bluuebunny/crossref_metadata_2025_split huggingface dataset:
Timely completion of vaccination and its determinants among children in Northwest, Ethiopia: A multilevel analysis
Authors: Mekonnen Zeleke Abebaw , Gelaye Kassahun Alemu , Were Martin C. , Tilahun Binyam 
Published: April 2020

Abstract
Background: Timely vaccination is key to prevent unnecessary childhood mortality from vaccine-preventable diseases. Despite the substantial efforts to improve vaccination completeness, the effort towards timeliness of vaccination is limited with non-attendance and delays to vaccination appointments remaining a big challenge in developing countries. There is also a limited evidence on timeliness of vaccination. Therefore, this study aimed to determine the magnitude and associated factors for timely completion of vaccination among children in Gondar city administration, north-west, Ethiopia.Method: This study employed a community-based cross sectional study design. A sample size of 821 children aged 12 to 23 months were considered. Two stages random sampling technique was used to select study subjects. To account the effect of clustering, bivariable and multivariable multilevel logistic regression analysis were applied. The measures of association estimates were expressed as adjusted odds ratio (AOR) with their 95 % confidence intervals (CIs).Results: Of the 774 children included for analysis, 498 (64.3%) were fully vaccinated while 247 (31.9%) were fully vaccinated on-time. Caregivers aged above 35 years (AOR= 0.469; 95 % CI: 0.253-0.869], who had secondary education and above (AOR = 2.391; 95 % CI: 1.317- 4.343), from richest households (AOR = 2.381; 95 % CI: 1.502-3.773), children whose mother attended four or more ante natal care visits (AOR = 2.844; 95 % CI: 1.310-6.174) and whose mother had two or more post natal care visits (AOR =2.054; 95%CI:1.377-3.063) were positively associated with on-time full vaccination. In contrary, being vaccinated at health post (AOR=0.144; 95%CI: 0.048-0.428) and travelling more than 30 minutes to the vaccination site (AOR= 0.158; 95%CI: 0.033-0.739) were negatively associated with on-time full vaccination. The random effects indicated that 26% of the variability in on-time full vaccination was attributable to differences between communities.Conclusion: In this study, untimely vaccination was found to be high. Different individual and contextual factors were found to be associated with on-time full vaccination. Therefore, tailored strategies have to be designed and implemented to address people and the communities where they live. Moreover, timeliness of vaccination should be considered as important indicator of the immunization program performance in Ethiopia.
Indonesian adolescents’ perspectives on smoking habits as a reference for a prevention program: a qualitative study
Authors: fithria fithria , Adlim Muhammad , Jannah Syarifah Rauzatul , Tahlil Teuku 
Published: April 2020

Abstract
Background: Religious factors have been used in tobacco control campaigns but due to different perceptions among Muslim scholars that might have an effect on followers, the strategies of control programs are still interesting. Therefore, this qualitative research aimed to explore the perspectives of Muslim adolescents on smoking habits as a reference for developing effective prevention programs.Methods: Three focus group discussions involving 24 junior high school students (mean age=13.75 years) were the main source of data for this phenomenological qualitative study. The discussion guide was developed by the researchers based on the reviewed literature and validated by experts. The research findings were analyzed using an inductive content method with systematic steps based on the stages of qualitative data analysis.Results: Adolescent perspectives on smoking were grouped into two themes: (a) perception, which encompassed three sub-themes: smoking as a social habit, contradictive feelings, and the Islamic perspective; (b) smoking-related factors involving peer pressure, the parents’ smoking status, curiosity, and masculinity.Conclusion: The results indicated that adolescents consider smoking as a social habit but with contradictive feelings. From an Islamic perspective, smoking is not forbidden by the religion’s beliefs. The smoking habit was also stimulated by peer pressure, imitating parents who smoke, curiosity, and feeling masculine. We suggest that health professionals who are interested in developing smoking prevention programs should consider the adolescent perspective on smoking so that the prevention program will be more effective and appropriate for adolescents.
Adverse influence of multilevel socioeconomic status on physical activity: results from a national survey in Vietnam
Authors: Vu Lan , Bui Quyen , Nguyen Ngan , Hoang Minh 
Published: April 2020

