bluuebunny/crossref_metadata_2025_split huggingface dataset:
“You don't know my story. You don't know what I've been going through.” A qualitative exploration of HIV survivorship over decades through the lens of symbolic violence
Authors: Freeman Robert , Gwadz Marya , Wilton Leo , Silverman Elizabeth , Cluesman Sabrina , Martinez Belkis Y. , Collins Linda M. , Leonard Noelle R. , Dorsen Caroline 
Published: February 2020

Abstract
Background Persons living with HIV (PLWH) are living longer, although racial/ethnic and socioeconomic status (SES) disparities persist. Yet, little is known about successful HIV management over decades. To address this gap, the present study took a qualitative approach and used the lens of symbolic violence, a type of internalized, non-physical violence manifested in the power differential between social groups. We focused on adult African American/Black and Hispanic/Latinx (AABHL) PLWH from low SES-backgrounds. Methods Data were drawn from two studies with AABHL PLWH in New York City ( N =59). After providing signed informed consent, participants engaged in in-depth semi-structured interviews on aspects of HIV management. Interviews were audio-recorded and professionally transcribed verbatim, and data were analyzed using a systematic content analysis approach. Results Participants in the two studies were comparable on sociodemographic and HIV history characteristics. They had lived with HIV for 20 years, on average (range 3-33 years). All were from low-SES backgrounds and most were African American/Black and men. Participants experienced a convergence of multiple intersecting social exclusions, harms, and stigmas, consistent with symbolic violence, which contributed to disengagement from HIV care and medications. We found five specific sub-themes: (1) material, social, and emotional challenges combined to “grind down” participants over time and diminish self-worth and even, at times, the will to live, (2) social isolation and self-isolation, based in part on feeling devalued and dehumanized, served as both a stigma-avoidance strategy and a mechanism of social exclusion, (3) stigmatizing aspects of patient-provider interactions, both experienced and anticipated, and (4) perceived restricted autonomy in HIV care reduced engagement, and (5) poor HIV management was internalized as a personal failure. Importantly, resilience was also evident throughout the five sub-themes. Conclusions Symbolic violence is a useful framework for understanding the experiences of long-term HIV management/survivorship among AABHL PLWH from low-SES backgrounds. Aspects of symbolic violence are internalized over time (e.g., experiencing devaluation, dehumanization, loss of self-worth, and anticipated stigma), thereby impeding successful HIV management, including because avoiding HIV care and stopping HIV medications are primary coping strategies. Study findings have implications for interventions in community and health care settings.
Population-level investigation of the knowledge of ocular chemical injuries and proper immediate action
Authors: Seraj Hadeel , Khawandanh Shahad , Fatani Arwa , Saeed Afnan , Alotaibi Ghadeer , Basheikh Ahmed 
Published: February 2020

Abstract
Objective: Although the eyes occupy 0.1% of the total body surface, eye injuries are serious because vision is arguably the most important sense. We aimed to assess knowledge of Saudi Arabian residents regarding steps to be taken in cases of chemical eye injury, in order to promote awareness of such procedures. Results: A cross-sectional design was done. A random sampling method was utilized to select 888 individuals in the Saudi community. Participants completed an electronic closed ended, validated, anonymous, self-administered questionnaire. Two experts assessed content and face validity. Respondents were 18–29 years of age. 74 (8.3%) had a history of chemical eye injury. Regarding the first step taken in case of chemical eye injury, 697 (78.5%) respondents indicated washing with water, 164 (18.5%) indicated visiting the emergency department, 11 (1.2%) indicated using eye drops, and 5 (0.6%) indicated covering the eye immediately. Seventy-five (8.4%) respondents agreed that an eye injured with an acidic material should be washed with an alkaline solution. These results should be confirmed by health authorities and appropriate interventions should be developed for improving knowledge among masses, thereby promoting a healthier society. Keywords: Eye damage, Saudi Arabia, corrective steps, alkaline, acidic
Misconceptions about transmission, symptoms and prevention of HIV/AIDS among adolescents in Ebonyi state, South-east Nigeria
Authors: Agu Ifunanya Clara , Mbachu Chinyere Ojiugo , Okeke Chinyere , Eze Irene , Agu Chibuike , Ezenwaka Uchenna , Ezumah Nkoli , Onwujekwe Obinna 
Published: February 2020

