bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of myopia and associated risk factors among primary students in Chongqing: multilevel modeling
Authors: Xie Zhihao , Long Yue , Wang Jingxuan , Li Qiaoqiao , Zhang Qiang 
Published: April 2020

AbstractBackgroundThe prevalence of myopia and associated risk factors among children in Chongqing has not yet been determined. This study investigated the prevalence of myopia and possible relationships between myopia and several related factors among school children in Chongqing.MethodsThis cross-sectional study assessed a sample of 997 children (7–13 years of age) attending primary school in Chongqing. Data were obtained from visual acuity and refractive error measurements and a structured questionnaire. Myopia was defined as visual acuity < 5.0 and refractive error (spherical equivalent) of < − 0.50 diopters (D) in either eye. Multilevel modeling was applied to investigate potential risk factors.ResultsThe overall prevalence of myopia was 33.9% [95% confidence interval (CI) = 31.0–36.8]; myopia prevalence significantly increased with age. Girls were at a higher risk of myopia than boys [odds ratio (OR) = 1.449, 95% CI = 1.060–1.979]. Children with paternal myopia (OR = 2.130, 95% CI = 1.376–3.297) or maternal myopia (OR = 1.861, 95% CI =1.153–3.002) had a higher risk of myopia than those without myopic parents. Children who spent more than 1 h daily outdoors were less likely to have myopia; meanwhile, children who did homework more than 3 h daily (OR = 2.237, 95% CI = 1.041–4.804), watched television more than 3 h daily (OR = 2.106, 95% CI = 1.200–3.697), or played electronics more than 1 h daily (OR = 2.983, 95% CI = 2.088–4.262) had a higher risk of myopia.ConclusionsMyopia in school children is a serious public health problem in Chongqing. Myopia was significantly positively associated with higher age, female sex, parental myopia, and spending a long time indoors; notably, playing with electronics had the greatest influence on the risk of myopia.
Outcome of intravitreal bevacizumab injection without pre and postoperative antibiotics
Authors: Shrestha Ruchi , Karki Pratap , Joshi Sagun Narayan 
Published: April 2020

Abstract
Backgound
Intravitreal injections are the most common treatment modality for several retinal pathologies. Despite endophthalmitis being the most feared complication, antibioprophylaxis remains controversial in intravitreal injections.

Methods
This was a retrospective study done for a period of 2 years from 1st January 2017 to 31st December 2018 in B. P Koirala Lions Centre for Ophthalmic Studies (BPKLCOS) among patients receiving intravitreal bevacizumab. The intravitreal injection was given by a single surgeon. It included 503 eyes which received intravitreal bevacizumab over a period of 2 years without pre and postoperative antibiotics.

Results
Out of 503 eyes studied over a period of 2 years without antibiotic prophylaxis the rate of endophthalmitis was 0.0019% which is very low compared to the other studies with rate of endophthalmitis between 0.019–0.09%.

Conclusion
The risk of endophthalmitis was low even without pre/post-operative antibiotics. Intravitreal injection can be given safely without pre-operative and post-operative antibiotics. Trial Registration not applicable as it is a retrospective study.
Study protocol: NeoCLEAR: Neonatal Champagne Lumbar punctures Every time – An RCT: a multicentre, randomised controlled 2 × 2 factorial trial to investigate techniques to increase lumbar puncture success
Authors:   on behalf of the ‘The NeoCLEAR Collaborative Group’, Marshall Andrew S. J. , Sadarangani Manish , Scrivens Alexandra , Williams Rachel , Yong Jean , Bowler Ursula , Linsell Louise , Chiocchia Virginia , Bell Jennifer L. , Stokes Caz , Santhanadass Patricia , Adams Eleri , Juszczak Edmund , Roehr Charles C. 
Published: April 2020

