bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self-management and blood pressure control in China: a community-based multicentre cross-sectional study
Authors: Qu Zhan , Parry Monica , Liu Fang , Wen Xiulin , Li Jieqiong , Zhang Yanan , Wang Duolao , Li Xiaomei 
Published: March 2019

ObjectivesThis study explored the relationship between self-management and blood pressure (BP) control in China.DesignA cross-sectional study.SettingEight community health centres from four cities in the Northeast (Shenyang), Northwest (Xi’an), Southwest (Chengdu) and South (Changsha) of China.ParticipantsA total of 873 adults with hypertension, including 360 men and 513 women. Hypertension was defined as systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mm Hg.Outcome measurementsBP control was the primary outcome variable. This was categorised as good control if individuals with hypertension reduced their BP to <140/90 mm Hg, otherwise, it was categorised as poor control. Secondary outcomes included self-management, defined as: (1) context or condition-specific factors or physical/social environments (eg, age, sex, marital status, education, personal income and health insurance) and (2) process or knowledge/beliefs, self-regulation skills/abilities and social facilitation (eg, treatment, diet, exercise and risk factor management). Data were analysed using logistic regression models using SPSS V.20.ResultsA total of 67.1% (n=586) participants had poor BP control. Limited outpatient care benefits in mainly rural residents (OR 2.26, 95% CI 1.06 to 4.81) and longer disease duration (OR 1.03, 95% CI 1.01 to 1.04) were associated with poor BP control. Self-management practices reduced the odds of having poor BP control (OR 0.98, 95% CI 0.97 to 0.99).ConclusionsThe individual and family self-management theory can serve as an effective theory for understanding the key contexts, processes and outcomes essential for BP control in China. Future research should evaluate the effect of a self-management intervention (eg, self-monitoring, medication adherence, regular and routine doctor visits, and social supports) for BP control in China using a multisite cluster randomised controlled trial. Sex and gender difference, cost and patient-reported outcomes should also be examined.
International multiphase mixed methods study protocol to develop a cross-cultural patient-reported outcome and experience measure for hand conditions (HAND-Q)
Authors: Sierakowski Kyra , Dean Nicola R , Pusic Andrea L , Cano Stefan J , Griffin Philip A , Bain Gregory I , Klassen Anne , Lalonde Donald 
Published: March 2019

Introductionpatient-reported outcome measures (PROMs) are instruments used to measure outcomes and experiences of healthcare from the patient perspective. The specific methodology used to develop a PROM should be communicated to establish the quality of the instrument. This mixed methods protocol describes the development of a cross-cultural, internationally applicable PROM for hand conditions, the HAND-Q.Methods and analysisThe multiphase approach used for this study has been previously used with the development of other PROMs by our team (eg, BODY-Q, BREAST-Q, CLEFT-Q, FACE-Q). In Phase I, we establish what important concepts matter to patients with hand conditions. A conceptual framework is developed from a systematic review of existing PROMs in the field and an extensive international qualitative study. Interpretive description is the qualitative approach used. Item generation is based on the qualitative data. The preliminary scales will be created for each theme identified in the conceptual framework. These scales will be refined by cognitive debriefing interviews with participants and expert input. Phase II involves a large international sample of patients with varied hand conditions completing the field-test version of the HAND-Q. The scales will be refined using the modern psychometric approach of Rasch Measurement Theory. Analysis will result in a shortened set of clinically meaningful and scientifically robust HAND-Q scales.Ethics and disseminationThis study is coordinated at Flinders University (Adelaide, Australia) where it has ethics board approval for phase I and phase II. Findings will be published in peer-reviewed journals and presented at local, national and international conferences.
Recognition and response to life-threatening situations among women with perinatal mental illness: a qualitative study
Authors: Easter Abigail , Howard Louise Michelle , Sandall Jane 
Published: March 2019

