bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diabetes care in remote Australia: the antenatal, postpartum and inter-pregnancy period
Authors:   On behalf of the NT Diabetes in Pregnancy Partnership, Kirkham R. , Trap-Jensen N. , Boyle J. A. , Barzi F. , Barr E. L. M. , Whitbread C. , Van Dokkum P. , Kirkwood M. , Connors C. , Moore E. , Zimmet P. , Corpus S. , Hanley A. J. , O’Dea K. , Oats J. , McIntyre H. D. , Brown A. , Shaw J. E. , Maple-Brown L. 
Published: October 2019

Abstract

Background
Aboriginal and Torres Strait Islander women experience high rates of diabetes in pregnancy (DIP), contributing to health risks for mother and infant, and the intergenerational cycle of diabetes. By enhancing diabetes management during pregnancy, postpartum and the interval between pregnancies, the DIP Partnership aims to improve health outcomes and reduce risks early in the life-course. We describe a mixed methods formative study of health professional’s perspectives of antenatal and post-partum diabetes screening and management, including enablers and barriers to care.

Methods
Health professionals involved in providing diabetes care in pregnancy, from a range of health services across the Northern Territory, completed the survey (n = 82) and/or took part in interviews and/or focus groups (n = 62).

Results
Qualitative findings highlighted factors influencing the delivery of care as reported by health professionals, including: whose responsibility it is, access to care, the baby is the focus and pre-conception care. The main challenges were related to: disjointed systems and confusion around whose role it is to provide follow-up care beyond six weeks post-partum. Quantitative findings indicated that the majority of health professionals reported confidence in their own skills to manage women in the antenatal period (62%, 40/79) and slightly lower rates of confidence in the postpartum interval (57%, 33/58).

Conclusion
These findings regarding whose role it is to provide postpartum care, along with opportunities to improve communication pathways and follow up care have informed the design of a complex health intervention to improve health systems and the provision of DIP related care.
Flemish breast cancer screening programme: 15 years of key performance indicators (2002–2016)
Authors: Goossens M. , De Brabander I. , De Grève J. , Van Ongeval C. , Martens P. , Van Limbergen E. , Kellen E. 
Published: October 2019

Abstract

Background
We examined 15 years of key performance indicators (KPIs) of the population-based mammography screening programme (PMSP) in Flanders, Belgium.

Methods
Individual screening data were linked to the national cancer registry to obtain oncological follow-up. We benchmarked crude KPI results against KPI-targets set by the European guidelines and KPI results of other national screening programmes. Temporal trends were examined by plotting age-standardised KPIs against the year of screening and estimating the Average Annual Percentage Change (AAPC).

Results
PMSP coverage increased significantly over the period of 15 years (+ 7.5% AAPC), but the increase fell to + 1.6% after invitation coverage was maximised. In 2016, PMSP coverage was at 50.0% and opportunistic coverage was at 14.1%, resulting in a total coverage by screening of 64.2%. The response to the invitations was 49.8% in 2016, without a trend. Recall rate decreased significantly (AAPC -1.5% & -5.0% in initial and subsequent regular screenings respectively) while cancer detection remained stable (AAPC 0.0%). The result was an increased positive predictive value (AAPC + 3.8%). Overall programme sensitivity was stable and was at 65.1% in 2014.
In initial screens of 2015, the proportion of DCIS, tumours stage II+, and node negative invasive cancers was 18.2, 31.2, and 61.6% respectively. In subsequent regular screens of 2015, those proportions were 14.0, 24.8, and 65.4% respectively. Trends were not significant.

Conclusion
Besides a suboptimal attendance rate, most KPIs in the Flemish PMSP meet EU benchmark targets. Nonetheless, there are several priorities for further investigation such as a critical evaluation of strategies to increase screening participation, organising a biennial radiological review of interval cancers, analysing the effect that preceding opportunistic screening has on the KPI for initial screenings, and efforts to estimate the impact on breast cancer mortality.
Effect of skill drills on neonatal ventilation performance in a simulated setting- observation study in Nepal
Authors: Gurung Rejina , Gurung Abhishek , Sunny Avinash K. , Basnet Omkar , Shrestha Shree Krishna , Gomo Øystein Herwig , Myklebust Helge , Girnary Sakina , KC Ashish 
Published: October 2019

Abstract

Aim
Maintaining neonatal resuscitation skills among health workers in low resource settings will require continuous quality improvement efforts. We aimed to evaluate the effect of skill drills and feedback on neonatal resuscitation and the optimal number of skill drills required to maintain the ventilation skill in a simulated setting.