AbstractBackgroundThe neonatal period carries the highest risk of bacterial meningitis (~ 1 in 5000 births), bearing high mortality (~ 10%) and morbidity (20–50%) rates. Lumbar puncture (LP) remains essential to the diagnosis of meningitis. Though LP is a common procedure in neonates, success rates are lower (50–60%) than in other patient populations. None of the currently-practised neonatal LP techniques are supported by evidence from adequately-powered, randomised controlled trials (RCTs). NeoCLEAR aims to compare two modifications to the traditional technique which are free, accessible, and commonly practised: sitting (as opposed to lying) position, and ‘early’ (as opposed to ‘late’) stylet removal.Methods/designWritten parental informed consent permitting, infants in neonatal/maternity wards, of 27+ 0to 44+ 0weeks corrected gestational age and weighing ≥1000 g, who require an LP, will be randomly allocated to sitting or lying position, and to early or late stylet removal. The co-primary objectives are to compare success rates (the proportion of infants with cerebrospinal fluid red cell count < 10,000/mm3on first LP procedure) in 1020 infants between the two positions, and between the two methods of stylet removal. Secondary outcomes relate to LP procedures, complications, diagnoses of meningitis, duration of antibiotics and hospital stay. A modified intention-to-treat analysis will be conducted.DiscussionTwo modifications to the traditional LP technique (sitting vs lying position; and early vs late stylet removal) will be simultaneously investigated in an efficient and appropriately-powered 2 × 2 factorial RCT design. Analysis will identify the optimal techniques (in terms of obtaining easily-interpretable cerebrospinal fluid), as well as the impact on infants, parents and healthcare systems whilst providing robust safety data. Using a pragmatic RCT design, all practitioners will be trained in all LP techniques, but there will inevitably be variation between unit practice guidelines and other aspects of individual care.An improved LP technique would result in:• Fewer uninterpretable samples, repeated attempts and procedures• Reduced distress for infants and families• Decreased antibiotic use and risk of antibiotic resistance• Reduced healthcare costs due to fewer procedures, reduced length of stay, shorter antibiotic courses, and minimised antibiotic-associated complicationsTrial registrationISRCTN14040914. Date assigned: 26/06/2018.
Assessing vulnerability to risk of suicide and self-harm in prisoners: a Rasch analysis of the suicide concerns for offenders in the prison environment (SCOPE-2)
Authors: Perry Amanda E. , Horton Mike 
Published: April 2020

Abstract
Background
With increasing levels of suicide and self-harm behaviour in the criminal justice system professionals would benefit from a tool that can identify individuals who may be at risk of self-harm and/or suicidal behaviour.

Method
The Suicide Concerns for Offenders in the Prison Environment (SCOPE) tool was originally devised and validated in six UK prisons between 2003 and 2004. The goal of this study is to re-evaluate the SCOPE using Rasch methodology to produce a psychometrically robust instrument. Data were presented from 1051 SCOPE assessments of male and female offenders.

Results
The analysis produced a revised SCOPE-2 tool reducing the tool from a 27 to a 19 items and simplifying the categorical six point scale to a four item scale.

Conclusions
Further validation of the new SCOPE-2 tool is required in samples of male and female prisoners to assess different cut-off points for clinical and policy use.
Prevalence and determinants of perinatal depression among labour migrant and refugee women on the Thai-Myanmar border: a cohort study
Authors: Fellmeth Gracia , Plugge Emma , Fazel Mina , Oo May May , Pimanpanarak Mupawjay , Phichitpadungtham Yuwapha , Wai Kerry , Charunwatthana Prakaykaew , Simpson Julie A. , Nosten François , Fitzpatrick Raymond , McGready Rose 
Published: April 2020

Abstract
Background
Perinatal depression is a significant contributor to maternal morbidity and mortality globally. Migrant women, particularly those living in low- and middle-income settings, represent a particularly vulnerable group due to stressors experienced before, during and after migration. The vast majority of global migration flows occurring within and between low- and middle-income regions, yet existing evidence focuses predominantly on migrants in high-income destinations. This study aimed to redress this significant gap in the evidence by determining the prevalence and determinants of perinatal depression among migrant women on the Thai-Myanmar border.