ObjectiveMental illness has persistently been found to be a leading cause of death during pregnancy and the year after birth (the perinatal period). This study aims to explore barriers to detection, response and escalation of mental health-related life-threatening near miss events among women with perinatal mental illness.DesignQualitative study.ParticipantsHealthcare professionals (HCP) working in psychiatry, maternity and primary care (n=15) across community and hospital maternity and perinatal services within the UK.MethodsIn-depth semistructured interviews were conducted with a range of healthcare professionals working with women during the perinatal period. An iterative process of inductive and deductive thematic analysis, informed by systems theories of healthcare and the Three Delays model, was employed to analyse the data.ResultsThree overarching themes were identified: recognition of severity, communication of risk and service provision and access to treatment. Differing perspectives of mental illness severity influenced how life-threatening situations among women with perinatal mental illness were described, recognised and communicated between teams. Under-resourced mental health service provision, particularly within emergency and specialist perinatal mental health services, unclear thresholds for escalating care and poor infrastructure for sharing information all contributed to delays in a timely response to crisis situations. Reluctance to prescribe medication or admit women to psychiatric hospital, stigma and missed appointments created further delays.ConclusionsResponse and escalation of care for life threatening near miss events among women with mental illness is strongly influenced by professional culture and understandings of mental illness embedded within different healthcare disciplines. Focusing on how differences in organisational and professional culture contribute to the recognition of severe mental illness and interdisciplinary communication may help facilitate clearer co-ordination between teams.
Does cigarette demand respond to price increases in Uganda? Price elasticity estimates using the Uganda National Panel Survey and Deaton’s method
Authors: Chelwa Grieve , van Walbeek Corne 
Published: March 2019

ObjectiveTo provide the first published estimates of the price elasticity of demand for cigarettes in Uganda and thereby contribute to growing the evidence base of the likely impact of excise taxes on cigarette consumption and tax revenues in Sub-Saharan Africa.MethodWe use a linear approximation of the Almost Ideal Demand System along with expenditure data from the Uganda National Panel Survey and exploit the fact that prices of cigarettes vary across geographical space in Uganda.ResultsWe find that cigarettes are price inelastic in Uganda with elasticity estimates ranging between −0.26 and −0.33. That is, we expect that cigarette demand will decline by between 2.6% and 3.3% every time cigarette prices rise by 10%. These elasticity estimates are in line with international evidence and are robust to outliers in the data.ConclusionOur estimates of the price elasticity of demand for cigarettes suggest that the authorities in Uganda can reduce cigarette consumption and simultaneously increase tax revenues by increasing the excise taxes on cigarettes.
End-of-life cost and its determinants for cancer patients in urban China: a population-based retrospective study
Authors: Li Zhong , Pan Zijing , Zhang Liang , He Ruibo , Jiang Shan , Xu Chengzhong , Lu Fangfang , Zhang Pei , Li Boyang 
Published: March 2019

ObjectiveThis study aimed to define the end-of-life (EOL) healthcare utilisation and its cost and determinants for cancer patients and to proactively inform related strategies in mainland China.DesignA population-based retrospective study.Setting and participantsData from 894 cancer patients were collected in urban Yichang, China from 01 July 2015 to 30 June 2017.Outcome measuresEmergency department (ED) visits, outpatient and inpatient hospitalisation services, intensive care unit (ICU) admission and total costs were used as the main outcomes.ResultsIn this study, 66.8% of the 894 patients were male, and the average age was 60.4 years. Among these patients, 37.6% died at home, and patients had an average of 4.86 outpatient services, 2.23 inpatient hospitalisation services and 1.44 ED visits. Additionally, 5.9% of these patients visited the ICU at least once. During the EOL periods, the costs in the last 6 months, 3 months, 1 month and 1 week were US$18 234, US$13 043, US$6349 and US$2085, respectively. The cost increased dramatically as death approached. The estimation results of generalised linear regression models showed that aggressive care substantially affected expenditure. Patients with Urban Employee Basic Medical Insurance spent more than those with Urban Resident-based Basic Medical Insurance or the New Rural Cooperative Medical Scheme. The place of death and the survival time are also risk factors for increased EOL cost.ConclusionThe findings suggested that the EOL cost for cancer patients is associated with aggressive care, insurance type and survival time. Timing palliative care is urgently needed to address ineffective and irrational healthcare utilisation and to reduce costs.Ethics and disseminationThis study was approved by the Ethics Committee of the Tongji Medical College, Huazhong University of Science and Technology (IORG No.: IORG0003571). All the data used in this study were de-identified.
Prelegalisation patterns and trends of cannabis use among Canadian youth: results from the COMPASS prospective cohort study
Authors: Zuckermann Alexandra M E , Battista Katelyn , de Groh Margaret , Jiang Ying , Leatherdale Scott T 
Published: March 2019