Abstract
Objectives: Nigeria has the second largest number of adolescents and young people living with HIV/AIDS in the world. Misconceptions about HIV/AIDS contribute to spread of HIV, and constrain uptake of preventive services. This paper explored misconceptions about HIV/AIDS among adolescents in south-east Nigeria. A qualitative study was conducted in six urban and rural local government areas of Ebonyi state. Data were collected through twelve focus group discussions (FGD) with unmarried adolescents aged 13-18 who were either attending school or out-of-school. The FGDs were conducted using a pre-tested topic guide. Data were coded manually and analyzed using a thematic framework approach. Results : There are persistent misconceptions about transmission of HIV/AIDS through mosquito bites and sharing of personal belongings. Some adolescents had inaccurate notions that a HIV infected person could be identified through changes in physical features such as abdominal swelling and longer fingernails. A few of them also reported that HIV could be treated with antibiotics. These misconceptions were expressed by both male and female adolescents. Adolescents have some mistaken beliefs about HIV/AIDS which constrain them from taking necessary preventive measures. Hence, the need to target adolescents with health education interventions on HIV/AIDS.
Compbdt: an R program to compare two binary diagnostic tests subject to a paired design
Authors: Roldán-Nofuentes Jose Antonio 
Published: February 2020

Abstract
Background: The comparison of the effectiveness of two binary diagnostic tests is an important topic in Clinical Medicine. The most frequent type of sample design to compare two binary diagnostic tests is the paired design. This design consists of applying the two binary diagnostic tests to all of the individuals in a random sample, where the disease status of each individual is known through the application of a gold standard . This article presents an R program to compare parameters of two binary tests subject to a paired design. Results: The “compbdt” program estimates the sensitivity and the specificity, the likelihood ratios and the predictive values of each diagnostic test applying the confidence intervals with the best asymptotic performance. The program compares the sensitivities and specificities of the two diagnostic tests simultaneously, as well as the likelihood ratios and the predictive values, applying the global hypothesis tests with the best performance in terms of Type I error and power. When the global hypothesis test is significant, the causes of the significance are investigated solving the individual hypothesis tests and applying the multiple comparison method of Holm. The most optimal confidence intervals are also calculated for the difference or ratio between the respective parameters. Based on the data observed in the sample, the program also estimates the probability of making a Type II error if the null hypothesis is not rejected, or estimates the power if the if the alternative hypothesis is accepted. The “compbdt” program provides all the necessary results so that the researcher can easily interpret them. The estimation of the probability of making a Type II error allows the researcher to decide about the reliability of the null hypothesis when this hypothesis is not rejected. The “compbdt” program has been applied to a real example on the diagnosis of coronary artery disease. Conclusions: The “compbdt” program is one which is easy to use and allows the researcher to compare the most important parameters of two binary tests subject to a paired design. The “compbdt” program is available as supplementary material.
SARFIMA model prediction for infectious diseases: application to hemorrhagic fever with renal syndrome and comparing with SARIMA
Authors: Qi Chang , Zhang Dandan , Zhu Yuchen , Liu Lili , Li Chunyu , Wang Zhiqiang , Li Xiujun 
Published: February 2020