Abstract
Background: This study aims to explore associations of individual- and provincial-level socioeconomic status (SES) and the combined interaction among these SES with individual physical activity (PA). Method: This analyze used data of 3068 Vietnamese people aged 18-65 years from the national representative STEPS survey in 2015 (STEPS2015). The survey collected PA-related data using the Global PA Questionnaire Version 2 and those on provicial-level characteristics from two surveys in 2014, namely the Intercensal Population and Housing Survey (IPHS) and The Vietnam Household Living Standard Survey (VLSS2014). Multilevel linear analyze was performed with individual and provincial characteristics as independent variables and the metabolic equivalent (MET) score – the indicator of individual PA – as the dependent variable.Results: Male and female participants with insufficient PA accounted for 20.2% and 35.7%, respectively. Both individual- and provicial-level SES were inversely associated with the individual PA level . As the provincial-level monthly income increased by 1 million Vietnam Dongs, the total PA score of individuals residing in that province reduced by 1,900 METS. A buffering effect was reported between provincial and individual SES, as the provincial average income increased, the differences in PA scores between different SES groups decreasedConclusion: Our data suggest that Vietnamese individuals in low SES groups tended to be more physically active than those in high SES groups because their PA was largely related to work.
Burden of caregivers of children with cerebral palsy: an intersectional analysis of gender, poverty, stigma, and public policy.
Authors: Vadivelan K , Sekar P , Sru S Shri , Gopichandran Vijayaprasad 
Published: April 2020

Abstract
Background: Caregivers of children with cerebral palsy suffer from substantial psycho-social burden. However, there is scarcity of documentation of the various sources of burden in the low- and middle-income settings. Methods: We conducted qualitative in-depth interviews among mothers of children with cerebral palsy attending a physiotherapy facility. We purposively sampled mothers from rural and peri-urban areas in Tamil Nadu, India, till the point of data saturation. We analysed the transcripts using the socio-ecological model to identify major dimensions of psycho-social burden among these mothers. Results: At the individual level the mothers perceived aches and pains due to the heavy physical activity of caregiving. They also suffered from a feeling of guilt about the child’s condition. Due to difficulty in balancing family and work, they had significant financial burdens. They also perceived a lack of knowledge and awareness about possible options for treatment of their child. At the interpersonal level, the mothers lacked support from their husband and family in the process of caregiving. They also had to suffer the ill effects of alcoholism and domestic violence from the husbands. They had to compromise on the care they provided to the other family members and their children without cerebral palsy. At the community level the mothers had no support from the community members and felt isolated from others. The mothers also reported discrimination and lack of participation in social events. Environmental stressors like lack of inclusive public spaces, lack of options for public transport and unfriendly work timings and environment were a major source of burden. The mothers felt that the disability welfare support offered by the government was grossly insufficient and there was no platform for interactions with other peers and mothers suffering from similar burden. Conclusion: Caregivers of children with cerebral palsy have unique burdens in a typical low- and middle-income setting including an intersection of gender norms, poverty, stigmatization and non-inclusive public policy, which need to be addressed to improve the quality of life of caregivers.
Availability, Accessibility, and Quality of Adolescent Sexual and Reproductive Health Services in Urban Health Facilities of Rwanda: A survey among social and healthcare providers
Authors: Ndayishimiye Pacifique , Uwase Rosine , Kubwimana Isabelle , Niyonzima Jean de la Croix , Dzekem Roseline Dine , Nyandwi Jean Baptiste , Kadima Justin Ntokamunda 
Published: April 2020