ObjectiveCanada federally legalised recreational cannabis use among adults in October 2018. The impact this will have on Canadian youth is cause for concern. The current study examined changes in youth cannabis use over the time prior to legalisation to explore the impact of the beginning federal discourse around legalisation during the 2016/2017 school year.DesignCOMPASS, a prospective cohort study based on annual self-administered questionnaires.SettingOntario and Alberta during the first 6 years of the COMPASS study (2012/2013 to 2017/2018).ParticipantsCanadian grade 9–12 students attending secondary schools participating in COMPASS. In total, 2 30 404 questionnaires were included in the analysis (Y1: 2012/2013, n=24 173; Y2: 2013/2014, n=45 298; Y3: 2014/2015, n=42 355, Y4: 2015/2016, n=40 436; Y5: 2016/2017, n=37 060; Y6: 2017/2018, n=34 897).Primary and secondary outcome measuresLifetime cannabis use, past-year cannabis use, weekly cannabis use, ease of access to cannabis and age at first cannabis use.ResultsCannabis never-use decreased between Y5 and Y6. Changes in age at first cannabis use mirrored this trend, with male students consistently starting younger. Cannabis access rates increased from Y4, mainly led by female students. Lifetime and past-year use rates were lowest in Y4 then increased in Y5 and Y6 due to a rise in the occasional use more common among female students, who reported use increases first. Non-white students were more likely use cannabis, with black and Aboriginal students the only two groups consistently reporting more weekly than occasional use, though with opposing trajectories. Overall, Aboriginal students had the highest odds of reporting lifetime, past-year and weekly use among the demographic groups examined.ConclusionAfter a steady decrease in patterns of cannabis among youth over several years, it appears that there has been a gradual increase in cannabis use among youth following the start of discourse around cannabis legalisation, with some populations of youth being at greater risk.
Prevalence and characteristics of psoriasis in Denmark: findings from the Danish skin cohort
Authors: Egeberg Alexander , Andersen Yuki M F , Thyssen Jacob P 
Published: March 2019

BackgroundWide-ranging psoriasis prevalence estimates have been reported, possibly due to methodological differences.ObjectivesTo assess the prevalence of psoriasis in Denmark and to validate the use of questionnaire-based data to identify patients with psoriasis.MethodsWe used data from the Danish Skin Cohort, a prospective cohort comprising general population adults, as well as patients with dermatologist-verified psoriasis and atopic dermatitis, respectively. The general population cohort was interviewed to assess the psoriasis prevalence in Denmark, and validation of the questions was performed.ResultsFrom 3490 general population participants, 7.9% (n=275) were found to have self-reported psoriasis. Of these, 221 (prevalence 6.3%) had their disease diagnosed by a physician (the dermatologist-diagnosed prevalence was 4.3%), whereas 54 (prevalence 1.6%) were not diagnosed by a physician. A total of 176 (5%) had active psoriasis within the last 12 months. More than half of patients had at least one disease flare in the last 12 months, and 44.4% of patients with psoriasis had at least one family member with psoriasis, whereas this was only the case for 13.7% of non-psoriasis individuals. Validation of the psoriasis diagnosis yielded a high sensitivity and specificity, with little incremental value of limiting diagnoses to those diagnosed by a physician.ConclusionThe lifetime-prevalence of self-reported psoriasis was found to be 7.9%, whereas the 1-year prevalence (ie, currently active psoriasis) was 5.0%. If used appropriately, questionnaire-based data may accurately identify patients with psoriasis.
Systemic pharmacokinetic/pharmacodynamic analysis of intravitreal aflibercept injection in patients with retinal diseases
Authors: Kaiser Peter K , Kodjikian Laurent , Korobelnik Jean-Francois , Winkler Julia , Torri Albert , Zeitz Oliver , Vitti Robert , Ahlers Cristiane , Zimmermann Torsten , Dicioccio A Thomas , Höchel Joachim 
Published: March 2019