Methods
An observational study was conducted for a period of 3 months in a referral hospital of Nepal. Sixty nursing staffs were trained on Helping Babies Breathe (HBB) 2.0 and daily skill drills using a high-fidelity manikin. The high-fidelity manikin had different clinical case scenarios and provided feedback as “well done” or “improvement required” based on the ventilation performance. Adequate ventilation was defined as bag-and-mask ventilation at the rate of 40–60 breaths per minute. The effective ventilation was defined as adequate ventilation with a “well done” feedback. We assessed the correlation of number skill drills and clinical case scenario with adequate ventilation rate using pearson’s correlation. We assessed the correlation of number of skill dills performed by each participant with effective ventilation using Mann Whitney test.

Results
Among the total of 60 nursing staffs, all of them were competent with an average score of 12.73 ± 1.09 out of 14 (p < 0.001) on bag-and-mask ventilation skill checklist. Among the trained staff, 47 staffs participated in daily skill drills who performed a total of 331 skill drills and 68.9% of the ventilations were done adequately. Among the 47 nursing staffs who performed the skill drills, 228 (68.9%) drills were conducted at a ventilation rate of 40–60 breathes per minute. There was no correlation of the adequate ventilation with skill drill category (p = 0.88) and the level of skill performed (p = 0.28). Out of 47 participants performing the skill drills, 74.5% of them had done effective ventilation with a mean average of 8 skill drills (SD ± 4.78) (p-value- 0.032).

Conclusion
In a simulated setting, participants who had an average skill drill of 8 in 3 months had effective ventilation. We demonstrated optimal skill drill sessions for maintain the neonatal resuscitation competency. Further evaluation will be required to validate the findings in a scale up setting.
Later achievement of infant motor milestones is related to lower levels of physical activity during childhood: the GECKO Drenthe cohort
Authors: Brouwer Silvia I. , Stolk Ronald P. , Corpeleijn Eva 
Published: October 2019

AbstractBackgroundThe aim of this study is to investigate whether age of infant motor milestone achievement is related to levels of physical activity (PA), weight status and blood pressure at age 4–7 years of age.MethodsIn the Dutch GECKO (Groningen Expert Center of Kids with Obesity) Drenthe cohort, the age of achieving the motor milestone ‘walking without support’ was reported by parents. Weight status and blood pressure were assessed by trained health nurses and PA was measured using the Actigraph GT3X between age 4 and 7 years.ResultsAdjusted for children’s age, sex and the mother’s education level, infants who achieved walking without support at a later age, spent more time in sedentary behaviour during childhood and less time in moderate-to-vigorous PA. Later motor milestones achievement was not related to higher BMI Z-score, waist circumference Z-score, diastolic or systolic blood pressure.ConclusionThe results of this study indicate that a later age of achieving motor milestone within the normal range have a weak relation to lower PA levels at later age. It is not likely that this will have consequences for weight status or blood pressure at 4–7 years of age.
Fetal alcohol spectrum disorder: neurodevelopmentally and behaviorally indistinguishable from other neurodevelopmental disorders
Authors: Lange Shannon , Shield Kevin , Rehm Jürgen , Anagnostou Evdokia , Popova Svetlana 
Published: October 2019

Abstract

Background
The lack of universally accepted diagnostic criteria and the high rate of psychiatric comorbidity make it difficult to diagnose Fetal Alcohol Spectrum Disorder (FASD). In an effort to improve the diagnosis of FASD, the current study aimed to identify a neurodevelopmental profile that is both sensitive and specific to FASD.