Abstract
Background The early warning model of infectious diseases plays a key role in prevention and control. Our study aims to using seasonal autoregressive fractionally integrated moving average (SARFIMA) model to predict the incidence of hemorrhagic fever with renal syndrome (HFRS) and comparing with seasonal autoregressive integrated moving average (SARIMA) model to evaluate its prediction effect. Methods Data on notified HFRS cases in Weifang city, Shandong Province were supplied by the Disease Reporting Information System of the Shandong Center for Disease Control and Prevention from January 1, 2005 to December 31, 2018. The SARFIMA model considering both the short-memory and long-memory were performed to fit and predict the HFRS series. Besides, we compared accuracy of fitting and prediction between SARFIMA and SARIMA which were used widely in infectious diseases. Results Both SARFIMA and SARIMA models show good fit of data. Model assessments indicated that the SARFIMA model has better goodness of fit (SARFIMA(2, 0.15, 2)(1, 0, 0) 12 : Akaike information criterion (AIC): -630.61; SARIMA(2, 0, 2)(1, 1, 0) 12 : AIC: -196.04) and better predictive ability than the SARIMA model (SARFIMA: root mean square error (RMSE): 0.067; SARIMA: RMSE: 0.111). Conclusions The SARFIMA model produces superior forecast performance than the SARIMA model for HFRS. Hence, the SARFIMA model may help us to improve the forecast of HFRS incidence.
Association of plasma chromium with metabolic syndrome among Chinese adults: a case-control study
Authors: Chen Sijing , Zhou Li , Guo Qianqian , Fang Can , Wang Mengke , Peng Xiaobo , Yin Jiawei , Li Shuzhen , Zhu Yalun , Yang Wei , Zhang Yan , Shan Zhilei , Chen Xiaoyi , Liu Liegang 
Published: February 2020

Abstract
Backgroud Chromium has been suggested playing a role in alleviating diabetes, insulin resistance and lipid anomalies, but the effect on MetS in humans remains controversial. Methods We conducted a matched case-control study in a Chinese population, involving 2,141 MetS cases and 2,141 healthy controls, which were 1:1 matched by age (±2 years) and sex. Plasma chromium was measured by inductively coupled plasma mass spectrometry. Results Plasma chromium levels were lower in MetS group than in control group (median: 4.23 μg/L and 4.46 μg/L, respectively, P < 0.001), and progressively decreased with the number of MetS components ( P for trend <0.001). After adjustment for potential confounding factors, the odds ratios (95% confidence intervals) for MetS across increasing quartiles of plasma chromium levels were 1 (reference), 0.84 (0.67-1.05), 0.76 (0.61-0.95), and 0.62 (0.49-0.78), respectively ( P for trend < 0.001). For the components of MetS (high waist circumference, high triglycerides and high blood glucose), the odds ratios (95% confidence intervals) of the highest quartiles were 0.77 (0.61-0.95), 0.67 (0.55-0.80), and 0.53 (0.44-0.64), respectively ( P for trend < 0.05). Conclusions Our results indicated that plasma chromium levels were inversely associated with MetS in Chinese adults. The association may be explained by the relations between plasma chromium levels and high waist circumference, and the triglycerides and blood glucose levels.
A policy Analysis of Phenylketonuria Screening National Program in Iran
Authors: Heidari Alireza , Arab Mohammad , Damari Behzad 
Published: February 2020

Abstract
Background Phenylketonuria (PKU) Screening is a public health measure aimed at identifying the early cases and managing the affected infants and trying to reduce infant morbidity and mortality. The aim of this study was to analyze the policies of the PKU national screening program in Iran. Methods PKU screening program policies were analyzed according to the policy triangle model. Document review and 38 semi-structured interviews were used for data collection. Document review data were analyzed using content analysis and interview data were analyzed using framework analysis. Results The findings of the study were categorized according to the content (structure and organization, rules, bylaws and guidelines), process (agenda setting, formation, implementation, and evaluation of screening policies and programs), the policy context (political and executive factors, economic and financial factors, social and cultural factors), and the stakeholders(Genetics office, Network Development Bureau, Population and Family Health Bureau, Health Reference Laboratory, Pediatric Health Department, Health Vice-Chancellor of Medical Sciences, Health Ministry Deputy of Health, PKU Selected Hospitals, Pastor Institute, Food and Drug Administration and Research Centers. Welfare Organization, the Health Insurance Agency, the PKU Patient Support Association, the Post Company, and the Registry). Conclusions The policy triangle framework helped to explain the different components of the PKU screening program.
"Once the child is delivered, he is no more your baby," Exclusive Breastfeeding experiences of first-time mothers in Kassena-Nankana Municipality, Ghana - a qualitative study
Authors: Adda Louisa , Opoku-Mensah Kwabena , Dako-Gyeke Phyllis 
Published: February 2020

Abstract
Background

Exclusive Breastfeeding (EBF) is globally accepted as the preferred method for infant feeding. In Ghana, an estimated 84% of children < 2 months old are exclusively breastfed. But by age 4 to 5 months, only 49% continue to receive EBF. This situation continues to deteriorate. Thus, the need to explore perceptions, practices as well as factors that influence EBF in Ghana.

