bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of the Healthy Start-Départ Santé approach on physical activity, healthy eating and fundamental movement skills of preschoolers attending childcare centres: A randomized controlled trial
Authors: Leis Anne , Ward Stéphanie , Vatanparast Hassan , Humbert Louise , Chow Amanda Froehlich , Muhajarine Nazeem , Engler-Stringer Rachel , Bélanger Mathieu 
Published: August 2019

Abstract
Background

Since young children spend approximately 30 hours per week in early childcare centres (ECC), this setting is ideal to foster healthy behaviors. This study aimed to assess the effectiveness of the Healthy Start-Départ Santé (HSDS) randomized controlled trial in increasing physical activity (PA) levels and improving healthy eating and fundamental movement skills in preschoolers attending ECC.

Methods

Sixty-one ECC were randomly selected and allocated to either the usual practice (n=30; n=433 children) or intervention group (n=31; n=464 children). The HSDS intervention group was provided a 3-hour on-site training for childcare educators which aimed to increase their knowledge and self-efficacy in promoting healthy eating, PA and development of fundamental movement skills in preschoolers. PA was measured during childcare hours for five consecutive days using the Actical accelerometer. Preschoolers’ fundamental movement skills were assessed using the standard TGMD-II protocol and POMP scores. Food intake was evaluated using digital photography-assisted weighted plate waste at lunch, over two consecutive days. All data were collected prior to the HSDS intervention and again 9 months later. Mixed-effect models were used to analyse the effectiveness of the HSDS intervention on all outcome measures.

Results

Total number of children who provided valid data at baseline and endpoint for PA, food intake and fundamental movement skills were 259, 670 and 492, respectively. Children in the HSDS intervention group had, on average, a 3.33 greater point increase in their locomotor motor skills scores than children in the control group (β=3.33, p=0.009). No significant differences in effects were observed for object control, PA and food intake. However, results demonstrated a marginal increase in portions of fruits and vegetables served in the intervention group compared to control group (β=0.06, p=0.05).

Conclusion

Locomotor skills showed a significant improvement in the intervention group compared to the control one. Although modest beneficial effects of HSDS were found, most outcome indicators progressed in a direction favouring the HSDS intervention compared to the usual practice group.
Prevalence and associated factors of chronic kidney disease among adult hypertensive patients in Tigray teaching hospitals: A cross-sectional study
Authors: Bahrey Degena , Gebremedhn Gebreamlak , Mariye Teklewoini , Girmay Alem , Aberhe Woldu , Hika Assefa , Teklay Girmay , Tasew Hagos , Zeru Teklay , Gerensea Hadgu , Demoz Gebre Teklemariam 
Published: August 2019

Abstract
Objective: The aim of this study was to assess the prevalence of chronic kidney disease and to identify associated factors of chronic kidney disease among hypertensive patients. A cross-sectional study was conducted among selected five hundred seventy eight hypertensive patients. Data were collected using face to face interviewing questionnaires and from medical chart review. Binary logistic regression analyses were performed and analyzed using SPSS version 23.0.
Result: Of the total 578 hypertensive patients the prevalence of chronic kidney disease was found to be 128 ( 22.1%). Of these hypertensive patients, patients with uncontrolled blood pressure, overweight/obesity, dyslipidemia and diabetic mellitus, 43.3%, 33.7% , 27.3 % and 28.2 respectively. After adjustment, the independent variables the significant associated factors of chronic kidney disease among hypertensive patients were age [AOR (95% CI = 1.43 (1.07-1.81) ] , uncontrolled hypertension 4.434 [AOR ( 95%CI =9.45 (1.34, 14.73) ] , overweight/obese [AOR ( 95%CI =7.422 ( 2.72, 20.28) ] , dyslipidemia [AOR (95% CI) = 13.749 (5.69, 33.215)], diabetic mellitus [AOR (95% CI) = 2.137 (1.07, 4.26)]. In conclusion, the prevalence of chronic kidney disease was considerably high. The major associated factors of chronic kidney disease were age, uncontrolled hypertension, overweight/obese, diabetic mellitus and dyslipidemia.
Mental health among immigrants in Germany – the impact of self-attribution and attribution by others as an immigrant
Authors: Nesterko Yuriy , Friedrich Michael , Brähler Elmar , Hinz Andreas , Glaesmer Heide 
Published: August 2019

