bluuebunny/crossref_metadata_2025_split huggingface dataset:
Family caregiving in the community up to 8-years after onset of dementia
Authors: Jutkowitz Eric , Gaugler Joseph E. , Trivedi Amal N. , Mitchell Lauren L. , Gozalo Pedro 
Published: June 2020

Abstract
Background
Persons with Alzheimer’s disease and related dementias (ADRD) receive care from family/friends, but how care changes from the onset of dementia remains less understood.

Methods
We used the Health and Retirement Study (2002–2012) to identify community-dwelling individuals predicted to have incident ADRD. We investigated the amount of caregiving received for activities of daily living in the 8-years after disease onset.

Results
At incidence (n = 1158), persons with ADRD received 151 h (SD = 231) of caregiving a month, 25 (SD = 26) caregiving days a month and had 1.3 (SD = 1.4) caregivers a month. By 8-years post incidence, 187 (16%) individuals transitioned to a nursing home and 662 (57%) died in the community. Community-dwelling persons with ADRD at 8-years post incidence (n = 30) received 283 h (SD = 257) of caregiving, 38 (SD = 24) caregiving days, and had 2.2 (SD = 1.3) caregivers.

Conclusions
Community-dwelling persons with ADRD receive a substantial amount of caregiving over the first 8-years after disease onset.
Does time taken by paediatric critical care transport teams to reach the bedside of critically ill children affect survival? A retrospective cohort study from England and Wales
Authors: Seaton Sarah E. , Ramnarayan Padmanabhan , Davies Patrick , Hudson Emma , Morris Stephen , Pagel Christina , Rajah Fatemah , Wray Jo , Draper Elizabeth S. ,   on behalf of the DEPICT Study Team
Published: June 2020

Abstract
Background
Reaching the bedside of a critically ill child within three hours of agreeing the child requires intensive care is a key target for Paediatric Critical Care Transport teams (PCCTs) to achieve in the United Kingdom. Whilst timely access to specialist care is necessary for these children, it is unknown to what extent time taken for the PCCT to arrive at the bedside affects clinical outcome.

Methods
Data from transports of critically ill children who were admitted to Paediatric Intensive Care Units (PICUs) in England and Wales from 1 January 2014 to 31 December 2016 were extracted from the Paediatric Intensive Care Audit Network (PICANet) and linked with adult critical care data and Office for National Statistics mortality data. Logistic regression models, adjusted for pre-specified confounders, were fitted to investigate the impact of time-to-bedside on mortality within 30 days of admission and other key time points. Negative binomial models were used to investigate the impact of time-to-bedside on PICU length of stay and duration of invasive ventilation.

Results
There were 9116 children transported during the study period, and 645 (7.1%) died within 30 days of PICU admission. There was no evidence that 30-day mortality changed as time-to-bedside increased. A similar relationship was seen for mortality at other pre-selected time points. In children who waited longer for a team to arrive, there was limited evidence of a small increase in PICU length of stay (expected number of days increased from: 7.17 to 7.58).

Conclusion
There is no evidence that reducing the time-to-bedside target for PCCTs will improve the survival of critically ill children. A shorter time to bedside may be associated with a small reduction in PICU length of stay.
Examining the spatial variations of co-morbidity among young children in Ethiopia
Authors: Takele Kasahun , Zewotir Temesgen , Ndanguza Denis 
Published: June 2020

Abstract
Background
Addressing the issues of childhood comorbidity remains a crucial global public health issue due to its consequences in child wellbeing. This study aims to account for nonlinear, spatial effect and to evaluate spatial variation in childhood co-morbidity at cluster level while controlling for important risk factors.

Methods
Using the 2016 Ethiopia DHS data, a multinomial logistic model was assessed by linear, nonlinear and random effects. The study also employed a spatial analysis tool which is Getis-Ord to identify hotspot areas of child comorbidity at the cluster level. The model with fixed, nonlinear and spatial effects identified as the best model to identify risk factors related to the coexistence of childhood illnesses.