Methods
A secondary analysis was conducted on data obtained from the Canadian component of the World Health Organization International Study on the Prevalence of FASD. Data on neurodevelopmental status and behavior were derived from a battery of standardized tests and the Child Behavior Checklist for 21 children with FASD, 28 children with other neurodevelopmental disorders, and 37 typically developing control children, aged 7 to 11 years. Two latent profile analyses were performed to derive discriminative profiles: i) children with FASD compared with typically developing control children, and ii) children with FASD compared with typically developing control children and children with other neurodevelopmental disorders. The classification function of the resulting profiles was evaluated using the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Confidence intervals (CIs) were approximated using 10,000 bootstrapped samples.

Results
The neurodevelopmental profile of FASD tested consisted of impairments in perceptual reasoning, verbal comprehension, visual-motor speed and motor coordination, processing speed (nonverbal information), attention and executive function, visuospatial processing, and language, in combination with rule-breaking behavior and attention problems. When children with FASD were compared with typically developing control children, a 2-class model fit the data best and resulted in a sensitivity of 95.2% (95% CI: 84.2–100.0%), specificity of 89.2% (95% CI: 78.4–97.5%), PPV of 83.3% (95% CI: 66.7–96.2%), and NPV of 97.1% (95% CI: 90.3–100.0%). When children with FASD were compared with typically developing control children and children with other neurodevelopmental disorders, the neurodevelopmental profile correctly identified only 56.9% (95% CI: 45.1–69.2%) of typically developing children and children with other neurodevelopmental disorders as not having FASD, and thus the profile was found not to be specific to children with FASD.

Conclusion
The findings question the uniqueness of children with FASD with respect to their neurodevelopmental impairments and behavioral manifestations.
Risk factors for suicidal thoughts in informal caregivers: results from the population-based Netherlands mental health survey and incidence Study-2 (NEMESIS-2)
Authors: Joling Karlijn J. , ten Have Margreet , de Graaf Ron , O’Dwyer Siobhan T. 
Published: October 2019

Abstract

Background
Previous research suggests that family caregivers contemplate suicide at a higher rate than the general population. Much of this research has been disease specific and in relatively small samples. This study aimed to compare suicidal thoughts between non-caregivers and informal caregivers of people with a variety of conditions, in a large representative sample, and to identify significant risk factors.

Methods
The general population study NEMESIS-2 (N at baseline = 6646) included 1582 adult caregivers at the second wave (2010–2012) who also participated at the third wave (2013–2015). Suicidal thoughts were assessed over 4 years, with the Suicidality Module of the Composite International Diagnostic Interview 3.0. The presence of suicidal thoughts was estimated and risk factors for suicidal thoughts were assessed with logistic regression analyses adjusted for age and gender.

Results
Thirty-six informal caregivers (2.9%) reported suicidal thoughts during the 4 year study period. The difference between caregivers and non-caregivers (3.0%) was not significant. Among caregivers, significant risk factors for suicidal thoughts included being unemployed, living without a partner, having lower levels of social support, having a chronic physical disorder, a mood disorder or an anxiety disorder, and having impaired social, physical and emotional functioning. These risk factors were also found in non-caregivers. No caregiving-related characteristics were associated with suicidal thoughts.

Conclusion
There was no elevated rate of suicidal thoughts in caregivers and risk factors for suicidal thoughts in caregivers were consistent with risk factors in non-caregivers. No association between caregiving characteristics and suicidal thoughts was found. Caregivers with limited resources and in poorer health might still benefit from prevention and intervention efforts.
Mortality of site-specific cancer in patients with schizophrenia: a systematic review and meta-analysis
Authors: Ni Liwei , Wu Jian , Long Yuming , Tao Jialong , Xu Jianhao , Yuan Xuya , Yu Na , Wu Runhong , Zhang Yusong 
Published: October 2019

Abstract

Background
Numerous studies have reported contradicting results on the relationship between cancer mortality and schizophrenia. Our aim is to quantify the mortality rate of common site-specific cancers among patients with schizophrenia and to synthesize the available research evidence.

Methods
We performed a systemic search of the PubMed, EMBASE and Web of Science databases. Studies reporting the mortality rate of different cancer in patients with schizophrenia were included. A random-effects model was applied to calculate the pooled relative risks (RRs) with 95% confidence intervals (95%CIs).

