bluuebunny/crossref_metadata_2025 huggingface dataset:
Summarizing the extent of visit irregularity in longitudinal data
Authors:   on behalf of the TARGet Kids! Collaboration, Lokku Armend , Lim Lily S. , Birken Catherine S. , Pullenayegum Eleanor M.
Published: May 2020

Background

Observational longitudinal data often feature irregular, informative visit times. We propose descriptive measures to quantify the extent of irregularity to select an appropriate analytic outcome approach.

Methods

We divided the study period into bins and calculated the mean proportions of individuals with 0, 1, and > 1 visits per bin. Perfect repeated measures features everyone with 1 visit per bin. Missingness leads to individuals with 0 visits per bin while irregularity leads to individuals with > 1 visit per bin. We applied these methods to: 1) the TARGet Kids! study, which invites participation at ages 2, 4, 6, 9, 12, 15, 18, 24 months, and 2) the childhood-onset Systemic Lupus Erythematosus (cSLE) study which recommended at least 1 visit every 6 months.

Results

The mean proportions of 0 and > 1 visits per bin were above 0.67 and below 0.03 respectively in the TARGet Kids! study, suggesting repeated measures with missingness. For the cSLE study, bin widths of 6 months yielded mean proportions of 1 and > 1 visits per bin of 0.39, suggesting irregular visits.

Conclusions

Our methods describe the extent of irregularity and help distinguish between protocol-driven visits and irregular visits. This is an important step in choosing an analytic strategy for the outcome.
Kaumātua Mana Motuhake: peer education intervention to help Māori elders during later-stage life transitions
Authors: Oetzel John G. , Cameron Michael P. , Simpson Mary L. , Reddy Rangimahora , Nock Sophie , Greensill Hineitimoana , Meha Pare , Johnston Kirsten , Harding Truely , Shelford Pita , Smith Linda Tuhiwai , Hokowhitu Brendan
Published: May 2020

Background

Aotearoa/New Zealand has a population that is ageing and there are challenges to health and social outcomes related to related to key life transitions (e.g., retirement, change in health conditions, loss of spouse). Further, there are significant inequities between Māori (Indigenous people) and non-Māori in ageing outcomes. The purpose of this study was to test the impacts and cost effectiveness of a tuakana/teina (peer education) intervention on kaumātua (elders) receiving the intervention. This study was framed by a strengths-based approach based on the key cultural concept of mana motuhake (autonomy and self-actualisation).

Methods

This study was grounded in principles of Kaupapa Māori and community-based participatory research to bring together a diverse group of stakeholders to co-develop and co-evaluate the intervention. The intervention had tuakana (peer educators) having conversations with up to six teina (recipients) and providing information related to health and social services. The research design was a pre- and post-test, clustered staggered design. Participants completed a baseline assessment of health and mana motuhake measures consistent with Māori worldviews along with two follow-up assessments (one after the first intervention group completed its activities and a second after the second intervention group completed its activities). Additionally, five focus groups and open-ended questions on the assessments were used to provide qualitative evaluation.

Findings

A total of 180 kaumātua were recruited to the intervention with 121 completing it. The analysis revealed improvements over time in the expected direction on most of the variables. However, only three of the variables had statistically significant intervention effects: received support, tribal identity, and trouble paying bills. Qualitative results supported impacts of the intervention on mana motuhake, social connectedness, and tangible/information support related to services. Cost-effectiveness analysis showed that the intervention is cost effective, with a cost per QALY of less than the conventional threshold of three times gross domestic product per capita.

Conclusions

The findings support the relevancy and importance of kaumātua knowledge to create a strengths-based approach to improve health and social outcomes. This study demonstrates that a contextually based and culturally safe age-friendly environments can facilitate engagement and participation by kaumātua for kaumātua.

Trial registry

Australia New Zealand Clinical Trial Registry (ACTRN12617001396314); Date Registered: 3 October 2017 (retrospectively registered);https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373733&isClinicalTrial=False
Neurocognitive impairment in treatment-experienced adults living with HIV attending primary care clinics in Zimbabwe
Authors: Nyamayaro Primrose , Gouse Hetta , Hakim James , Robbins Reuben N. , Chibanda Dixon
Published: May 2020

Background

HIV affects the central nervous system resulting in HIV associated neurocognitive impairment (NCI) in approximately 50% of people living with HIV. It typically affects memory, learning, working memory, fine motor skills, speed of information processing, verbal fluency and executive functioning cognitive domains. NCI can affect adherence to antiretroviral therapy (ART), employability, driving ability and activities of daily living. NCI is not routinely screened for in Zimbabwe, and the burden is not known in this setting. The objectives of this study were: 1) To determine NCI prevalence using a comprehensive neuropsychological battery at two primary health care clinics in Harare; 2) To assess the pattern of cognitive impairment across cognitive domains using a gold standard neuropsychological (NP) battery in HIV-positive patients compared to HIV-negative controls.