Abstract
Background In Germany, the term ‘migration background' has been established to differentiate between immigrants and natives. In the present study post-traumatic stress disorder (PTSD), anxiety and depression were analysed in immigrant populations in Germany by considering self-attribution as well as attribution by others on one’s own ‘migration background’. Methods In a population-based survey (N = 2317), socio-demographic characteristics, migration background (official statistics definition vs. self-attribution as well as the anticipated attribution by others), PTSD (PCL-5), symptoms of anxiety and depression (PHQ-4) were assessed. Logistic regression models were applied to predict mental health outcomes by considering socio-demographic and immigration-related factors. Results A total of 10.7% of the respondents (N = 248) had a ‘migration background’. Immigrants of the 2nd generation compared to 1st generation immigrants are less likely to see themselves as immigrants. Attribution as an immigrant (self and/or by others) was found as significant predictor for PTSD and depression, but not anxiety. Conclusions It seems useful to focus on immigration-related factors considering subjective perspectives and not only comparing immigrants and natives using a federal statistics definition. Our findings suggest that research on the association between immigration-related factors such as attribution as an immigrant and mental health outcomes might be a promising approach to better identify subgroups at higher risk of mental distress.
Diagnostic efficacy of double-balloon enteroscopy in patients with suspected isolated small bowel Crohn’s disease
Authors: Huang Zihan , Liu Xiang , Yang Fei , Wang Guoxin , Ge Nan , Wang Sheng , Guo Jintao , Sun Siyu 
Published: August 2019

Abstract
Background

Due to the development of double-balloon enteroscopy and video capsule endoscopy, direct visualization of the entire small intestinal mucosa has been achieved. Compared with video capsule endoscopy, double-balloon enteroscopy has the advantages of biopsy samples and endoscopic treatment. The aim of this research was to explore the value of double-balloon enteroscopy for isolated small bowel Crohn’s disease.

Methods

This study included patients with suspected isolated small bowel Crohn’s disease who were hospitalized in Shengjing Hospital from April 2014 to June 2018. We included patients with symptoms of chronic diarrhea, abdominal pain, abdominal mass, perianal lesions, and systemic symptoms including weight loss, fever, and anemia after excluding infection factors. Patients with purely colonic Crohn’s disease were excluded from this cohort. Patients with suspected isolated small bowel Crohn’s disease underwent double-balloon enteroscopy.

Results

With clear endoscopic images and histological support, 14 patients were diagnosed with isolated small bowel Crohn’s disease. Three patients who were diagnosed with small bowel Crohn’s disease by double-balloon enteroscopy showed improved morphological features of the small bowel when the double-balloon enteroscopy was reviewed after medical treatment.

Conclusions

The diagnosis of Crohn’s disease is usually based on the patient’s clinical history and related examinations. Double-balloon enteroscopy provides imaging support and histological support for the definitive diagnosis of Crohn’s disease and can be considered as a useful tool to evaluate the therapeutic efficacy in the future.
Predictors of Anaemia prevalence among pregnant women in urban Ghana: a cross-sectional study
Authors: Akowuah Jones Asafo , Owusu-Addo Ebenezer , Antwiwaa Ama Opuni 
Published: August 2019

