropolis in the southeastern region of Brazil is influenced by contextual, predisposing, enabling, and health needs characteristics. Those who are female, aged between 30 and 59 years, having an income less than or equal to 2 times minimum wage in Brazil, are at the lowest levels of access, which reinforces the role social determinants in health.
Perceived influence of alcohol consumption, substance use, and mental health on PrEP adherence and condom use among PrEP-prescribed gay, bisexual, and other men-who-have-sex-with-men: a qualitative investigation
Authors: Shuper Paul A. , Varatharajan Thepikaa , Kinitz David J. , Gesink Dionne , Joharchi Narges , Bogoch Isaac I. , Loutfy Mona , Rehm Jürgen 
Published: October 2022

Abstract
Background
Gay, bisexual, and other men-who-have-sex-with-men (GBMSM) continue to be disproportionately affected by Human Immunodeficiency Virus (HIV). Although HIV pre-exposure prophylaxis (PrEP) offers an effective means of reducing incident HIV among this population, the HIV-preventive success of oral-based PrEP is contingent upon regimen adherence. Elevated rates of alcohol-, substance use-, and mental health-related issues among GBMSM potentially hinder PrEP-taking efforts, however the evidence for this remains mixed. Accordingly, the present study entailed a comprehensive qualitative investigation to explore PrEP-prescribed GBMSM’s perceptions surrounding the influence of alcohol, substance use, and mental health on PrEP adherence.

Methods
PrEP-prescribed GBMSM (age ≥ 18 years; prescribed PrEP for ≥ 3 months) were recruited from two PrEP-delivery clinics in Toronto, Canada for focus groups as part of the formative phase of an alcohol-, substance use-, and mental health-focused randomized controlled intervention trial. Focus group discussions qualitatively explored perceived strengths and barriers associated with adherence to PrEP treatment; with an emphasis on alcohol, substance use, and mental health concerns. Condom use among PrEP-prescribed GBMSM within the context of these concerns was also discussed.

Results
A total of five focus groups involving 35 GBMSM were conducted (4–10/group; mean age = 42.4; white = 71.4%). Although participants themselves generally reported successfully adhering to their PrEP regimens—resulting from a strong, underlying motivation for self-care—they recognized the detrimental impact that alcohol, substance use, and mental health had on adherence among their peers. In this regard, alcohol and substances were perceived as detracting from adherence only when consumption was excessive or temporally linked to PrEP dosing. Pronounced mental health issues (e.g., severe depression) were also seen as hindering adherence, although these effects were nuanced and perceived as person-dependent. Alcohol and substances were linked to condomless sex, regardless of PrEP use, and PrEP was therefore viewed as an HIV-protective ‘safety net.’

Conclusions
Overall, findings suggest that PrEP adherence can often be successfully achieved in the presence of alcohol-, substance use-, and mental health-related issues. Augmenting self-care, and addressing pronounced addictions- and mental health-related concerns, may enhance PrEP treatment among GBMSM.
Use of mobile phones for rehabilitative services among prosthetics users in rural Acholi sub-region of northern Uganda: findings from a qualitative study
Authors: Yagos Walter Onen , Olok Geoffrey Tabo , Moro Emmanuel Ben , Huck Jonathan , Nirmalan Mahesh 
Published: October 2022

Abstract
Background
Digital technologies such as mobile phones have shown potential as vital tools for use in healthcare and related services. However, little has been done to explore its use for prosthetics rehabilitative services, especially in the Acholi sub-region of northern Uganda. We address this gap by exploring ownership of the mobile phone, knowledge of the use of mobile phone applications, use of mobile phones for prosthetics rehabilitative services and challenges faced in using the mobile phones.

Methods
A case study design was used. We conducted semi-structured one-on-one interviews with 16 prosthetics users spread in the four districts of Nwoya, Amuru, Omoro, and Gulu of the Acholi sub-region of northern Uganda. We transcribed the data verbatim and explored the contents thematically to derive themes.

Results
More prosthetics users (63%) owned mobile phones compared to those without (37%). Many who owned and use mobile phones are knowledgeable about applications for calls and messaging (47%). Some prosthetics users are knowledgeable in mobile money applications (21%), call applications only (16%) and, others were able to use the internet (16%). Many of the prosthetics users in this study use mobile phones to seek information, mainly relating to the management of prosthetics and treatment of diseases. Many participants were positive about the benefits of the use of mobile phones for prosthetics rehabilitation and related services. Common challenges affecting the use of mobile phones include the expensive price of airtime, few places for charging mobile phones, lack of electricity and inadequate skills to operate a mobile phone.

Conclusion
The use of mobile phones can break down barriers created by distance and allow effective communication linkages between prosthetics users and rehabilitation services. Our results suggest that some prosthetics users owned mobile phones and used them to seek information relating to prosthetics rehabilitation services. We believe that promoting the use of the mobile phone for prosthetic rehabilitative services among prosthetics users is necessary and should be considered for practical and policy discussion relating to its use for prosthetics rehabilitation in rural areas.
Rationale and guidance for strengthening infection prevention and control measures and antimicrobial stewardship programs in Bangladesh: a study protocol
Authors: Harun Md. Golam Dostogir , Anwar Md Mahabub Ul , Sumon Shariful Amin , Hassan Md. Zakiul , Mohona Tahrima Mohsin , Rahman Aninda , Abdullah Syed Abul Hassan Md , Islam Md Saiful , Kaydos-Daniels S. Cornelia , Styczynski Ashley R. 
Published: October 2022

Abstract
Background
Hospital-acquired infections (HAIs) and antimicrobial resistance (AMR) are major global health challenges. Drug-resistant infectious diseases continue to rise in developing countries, driven by shortfalls in infection control measures, antibiotic misuse, and scarcity of reliable diagnostics. These escalating global challenges have highlighted the importance of strengthening fundamental infection prevention and control (IPC) measures and implementing effective antimicrobial stewardship programs (ASP). This study aims to present a framework for enhancing IPC measures and ASP efforts to reduce the HAI and AMR burden in Bangladesh.