ObjectiveExplore relationships between systemic exposure to intravitreal aflibercept injection (IAI) and systemic pharmacodynamic effects via post hoc analyses of clinical trials of IAI for neovascular age-related macular degeneration (nAMD) or diabetic macular oedema (DME).Methods and analysisAdults from VGFT-OD-0702.PK (n=6), VGFT-OD-0512 (n= 5), VIEW 2 (n=1204) and VIVID-DME (n=404) studies were included. Validated ELISAs were used to measure concentrations of free and bound aflibercept (reported as adjusted bound) in plasma at predefined time points in each study. Non-compartmental analysis of concentration–time data was obtained with dense sampling in VGFT-OD-0702.PK and VGFT-OD-0512. Sparse sampling was used in VIEW 2 and VIVID-DME. Blood pressure or intrarenal function changes were also investigated.ResultsFollowing intravitreal administration, free aflibercept plasma concentrations quickly decreased once maximum concentrations were achieved at 1–3 days postdose; pharmacologically inactive adjusted bound aflibercept concentrations increased over a longer period and reached plateau 7 days postdose. Ratios of free and adjusted bound aflibercept decreased over time. There were no meaningful changes in systolic/diastolic blood pressure over the duration of each study at all systemic aflibercept exposure levels. For all treatment arms in VIEW 2, there was no clinically relevant change in mean intrarenal function from baseline at week 52. Overall, incidence of systemic adverse events in VIEW 2 and VIVID-DME was low and consistent with the known safety profile of IAI.ConclusionIAI administration was not associated with systemic effects in patients with nAMD or DME as measured by blood pressure or intrarenal function, two known pharmacologically relevant effects of anti-vascular endothelial growth factor.
Prevalence and correlates of diabetes and its comorbidities in four Gulf Cooperation Council countries: evidence from the World Health Survey Plus
Authors: Morgan Sara Afshar , Ali Mohamed Mahmoud , Channon Andrew Amos , Al-Sabahi Sultana , Al Suwaidi Huda , Osman Nabil , Al Salameen Mostafa , Khoja Tawfik 
Published: March 2019

BackgroundThe Gulf Cooperation Council countries are witnessing unprecedented changes due to fast economic development and population growth. The aims of this study were twofold: first, to estimate the prevalence of diabetes and its comorbidities; second, to examine the association of sociodemographic risk factors and healthcare service utilisation with diabetes.MethodsData from the World Health Survey Plus (WHS+) from Kuwait, Oman, Saudi Arabia and the United Arab Emirates were used. The WHS+ is a nationally representative household survey of the adult population, conducted between 2008 and 2009. Both logistic regression and zero-inflated Poisson models were applied to examine the associations of risk factors, comorbidity and treatment with self-reported diabetes.ResultsThe highest level of diabetes was observed in Kuwait, with 40.8% among the oldest age group. High body mass index, older age and low education were all associated with diabetes in all settings. High levels of comorbidity existed within the diabetic population. Over 50% of diabetics in all countries reported having at least one chronic condition. In Kuwait and Saudi Arabia, one in five diabetics reported having two or more comorbidities. Treatment prevalence was above 80% across all sociodemographic categories.ConclusionThe burden of diabetes, although high, is not uniform across populations in the four Gulf countries. Differential exposure to risk, such as unhealthy lifestyles, may be creating a disadvantage for certain populations and influencing the co-occurrence of chronic conditions. In response, a multifaceted and patient-centred approach is needed at all levels of healthcare to control and prevent non-communicable diseases.
Cross-national comparison of two general population job exposure matrices for physical work exposures
Authors: Evanoff Bradley , Yung Marcus , Buckner-Petty Skye , Baca Matthew , Andersen Johan Hviid , Roquelaure Yves , Descatha Alexis , Dale Ann Marie 
Published: March 2019