Abstract
Background Anaemia during pregnancy is a major public health concern. Despite its wide scope and adverse effects including increased maternal and perinatal morbidity and mortality, and long-term adverse effects in the new born, extensive interventions using upstream approaches to public health have largely not been implemented. This study investigated the prevalence and associated factors of anaemia in pregnant women in four health facilities in the Kwabre East Municipality of Ghana.Method A cross-sectional survey with a two-stage sampling technique was conducted on 220 pregnant women who attended antenatal care at the selected health facilities. Interview-based structured questionnaires were used. Bivariate and multivariate logistic regression were used to identify predictors.Results The prevalence of anaemia was 11.4%. Few women (25) were anaemic and morphologically, 14 had normocytic normochromic (56%) anemia and 9 had Microcytic hypochromic (36) anaemia. Iron deficiency was reported in 19 (8.6%) pregnant women. Iron sulphate intake (AOR [95% CI] = 3.16 [1.15, 7.37], ANC follow-up during pregnancy (AOR [95% CI] = 3.07 [1.59, 7.99], household size of ≥ 5 (AOR [95% CI] = 3.58 [1.75, 9.52], folic acid intake (AOR [95% CI] = 5.29 [2.65, 12.39] and the period in pregnancy AOR [95% CI]= ≥36 weeks 3.2 (1.3–4.5) were independent predictors of anemia.Conclusion Though anaemia prevalence has been low in urban areas as previously reported, collaborated healthcare measures that aim at eradicating the menace are encouraged. Maternal health care interventions including the administration of folic acid, regular iron sulphate intake and intensive education on early ANC are recommended.
Pain talk in palliative care: A qualitative analysis
Authors: Wu Yijin 
Published: August 2019

Abstract
Aim

Using the method of Conversation Analysis (CA), this study aims to demonstrate how the palliative care provider uses different types of interactional practices to address patient’s pain concerns.

Background

The delivery of palliative care services could be facilitated through effective communication. The method of conversation analysis is effective in improving communication skills. Conversation analysis, used in other healthcare settings, also is a useful way to explore the interactional details between palliative care providers and terminally ill patients.

Method

The data showed in this study are obtained from 2 videotapes of provider-patient interaction in palliative care settings. The videos and the initial transcript of them are collected from the Alexander St website http://ctiv.alexanderstreet.com, an educational resource presenting a large collection of psycho-therapeutic videos. The data is analyzed using the method of conversation analysis.

Results

In this study, an illustrative analysis is demonstrated to show the potential of conversation analysis for research on pain talk in palliative care. It has been shown that conversation analysis could contribute to unfolding the interactional details regarding “pain talk” in palliative care settings. Specifically, CA could provide a detailed a description and interpretation of the conversational practices used to construct palliative care provider participation in delivering pain talk. In addition, CA could also demonstrate the interactional resources by which patients disclose their experiences of physical and spiritual pain to the palliative care provider and the way how the palliative care provider responds to patient’s problematic experiences.

Conclusion

This study identifies five types of interactional resources which are used to deal with patient’s pain concerns in palliative care setting. A conversation analytical study of pain talk in palliative care could provide a turn-by-turn description of how the palliative care provider communicates with the terminally ill patient in terms of pain concerns. The findings in this study could inform how the palliative care provider initiates, delivers and develops a pain talk with the terminally ill patient effectively.
Nurses’ knowledge towards pressure ulcer and its associated factors at Hawassa University Comprehensive Specialized Hospital Hawassa, Ethiopia, 2018.
Authors: Muhammed Ezedin Molla , Bifftu Berhanu Boru , Temachu Yemataw Zewdu , Walle Tarkie Abebe 
Published: August 2019

Abstract
Introduction

Pressure ulcer is largely avoidable, but its prevalence rate increased more than 80% in a thirteen years study. Nurses have a great position to advance best practice towards prevention of pressure ulcer. Therefore they should be knowledgeable of the signs and symptoms of pressure ulcers, and preventive strategies to reduce its incidence, but there is limited evidence on nurses’ knowledge and its associated factors to prevent pressure ulcer in Ethiopia.Objectives

The aim of the study was to assess Nurses’ knowledge and associated factors towards pressure ulcer prevention at Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia, 2018.Methods

A hospital-based cross-sectional study was conducted from March 25 – April 23/ 2018. A total of 356 nurses were selected by stratification with simple random sampling technique. Pretested structured questionnaire with closed and open-ended questions was used to collect data. Frequency distribution and percentage were computed to describe each variable. Bivariate and multivariable logistic regression with 95% confidence interval was also carried out to see the effect of each independent variable on the dependent variable and declared statistical significant association with P< 0.05.Result