Abstract
Background: Access and utilization of quality and comprehensive sexual and reproductive health services (SRHS) is crucial for the health of young adolescents worldwide. This study assessed the quality of SRHS provided to Rwandan adolescents in urban health facilities in terms of availability, accessibility, cost, and counseling, with particular emphasis on HIV and family planning-related education.Method: The study was a descriptive cross-sectional survey conducted between May 2018 and May 2019 in six selected cities of Rwanda using a mixed-methods approach, including semi-structured questionnaire administration and in-depth interviews with 159 conveniently selected SRH services providers. All survey tools had been previously validated. SPSS version 20 was used for descriptive statistical analysis of quantitative data and ATLAS TI version 5.2 was used to code and analyze the qualitative data thematically.Results: Overall, the availability of adolescent SRHS is satisfactory in more than 80% of health facilities surveyed, including access to accurate SRH information, contraceptive methods, prevention and management of STIs and HIV, and counselling. However the accessibility of some services remains limited. According to respondents, some products such as female condoms are less in demand and often expire before they can be distributed. In-depth interviews revealed that 94.3% of centers provide information to adolescents on SRHS available and 51.6% affirmed delivering services at a low cost. One nurse clarified that they render services at a low price if an adolescent has insurance medical coverture. Private health facilities offer HIV testing for free, but for treatment and other services, they channel adolescents to public health facilities. Only 57.2% of respondents mentioned that adolescents are involved in designing the feedback mechanisms at their facilities. Religious leaders and family members may hinder adolescents from seeking behavior by promoting only abstinence and discouraging using protective means.Conclusion: SRHS were generally available for distribution to adolescents at most of the facilities but limited in access. Adolescents were said to face structural and social challenges towards accessing services. There is a need to improve the accessibility of SRH services delivery sites while considering innovative methods to broaden access to services.
Association between social capital and mental health among older people living with HIV: The Sichuan Older HIV-Infected Cohort Study (SOHICS)
Authors: Han Jiayu , Jia Peng , Huang Yuling , Gao Bo , Yu Bin , Yang Shifan , Yu Jun , Xiong Jun , Liu Chang , Xie Tian , Dong Peijie , Yang Chao , Wang Zixin , Yang Shujuan 
Published: April 2020

Abstract
Background: Mental health problems are common among older people living with HIV and associated with poorer health outcomes. Social capital is an important determinant of mental health problems but under-studied in this population. This study investigated the association between social capital and mental health problems among older people living with HIV in China.Methods: The study was based on the baseline data of a cohort study investigating mental health among older people living with HIV in Sichuan, China during November 2018 to February 2019. Participants were people living with HIV aged ≥50 years living in Sichuan province. Stratified multi-stage cluster sampling was used to recruit participants from 30 communities/towns; 529 out of 556 participants being approached completed the face-to-face interview. Social capital was measured by two validated health-related social capital scales: the Individual and Family scale and the Community and Society scale. Presence of probable depression (CES-D-10 score ≥10) and probable anxiety (GAD-7 score ≥5) were used as dependent variables. Two-level logistic regression models were applied to examine the association between social capital and probable depression/anxiety. Results: The prevalence of probable depression and probable anxiety was 25.9% (137/529) and 36.3% (192/529), respectively. After adjusting for significant covariates, the individual/family level of social capital was inversely associated with both probable depression (odds ratios (OR): 0.89, 95%CI: 0.84-0.93, p<0.001) and probable anxiety (OR: 0.90, 95%CI: 0.86-0.95, p<0.001). The community/society level social capital was associated with probable depression (OR: 0.91, 95%CI: 0.84-0.99, p<0.001) but not probable anxiety (p>0.05).Conclusions: Interventions building up social capital should be considered to improve mental health of older people living with HIV. Some useful strategies include cognitive processing therapy, improving community networking and engagement, and promoting social bonding with neighborhood.
Clinical observation of extensive fascial resection combined with autologous limbal stem cell sharing transplantation for treatment of pterygium
Authors: Zhang Wen-Jia , Kong Lei , Feng Xiao-Xiao , Yang Ji , Liu Hai , Ke Hong-Qin , Zhang Qian , Wang Yin-Ting , Li Yan , Hu Zhulin 
Published: April 2020

