bluuebunny/crossref_metadata_2025_split huggingface dataset:
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

AbstractBackgroundBreastfeeding 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.MethodsQualitative 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.ResultsMothers 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.ConclusionMothers 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

Abstract
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

Abstract
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

Abstract
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

Abstract
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

Abstract
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

Abstract
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

Abstract
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

Abstract
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

Abstract
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.