Mean knowledge score of nurses was 25.22 out of 41 item questions. Fifty-two point five percent of nurses score above the mean. Males [AOR=0.44, 95% CI (0.26 – 0.73)], working a maximum of eight hours [AOR= 3.57, 95% CI (1.48 – 8.61), not having training [(AOR= 2.31, 95% CI (1.14 – 4.61)], Low salary [AOR= 3.47, 95% CI (1.03 – 11.67)] were significantly associated with inadequate knowledge.Conclusion

Generally a nurse's knowledge of pressure ulcer was inadequate. Being female, working less than or equal to eight hours, not having the training and low working salary are contributors to a low level of knowledge for pressure ulcer.
Burden of Relapsing-Remitting Multiple Sclerosis on Workers in the US: A Cross-sectional Analysis of Survey Data
Authors: Nicholas Jacqueline , Electricwala Batul , Lee Lulu K. , Johnson Kristen M 
Published: August 2019

Abstract
Background: MS is prevalent among working age individuals (20-60 years), leading to high burden on work productivity. Few data are available about the absenteeism and presenteeism in employed individuals with MS in comparison to non-MS personnel. This study aimed to quantify the burden of illness of employed US adults with relapsing-remitting multiple sclerosis (RRMS) and examine burden by levels of work impairment.

Methods: A retrospective cross-sectional analysis was conducted using patient-reported responses from the US National Health and Wellness Survey (NHWS). Data from NHWS 2015-2016 were analyzed from 196 employed RRMS respondents who were matched 1:4 to employed respondents without multiple sclerosis (MS) based on demographic and general health characteristics. Demographic and general health characteristics for employed RRMS individuals were analyzed by levels of work impairment (none, 1-30%; 31-68%; 69-100%). Work productivity (absenteeism, presenteeism, and work impairment), decrements in health-related quality of life (HRQoL) (short form-36, EQ-5D), and healthcare resource utilization (HCRU) were compared to determine the burden of RRMS.

Results: After propensity score matching, the levels of absenteeism and presenteeism were 2 and 1.8 times higher in the employed RRMS population than the employed non-MS population, respectively (P<0.001 for both). HRQoL was significantly lower in employed respondents with RRMS than those without MS (P<0.001 for all). Employed respondents with RRMS had significantly more HCRU over 6 months compared to those without MS (P<0.001). Furthermore, among employed RRMS respondents, greater levels of impairment were associated with increasing disease severity, greater healthcare resource use, fatigue, and cognitive impairment and inversely associated with mental and physical HRQoL (P<0.0001 for all).

Conclusions: Among employed individuals, respondents with RRMS had lower, work productivity, HRQoL, and higher HCRU as compared with those without MS. Given the large impact RRMS has on work impairment, a need exists to manage individuals on therapies that improve HRQoL, reduce symptoms, and improve their ability to perform in the workforce.
The reliability and validity of a slightly optimized Chinese version simplified modified Rankin scale questionnaire
Authors: yuan Junliang , wang yunxiao , Hu Wenli , Bruno Askiel 
Published: August 2019

Abstract
Background: The slightly optimized English version simplified modified Rankin scale questionnaire smRSq(2011) was shown to be reliable, valid, and useful in scoring the modified Rankin scale (mRS) after stroke. Our aim was to assess the inter-rater reliability and validity of a novel Chinese version smRSq(2011).
Methods: The English version smRSq(2011) was translated into Chinese by a standard process. We recruited 300 consecutive hospitalized ischemic stroke patients in the department of neurology, Beijing Chaoyang Hospital. Six randomly paired raters scored the conventional mRS, the novel Chinese version smRSq(2011), the National Institutes of Health Stroke Scale (NIHSS), and the Barthel index (BI) in-person. Inter-rater reliability and validity were assessed.
Results: Among the 300 ischemic stroke patients, mean age was 64.9±12.1 years, and 220 (73%) were male. For inter-rater reliability of the smRSq(2011), the percent agreement among raters was 87%, the kappa (κ) was 0.84 (95% CI, 0.79-0.88), and the weighted kappa (κw) was 0.96 (95% CI, 0.95-0.98). The percent agreement between the conventional mRS and the smRSq(2011) was 63%, κ=0.57 (95% CI, 0.50-0.63) and κw=0.93 (95% CI, 0.91-0.95). In construct validity testing, the Spearman’s correlation coefficients comparing the smRSq(2011) to the NIHSS and the BI were 0.83 (P<0.001) and 0.86 (P<0.001), respectively.
Conclusions: Our results suggest usefulness of the novel Chinese version smRSq(2011) in scoring the mRS in Chinese stroke patients. Further validation in other clinical settings, including in communities and by remote methods in China is warranted.
Self-medication with antibiotics in WHO Eastern Mediterranean Region: A Systematic Review and Meta-analysis
Authors: Shayan Shah Jahan , Negarandeh Reza , Nazari Rajab , Kiwanuka Frank , Rad Sanaz Akhavan 
Published: August 2019