Results
The results indicated that statistically significant high hotspots of comorbidity were found in Tigray and Oromia whereas low hotspots were found in Harari and Somali regions. Children between 10 and 15 months old were at high risk of co-morbidity in Ethiopia. Besides, our findings revealed that being male children, not-breastfed children, from households lack of toilet facility, children from households who use spring water, children born first, children from working mother, anemic children and children from uneducated mother are at high risk of multiple illnesses.

Conclusions
Comorbidity in childhood is not random in the country, with high hotspots of comorbidity in the regions of Tigray and Oromia. The results show a critical upshot for a combined morbidity control method for decreasing children’s illnesses and death. The maps remain novel to design appropriate healthcare interventions at regional as well as cluster level. Regions with high hotspots of child comorbidity should be considered for health healthcare interventions.
How do worry and clinical status impact working memory performance? An experimental investigation
Authors: Held Judith , Vîslă Andreea , Zinbarg Richard E. , Wolfer Christine , Flückiger Christoph 
Published: June 2020

Abstract
Background
Previous research has suggested that worry is negatively associated with working memory performance. However, it is unclear whether these findings would replicate across different worry levels and in individuals with anxiety and depressive disorders (i.e. clinical statuses).

Method
One-hundred-thirty-eight participants performed a two-block working memory task (150 trials per block). Based on participants` current clinical status, four groups were considered (generalised anxiety disorder group: n = 36; clinical group with another anxiety or mood disorders: n = 33; subclinical group: n = 27; control group: n = 42). Trait worry levels were collected from all of the participants. Working memory performance was measured as accuracy and reaction time.

Results
During the first block, higher worry scores were significantly associated with longer reaction times. Moreover, the generalised anxiety disorder group, clinical group, and subclinical groups demonstrated significantly longer reaction times compared to the control group in Block 1, when age was controlled for. From Block 1 to Block 2, all of the participants demonstrated a significant decrease in accuracy and reaction time, regardless of worry level or clinical status.

Conclusion
The results indicate that higher worry levels negatively impact WM processing efficiency. Moreover, when age was controlled for, we found participants` clinical status to be linked with WM impairments. The results highlight the relevance of investigating the impact of different worry levels on cognitive processes across clinical and non-clinical populations.
A psychometric approach to assessments of problematic use of online pornography and social networking sites based on the conceptualizations of internet gaming disorder
Authors: Mennig Manuel , Tennie Sophia , Barke Antonia 
Published: June 2020

Abstract
Background
The problematic use of online gaming, social networking sites (SNS) and online pornography (OP) is an evolving problem. Contrary to the problematic use of SNS and OP, Internet gaming disorder (IGD) was included in the new edition of the Diagnostic and statistical manual of mental disorders (DSM-5) as a condition for further study. The present study adapted the criteria for IGD to the problematic use of SNS and OP by modifying a validated questionnaire for IGD (Internet Gaming Disorder Questionnaire: IGDQ) and investigating the psychometric properties of the modified versions, SNSDQ and OPDQ.

Methods
Two online samples (SNS: n = 700, 25.6 ± 8.4 years, 76.4% female; OP: n = 700, 32.9 ± 12.6 years, 76.7% male) completed the SNSDQ/OPDQ, the Brief Symptom Inventory (BSI) and the short Internet Addiction Test (sIAT) and provided information on their SNS/OP use. Standard item and reliability analyses, exploratory and confirmatory factor analyses and correlations with the sIAT were calculated. Problematic and non-problematic users were compared.

Results
The internal consistencies were ωordinal = 0.89 (SNS) and ωordinal = 0.88 (OP). The exploratory factor analyses extracted one factor for both questionnaires. Confirmatory factor analyses confirmed the results. The SNSDQ/OPDQ scores correlated highly with the sIAT scores and moderately with SNS/OP usage time. Of the users, 3.4% (SNS) and 7.1% (OP) lay above the cutoff for problematic use. Problematic users had higher sIAT scores, used the applications for longer and experienced more psychological distress.