Results
Seven studies consisting of 1,162,971 participants with schizophrenia were included in this meta-analysis. Data regarding mortality risk of breast, colon, lung and prostate cancer among schizophrenia patients were subjected to quantitative analysis. Pooled results showed significant increases in mortality risk of breast cancer (RR = 1.97, 95%CI 1.38–2.83), lung cancer (RR = 1.93, 95%CI 1.46–2.54) and colon cancer (RR = 1.69, 95%CI 1.60–1.80) in patients with schizophrenia compared with those in the general population or control group. The mortality risk of prostate cancer increased in male patients, although no significant difference was detected (RR = 1.58, 95% CI 0.79–3.15). Increased risks of mortality from lung and colon cancer were observed in female patients (RR = 2.49, 95%CI 2.40–2.59 and RR = 2.42, 95%CI 1.39–4.22, respectively) and elevated risks of mortality from lung and colon cancer in male patients (RR = 2.40, 95%CI 2.30–2.50 and RR = 1.90, 95%CI 1.71–2.11, respectively) were detected.

Conclusions
Individuals with schizophrenia have a significantly high risk of mortality from breast, colon, and lung cancer.
Parental support of the Canadian 24-hour movement guidelines for children and youth: prevalence and correlates
Authors: Rhodes Ryan E. , Spence John C. , Berry Tanya , Faulkner Guy , Latimer-Cheung Amy E. , O’Reilly Norman , Tremblay Mark S. , Vanderloo Leigh 
Published: October 2019

Abstract

Background
To explore the prevalence of parental support for meeting the Canadian 24-Hour Movement Guidelines for Children and Youth, identify key interactive support profiles among the four movement behaviors, and investigate subsequent sociodemographic and social cognitive correlates of these profiles.

Methods
A sample of Canadian parents (N = 1208) with children aged 5 to 17 years completed measures of the theory of planned behavior (TPB), and support of the four child movement behaviors via questionnaire. Differences in the proportion of parents supporting these four health behaviors were explored and demographic and social cognitive (attitude and perceived control) correlates of combinations of parental support for the four health behaviors were evaluated.

Results
Child and youth sleep behavior had the highest parental support (73%) and moderate to vigorous physical activity support had the lowest prevalence (23%). Interactive profiles of the four movement behaviors yielded six primary clusters and comprised wide variation from parents who supported none of these behaviors (19%), to parents who supported all four behaviors (14%). These profiles could be distinguished by the age of the child (younger children had higher support) and the gender of the parent (mothers provided more support), as well as constructs of the TPB, but TPB cognitions were more specific predictors of each health behavior rather than general predictors of aggregate health behavior clusters.

Conclusions
Teenagers and fathers may represent key targets for parental support intervention of the 24-Hour Movement Guidelines. Intervention content may need to comprise the underlying foundations of attitude and perceived behavioral control to change parental support while considering the unique features of each health behavior to maximize related intervention effectiveness.
Reliability of a new measure to assess modern screen time in adults
Authors: Vizcaino Maricarmen , Buman Matthew , DesRoches C. Tyler , Wharton Christopher 
Published: October 2019

AbstractBackgroundScreen time among adults represents a continuing and growing problem in relation to health behaviors and health outcomes. However, no instrument currently exists in the literature that quantifies the use of modern screen-based devices. The primary purpose of this study was to develop and assess the reliability of a new screen time questionnaire, an instrument designed to quantify use of multiple popular screen-based devices among the US population.MethodsAn 18-item screen-time questionnaire was created to quantify use of commonly used screen devices (e.g. television, smartphone, tablet) across different time points during the week (e.g. weekday, weeknight, weekend). Test-retest reliability was assessed through intra-class correlation coefficients (ICCs) and standard error of measurement (SEM). The questionnaire was delivered online using Qualtrics and administered through Amazon Mechanical Turk (MTurk).ResultsEighty MTurk workers completed full study participation and were included in the final analyses. All items in the screen time questionnaire showed fair to excellent relative reliability (ICCs = 0.50–0.90; all < 0.000), except for the item inquiring about the use of smartphone during an average weekend day (ICC = 0.16,p = 0.069). The SEM values were large for all screen types across the different periods under study.ConclusionsResults from this study suggest this self-administered questionnaire may be used to successfully classify individuals into different categories of screen time use (e.g. high vs. low); however, it is likely that objective measures are needed to increase precision of screen time assessment.
Trajectories of Haemoglobin and incident stroke risk: a longitudinal cohort study
Authors: Dayimu Alimu , Qian Wendi , Fan Bingbing , Wang Chunxia , Li Jiangbing , Wang Shukang , Ji Xiaokang , Zhou Guangshuai , Zhang Tao , Xue Fuzhong 
Published: October 2019