Abstract
Introduction To observe the short-term and long-term effects of extensive fascial resection combined with autologous limbal stem cell sharing transplantation for pterygium. Methods A retrospective case series analysis was performed with 403 patients (420 eyes) who underwent extensive fascial resection combined with autologous limbal stem cell sharing transplantation in the Department of Ophthalmology, Second People's Hospital of Yunnan Province from January 2017 to June 2018. Before, and 10 days, 1 month, 3 months, and 6 months after surgery, the tear film rupture time (BUT), the height of the tear river (SLT), and the anterior segment of the fluoroscopy staining were recorded to record the scar on the conjunctiva and corneal surface. Patient self-consciousness and satisfaction with the appearance of the survey. Results BUT after surgery was prolonged than before operation, and there was no significant difference in tear height preoperative and postoperative. The postoperative follow-up period (6 months), the recurrence rate of pterygium was 0.21%.Patients have higher satisfaction with appearance, and have no obvious foreign body sensation, photophobia, tearing and other subjective symptoms. Discussion and conclusion Extensive fascial resection combined with autologous limbal stem cell sharing transplantation for the treatment of pterygium, the patient's appearance satisfaction is higher, and the recurrence probability is lower than the average recurrence rate of limbal stem cell transplantation. The operation is simple and easy to learn. This is a surgical procedure worth promoting.
Younger age of patients with myocardial infarction correlates with higher number of relatives with history of premature atherosclerosis
Authors: Ambroziak Michał , Niewczas-Wieprzowska Katarzyna , Maicka Agnieszka , Budaj Andrzej 
Published: April 2020

Abstract
Background. Premature coronary artery disease belongs to the most pressing global issues in a modern cardiology. Family history appears to be one of the most important and significant risk factors in young patients with myocardial infarction (MI). The aim of the study was to investigate the role of family history of premature cardiovascular disease (CVD) in patients <50 years with myocardial infarction (MI) compared to patients ≥ 50 years with MI and to young healthy people.Methods. The studied group (MI<50) consisted of 240 patients aged 26-49 years with MI. The control groups consisted of 240 patients (MI≥50) with MI aged 50-92 years and 240 healthy people aged 30-49 years.Results. There were statistically significant differences between the MI<50 and MI≥50 and young healthy groups regarding family history of premature MI/ischaemic stroke and percent of patients with of ≥2 relatives affected including parents, children, siblings, siblings of parents and grandparents (10.8%, 2.9%, 3.7%, respectively; p<0.0001). There was a statistically significant negative correlation between the age of the first episode of MI and the number of relatives with a history of premature MI/stroke (r=0.249, p<0.05) within all MI patients. Statistically significant differences between MI<50 and MI≥50 groups as well as young healthy control group were revealed regarding prevalence of smoking, body mass index (BMI), LDL, HDL, triglycerides (TG) and glucose levels.Conclusions. Younger age of patients with myocardial infarction correlates with a higher number of relatives with a history of premature MI/ischemic stroke. Thus, the family history of premature atherosclerosis involving not only the first-, but also the second-degree relatives, seems to be valuable and could be considered in an individual CVD risk evaluation in young people.
Analysis of axial length, retinal nerve fiber layer, macular area and estimated retinal ganglion cell count in myopic preperimetric glaucomatous eyes: an observational study
Authors: Rolle Teresa , Bonetti Beatrice , Mazzucco Alberto , Dallorto Laura 
Published: April 2020

Abstract
BACKGROUND: The aim of the study is to evaluate the diagnostic ability of OCT parameters and retinal ganglion cells (RGCs) count in identify glaucomatous disease in myopic preperimetric eyes.METHODS: This was a cross-sectional observational study. The study group consisted of 154 eyes: 36 healthy, 64 preperimetric (PPG), and 54 primary openangle glaucoma (POAG) eyes. Each group was divided into three subgroups based on axial length: emmetropic, myopic with axial length (AL) <25 mm, and myopic with AL>25 mm, to analyze the effect of myopia. The RGCs count was obtained using a model described later. As regard the influence of myopia on OCT parameters and RGC count, we performed Pearson’s correlation. The Area Under Receiver Operator Characteristics Curves (AUROC curves) evaluated which parameter had the best sensitivity and specificity in identifying glaucoma in myopic eyes.RESULTS: In Pearson’s test, all Ganglion Cell Complex (GCC) thicknesses showed the weakest and less significant correlation with AL in all groups. All the AUROCs were statistically significant, and above 0.5. Inferior GCC and Global Loss Volume (GLV) showed the highest AUCs in all myopic group and the best diagnostic ability in distinguishing healthy from glaucomatous eyes. RGCcount showed good AUROC in all groups, with sensitivities of about 83% in myopic eyes, and specificity over 91% in all groups.CONCLUSIONS: GCC is the parameter less influenced by the AL, and the inferior GCC and the GLV have the best diagnostic performance. The RGCcount has good sensitivity and specificity, so it can be used as a complementary test in the diagnosis of glaucoma in myopic preperimetric eyes.
How do people in China think about causes of their back pain? A predominantly qualitative cross-sectional survey
Authors: Li Yijun , Coppieters Michel W , Setchell Jenny , Hodges Paul , Scholten-Peeters Gwendolyne GM 
Published: April 2020