Methods
This implementation approach will employ a mixed-methods strategy, combining both quantitative and qualitative data from 12 tertiary hospitals in Bangladesh. A baseline assessment will be conducted using the Infection Prevention and Control Assessment Framework (IPCAF) developed by the WHO. We will record IPC practices through direct observations of hand hygiene, personal protective equipment (PPE) utilization, and hospital ward IPC infrastructure. Additionally, data on healthcare providers’ knowledge, attitudes, and practices regarding IPC and antibiotic prescribing will be collected using both structured questionnaires and qualitative interviews. We will also assist the hospital leadership with establishing and/or strengthening IPC and ASP committees. Based on baseline assessments of each healthcare facility, tailored interventions and quality improvement projects will be designed and implemented. An end-line assessment will also be conducted after 12 months of intervention using the same assessment tools. The findings will be compared with the baseline to determine changes in IPC and antibiotic stewardship practices.

Discussion
Comprehensive assessments of healthcare facilities in low-resource settings are crucial for strengthening IPC measures and ASP activities,. This approach to assessing existing IPC and ASP activities will provide policy-relevant data for addressing current shortfalls. Moreover, this framework proposes identifying institutionally-tailored solutions, which will ensure that response activities are appropriately contextualized, aligned with stakeholder priorities, and offer sustainable solutions.

Conclusion
Findings from this study can guide the design and implementation of feasible and sustainable interventions in resource-constrained healthcare settings to address gaps in existing IPC and ASP activities. Therefore, this protocol will be applicable across a broad range of settings to improve IPC and ASP and reduce the burden of hospital-acquired infections and AMR.
Health workers’ experiences of implementation of Helping Mothers Survive Bleeding after Birth training in Tanzania: a process evaluation using the i-PARIHS framework
Authors: Alwy Al-beity Fadhlun M , Baker Ulrika , Kakoko Deodatus , Hanson Claudia , Pembe Andrea B 
Published: October 2022

Abstract
Background
In-service training, including the competency-based Helping Mothers Survive Bleeding After Birth (HMS BAB) is widely implemented to improve the quality of maternal health services. To better understand how this specific training responds to the needs of providers and fits into the existing health systems, we explored health workers’ experiences of the HMS BAB training.

Methods
Our qualitative process evaluation was done as part of an effectiveness trial and included eight focus group discussions with 51 healthcare workers in the four districts which were part of the HMS BAB trial. We employed deductive content analysis informed by the Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) construct of context, recipients, innovation and facilitation.

Results
Overall, health workers reported positive experiences with the training content and how it was delivered. They are perceived to have improved competencies leading to improved health outcomes. Interviews proposed that peer practice coordinators require more support to sustain the weekly practices. Competing tasks within the facility in the context of limited time and human resources hindered the sustainability of weekly practices. Most health facilities had outlined the procedure for routine learning environments; however, these were not well operational.

Conclusion
The HMS BAB training has great potential to improve health workers’ competencies around the time of childbirth and maternal outcomes. Challenges to successful implementation include balancing the intervention within the routine facility setting, staff motivation and workplace cultures.
From screening to treatment: the new landscape of diabetic kidney disease
Authors: Cervantes C. Elena , Hanouneh Mohamad , Jaar Bernard G. 
Published: October 2022

AbstractGlobally, diabetes mellitus is the leading cause of chronic kidney disease (CKD), and it is predicted to increase in the following years. Despite its high prevalence, CKD remains under diagnosed. In this BMC Medicine collection of articles on diabetic kidney disease (DKD), we place in context the importance of screening and early detection of DKD and the most accurate tools to monitor for optimal glycemic control in this his risk population. Further, we address this population's risk for severe complications such as stroke and all-cause mortality. We close this editorial by summarizing recent advances in management of this vulnerable population of patients with DKD, including guideline-directed medical therapy, novel treatments, and predictors of treatment failure.
The effect of CT and MRI with and without arthrography on the appearance of the feline carpal ligaments
Authors: Basa Rachel M. , Johnson Kenneth A. , Podadera Juan M. 
Published: October 2022

Abstract
Background
The current diagnosis of feline carpal injuries is based on radiographic examination including stress views and computed tomography; however, these techniques do not allow for direct evaluation of the carpal ligaments. The purpose of this cadaveric study was to assess the ability of CT arthrography (CTA) and MR arthrography (MRA) to provide this information using a single contrast mixture. A protocol for intra-articular injection of the feline carpus was also described. A contrast solution containing gadolinium and iohexol with a 50% gadolinium solution (Magnevist—gadolinium 0.5 mmol/mL diluted to a 0.05 mmol/mL solution) and 50% of iodine (Iohexol—iodine 300mgI/mL) was injected into the antebrachiocarpal and middle carpal joints of feline carpi using fluoroscopic guidance.

Results
CTA allowed for identification of intra-articular ligaments and the silhouette of select extra-articular ligaments when there was adequate joint distension, however it was not considered to be superior to MRI. MRA allowed for improved identification of the dorsal radiocarpal, accessorioulnocarpal, accessorioquartile, short ulnar and short radial collateral ligaments.

Conclusion
In this ex-vivo study, combined CTA and MRA enhanced the appearance of the feline carpal ligaments and may provide a foundation for future studies in the diagnosis of carpal injuries.