Methods

Inclusion criteria: 18 years or older; minimum 7 years education; no neurological or psychiatric disorders. HIV-positive participants were on ART for ≥3 months; HIV-negative participants had a confirmed HIV negative status in the past month. A comprehensive NP battery, functional assessments, demographic and medical history questionnaires were administered. The NP battery consisted of tests assessing memory, learning, working memory, fine motor skills, speed of information processing, verbal fluency and executive functioning.

Results

Two-hundred-and-thirty-one participants were recruited. Of those, 155 were HIV-positive (Female = 70%, Age M = 37.8; SD 11.2) and 76 HIV-negative (Female = 63%, Age M = 31.2; SD 9.9). HIV-positive participants were on ART for an average of 6 years. NCI was present in 49.7% HIV positive participants. Compared to HIV-negative participants, the HIV-positive group had significantly poorer scores in 5 out of 7 cognitive domains. A good level of education is negatively correlated with NCI.

Conclusions

NCI prevalence in HIV-positive population Zimbabwe is consistent with global estimates. NCI persists in adults who are on ART. Routine assessment of NCI in adults attending primary care clinics using this adapted battery is therefore important so that they are identified early and are provided the necessary interventions.
Epidemiology and risk factors of Staphylococcus aureus CC398 bone and joint infections
Authors: Bouiller Kevin , Hocquet Didier , Sauget Marlene , Bertrand Xavier , Chirouze Catherine
Published: May 2020

Background

A particular ability of the Staphylococcus aureus clonal complex 398 (CC398) to cause bone and joint infections (BJI) remains questionable, since some studies have described high prevalence of MSSA CC398 in prosthetic joint infection (PJI) and diabetic foot ostemolyelitis (DFO). Here, we described the long-term epidemiology of CC398 among S. aureus isolated from BJI and identified risk factors associated with CC398.

Methods

We included all bone and joint samples with S. aureus-positive culture in our university hospital between January 2010 and December 2017. Logistic regression was used for univariate and multivariate analysis.

Results

We identified 124 CC398 isolates among the 958 BJI-associated S. aureus. The proportion of CC398 among S. aureus increased steadily from 4% in 2010 to 26% in 2017. Only 4 isolates of CC398 were resistant to methicillin. The distribution of BJI types due to CC398 and non CC398 isolates was similar. In multivariate analysis, age (p = 0.034, OR = 3.9), McCabe score (p = 0.005, OR = 5) and inoculation mechanism (p = 0.020, OR = 3.7) were associated with PJI-related CC398. The year of infection (p < 0.001, OR = 1.6), Charlson’s score (p = 0.001, OR = 1.5) and grade 4 (severe) of the International Working Group of the Diabetic Foot classification (p < 0.001, OR = 8.5) were associated with DFO-related CC398.

Conclusion

We highlighted here the emergence and spread of CC398-MSSA in BJI. Patients with comorbidities are at high risk of CC398 MSSA PJI and DFO. The spread of CC398 in the community and hospital settings remains unclear and further epidemiological studies are needed to identify the determinants of its success.
Prognostic accuracy of SIRS criteria and qSOFA score for in-hospital mortality among influenza patients in the emergency department
Authors: Chu Sheng-En , Seak Chen-June , Su Tse-Hsuan , Chaou Chung-Hsien , Tseng Hsiao-Jung , Li Chih-Huang
Published: May 2020

Background

The seasonal influenza epidemic is an important public health issue worldwide. Early predictive identification of patients with potentially worse outcome is important in the emergency department (ED). Similarly as with bacterial infection, influenza can cause sepsis. This study was conducted to investigate the effectiveness of the Systemic Inflammatory Response Syndrome (SIRS) criteria and the quick Sequential Organ Failure Assessment (qSOFA) score as prognostic predictors for ED patients with influenza.

Methods

This single-center, retrospective cohort study investigated data that was retrieved from a hospital-based research database. Adult ED patients (age ≥ 18 at admission) with laboratory-proven influenza from 2010 to 2016 were included for data analysis. The initial SIRS and qSOFA scores were both collected. The primary outcome was the utility of each score in the prediction of in-hospital mortality.

Results

For the study period, 3561 patients met the study inclusion criteria. The overall in-hospital mortality was 2.7% (95 patients). When the qSOFA scores were 0, 1, 2, and 3, the percentages of in-hospital mortality were 0.6, 7.2, 15.9, and 25%, respectively. Accordingly, the odds ratios (ORs) were 7.72, 11.92, and 22.46, respectively. The sensitivity and specificity was 24 and 96.2%, respectively, when the qSOFA score was ≥2. However, the SIRS criteria showed no significant associations with the primary outcome. The area under the receiver operating characteristic curve (AUC) was 0.864, which is significantly higher than that with SIRS, where the AUC was 0.786 (P < 0.01).

Conclusions

The qSOFA score potentially is a useful prognostic predictor for influenza and could be applied in the ED as a risk stratification tool. However, qSOFA may not be a good screening tool for triage because of its poor sensitivity. The SIRS criteria showed poor predictive performance in influenza for mortality as an outcome. Further research is needed to determine the role of these predictive tools in influenza and in other viral infections.
Associations of urological malignancies with renal progression and mortality in advanced chronic kidney disease: a propensity-matched cohort study
Authors: Chinnadurai Rajkumar , Clarke Noel W. , Kalra Philip A.
Published: May 2020

Background

Urological malignancy (UM) in patients with chronic kidney disease (CKD) is an added burden to their overall morbidity and mortality. UM is itself a common cause of CKD. Understanding the associations of UM with outcomes in advanced CKD can help in optimisation of the management of these patients. This study investigates the distribution and association of urological malignancy with outcomes (renal progression and mortality) in patients with advanced non-dialysis dependent CKD.