Methods
A cohort of labour migrant and refugee women was followed-up from the first trimester of pregnancy to one month post-partum. Depression status was assessed in the first, second and third trimesters of pregnancy and at one month post-partum using the Structured Clinical Interview for the Diagnosis of DSM-IV Disorders. Women diagnosed with depression had immediate access to care. Data on potential demographic, social and clinical associated factors was collected using a questionnaire. Prevalence and incidence of any depressive disorder and moderate-severe depressive disorder was calculated. Univariable and multivariable logistic regression using complete case analysis was used to estimate odds ratios (OR) of association between exposure variables and depression status.

Results
Five hundred sixty-eight women participated. Period prevalence (from first trimester of pregnancy to one month post-partum) of moderate-severe perinatal depression was 18.5% (95% CI 15.4–21.9%). Overall, 15.4% (95% CI 11.8–19.6%) of women developed new-onset moderate-severe depression during the study period. Forty-two participants received treatment for depression. Risk factors were interpersonal violence (OR 4.5; 95% CI 1.9–11.1); history of trauma (OR 2.4; 95% CI 1.4–4.3); self-reported history of depression (OR 2.3; 95% CI 1.2–4.2); labour migrant status (OR 2.1; 95% CI 1.1–4.0); low social support (OR 2.1; 95% CI 1.1–3.7); and maternal age (OR 1.1 per year; 95% CI 1.0–1.1). Limitations of the study include that culturally specific manifestations of depression may have been missed.

Conclusions
Perinatal depression represents a significant burden among migrant women on the Thai-Myanmar border. Programmes to address the determinants along with early case identification and effective treatment and referral systems are key to addressing perinatal depression in this low-resource setting.
Practice of stress management behaviors and associated factors among undergraduate students of Mekelle University, Ethiopia: a cross-sectional study
Authors: Hailu Gebrezabher Niguse 
Published: April 2020

Abstract
Background
Stress is one of the top five threats to academic performance among college students globally. Consequently, students decrease in academic performance, learning ability and retention. However, no study has assessed the practice of stress management behaviors and associated factors among college students in Ethiopia. So the purpose of this study was to assess the practice of stress management behaviors and associated factors among undergraduate university students at Mekelle University, Tigray, Ethiopia, 2019.

Methods
A cross-sectional study was conducted on 633 study participants at Mekelle University from November 2018 to July 2019. Bivariate analysis was used to determine the association between the independent variable and the outcome variable at p < 0.25 significance level. Significant variables were selected for multivariate analysis.

Results
The study found that the practice of stress management behaviors among undergraduate Mekelle university students was found as 367(58%) poor and 266(42%) good. The study also indicated that sex, year of education, monthly income, self-efficacy status, and social support status were significant predictors of stress management behaviors of college students.

Conclusion
This study found that the majority of the students had poor practice of stress management behaviors.
Civic engagement and mental health system strengthening in Indonesia: a qualitative examination of the views of health professionals and national key stakeholders
Authors: Irmansyah Irman , Susanti Herni , James Karen , Lovell Karina , Idaiani Sri , Imah Soimah , Hargiana Giur , Keliat Budi-Anna , Utomo Bagus , Colucci Erminia , Brooks Helen 
Published: April 2020

Abstract
Background
Mental health services in Indonesia are developing rapidly in response to national and global health policy to support people living with psychosis. This presents a unique opportunity for civic engagement, the active involvement of patients, carers and communities in mental health care, to shape emergent services. In-depth explorations of the views of professionals and other key stakeholders in mental health care on the use of civic engagement in Indonesia are lacking which contributes to a limited understanding of its potential in this regard. The study aimed to explore contemporary professionals’ and other key stakeholders’ perspectives on the current use of and potential for civic engagement to strengthen mental health systems in Indonesia.

Methods
Qualitative interviews were undertaken and analysed using thematic analysis underpinned by a critical realist approach. Eighteen multi-disciplinary professionals and lay health workers involved in mental health care in Jakarta and Bogor and 10 national key stakeholders were recruited.