Abstract

Background
Studies have demonstrated that high or low haemoglobin increases the risk of stroke. Previous studies, however, performed only a limited number of haemoglobin measurements, while there are dynamic haemoglobin changes over the course of a lifetime. This longitudinal cohort study aimed to classify the long-term trajectory of haemoglobin and examine its association with stroke incidence.

Methods
The cohort consisted of 11,431 participants (6549 men) aged 20 to 50 years whose haemoglobin was repeatedly measured 3–9 times during 2004–2015. A latent class growth mixture model (LCGMM) was used to classify the long-term trajectory of haemoglobin concentrations, and hazard ratios (HRs) and 95% confidence intervals (95% CI) according to the Cox proportional hazard model were used to investigate the association of haemoglobin trajectory types with the risk of stroke.

Results
Three distinct trajectory types, high-stable (n = 5395), normal-stable (n = 5310), and decreasing (n = 726), were identified, with stroke incidence rates of 2.7, 1.9 and 3.2 per 1000 person-years, respectively. Compared to the normal-stable group, after adjusting for the baseline covariates, the decreasing group had a 2.94-fold (95% CI 1.22 to 7.06) increased risk of developing stroke. Strong evidence was observed in men, with an HR (95% CI) of 4.12 (1.50, 11.28), but not in women (HR = 1.66, 95% CI 0.34, 8.19). Individuals in the high-stable group had increased values of baseline covariates, but the adjusted HR (95% CI), at 1.23 (0.77, 1.97), was not significant for the study cohort or for men and women separately.

Conclusions
This study revealed that a decreasing haemoglobin trajectory was associated with an increased risk of stroke in men. These findings suggest that long-term decreasing haemoglobin levels might increase the risk of stroke.
Knowledge, attitudes, practices and information demand in relation to haze in China: a cross-sectional study
Authors: Zhao Minghui , Zhang Meiling , Ying Jie , Wang Shouqi , Shi Ying , Li Huanhuan , Li Yuan , Xing Zhuangjie , Sun Jiao 
Published: October 2019

AbstractBackgroundInformation on the effects of haze on health and corresponding knowledge, attitudes, and practices (KAP) will improve self-care ability against the ill effects of haze pollution and make environmental health policies more targeted and effective. In this study, we aim to determine the KAP and information demand in the context of haze and its effects on health.MethodsA cross-sectional survey was conducted in Changchun, China, between October and November 2016. A purposive sample comprising four groups (college students, occupational population, traffic police, and elderly population) were investigated. Personal information and questions pertaining to KAP and information demand on haze pollution and health were collected through questionnaire.ResultsThe questionnaire was completed by 888 residents. The awareness rate was 57.7% and varied significantly with education, exercise, and population group (p < 0.05). Among the four groups, college students scored the lowest in attitudes and practices, whereas traffic police scored the highest. Concerning the source of information demand, the elderly and traffic police preferred traditional information access (i.e., television and newspaper), whereas college students and the occupational population preferred new social media (i.e., mobile newspaper and social media sites). Regarding the most trusted department that releases information, all residents relied on the haze information released by the environmental protection department and meteorological department. The latest air quality was the most desired information of the residents.ConclusionsChangchun residents have a relatively high knowledge awareness rate. The elderly and less-educated residents are the targetable population for haze education. Education should be disseminated in such manner as to meet the needs of different people.