Methods

The study was conducted in 2637 of 3115 patients recruited in the Salford Kidney Study between the years 2002 and 2016. A comparative analysis was performed between 160 patients with UM (at baseline and incident) and 2477 patients with no malignancy. Cox-regression models and Kaplan-Meir estimates were used to explore the association between the presence of UM with mortality and renal outcome. Linear regression analysis was used to calculate the rate of progression of CKD in the groups. A 1:3 propensity score matched cohort of 640 patients was generated and utilised in the above analyses.

Results

4.4% had a history of UM at baseline with the annual incident rate being 0.37%. The site of malignancy was the kidney in 40% with comparable numbers for prostatic malignancy (39%). 70% (111/160) of UM patients had a medical cause as their primary diagnosis for CKD. Over a median follow up of 4 years, 34% (905) patients died. In the matched sample, the proportion of deaths was similar between the groups (UM 44% versus no malignancy 48%, p = 0.36). 30% reached end-stage renal disease (ESRD) with no difference between the groups. In the Cox-regression model, UM did not prove to be a risk factor associated with either all-cause mortality (HR:1.03; CI: 0.79–1.35; p = 0.81) or reaching ESRD (HR:1.12; CI: 0.80–1.58; p = 0.49). The rate of decline in estimated glomerular filtration rate (eGFR) was similar between the groups (− 1.05 vs − 1.25 mL/min/1.73m2/year, p = 0.31).

Conclusions

There was no correlation observed between UM and all-cause mortality or ESRD. Medical causes of CKD have a significant influence on the outcomes in patients with UM, whereas the UM did not. Hence, a coordinated approach with early liaison between the urology and nephrology teams is needed in the management of UM patients with CKD.
Magnitude and associated factors of unintended pregnancy in Ethiopia: a multilevel analysis using 2016 EDHS data
Authors: Teshale Achamyeleh Birhanu , Tesema Getayeneh Antehunegn
Published: May 2020

Background

Unintended pregnancy has become a significant public health and reproductive health problem that has had a substantial and appreciable adverse impact on mother, child, and the general public. Despite the paramount negative effects of unintended pregnancy, many pregnancies are unintended in Ethiopia. Therefore, this study aimed to determine the prevalence and associated factors of unintended pregnancy in Ethiopia.

Methods

This study was based on the nationally representative 2016 Ethiopian Demographic and Health Survey data. We used a total weighted sample of 7590 reproductive-aged women who gave birth in the 5 years preceding the survey. A multi-level logistic regression analysis was used to account for the hierarchal nature of the DHS data. In the multivariable multilevel analysis, those variables with p-value < 0.05 were considered to be significantly associated with unintended pregnancy.

Result

The prevalence of unintended pregnancy was 26.6% [95%CI: 25.6, 27.6]. In the multivariable multilevel logistic regression analysis; individual level variables such as being in the age group 20 to 34 [adjusted odds ratio (AOR) = 0.57; 95%CI: 0.41, 0.79] and 35 to 49 [AOR = 0.68; 95%CI: 0.47, 0.97], being follower of Muslim religion [AOR = 0.73; 95%CI: 0.60, 0.88], being married [AOR = 0.46; 95%CI: 0.37–0.58], household size of four to six [AOR = 1.38; 95%CI: 1.10, 1.69] and seven and above [AOR = 1.54; 95%CI: 1.20, 1.99], and being multiparous [AOR = 1.36; 95%CI: 1.10, 1.69] and grand multiparous [AOR = 1.92; 95%CI: 1.47, 2.52] were significantly associated with unintended pregnancy. Among community level variables; being living in large central [AOR = 2.56; 95%CI: 2.06, 3.17] and metropolitan regions [AOR = 1.91; 95%CI: 1.44, 2.53] were significantly associated with unintended pregnancy.

Conclusion

In this study the prevalence of unintended pregnancy was high. Maternal age, religion, marital status, household size, parity, and region were the most important factors associated with unintended pregnancy. Special attention should, therefore, be given to younger, single, multiparous and grand multiparous women, and not follower of Muslim religion as well as mothers from large central and metropolitan regions in terms of increasing accessibility and affordability of maternal health services, which could minimize unintended pregnancy.
Breastfeeding and caring for children: a qualitative exploration of the experiences of mothers with physical impairments in Ghana
Authors: Acheampong Angela Kwartemaa , Aziato Lydia , Marfo Margaret , Amevor Philomena
Published: May 2020

Background

Breastfeeding and caring for children demand time, energy and effort. Mothers with physical impairments in Ghana require special needs to be able to achieve optimal motherhood as society demands. Globally, literature on breastfeeding and caring for children among mothers with physical disabilities is limited. Similarly, there is dearth of literature on the experiences of mothers with physical impairments in Ghana. Therefore, this study sought to add to literature by exploring the experiences of mothers with physical impairments with regards to breastfeeding and how they care for their children.