ObjectivesJob exposure matrices (JEMs) are increasingly used to estimate physical workplace exposures. We conducted a cross-national comparison of exposure estimates from two general population JEMs to aid the interpretation of exposure–outcome associations across countries and to explore the feasibility of cross-national application of JEMs to provide workplace physical exposure estimates.MethodsWe compared physical exposure estimates from two general population JEMs created from the FrenchCohorte des consultants des Centres d’examens de santé study (27 exposure variables) and the American Occupational Information Network database (21 exposure variables). These exposure variables were related to physical demands or ergonomic risk factors for musculoskeletal disorders. We used a crosswalk to match French Profession et Catégorie Sociale job codes with American Standard Occupational Classification job codes and calculated Spearman’s correlations and Cohen’s kappa values for exposure variable pairs between these French and American JEMs. We defined a priori 50 matched French and American JEM variable pairs that measured similar exposures.ResultsAll variable pairs measuring similar physical exposures demonstrated positive correlations. Among the 50 matched pairs, 33 showed high correlation (ρ≥0.70) and 46 showed at least moderate agreement (κ≥0.41). Exposures expected to be mutually exclusive (manual work vs office work) showed strongly negative correlations.ConclusionsFrench and American general population physical exposure JEMs were related, sharing moderate to high association and moderate to substantial agreement between the majority of variable pairs measuring similar exposures. These findings will inform cross-national comparisons of study results and support some uses of general population JEMs outside their countries of origin.
Automatic Lip Reading Using Convolution Neural Network and Bidirectional Long Short-term Memory
Authors: Lu Yuanyao , Yan Jie 
Published: March 2019

Traditional automatic lip-reading systems generally consist of two stages: feature extraction and recognition, while the handcrafted features are empirical and cannot learn the relevance of lip movement sequence sufficiently. Recently, deep learning approaches have attracted increasing attention, especially the significant improvements of convolution neural network (CNN) applied to image classification and long short-term memory (LSTM) used in speech recognition, video processing and text analysis. In this paper, we propose a hybrid neural network architecture, which integrates CNN and bidirectional LSTM (BiLSTM) for lip reading. First, we extract key frames from each isolated video clip and use five key points to locate mouth region. Then, features are extracted from raw mouth images using an eight-layer CNN. The extracted features have the characteristics of stronger robustness and fault-tolerant capability. Finally, we use BiLSTM to capture the correlation of sequential information among frame features in two directions and the softmax function to predict final recognition result. The proposed method is capable of extracting local features through convolution operations and finding hidden correlation in temporal information from lip image sequences. The evaluation results of lip-reading recognition experiments demonstrate that our proposed method outperforms conventional approaches such as active contour model (ACM) and hidden Markov model (HMM).
Welcome to the Europe region special section
Authors: Fatourou Panagiota , Hankin Chris 
Published: March 2019

The computing community throughout the European Region is championing many enterprising industry, academic, and government initiatives to further develop the field and ensure a workforce prepared to take it on.
The articles in this special section, written by some of the leading voices in the region, tell stories of informatics and ICT innovations, Web science in Europe, the EuroHPC, future research directions planned for this vibrant part of the world, and much more.