bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dignity in nursing homes: A qualitative descriptive study of older adults’ experiences
Authors: Liu Yujia , Wang Yanjie , Li Xueying , Ma Li , Li Xiaohan 
Published: December 2024

Background With the deepening trend of global aging, the issue of dignity of older adults has received widespread attention. The research on the dignity of older adults in nursing homes in China has only just begun, and it is necessary to further explore the dignity experience of older adults in nursing homes. Research Objective To investigate the thematic features of dignity experiences of older adults residing in nursing homes in mainland China. Furthermore, it may serve as a starting point for further research that formulates intervention strategies. Research Design This is a qualitative descriptive study. Twenty older adults living in one of two private nursing homes between September and November 2022 were selected as participants. For each patient, we conducted semi-structured interviews, from which we extracted and assessed information using qualitative content analysis method. SRQR reporting guidelines were used. Ethical considerations ‘Ethical considerations' with information regarding ethical review, informed consent process and confidentiality. Results Five themes and eight subthemes emerged from the transcripts: (1) self-esteem (sense of self-worth and becoming a burden), (2) perceived value to society (being respected and belonging), (3) interpersonal relationships (relationships with others and respectful behavior toward others), (4) autonomy (control of daily life and participation in decision-making), and (5) acceptance and adaptation. Conclusion Dignity in older adults can be preserved by realizing self-worth, relieving the burden of self-perceived, promoting belonging, strengthening social ties, enhancing autonomy, and engaging in activities.
Knowledge, Attitude and Practice Regarding Nonsteroidal Anti-inflammatory Drugs and Corticosteroids Use Among Patients With Chronic Rheumatology Condition: A Cross-Sectional Study From Vietnam
Authors: Nguyen Hoa Thi Nhu , Nguyen Quan Manh , Ha Khuyen Thi Kim , Le Quynh Thi Nhu , Bui Binh Hai 
Published: December 2024

Objectives: To identify gaps in knowledge, attitude, and practice regarding the use of corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs) among patients with chronic rheumatic diseases. Methods: A cross-sectional study was conducted using a questionnaire including 12 knowledge questions, 13 attitude assessment statements, 5 barrier assessment statements, and 7 practical scenarios. We counted the total numbers of correct answers in knowledge, positive attitudes, barriers, and appropriate practices and fitted using Poisson regression to examine factors associated with knowledge, attitudes, and practices. Results: A total of 182 participants were included in this study, a large proportion of them had never heard of corticosteroids (34%) and NSAIDs (54%) before. Physicians were the source of information regarding corticosteroids and NSAIDs in 83% and 84% of the cases, respectively. Gastric ulcer was the most commonly recognized adverse drug reaction (ADR) for corticosteroids (64%) and the only ADR recognized for NSAIDs (95%), while only few patients were aware of life-threatening ADRs. The primary barrier, with a 40% agreement, was health care providers’ time constraints in providing medication information to patients. Our study findings did not reveal any gaps in practice, nor did they show any correlation between patients’ knowledge and attitudes to the practice of using corticosteroids and NSAIDs. Conclusion: There were gaps in knowledge, attitudes, and barriers to information access regarding NSAIDs and corticosteroid use in Vietnamese patients with chronic rheumatic diseases. Potential solutions include allocating more time for information exchange between physicians and patients, creating new channels to provide reliable information for patients, and emphasizing the important ADRs.
A comprehensive model of the theory of planned behavior in explaining tourists’ littering behavior in a natural tourism destination
Authors: Setiawan Budi , Munawar Aang , Lee Chui Ying , Romadona Mia Rahma 
Published: December 2024

Background The tourism industry’s growth and environmental impact have prompted the need for sustainable tourism models. With the rising popularity of natural ecotourism in Indonesia, there are concerns about waste generation and environmental damage caused by tourists’ behavior, particularly littering. Focus of the Article This study employs the Theory of Planned Behavior (TPB) to understand the psychological factors influencing tourists’ intentions not to litter at natural tourism destinations. Research Question/Hypotheses This study investigates what influences tourists’ intentions and behavior not to litter. It hypothesizes that experiential attitude, instrumental attitude, injunctive norm, descriptive norm, and perceived behavioral control significantly affect intentions and examines the relationship between perceived behavioral control, intention, and actual behavior. Importance to the Social Marketing Field This study contributes by differentiating two key aspects in the constructs’ attitude, experiential and instrumental, toward behavior and subjective norm of tourists’ intention not to litter. This study provides insights into tourists’ littering behavior, aiding social marketing strategies for sustainable tourism in natural destinations. Methods A study at the Bogor Botanical Garden in Indonesia surveyed 400 respondents. A combination of structural equation modeling (SEM), confirmatory factor analysis (CFA), discriminant validity analysis, and goodness-of-fit (GoF) tests was used for the data analysis using LISREL 8.8. Results The study findings confirm and support all hypotheses, demonstrating that both affective and instrumental attitudes significantly influence intentions not to litter. Additionally, injunctive and descriptive norms play crucial roles in shaping these intentions, while perceived behavioral control significantly impacts both intentions and actual behavior. Recommendations for Research or Practice These findings suggest emphasizing instrumental attitudes is crucial for designing social marketing strategies to promote responsible behavior and environmental sustainability in natural tourism destinations.
Early intervention with Ustekinumab is associated with higher rates of clinical and endoscopic remission in patients with Crohn’s disease
Authors: Tu Tong , Chen Mengqi , Li Manying , Liu Linxin , Chen Zihan , Lin Jianming , Chen Baili , He Yao , Chen Minhu , Zeng Zhirong , Zhuang Xiaojun 
Published: December 2024