Methods

Qualitative descriptive exploratory design was used. Twelve mothers with physical impairments who had been purposively sampled gave informed consent before data was collected through in-depth one-on-one interviews. Data was recorded, transcribed and analyzed inductively using the content analysis technique.

Results

Mothers with physical impairments perceived breastfeeding as difficult and expensive due to issues relating to disruption of sleep, dysfunctional limbs and the need for breastfeeding mothers to eat nutritionally balanced meals. Participants felt prejudged and discriminated at different points in their daily encounters.

Conclusion

Mothers with physical impairments have challenges. Therefore, attitudinal change should be advocated in the Ghanaian society with respect to issues concerning people living with disabilities.
Perioperative blood transfusion has distinct postsurgical oncologic impact on patients with different stage of hepatocellular carcinoma
Authors: Chen Gui-Xing , Qi Chao-Ying , Hu Wen-Jie , Wang Xiao-Hui , Hua Yun-Peng , Kuang Ming , Peng Bao-Gang , Li Shao-Qiang
Published: May 2020

Background

The influence of perioperative blood transfusion (PBT) on postsurgical survival of patients with different stage of hepatocellular carcinoma (HCC) is not well clarified. This study aimed to evaluate the impact of PBT on survival outcomes of different stage of HCC patients.

Methods

Consecutive patients who underwent liver resection for HCC between January 2009 and November 2015 were identified from an HCC prospective database in authors’ center. The survival outcomes were compared between patients receiving PBT and those without PBT before and after propensity score matching (PSM) in different stage subsets. Cox regression analysis was performed to verify the impact of PBT on outcomes of HCC.

Results

Among 1255 patients included, 804 (64.1%) were Barcelona Clinic Liver Cancer (BCLC) stage 0-A, and 347 (27.6%) received PBT. Before PSM, patients with PBT had worse disease free survival (DFS) and overall survival (OS) compared with those without PBT in both BCLC 0-A subset and BCLC B-C subset (all P < 0.05). After PSM, 288 pairs of patients (with and without PBT) were created. In the subset of BCLC 0-A, the median DFS of patients with PBT was shorter than those without PBT (12.0 months vs. 36.0 months, P = 0.001) Similar result was observed for OS (36.0 months vs. 96.0 months, P = 0.001). In the subset of BCLC B-C, both DFS and OS were comparable between patients with PBT and those without PBT. Cox regression analysis showed that PBT involved an increasing risk of DFS (HR = 1.607; P < 0.001) and OS (HR = 1.756; P < 0.001) for this subset. However, PBT had no impact on DFS (P = 0.126) or OS (P = 0.139) for those with stage B-C HCC.

Conclusions

PBT negatively influenced oncologic outcomes of patient with BCLC stage 0-A HCC, but not those with stage B-C after curative resection.
Developmental and sequenced one-to-one educational intervention (DS1-EI) for autism spectrum disorder and intellectual disability: a two-year interim report of a randomized single-blind multicenter controlled trial
Authors:   the GPIS study group, Tanet Antoine , Hubert-Barthelemy Annick , Clément Marie-Noëlle , Soumille François , Crespin Graciela C. , Pellerin Hugues , Allaert François-André , Cohen David , Saint-Georges Catherine
Published: May 2020

Background

Children with autism spectrum disorder (ASD) and moderate to severe intellectual disability (ID) face many challenges. There is little evidence-based research into educational settings for children with ID and ASD and in France. Little is known about how this unserved population could benefit from intervention and education. This study assessed the feasibility and efficacy of a new intervention model using an individualized educational approach.

Methods

We conducted a randomized, single-blind controlled trial to assess a novel intervention: the “Developmental and Sequenced One-to-One Intervention (DS1-EI)”. In DS1-EI, trained teachers worked one-to-one with each child in a small classroom setting, offering 10 h per week of the intervention. The focus was on encouraging spontaneous communication, promoting skills through play with peers, supporting positive interactions, and developmental and sequenced learning. We enrolled 5- to 9-year-old children with ASD and ID across 11 French child care institutions for children with co-occurring ASD and ID. Participants were matched in dyads by developmental quotient and randomized to the treatment-as-usual (TAU) group or the DS1-EI group. Independent raters blindly assessed the primary variables: The Childhood Autism Rating scale (CARS) and the Psychoeducational Profile, third edition (PEP-3). The secondary variables included the Vineland Adaptive Behavior Scale II (VABS-II) and the Clinical Global Assessment Scale (CGAS). Here we perform interim analyses at 24 months.

Results

At baseline, 72 participants were randomized. Nine patients (5 in the DS1-EI group and 4 in the TAU group) dropped out of the study. Using linear mixed models, both intent-to-treat (ITT) and per-protocol (PP) analyses at the 12-, 18- and 24-month outcomes showed no significant group nor group-by-time interaction effects. However, we found significant improvements in most primary and secondary variables over time in both groups.