Conclusion
Overall, the results of the study indicate that the adaption of the IGD criteria is a promising approach for measuring problematic SNS/OP use.
Independent Housing and Support for non-homeless individuals with severe mental illness: randomised controlled trial vs. observational study – study protocol
Authors: Adamus Christine , Mötteli Sonja , Jäger Matthias , Richter Dirk 
Published: June 2020

AbstractBackgroundSocial inclusion is essential for an adequate rehabilitation process for people with serious mental illness (SMI). Various supported housing settings aim to promote housing competencies and social inclusion in service users. Nevertheless, there is a strong preference in service users for independent living. We aim to evaluate the effectiveness and efficiency of Independent Housing and Support (IHS) compared to institutionalised residential care settings and other treatment as usual conditions (RCS/TAU) in two cities in Switzerland.MethodsThis is a prospective multi-centre, four-arm, non-inferiority cohort study investigating the effectiveness and efficiency of IHS and RCS/TAU for people with SMI. Effectiveness will be measured by a standardised measure of social inclusion as primary outcome as well as by measures of functioning and well-being. Efficiency will be analysed on the basis of service usage and costs associated with the different housing settings. Participants will be consecutively recruited and subsequently enrolled between April 2019 and December 2020 and assessed at baseline and after six, twelve and after 24 months. At one study site, 56 participants will be randomly assigned to one of the conditions; the other study site will be conducted as an observational study investigating 112 admitted participants.DiscussionWhile the UN Convention of the Rights of People with Disabilities aims to promote the opportunity to choose one’s place of residence, the limited supply of alternative forms of housing does not guarantee genuine freedom of choice. Increased diversification and flexibility of housing support is essential. If IHS shows non-inferiority in terms of their effectiveness and efficiency, users should be allowed to choose their kind of housing support.Trial registrationClinicalTrials.gov:NCT03815604, December 04, 2019.
The influence of antidepressant and psychotherapy treatment adherence on future work leaves for patients with major depressive disorder
Authors: Gaspar Fraser W. , Wizner Kerri , Morrison Joshua , Dewa Carolyn S. 
Published: June 2020

Abstract
Background
Depression is the greatest contributor to worldwide disability. The purpose of this study was to understand the influence of antidepressant and psychotherapy treatment adherence on future work leaves for patients with major depressive disorder.

Methods
Patients with a newly diagnosed major depressive disorder (n = 26,256) were identified in IBM® Watson™ MarketScan® medical and disability claims databases. Antidepressant and psychotherapy adherence metrics were evaluated in the acute phase of treatment, defined as the 114 days following the depression diagnosis. Multiple variable Cox proportional hazards regression models evaluated the influence of antidepressant and/or psychotherapy adherence on future injury or illness work leaves.

Results
The majority of work leaves in the 2-year follow-up period occurred in the acute phase of treatment (71.2%). Among patients without a work leave in the acute phase and who received antidepressants and/or psychotherapy (n = 19,994), those who were adherent to antidepressant or psychotherapy treatment in the acute phase had a 16% (HR = 0.84, 95% CI = 0.77–0.91) reduced risk of a future work leave compared to treatment non-adherent patients. Patients who were non-adherent or adherent to antidepressant treatment had a 22% (HR = 1.22, 95% CI = 1.11–1.35) and 13% (HR = 1.13, 95% CI = 1.01–1.27) greater risk of a future work leave, respectively, than patients not receiving antidepressant treatment. Conversely, patients who were non-adherent or adherent to psychotherapy treatment had a 9% (HR = 0.91, 95% CI = 0.81–1.02) and 28% (HR = 0.72, 95% CI = 0.64–0.82) reduced risk of a future work leave, respectively, than patients not receiving psychotherapy treatment.

Conclusions
This analysis suggests that treatment adherence may reduce the likelihood of a future work leave for patients with newly diagnosed major depressive disorder. Psychotherapy appears more effective than antidepressants in reducing the risk of a future work leave.
Improving the health of workers with a low socioeconomic position: Intervention Mapping as a useful method for adaptation of the Participatory Approach
Authors: Schaap R. , Schaafsma F. G. , Bosma A. R. , Huysmans M. A. , Boot C. R. L. , Anema J. R. 
Published: June 2020

Abstract
Background
Workers with a low socioeconomic position (SEP) have a higher risk for health problems and premature dropout from the workforce. Unfavorable working conditions and unhealthy behaviors are more prevalent among this group of workers. The Participatory Approach (PA), is an evidence-based method to identify and solve problems at the workplace related to health issues of the worker. Health problems among workers with a low SEP are usually caused by an interplay of problems in and outside the workplace. To solve health problems on multiple life domains for workers with a low SEP we aim to adapt this approach to a broader perspective.