Background: Early biologic intervention after diagnosis has shown improved clinical and endoscopic outcomes in patients with Crohn’s disease (CD), while very little is known about the effectiveness of early versus late administration of Ustekinumab (UST). Objectives: We aimed to compare early versus late UST use in managing CD and identify potential predictors associated with clinical and endoscopic outcomes. Design: This was a retrospective observational study. Methods: This study included patients with CD who started UST treatment from 2020 to 2023 in our center. Clinical and endoscopic outcomes were compared between early stage (⩽24 months) and later-stage (>24 months) groups at 6 months after starting UST therapy, and clinical predictors associated with any of the outcomes were assessed by logistic regression model. Furthermore, time-to-event analyses were applied to observe CD-related prognosis during follow-up. Results: This study included 237 patients with CD, with 44.3% ( n = 105) starting UST at the early stage and 55.7% ( n = 132) at the later stage. Patients with early UST use demonstrated significantly higher rates of clinical and endoscopic remissions as compared to those with late UST use at 6 months after treatment. After adjusting for disease-related factors using multivariate logistic regression analysis, active perianal disease and severe disease were negatively associated with clinical and endoscopic remission in both early and late UST use groups. Finally, early UST administration was associated with a more favorable long-term outcome in terms of overall hospitalization and treatment escalation during follow-up. Conclusion: Starting UST therapy in the early stage of CD especially within the first 6 months was associated with high rates of clinical and endoscopic remission and a low rate of CD-related complications.
Quality of life aspects of intermittent catheterization in neurogenic and non-neurogenic patients: a systematic review on heterogeneity in the measurements used
Authors: van Doorn Tess , Coolen Rosa L. , Groen Jan , Scheepe Jeroen R. , Blok Bertil F. M. 
Published: December 2024

Background: Clean intermittent catheterization (CIC) is the golden standard in patients with lower urinary tract dysfunction, leading to bladder emptying problems, due to neurogenic or non-neurogenic causes. CIC affects patient Quality of Life (QoL) both positively and negatively. Objectives: The aim of this systematic review is to determine which measurements are used to report on the QoL of patients who are on CIC in the currently available literature, to determine the overall QoL of patients who are on CIC and lastly, to determine whether QoL in patients who are on CIC is dependent on the underlying cause (neurogenic vs non-neurogenic). Design: This systematic review was conducted following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Data sources and methods: The Embase, Medline, Web of Science Core Collection, CINAHL, Google Scholar, and the Cochrane CENTRAL register of trials databases were systematically searched for relevant publications until March 2023. Results: A total of 4430 abstracts were screened and 43 studies were included. Studies were published between 1993 and 2022 and consisted of only neurogenic patients in 22 studies, the others included a mixed population. The included patient populations and the used measurements/tools were heterogeneous. There were 21 measurements/tools used to measure QoL, of which 3 were not validated. One questionnaire was developed to measure QoL in patients on CIC (intermittent self-catheterization questionnaire). Other measurements were suitable for general health-related QoL, to evaluate neurogenic bladder symptoms or incontinence oriented. Conclusion: The 43 included studies showed a great variety of used tools to measure QoL in patients on CIC due to neurogenic and non-neurogenic causes. Because of lacking uniformity of the measured aspects of QoL, the different included studies could not be compared and subgroup analysis was not performed. Recommendations for future research and practice are provided. Trial registration: This systematic review was registered and published beforehand at Prospero (CRD42020181777; https://www.crd.york.ac.uk/prospero ).
Behavioral Intervention Functions in Type 2 Diabetes Apps: Literature Review
Authors: Gabarron Elia , Randine Pietro , Årsand Eirik 
Published: December 2024