Conclusions

The study did not show that DS1-EI was superior to TAU in treating children with ASD and ID over 24 months. However, the low dropout rate shows that DS1-EI is feasible, and well accepted. As the study is still ongoing, we need to wait for data at 36 months to ensure whether DS1-EI could be recommended.

Trial registration

ANSM130282B-31 (April 16, 2013) and ACTRN12616000592448. Registered 6 May 2016, retrospectively registered, http://www.anzctr.org.au/
Exploring the stress sensitization theory with temperamentally inhibited children: a population-based study
Authors: Brown Amy , Bennet Joanna , Rapee Ronald M. , Hirshfeld-Becker Dina R. , Bayer Jordana K.
Published: May 2020

Background

This study explored whether temperamentally inhibited children who experience early trauma are vulnerable to developing internalizing problems in the face of later life-stressors.

Methods

A validated screen for temperamental inhibition was distributed to parents of young children attending preschools in six government regions of Melbourne, Australia. Screening identified 11% of children as inhibited (703 of 6347 screened) and eligible for a prevention study. Participants were 545 parents of inhibited preschoolers (78% uptake), of whom 84% were followed into mid childhood (age 7–10 years: wave 1, n = 446; wave 2, n = 427; wave 3, n = 426). Parents and children then completed questionnaires for child internalizing (anxious and depressive) symptoms, and parents received a diagnostic interview for child anxiety disorder. In mid-childhood parents also completed questionnaires annually to describe recent life-stressors experienced by their child, and any potentially traumatic events in the first four years of life.

Results

Only one in 14 temperamentally inhibited children had experienced a potentially traumatic event in early childhood. In mid childhood 56% experienced recent life-stressors. Inhibited children who had early life trauma experienced slightly more anxiety disorder and symptoms in mid childhood. Those children with more recent life-stressors in mid childhood also had slightly more symptoms of anxiety and depression. In contrast to stress sensitization, inhibited children with early trauma plus recent stressors did not show especially high mid-childhood internalizing difficulties.

Conclusions

Early life trauma and recent life-stressors each convey a small risk for children with an inhibited temperament to develop internalizing problems. Nevertheless, early life stress may not always result in negative sensitization for children in the general population.
Radiation therapy is an important factor to improve survival in pediatric patients with head and neck rhabdomyosarcoma by enhancing local control: a historical cohort study from a single center
Authors: Wen Yuan , Huang Dongsheng , Zhang Weiling , Zhang Yi , Hu Huimin , Li Jing
Published: May 2020

Background

The purpose of this study is to analyze the influence of radiation therapy on survival in a historical cohort of 56 pediatric patients with head and neck rhabdomyosarcoma.

Methods

A historical cohort of 56 pediatric patients with head and neck rhabdomyosarcoma from June 1st, 2013 to June 30th, 2019 was chosen. Clinical data and follow up results were collected including all diagnosis, treatment and prognosis information. Overall survival (OS) and event free survival (EFS) as time-to-event distributions were estimated with Kaplan-Meier method, and univariate analysis was performed with log rank test to detect differences between groups. Multivariate analysis was performed to explore the risk factors for survival with Cox proportional hazard model.

Results

The media follow up time of all 56 patients was 31.8 months (range 3.5–74.6 months). There were 26 events during follow up, including 14 disease progressions and 12 relapses. The estimated 5-year OS of all patients was 69.9%, and the estimated 5-year EFS was 48.8%. Patients with radiation therapy as a component of the initial treatment plan had better 5-year OS and EFS compared with those without radiation therapy (OS 80.3% vs. 49.7%, p = 0.003 and EFS 63.9% vs. 21.9%, p < 0.001). In patients with events, those who received salvage radiation therapy had better 5-year OS compared with those who didn’t (OS 66.0% vs. 31.2%, p = 0.033). On multivariate analysis, tumor size > 5 cm and non-initial radiation therapy were independent risk factors for OS in all patients, non-initial radiation therapy was an independent risk factor for EFS in all patients, and tumor size > 5 cm was an independent risk factor for OS in patients with events.

Conclusions

Radiation therapy as a component of initial treatment can improve the OS and EFS in pediatric head and neck rhabdomyosarcoma patients by enhancing local control, and non-initial radiation therapy is an independent risk factor for OS and EFS. Salvage radiation therapy still can improve OS in patients with disease progression and relapse. Tumor size > 5 cm is an independent risk factor for OS in pediatric HNRMS patients with or without disease progression/relapse.
A systematic review of studies describing the influence of informal social support on psychological wellbeing in people bereaved by sudden or violent causes of death
Authors: Scott H. R. , Pitman A. , Kozhuharova P. , Lloyd-Evans B.
Published: May 2020

Background

Whilst any type of bereavement can be traumatic, bereavement through violent or sudden causes is associated with more severe negative health and wellbeing outcomes compared to other types of loss. Social support has been found to have a positive impact on wellbeing after traumatic events in general. However, this association appears to be less consistently demonstrated in studies that focus on bereavement, and the literature in this area has not yet been systematically reviewed. This study aimed to review the international literature to examine systematically whether there is an association between informal social support from family and friends after bereavement through sudden and/or violent causes and post-bereavement wellbeing.