Methods
An Intervention Mapping (IM) protocol was used to adapt the PA. First, a needs assessment was conducted combining literature with data from interviews and focus groups with workers with a low SEP, employers and occupational health professionals (OHPs). Based on the needs assessment a program goal and performance and change objectives were defined, which resulted in methods and practical strategies to solve problems on multiple life domains. Based on the results of these steps, the PA was adapted and an implementation and evaluation plan were developed.

Results
The needs assessment confirmed that an interplay of problems on multiple life domains affect work functioning and health of workers with a low SEP. Moreover, they perceived difficulties with solving problems or used passive or avoidant coping styles towards these problems. The program goal is to identify and solve problems on multiple life domains that affect healthy functioning at work. To achieve this workers need support from OHPs to solve problems. The PA protocol and materials were adapted using theoretical concepts of the Self-Determination Theory (SDT), which resulted in the Grip on Health intervention. For OHPs a training was developed on how to implement this intervention in practice. The intervention will be evaluated in a pilot implementation study among workers with a low SEP and other relevant stakeholders.

Conclusions
IM was a valuable tool for the adaptation of the PA to better support workers with a low SEP to improve their work functioning and health from a broader perspective.
Presentation intervals and the impact of delay on breast cancer progression in a black African population
Authors: Agodirin Olayide , Olatoke Samuel , Rahman Ganiyu , Olaogun Julius , Olasehinde Olalekan , Katung Aba , Kolawole Oladapo , Ayandipo Omobolaji , Etonyeaku Amarachukwu , Habeeb Olufemi , Adeyeye Ademola , Agboola John , Akande Halimat , Oguntola Soliu , Akanbi Olusola , Fatudimu Oluwafemi 
Published: June 2020

Abstract
Background
The help-seeking interval and primary-care interval are points of delays in breast cancer presentation. To inform future intervention targeting early diagnosis of breast cancer, we described the contribution of each interval to the delay and the impact of delay on tumor progression.

Method
We conducted a multicentered survey from June 2017 to May 2018 hypothesizing that most patients visited the first healthcare provider within 60 days of tumor detection. Inferential statistics were by t-test, chi-square test, and Wilcoxon-Signed Rank test at p-value 0.05 or 95% confidence limits. Time-to-event was by survival method. Multivariate analysis was by logistic regression.

Results
Respondents were females between 24 and 95 years (n = 420). Most respondents visited FHP within 60 days of detecting symptoms (230 (60, 95% CI 53–63). Most had long primary-care (237 of 377 (64 95% CI 59–68) and detection-to-specialist (293 (73% (95% CI 68–77)) intervals. The primary care interval (median 106 days, IQR 13–337) was longer than the help-seeking interval (median 42 days, IQR 7–150) Wilcoxon signed-rank test p = 0.001. There was a strong correlation between the length of primary care interval and the detection-to-specialist interval (r = 0.9, 95% CI 0.88–0.92). Patronizing the hospital, receiving the correct advice, and having a big tumor (> 5 cm) were associated with short intervals.
Tumors were detected early, but most became advanced before arriving at the specialist clinic. The difference in tumor size between detection and arriving at a specialist clinic was 5.0 ± 4.9 cm (95% CI 4.0–5.0). The hazard of progressing from early to locally advanced disease was least in the first 30 days (3%). The hazard was 31% in 90 days.