Background: As type 2 diabetes (T2D) is expected to increase, self-management becomes more crucial. Mobile apps are increasingly supporting self-management with tasks like blood glucose monitoring and medication management. Understanding the behavioral intervention functions used by diabetes apps today, is essential for improving future apps and systems for diabetes management. Objective: To analyze the behavioral intervention functions used in apps for managing T2D that integrate the three main elements: medication management, nutrition tracking, and blood glucose management. Methods: We conducted a literature review on T2D diabetes apps using SCOPUS, PubMed, and PsycINFO. After screening and removing duplicates, we analyzed app details and behavioral intervention functions based on the Behavior Change Wheel (BCW) framework. Results: We reviewed 644 scientific publications describing diabetes apps in clinical studies, narrowing it down to 20 studies, including 16 unique apps, after screening and exclusions. These studies were published between 2016 and 2024. Among the identified apps, automatic processing of medication data was reported in one study, while blood glucose data were automatically processed in 13 studies. Nutrition data processing varied. Most apps used Enablement and Persuasion as behavioral intervention functions, with Education and Training reported less frequently. Environmental Restructuring, Incentivization, Coercion, Restriction, and Modeling were not reported as being used in any studies. Conclusions: This review shows that while Enablement and Persuasion are common, other behavioral intervention functions seem to be underused or underreported. Future research could explore the potential of integrating additional behavioral intervention functions to enhance diabetes app efficacy and users’ self-management.
Is Strength the Main Risk Factor of Overuse Shoulder Injuries? A Cohort Study of 296 Amateur Overhead Athletes
Authors: Intelangelo Leonardo , Lassaga Ignacio , Gonzalo Elias , Mendoza Cristian , Manuel Ormazabal Juan , Roulet Iván , Bevacqua Nicolás , Jerez-Mayorga Daniel 
Published: December 2024

Background: Shoulder pain is one of the most common musculoskeletal complaints in overhead athletes. This study investigated the prevalence of the main risk factors and sex differences related to the development of shoulder pain in a cohort of amateur overhead athletes. Hypothesis: The external rotation/internal rotation (ER/IR) isometric strength ratio <0.75% is the most prevalent risk factor associated to overuse shoulder injuries in both sexes. Study Design: Cohort study. Level of Evidence: Level 3. Methods: A total of 296 (147 male and 149 female) amateur overhead athletes from handball, volleyball, and water polo participated in this cross-sectional study. Isometric strength, rotational range of motion, and scapular control were analyzed bilaterally. The measurements and motions were randomized between sides. Results: The ER/IR isometric strength ratio deficit among the disciplines was presented in 264 and 229 out of 296 athletes in the dominant and nondominant sides, respectively. Normalized isometric strength showed significant differences for dominant ( P < 0.01; ε² = 0.47) and nondominant IR ( P < 0.01; ε² = 0.60). No significant differences were observed between dominant ( P = 0.44; ε² = 0.05) and nondominant ER ( P = -0.24; ε² = 0.07). The prevalence of glenohumeral IR deficit (GIRD) ( P = 0.81) and total arc of motion differences (TAMD) ( P = 0.39) was low, with no difference between sexes. Male (16.3%) and female (12.1%) athletes had low rate of obvious scapular dyskinesis in their dominant shoulders. Conclusion: Muscle strength was the most prevalent risk factor. The ER/IR ratio imbalance was present in both sides, without sex differences. Risk factors such as scapular dyskinesis, GIRD, and TAMD were present in low percentages, without sex differences. Clinical Relevance: It is advisable to implement shoulder exercises to strengthen ER muscles to decrease differences between internal and external rotators and prevent injuries in overhead athletes.
Quality assessment and sexual health information analysis of mobile dating applications for men who have sex with men: A comprehensive evaluation using the User Version of the Mobile App Rating Scale
Authors: Zhou Xu , Wu Wei-Yi 
Published: December 2024

Objective Numerous mobile apps designed for men who have sex with men (MSM) are launched in recent years, potentially serving as crucial platforms for disseminating sexual health information and promoting healthy sexual behaviors. This study aimed to evaluate the quality of dating apps for MSM on the apps market and analyze the sexual health information they provide. Methods A systematic search was conducted in major apps platforms in China (including Apple, OPPO, Huawei, and Tencent) to identify current MSM dating apps. Apps fitting the inclusion criteria were independently assessed by two MSM users via using the User Version of Mobile App Rating Scale (uMARS), a user-assessed quality scale for mobile apps. Results Fifty mobile apps were identified and assessed, with an overall uMARS score of 3.64 ± 0.53 out of 5. More than half (29 out of 50) of apps included sexual health information. Conclusions The overall quality of the apps was satisfactory, whereas significant variations existed in sexual health information content and focus. It is recommended that app developers can further collaborate with public health experts to enhance the accuracy and utility of sexual health information on these platforms.
Metabolic Syndrome and Associated Factors Among People Living With HIV on Dolutegravir-Based Antiretroviral Therapy in Northern Tanzania
Authors: Mirai Tumaini E. , Kilonzo Kajiru G. , Sadiq Abid M. , Muhina Ibrahim Ali Ibrahim , Kyala Norman J. , Marandu Annette A. , Gharib Sarah K. , Costantine Andrea R. , Mkwizu Elifuraha W. , Howlett William P. , Shao Elichilia R. , Nyakunga Gissela B. , Akrabi Huda F. , Kshettry Vibhu R. , Maro Venance P. , Chamba Nyasatu G. , Lyamuya Furaha S. 
Published: December 2024