Methods

We conducted a systematic search for quantitative studies that tested for an association between social support and any outcome related to wellbeing after a sudden and/or violent loss. Included studies were assessed for quality, and findings were reported using the approach of narrative synthesis. The review was pre-registered on Prospero (registration number CRD42018093704).

Results

We identified 16 papers that met inclusion criteria, 11 of which we assessed as being of good or fair quality and 5 as poor quality. Fifteen different wellbeing outcomes were measured across all studies. We found consistent evidence for an inverse association between social support and symptoms/presence of depression, predominantly consistent evidence for an inverse association between social support and symptoms/presence of post-traumatic stress disorder (PTSD), and conflicting evidence for an inverse association between social support and symptoms/presence of complicated grief.

Conclusions

Our systematic review identified evidence to suggest that social support after sudden or violent bereavement is associated with a reduced severity of depressive and PTSD symptoms. Further longitudinal research is needed to explore potential causality in this relationship, widening the focus from common mental disorders to include other mental illnesses, wellbeing outcomes, and suicide-related outcomes after bereavement. There is also a need for consensus on the conceptualisation and measurement of social support. Our findings imply that interventions to improve access to and quality of social support may reduce the burden of mental illness after bereavement, and may therefore be worth investing in.
Prevalence of child passenger restraint use in Shantou, China from 2012 to 2017
Authors: Yan Shuzhen , Ding Kele , Yang Jingzhen , Ye Wanbao , Li Liping
Published: May 2020

Background

Child passenger safety is an important public health problem in China. This study aimed to examine the prevalence of child passenger restraint use while riding in a car in the city of Shantou in China from 2012 to 2017.

Methods

Three large-scale cross-sectional observational studies were conducted in 2012, 2015 and 2017, respectively. The observation sites included randomly selected hospitals, kindergartens, and primary and secondary schools. The outcome measures included the changes in percentages of seating position (e.g., front vs. rear), whether sitting on lap, and use of child restraint systems (CRS) or seat belts by year and by age group. Descriptive statistics, Chi-square tests and logistic regression were used to address the study aims.

Results

A total of 9858 commuting children aged 17 and younger were observed in passenger cars in Shantou, China during the study. The proportion of children aged 0–5 sitting on adult’s lap decreased from 26.6% in 2012 to 24.6% in 2017, while the proportion of CRS use among the children sitting in the rear row increased among children aged 0–5 (from 0.7% in 2012 to 14.2% in 2017) and children aged 6–11 (from 0.7% in 2012 to 2.4% in 2017). Comparing children aged 0–11 in 2012, children in the same ages were less likely to sit in the front row in 2015 (OR = 0.42, 95%CI = 0.37, 0.48) and in 2017 (OR = 0.27, 95%CI = 0.23, 0.31). Children aged 0–11 were more likely to sit in the rear row with CRS use in 2015 (OR = 8.50, 95%CI = 5.44, 13.28) and in 2017 (OR = 10.95, 95%CI = 7.02, 17.08) comparing with children in the same ages in 2012. As for children aged 12–17, they were more likely to use seat belt in 2017 (OR = 1.40, 95%CI = 1.06, 1.85) compared with those children in 2012.

Conclusions

While child passenger safety behaviors improved from 2012 to 2017 in Shantou, China, more efforts are needed to protect child passengers from injuries.
Low program access despite high burden of sexual, structural, and reproductive health vulnerabilities among young women who sell sex in Mombasa, Kenya
Authors:   on behalf of the Transitions Study Team, Roberts Elizabeth , Ma Huiting , Bhattacharjee Parinita , Musyoki Helgar K. , Gichangi Peter , Avery Lisa , Musimbi Janet , Tsang Jenkin , Kaosa Shem , Kioko Japheth , Becker Marissa L. , Mishra Sharmistha
Published: May 2020

Background

Across Sub-Saharan Africa, young women who sell sex (YSW) face institutional barriers in accessing sexual health and HIV prevention programs designed for female sex workers. In 2018, Kenya developed a national framework to guide service provision for YSW aged 14–24 years. To help inform the implementation of the framework, we estimated the burden of vulnerabilities related to the Sustainable Development Goals (SDGs related to health and gender equality) and program contact among YSW.

Methods

We used data from Transitions, a 2015 bio-behavioural cross-sectional survey of 408 YSW aged 14–24 years in Mombasa, Kenya. We estimated the prevalence of sexual (inconsistent condom use), structural (financial, violence), and reproductive health vulnerabilities; and characterized engagement with local HIV programs tailored to sex workers. We then compared the prevalence of vulnerabilities by age group (14–18 years, N = 117; 19–24 years, N = 291) and by program contact (ever contacted by local program for sex workers).

Results

47.3% reported inconsistent condom use with any partner in the previous week (no difference by age-group, p = 1.00). Structural vulnerabilities were common and did not vary by age: 83.6% did not have a regular source of income; 29.9 and 29.2% had experienced physical and sexual violence, respectively. 26.5% reported at least one pregnancy before age 18, and 18.5% used a non-reliable form of contraception with little variability by age. 25.7% were aware of at least one program, and only 13.7% of YSW had ever been contacted by a program (8.5% of those aged 14–18 years; and 15.8% of those aged 19–24 years, p = 0.06). Sexual, structural, and reproductive health vulnerabilities did not vary by program contact.