Method

Using a qualitative design, four focus group discussions were conducted among first-time mothers and eight in-depth interviews with health workers and traditional birth attendants. The study was conducted in four communities in the Kassena-Nankana municipality of Ghana. Discussions and interviews were recorded and later transcribed verbatim to English language. The transcribed data was then coded with the aid of analysis computer software (Nvivo version 10.0) and later analyzed for the generation of themes.

Result

Exclusive breastfeeding is practiced among first-time mothers due to its perceived benefits; which include nutritional advantage, ability to enhance growth whilst boosting immunity and its economic value. However misconceptions as well as, certain cultural practices (e.g. giving herbal concoctions, breastmilk purification rites), and relational influences, may threaten a mother’s intention to exclusively breastfeed. Relational influences are mainly from mother in-laws, traditional birth attendants, grandmothers, herbalists and other older adults in the community.

Conclusion

Although first time mothers attempt EBF, external influences make it practically challenging. The availabilty and utilization of information on EBF was found to positively influence perceptions towards EBF, leading to change in attitude towards the act.

Recommendations

The provision of education on EBF should be targeted to mothers during antenatal and postnatal clinics in order to help address misconceptions of EBF. Again, the practice of community based health services should be strengthened to provide support to first-time mothers as well as continuous education to the family and community leaders who influence decision making on breastfeeding of infants.
Quality of Life of Patients with Metastatic Pancreatic Adenocarcinoma Initiating First‐Line Chemotherapy in Routine Practice
Authors: Laquente Berta , Macarulla Teresa , Bugés Cristina , Martín Marta , García Carlos , Pericay Carles , Merino Sandra , Visa Laura , Martín Teresa , Pedraza Manuela , Carnero Beatriz , Guardeño Raquel , Verdaguer Helena , Mut Alejandro , Vilanova David , García Adelaida 
Published: February 2020

Abstract
Background Considering the physical decline of patients with metastatic pancreatic adenocarcinoma, assessing their health-related quality of life becomes a matter of major concern. Methods Observational, prospective, multicenter study including patients with metastatic pancreatic adenocarcinoma who started first‐line chemotherapy in 12 Spanish centers. Treatment and clinical characteristics were recorded at baseline. Patients’ health-related quality of life, ECOG, and Karnofsky index were measured at baseline, at Days 15 and 30, and every four weeks up to 6 months of chemotherapy. Health-related quality of life was measured using the EORTC-QLQ‐C30 and EQ-5D questionnaires. Other endpoints included overall survival and progression‐free survival. Results The study sample included 116 patients (median age of 65 years). Mean (SD) scores for the QLQ-C30 global health status scale showed a significant increasing trend throughout the treatment (p=0.005). Patients with either a Karnofsky index of 70-80 or ECOG 2 showed greater improvement in the QLQ-C30 global health status score than the corresponding groups with better performance status (p≤0.010). Pain, appetite, sleep disturbance, nausea, and constipation significantly improved throughout the treatment (p<0.005). Patients with QLQ-C30 global health status scores ≥50 at baseline had significantly greater overall survival and progression-free survival (p=0.005 and p=0.021, respectively). No significant associations were observed regarding the EQ-5D score. Conclusions Most metastatic pancreatic adenocarcinoma patients receiving first-line chemotherapy improved their health-related quality of life throughout the treatment. Patients with lower performance status and health-related quality of life at baseline tended to greater improvement. The EORTC QLQ-C30 scale is suitable for measuring the health-related quality of life of metastatic pancreatic adenocarcinoma patients receiving first-line chemotherapy.
Feasibility of an integrated multidisciplinary geriatric rehabilitation programme for older stroke patients: a process evaluation
Authors: Vluggen Tom , Haastregt Jolanda van , Verbunt Jeanine , Heugten Caroline van , Schols Jos 
Published: February 2020