Abstract
Background: Low back pain (LBP) is the second highest cause of health burden in China. Delayed recovery, poor clinical outcomes and persistence of LBP are associated with negative pain beliefs about LBP. Chinese philosophies are nested into Chinese people’s daily life, which is likely to influence pain beliefs. However, there is lack of knowledge about people’s thinking patterns regarding their LBP in China. The primary aim of this study was to explore the patterns of beliefs (discourses) underlying Chinese people’s beliefs about what causes their persistent or recurrent LBP. The secondary aim was to investigate the sources of these pain beliefs. Methods: People (n=152) from South Central, East and North Mainland China with LBP completed an online survey about what they believed caused their persistent or recurrent LBP and where these understandings came from. Potential causes of persistent or recurrent LBP were explored qualitatively using discourse analysis. The sources of these discourses were assessed by descriptive statistics with conventional content analysis. Results: Five discourses were identified to underpin participants’ beliefs about what caused their persistent or recurrent LBP, namely: (1) biomedical problems (66.4%), (2) unbalanced lifestyle (48.7%), (3) menstruation and ‘kidney’ status (9.2%), (4) the ‘Five Elements’ imbalance (7.9%), and (5) energy status (5.9%). Most participants responded that their pain beliefs were based on information derived from healthcare professionals (59.2%), followed by the internet (24.3%) and family (23.0%). Conclusions: Chinese people from moderately and well-developed parts of Mainland China think predominantly in line with a Western biomedical viewpoint about their LBP. Traditional Chinese medicine related pain beliefs were evident on contemporary Chinese society’s understandings of LBP. These cultural beliefs could be relevant to consider in LBP management and involve healthcare professionals, family and patient in this process.
A cross-sectional study on associations of physical symptoms, health self-efficacy and suicidal ideation among Chinese hospitalized cancer patients following diagnosis.
Authors: Xu Qingyi , Jia Shuhua , Fukasawa Maiko , Lin Lin , Na Jun , Mu Zhen , Li Bo , Li Ningning , Zhao Tong , Ju Zaishuang , He Meng , Yu Lianzheng , Kawakami Norito , Jiang Chao 
Published: April 2020

Abstract
Background: To examine the association between physical symptoms and suicidal ideation among Chinese hospitalized cancer patients post-diagnosis, and test the modifying effect of health self-efficacy on this association. Methods: A cross-sectional study was conducted among 544 cancer patients from oncology setting in two general hospitals in northeastern China. Suicidal ideation data was collected by face-to-face interview using the Yale Evaluation of Suicidality scale (YES). Patients also rated on the McGill Quality of Life Questionnaire (MQOL), the Hamilton Depression Rating scale (HAMD-17) and the Strategies Used by People to Promote Health scale (SUPPH). Multivariable logistic regression was applied to examine the impact of physical symptoms, health self-efficacy and their interactions on suicidal ideation. Results: We found a suicidal ideation rate of 26.3% in patients following cancer diagnosis. Logistic regression showed that insomnia (aOR=1.84, 95% CI 1.13 to 3.00, p =0.015), lack of appetite (aOR=2.14, 95% CI 1.26 to 3.64, p =0.005) were significantly associated with suicidal ideation, low health self-efficacy showed a marginally significant exaggerating effect on the association between pain and suicidal ideation (aOR = 2.77, 95% CI 0.99 to 7.74, p =0.053), even after controlling socio-demographic, clinical characteristics and depression. Conclusions: Insomnia, loss of appetite, even after adjusting depression, are associated with suicidal ideation, health self-efficacy play a moderating role on pain and suicidal ideation among Chinese cancer patients. Paying attention to these physical symptoms and promoting the sense of health self-efficacy could be useful for suicide intervention.