Conclusions

SDG-related vulnerabilities begin early in the lives of YSW who are not currently reached by programs designed for female sex workers.
Effectiveness of a family intervention on health-related quality of life–a healthy generation, a controlled pilot trial
Authors: Andermo Susanne , Hellénius Mai-Lis , Lidin Matthias , Hedby Ulrika , Nordenfelt Anja , Nyberg Gisela
Published: May 2020

Background

Physical activity is associated with better health, but knowledge about health promoting interventions, including physical activity for families in disadvantaged areas and the impact on health-related quality of life (HRQOL) is sparse. The aim of this study was to assess HRQOL in children and their parents after participation in the programme “A Healthy Generation”.

Methods

The programme is delivered in socioeconomically disadvantaged areas in Sweden and offers physical activity and a healthy meal or fruit twice a week from August to May to families with children in grade 2. Children (n = 67), aged 8–9 years, and their parents (n = 90) participated in this controlled study conducted in four schools, two control and two intervention schools. HRQOL of children and adults was assessed at baseline and follow-up after the intervention with the Pediatric Quality of Life Inventory (PedsQL) 4.0 and the Gothenburg Quality of Life scale, respectively. Analyses of covariance (ANCOVAs), linear regression and Pearson’s correlation were conducted.

Results

There were no significant differences between intervention and control in HRQOL among children or adults after the intervention. However, in a subgroup of children (n = 20) and adults (n = 29) with initial low HRQOL scores at baseline, there was a significant difference between the intervention group and control group after the intervention (children (total score): p = 0.02; adults (social domain) p = 0.04). Furthermore, within the intervention group, there was a significant relationship between level of participation in “A Healthy Generation” and the physical domain of HRQOL among girls (r = 0.44, p = 0.01), but not boys (r = − 0.07, p = 0.58).

Conclusion

Participation in the programme “A Healthy Generation” did not show a significant intervention effect on HRQOL in general. However, the findings suggest that HRQOL may be increased for children and adults with low HRQOL in disadvantaged areas. This knowledge can contribute to the development of health promoting interventions in such areas, and to more equitable health.

Trial registration

ISRCTN ISRCTN11660938. Retrospectively registered 23 September 2019.
Temporal and textual analysis of social media on collective discourses during the Zika virus pandemic
Authors: Lwin May Oo , Lu Jiahui , Sheldenkar Anita , Cayabyab Ysa Marie , Yee Andrew Zi Han , Smith Helen Elizabeth
Published: May 2020

Background

While existing studies have investigated the role of social media on health-related communication, little is known about the potential differences between different users groups on different social media platforms in responses to a health event. This study sets out to explore the online discourse of governmental authorities and the public in Singapore during the recent Zika pandemic in 2016.

Methods

Social media data were extracted from Facebook and Twitter using retroactive keyword sourcing of the word “Zika” to search for posts and a location filter of “Singapore”. Government posts, public posts, and replies to these original posts were included in the temporal and textual analysis.

Results

Overall, Facebook contained more government and individual content whereas Twitter had more content from news media accounts. Though the relative volume of Zika content from different data sources paralleled the peaks and troughs of Zika activities across time, discourses from different data sources differed in their temporal patterns, such that the public discourse died down faster than the government discourse after the outbreak was declared. In addition, the content of discourses differed among data sources. While government discourse included factual information of the disease, public discourse contained more elements of care such as worry about the risks to pregnant women, and elements of community such as well-wishes to each other.

Conclusions

Our study demonstrates the temporal and content differences between user groups and social media platforms in social media conversations during the Zika pandemic. It suggests that future research should examine the collective discourse of a health event by investigating social media discourses within varied sources rather than focusing on a singular social media platform and by one particular type of users.
College students responding to the Chinese version of Cardiff fertility knowledge scale show deficiencies in their awareness: a cross-sectional survey in Hunan, China
Authors: Zhou Yanhui , Luo Yang , Wang Ting , Cui Yanhui , Chen Mingzhu , Fu Jingxia
Published: May 2020

Background

Fertility knowledge is vital to the fertility health of young people and greatly impacts their fertility choices. Delayed childbearing has been increasing in high-income countries, accompanied by the risk of involuntary childlessness or having fewer children than desired. The aim of this study was to investigate knowledge about fertility issues, the related influencing factors, the method of acquiring fertility knowledge, and the relationship between fertility knowledge and fertility intentions among college students.

Methods

An online cross-sectional survey of Chinese college students was conducted in Hunan Province from March to April 2018. A total of 867 college students from three comprehensive universities responded to a poster invitation utilizing the Chinese version of the Cardiff Fertility Knowledge Scale (CFKS-C). Data were explored and analysed by SPSS (version 22.0) software. Descriptive statistics, chi-squared tests, T-tests, and Pearson’s correlations were used for the measurements.