Conclusion
Most respondents presented early to the first healthcare provider, but most arrived late at a specialist clinic. The primary care interval was longer than the help-seeking interval. Most tumors were early at detection but locally advanced before arriving in a specialist clinic. Interventions aiming to shorten the primary care interval will have the most impact on time to breast cancer presentation for specialist oncology care in Nigeria.
Association between parental separation and addictions in adolescents: results of a National Lebanese Study
Authors: Jabbour Nour , Abi Rached Vanessa , Haddad Chadia , Salameh Pascale , Sacre Hala , Hallit Rabih , Soufia Michel , Obeid Sahar , Hallit Souheil 
Published: June 2020

AbstractBackgroundSince divorce rates are on the rise in Lebanon (an increase of 101% between 2006 and 2017) and since previous international studies have shown a relationship between divorced parents and adolescents’ addiction to smoking, alcohol, and the internet, assessing the background of the Lebanese situation was deemed necessary. The study objective was to investigate the association between the divorce of parents and smoking, alcohol, and internet addiction among a representative sample of Lebanese adolescents.MethodsThis study was a cross-sectional, conducted between January and May 2019 using a proportionate random sample of schools from all Lebanese Mohafazat. Out of 2000 questionnaires distributed; 1810 (90.5%) were completed and collected back.ResultsThe mean age was 15.42 ± 1.14 years, with 53.3% females and 74.1% smokers. In addition, 11.9% [95% CI 0.104–0.134] of the adolescents had separated/divorced parents. Divorce in parents was significantly associated with higher alcohol use disorder (Beta = 8.035), higher cigarette dependence (Beta = 2.767) and a higher waterpipe dependence (Beta = 5.263) in adolescents. However, divorce in parents was not associated with internet addiction in adolescents.ConclusionParental divorce is correlated to higher alcohol and smoking, but not internet addiction among adolescents. Children whose parents are divorced should be subject to continuous follow-up by their parents and by a psychiatrist/psychologist in order not to develop an addiction that could potentially harm them.
Factors influencing sedentary behaviours after stroke: findings from qualitative observations and interviews with stroke survivors and their caregivers
Authors: Hall Jennifer , Morton Sarah , Fitzsimons Claire F. , Hall Jessica Faye , Corepal Rekesh , English Coralie , Forster Anne , Lawton Rebecca , Patel Anita , Mead Gillian , Clarke David J. 
Published: June 2020

Abstract
Background
Stroke survivors are more sedentary than healthy, age-matched controls, independent of functional capacity. Interventions are needed to encourage a reduction in overall sedentary time, and regular breaks in prolonged periods of sedentary behaviour. This study captured the views and experiences of stroke survivors and their caregivers related to sedentary behaviour after stroke, to inform the development of an intervention to reduce sedentary behaviour.

Methods
Mixed-methods qualitative study. Non-participant observations were completed in two stroke services, inclusive of inpatient and community settings in the United Kingdom. Semi-structured interviews were conducted with stroke survivors and their caregivers (if available) at six- or nine-months post-stroke. Underpinned by the capability, opportunity and motivation (COM-B) model of behaviour change, observational data (132 h) were analysed thematically and interview data (n = 31 stroke survivors, n = 12 caregivers) were analysed using the Framework approach.

Results
Observation participants differed in functional ability whereas stroke survivor interviewees were all ambulant. Six themes related to sedentary behaviour after stroke were generated: (1) sedentary behaviour levels and patterns after stroke; (2) the physical and social environment in the stroke service and in the home; (3) standing and movement capability after stroke; (4) emotion and motivation after stroke; (5) caregivers’ influence on, and role in influencing stroke survivors’ sedentary behaviour; and (6) intervening to reduce sedentary behaviour after stroke. Capability, opportunity and motivation were influenced by the impact of the stroke and caregivers’ inclination to support sedentary behaviour reduction. Stroke survivors reported being more sedentary than they were pre-stroke due to impaired balance and co-ordination, increased fatigue, and reduced confidence in mobilising. Caregivers inclination to support stroke survivors to reduce sedentary behaviour depended on factors including their willingness to withdraw from the caregiver role, and their perception of whether the stroke survivor would act on their encouragement.

Conclusions
Many stroke survivors indicate being open to reducing sedentary behaviour, with appropriate support from stroke service staff and caregivers. The findings from this study have contributed to an intervention development process using the Behaviour Change Wheel (BCW) approach to develop strategies to reduce sedentary behaviour after stroke.