Abstract
Background

Almost half of the stroke patients admitted to geriatric rehabilitation has persisting problems after discharge. Currently, there is no evidence based geriatric rehabilitation programme available for older stroke patients, combining inpatient rehabilitation with adequate aftercare aimed at reducing the impact of persisting problems after discharge from a geriatric rehabilitation unit. Therefore, we developed an integrated multidisciplinary rehabilitation programme consisting of inpatient neurorehabilitation treatment using goal attainment scaling, home based self-management training, and group based stroke education for patients and informal caregivers. We performed a process evaluation to assess to what extent this programme was performed according to protocol. Furthermore, we assessed the participation of the patients in the programme, and the opinion of patients, informal caregivers and care professionals on the programme.

Methods

In this multimethod study, process data were collected by means of interviews, questionnaires, and registration forms among 97 older stroke patients, 89 informal caregivers, and 103 care professionals involved in the programme.

Results

A substantial part of patients and informal caregivers did not receive all key elements of the programme. Almost all patients formulated rehabilitation goals, but only among two thirds of the patients the goal attainment scaling method was used. Furthermore, the self-management training was considered rather complex and difficult to apply for frail elderly persons with stroke, and the percentage of therapy sessions performed in the patients’ home environment was lower than planned. In addition, only about a quarter of the patients and informal caregivers attended the education sessions. However, a large majority of patients, informal caregivers and care professionals indicated the beneficial aspects of the programme.

Conclusion

This study revealed that although the programme in general is perceived to be beneficial by patients, and informal and formal caregivers, the feasibility of the programme needs further attention. Because of persisting cognitive deficits and specific care needs in our frail and multimorbid target population, some widely used methods such as goal attainment scaling, and self-management training seemed not feasible in their current form. To optimize feasibility of the programme, it is recommended to tailor these elements more optimally to the population of frail older patients.
Application of Real-Time Simultaneous Amplification and Testing Method to Accurately and Rapidly Detect Extra-pulmonary Tuberculosis
Authors: Li Tongxin , Shi Tao , Sun Ying , Zhou Kan , Huang Zhenggu , Wang Pengsen , Luo Ming , Nie Xiaoping , Yang Guoqing , Chen Yu , Chen Yaokai 
Published: February 2020

Abstract
Background: This study aimed to establish and evaluate a simultaneous amplification and testing method for detection of extra-pulmonary tuberculosis. Methods: From January 2016 and December 2017 the pus or surgical excision from the lesions of inpatients admitted from Chongqing Public Health Treatment Center were collected. According to the clinical diagnosis, the samples were divided into two groups including extra-pulmonary tuberculosis (Group A) and other diseases excluded from tuberculosis diseases (Group B). Simultaneous detection of Mycobacterium tuberculosis (MTB) used Roche culture method, liquid culture method and simultaneous amplification and testing method (SAT). The sensitivity and specificity of the SAT method were compared with culture methods and clinical diagnosis of extra-pulmonary tuberculosis. Results: For 433 extra-pulmonary tuberculosis (EPTB) specimens and 49 non-TB specimens, the SAT-TB results correlated with 80.5% (388/482 specimens) of the culture assay results. The sensitivity, specificity, and positive and negative predictive values of the SAT-TB test for the diagnosis of EPTB were 83.6%, 79.4%, 59.4%, and 93.0%, respectively, compared to culture methods. Compared with the clinical diagnosis of patients, the sensitivity and specificity of the SAT-TB test were 41.6% and 100%, respectively, the cultures test were 29.3% and 98.0%. Conclusions: SAT test is a simple and rapid test with high specificity which may enhance the detection of EPTB. SAT-TB is a higher clinical diagnosis value for EPTB in clinical microbiology laboratories.