Purpose Chronic systemic inflammation from human immunodeficiency virus (HIV) may cause metabolic abnormalities in lipid metabolism. Additionally, the development of metabolic syndrome has been associated with specific anti-retroviral therapy, particularly dolutegravir. This study aimed to determine the prevalence and associated factors of metabolic syndrome among people living with HIV on dolutegravir-based anti-retroviral therapy. Methods This was an analytical cross-sectional study conducted between October 1, 2022, and March 31, 2023, among 312 people living with HIV. A structured questionnaire was used to collect socio-demographic and clinical characteristics including anthropometric indices and a blood pressure reading. A blood sample was collected to measure plasma glucose levels and serum lipid levels. The outcome being metabolic syndrome, odds ratios were evaluated using logistic regression analysis, and a P-value of <.05 was considered statistically significant. Results The prevalence of metabolic syndrome was 42.3%. Waist circumference (73%) and reduced high-density lipoprotein cholesterol (59.9%) were the most prevalent components. Factors associated with metabolic syndrome were patients aged 18–44 years (aOR: 3.10; 95% CI: 1.24–7.79; P = .016), female gender (aOR: 5.40; 95% CI: 2.07–14.13; P = .001), no physical activity (aOR: 4.00; 95% CI: 1.05–15.10; P = .042), and patients who earned >300 000 Tanzanian shillings per month (aOR: 2.15; 95% CI: 1.07–4.32; P = .032). Conclusion The prevalence of metabolic syndrome among patients on dolutegravir-based therapy is high. There is a need to adhere to routine screening of metabolic syndrome among people living with HIV on dolutegravir-based anti-retroviral therapy.
Assessment of the Biomechanical Effects of Hindfoot Alignment in Supination External Rotation Malleolar Fractures in a Cadaveric Model
Authors: Seidel Angela , Chidda Amal , Perez Virginie , Krause Fabian , Zderic Ivan , Gueorguiev Boyko , Lalonde Karl-Andre , Meulenkamp Brad 
Published: December 2024

Category: Trauma; Hindfoot Introduction/Purpose: Pressure distribution in the ankle joint is known to be dependent on various factors, including hindfoot alignment. We seek to evaluate how hindfoot alignment affects contact pressures in the ankle joint in the setting of supination external rotation (SER) type ankle fractures. Methods: SER fractures were created in 10 human cadaver lower extremity specimens, simulating progressive stages of injury: without fracture (step 0), SER fracture and intact deltoid ligament (step1), superficial deltoid ligament disruption (step2) and deep deltoid ligament disruption (step3). At each step, varus and valgus alignment was simulated by displacing the calcaneal tuberosity 7mm medial or lateral. Each limb was axially loaded following each osteotomy at a static load of 350N. The center of force (COF), contact area (CA), and peak contact pressure (PP) under load were measured, and x-rays of the ankle mortise were taken to analyze the medial clear space (MCS) and talar tilt (TT). Results: The COF (5.3mm, p=0.030) and the CA (-188.4 mm2, p=0.015) changed in step 3 in the valgus hindfoot alignment compared to baseline parameters, indicating the importance of deep deltoid ligament integrity in maintaining normal ankle joint contact stress in the valgus hindfoot. These changes were not seen in the setting of varus alignment (COF: 2,3mm, p=0.059; CA -121mm2, p=0.133). PP were found to not change significantly in either varus or valgus (varus:-4.9N, p=0.132;valgus:-4N, p =0.464). The MCS demonstrated widening in step 3 compared to step 2 (0.7mm, p=0.020) in both varus and valgus hindfoot. The TT increased significantly in step 3 in the valgus hindfoot (2.8°, p=0.020) compared to step 0. Conclusion: SERIV fractures with valgus hindfoot alignment showed significant changes in pressure distribution and radiographic parameters when compared to SER IV fractures with varus hindfoot alignment. Based on this cadaver modelling study, patients with SERIV fracture with varus hindfoot alignment and complete deltoid ligament lesion may not need fracture fixation, whereas those with valgus hindfoot alignment likely need fracture fixation. Results of the measurements of COF (center of force), CA (contact area), PP (peak contact pressure) MCS (medical clear space) in mm, TT (talar tilt) in degree in varus and valgus hindfoot alignment in the different steps. It shows the mean and (standard deviation)