Results

The average percent-correct score on the CFKS-C was 49.9% (SD = 20.8), with greater knowledge significantly related to living in a city district, being not single status, majoring in medicine, being in year 4 or above of study, and intention to have children (allp<0.05). A total of 81.9% of the participants reported that they would like to have children, the average score of the importance of childbearing was 6.3 (SD = 2.7), and the female score was lower than the male score (p = 0.001). A small positive relationship was observed between the CFKS-C and the importance of childbearing (r = 0.074,p = 0.035). Respondents indicated that they gained most of their knowledge from the media and internet (41.4%) and from schools (38.2%).

Conclusion

Yong people in college have a modest level of fertility knowledge, a relatively low intention to have a child, and deficiencies in fertility health education. There is a need to improve the accessibility of fertility health services by developing a scientific and reliable fertility health promotion strategy.
Estimating utility value for female genital mutilation
Authors: Alinia Cyrus , Piroozi Bakhtiar , Jahanbin Fariba , Safari Hossein , Mohamadi-Bolbanabad Amjad , Kazemi-Karyani Ali , Moradi Ghobad , Farhadifar Fariba , Ebrahimi Mohammad
Published: May 2020

Background

Female genital mutilation/cutting (FGM/C) is a clear violation of women’s rights and can have adverse and irreversible health effects as well. Worldwide, more than 200 million women and girls have undergone FGM/C. Utility value of FGM/C has not been estimated yet, so we designed this study to extract the health utility value of FGM/C for the first time in the world.

Methods

In a cross-sectional study in Iran, 125 girls and women who underwent FGM/C procedure were examined by the trained midwives in order to determine its type. In addition, a questionnaire was completed for identifying the socio-demographic factors and extracting the health utility of these individuals. Health utility was measured using Time Trade-off method and also to determine the effects of the socio-demographic factors on the health utility a two-limit censored regression model was applied.

Results

The mean and median of the health utility of women with FGM/C were 0.971 (SE: 0.003) and 0.968 (IQR: 1–0.95), respectively. Number of non-traders was 58 (46.4%) who reported perfect health utility. However, the mean of health utility among traders was 0.946 (SE: 0.002). Only type 1 (Clitoridectomy) and type 2 (Excision) FGM/C were seen in this study. Women with Type 1 FGM/C had significantly lower health utility value (Mean: 0.968, Median: 0.957) than their type 2 counterparts (Mean: 0.987, Median: 1.00). Moreover, women in the age group of 31–45 years (Mean: 0.962, Median: 0.956), single (Mean: 0.950, Median: 0.954), divorced (Mean: 0.951, Median: 0.950), employed (Mean: 0.959, Median: 0.956), and with supplementary insurance (Mean: 0.962, Median: 0.950) had significantly lower health utility than their counterparts.

Conclusion

FGM/C affects physical and psychological well-being of these individuals, resulting in a lack of personal and marital satisfaction, which ultimately leads to a 3% reduction in their health related quality of life. Therefore, preventing from this practice is very important and should be considered by health system policy makers more than before.
The ripple effect: a digital intervention to reduce suicide stigma among farming men
Authors: Kennedy Alison J. , Brumby Susan A. , Versace Vincent Lawrence , Brumby-Rendell Tristan
Published: May 2020

Background

Compared with the general population, Australian farmers—particularly men—have been identified as at greater risk of suicide. A complex range of factors are thought to contribute to this risk, including the experience of Stigma. stigmaalso impacts those who have attempted suicide, their carers, and those bereaved by suicide—manifesting as shame, guilt, social isolation, concealment of death, reduced help seeking and ongoing risk of suicide. This paper evaluates the effectiveness of an intervention, tailored for the farming context, designed to reduce stigma among farming men with a lived experience of suicide.

Methods

The digital intervention used an adult learning model providing opportunity to share insights, reflect, learn and apply new knowledge among people with shared farming interests, suicide experience and cultural context. A range of content—tailored to the gender, farming type and suicide experience of participants—included video stories, postcard messages, education and personal goal setting. Pre- and post- assessment of suicide stigma and literacy was complemented by qualitative data collection during the intervention and participant feedback surveys.

Results

The intervention was successful in reaching members of the target group from across Australia’s rural communities—with diverse geographic locations and farming industries represented. One hundred and sixty-nine participants from the target group (farming males aged 30–64 years) were recruited. While the Stigma of Suicide Scale failed to identify a reduction in self- or perceived-stigma, qualitative data and participant feedback identified behavioural indicators of stigma reduction. Four subthemes—‘growth’, ‘new realisations’, ‘hope’ and ‘encouragement’—highlighted attitudinal and behaviour change indicative of reduced stigma associated with mental health and suicide.

Participants’ baseline suicide literacy (Literacy of Suicide Scale) was high when compared with previous community samples and total literacy scores did not demonstrate significant improvement over time, although literacy about the link between suicide and alcoholism did significantly improve.

Conclusions

These results highlight opportunities in groups with high suicide literacy for targeted stigma reduction and suicide prevention efforts for both the target group and other populations within Australia and internationally. Results also highlight the need to reassess how stigma change is understood and evaluated across a wider range of population groups.

Trial registration

This research project was registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) (ACTRN12616000289415) on 7th March, 2016.