Results
Despite high levels of awareness of and support for civic engagement amongst mental health professionals and policy makers combined with a nascent grass roots movement, analysis revealed unstructured and insufficient mechanisms for civic engagement which resulted in ad-hoc and mostly superficial levels of involvement activity. Civic engagement was thought to require a marked shift in existing practices as well as organisational and societal cultures. Challenging stigma is a key feature of civic engagement and our analysis highlights the relevance of social contact methods which are locally and culturally contextualised in this regard. Our findings point to a need to expand current definitions of civic engagement which focus on indivdiual enablement to ones that also encompass environmental and organisational enablement to optimise the future use of civic engagement in mental health settings.

Conclusions
Key mental health stakeholders have identified that central aspects of Indonesian culture are well aligned to the ethos of civic engagement which has the potential to facilitate the enactment of recent global health policy. However, full realisation is likely to be impeded by prevailing paternalistic cultures in mental health services and high levels of stigma and discrimination towards those with mental illness in Indonesia without intervention.
Clinical and cost effectiveness of staff training in the delivery of Positive Behaviour Support (PBS) for adults with intellectual disabilities, autism spectrum disorder and challenging behaviour - randomised trial
Authors:   the PBS study group, Strydom Andre , Bosco Alessandro , Vickerstaff Victoria , Hunter Rachael , Hassiotis Angela 
Published: April 2020

Abstract
Background
Although Positive Behaviour Support (PBS) is a widely used intervention for ameliorating challenging behaviour (CB), evidence for its use in adults with intellectual disability (ID) and comorbid autism (ASD) is lacking. We report a planned subsidiary analysis of adults with both ASD and ID who participated in a randomised trial of PBS delivered by health professionals.

Methods
The study was a multicentre, cluster randomised trial conducted in 23 community ID services in England, participants were randomly allocated to either the delivery of PBS (n = 11 clusters) or to treatment as usual (TAU; n = 12). One-hundred and thirteen participants (46% of all participants in the trial) had a diagnosis of ID, autism spectrum disorder and CB (ASD+); (47 allocated to the intervention arm, and 66 to the control). CB (primary outcome) was measured with the Aberrant Behaviour Checklist total score (ABC-CT). Secondary outcomes included mental health status, psychotropic medication use, health and social care costs and quality adjusted life years (QALYs) over 12 months.

Results
There were no statistically significant differences in ABC-CT between ASD+ groups randomised to the two arms over 12 months (adjusted mean difference = − 2.10, 95% CI: − 11.3 7.13, p = 0.655) or other measures. The mean incremental cost of the intervention per participant was £628 (95% CI -£1004 to £2013). There was a difference of 0.039 (95% CI − 0.028 to 0.103) for QALYs and a cost per QALY gained of £16,080.

Conclusions
Results suggest lack of clinical effectiveness for PBS delivered by specialist ID clinical teams. Further evidence is needed from larger trials, and development of improved interventions.

Trial registration
ClinicalTrials.gov: NCT01680276.
Prevalence of anxiety, depression, and stress in patients with multiple sclerosis in Kermanshah-Iran: a cross-sectional study
Authors: Karimi Saba , Andayeshgar Bahare , Khatony Alireza 
Published: April 2020

Abstract
Background
Multiple sclerosis (MS) is a chronic disease that decreases the physical ability and affects the mental health of the patients. This descriptive-analytical study investigated the prevalence of depression, anxiety and stress in MS patients.

Methods
A total of 87 MS patients were recruited in this study through simple random sampling method using a random number table. Data were collected by Depression, Anxiety, and Stress Scale-21 (DASS-21) and analyzed by descriptive and analytical statistics.

Results
The mean age of the patients was 35.5 ± 9.2 years. Of them, 41 (47.1%) had moderate depression, 34 (39.1%) had moderate anxiety, and 39 (44.8%) had moderate stress. There was a significant relationship between depression and job, education, and economic status of the participants. There was also a significant association between the participants’ economic status and anxiety. There was no significant relationship between stress and any of the variables.

Conclusion
Given the relatively high prevalence of anxiety, depression, and stress in MS patients as well as the significant relationship between their economic status and depression and anxiety, interventional measures are required to be taken to decrease their problems and to provide a favorable ground for their employment. Periodic examinations by psychologists / psychiatrists and treatment of patients with symptoms of stress, anxiety and depression are also essential.
How do education and experience with mental illness interact with causal beliefs, eligible treatments and stigmatising attitudes towards schizophrenia? A comparison between mental health professionals, psychology students, relatives and patients
Authors: Mannarini Stefania , Rossi Alessandro , Munari Cristina 
Published: April 2020

Abstract
Background
The main purpose of this study was to investigate the perception of schizophrenia in different categories of persons (directly and/or indirectly) involved with it. Hypotheses were made concerning the definition of a multi-class structure where each class should identify a profile characteristic of each respondent’s specific role, (e.g.: mental health professional, relative, patient, and student) and specific indicators of schizophrenia (e.g.: causal beliefs, eligible treatments, social distance, perceived dangerousness and public avoidance).

Methods
This study involved 577 participants all in contact with schizophrenia with different roles. A Latent Class Analysis (LCA) was applied to define a latent structure of schizophrenia aspects. Such structure was expected be affected by the interaction between respondents’ roles, as external variable, and schizophrenia indicators as manifest variables.

Results
A four-latent-class structure representing the four respondents’ roles was evidenced, further each class was characterized by schizophrenia indicators representing a profile for each role. Analogies and differences of views and preferences of the respondents’ roles concerning schizophrenia emerged clearly.

Conclusions
The four groups of people involved with schizophrenia with different roles demonstrated to interact significantly with specific indicators of schizophrenia shedding new lights on the understanding of schizophrenia in its complexity.
Factors affecting the quality of life of single mothers compared to married mothers
Authors: Kim Ga Eun , Kim Eui-Jung 
Published: April 2020

Abstract
Background
In this study, we aimed to compare the quality of life (QOL) of single mothers with that of married mothers and to identify the sociodemographic and psychological factors affecting single mothers’ QOL. We identified the factors that were similar and different between single and married mothers.

Methods
We analyzed survey data obtained from 195 single mothers and 357 married mothers living in an urban community in South Korea. The QOL was assessed with the World Health Organization Quality of Life-abbreviated form (WHOQOL-BREF). All participants completed the following self-report questionnaires: the Global Assessment of Recent Stress, the Center for Epidemiologic Studies-Depression Scale, the Scale for Suicide Ideation, the Korean version of the Alcohol Use Disorder Identification Test, and the WHOQOL-BREF. These self-rating scales were used as continuous variables. Multiple linear regression analysis was performed to examine the association of quality of life with the sociodemographic and psychological factors for single and married mothers.

Results
Single mothers showed lower QOL than married mothers. Older age, high income and education level, and professional job status were positively correlated with the QOL of single mothers. Residential instability, higher stress levels, depressive symptoms, suicidal ideation, and alcohol-related problems were negatively associated with the QOL of single mothers. Multiple regression analysis suggested that residential instability (public rental housing: β = − 10.779, p <  0.001; Jeonse rental housing: β = − 0.324, p = 0.01) and alcohol-related problems (β = − 0.522, p <  0.001) were independent factors affecting lower QOL, whereas professional job status (β = 8.452, p = 0.037) was independently associated with higher QOL in single mothers. However, these factors were not associated with the QOL of married mothers. Higher education level was independently associated with higher QOL in both groups (β = 3.149, p <  0.033 in single mothers, β = 12.052, p <  0.001 in married mothers).

Conclusions
Higher education level was associated with higher QOL in both groups. Unlike in married mothers, type of residence and occupation (related to the economic level) had a significant impact on QOL in single mothers. Alcohol-related problems were significantly correlated to QOL in single mothers compared to married mothers.