Abstract
Objective This review sought to assess the prevalence of antibiotic self-medication, common antibiotics and reasons for self-medication in the Eastern Mediterranean Region of World Health Organization (EMRWHO).Results We report on data from 45 articles and 29606 participants in this review. The overall prevalence of self-medication with antibiotics in EMRWHO was 49.7% (95% CI 49.2% – 50.2%). Yemen has the highest rate with a rate of 69.6% (95% CI 68.1% - 71.1%), whilst Kuwait has the lowest rate with a prevalence of 27.5%. The most common illnesses implicated in antibiotic self-medication were upper-respiratory infections and the most common antibiotic was Amoxicillin-Clavulanic acid. The commonest reasons for antibiotic self-medication include: saving time and money. Pharmacies pointed out as a most common source of obtaining antibiotics for self-medication.
Just Say “No”: Can Dentists Refuse Care on the Basis of Finances? A Survey Using an Ethical Vignette in an Iranian Dental School
Authors: Kazemian Ali , Fayyazi Mahsa , Shafiee Shahrzad 
Published: August 2019

Abstract
Background: Many dental procedures seem to be too expensive for many people. Responding to the requests of patients for fee reduction could be considered a common ethical issue of dental practice. The aim of this study was to evaluate dental students and tutors’ ethical attitude towards fee reduction at dental offices. Method: Our study was a questionnaire-based survey, which examined the ethical attitudes of students and tutors of an Iranian Dental School. The questionnaire included a vignette about an ethical dilemma at a dental office. Different ethical approaches, i.e. duty-based, virtue-oriented and consequentialist arguments, for or against fee reduction at dental office were suggested. Respondents were asked to rank those ethical options. Data was entered and analyzed in SPSS 16.0. 121 dental students and 36 faculty members (dental specialists) participated in this study. Result: Our findings revealed that the majority of dental students and tutors (68%) are in favor of making a reduction when facing an imagined request at dental office, using either virtue-oriented (54%) or consequentialist (14%) arguments. The difference between rankings of four options was statistically significant, while no statistically significant difference exists neither between male and female respondents, nor students and tutors. Conclusion: This case study provides a basis for fruitful discussions in ethics courses for dental students. Our study suggests that financial issues should be considered as a part of ethical training in the dental students’ curriculum.
An interprofessional cohort analysis of student interest in medical ethics education: A survey-based quantitative study
Authors: DeFoor Mikalyn T , Chung Yunmi , Zadinsky Julie K , Dowling Jeffrey , II Richard W Sams 
Published: August 2019

Abstract
Background : There is continued need for enhanced medical ethics education across the United States, particularly in an interprofessional setting. In an effort to guide medical ethics education reform, we report the first interprofessional survey of a cohort of graduate medical, nursing and allied health professional students that examined perceived student need for more formalized medical ethics education and assessed preferences for teaching methods in a graduate level bioethics curriculum. Methods : In January 2018, a cross-sectional survey was conducted with 562 of 1,357 responses received (41% overall response rate) among students enrolled in the School of Medicine, College of Nursing, Doctor of Physical Therapy and BS/(D)MD Professional Scholars programs at the [Name of institution blinded for review]. An in person or web-based questionnaire was designed to measure perceived need for a more structured bioethics curriculum. Results : The majority of respondents were female (333, 59.3%), white (326, 58.0%) and mid-20s in age (340, 60.5%). Almost half of respondents (47%) reported no prior medical ethics exposure or training in their previous educational experience, while 60% of students across all degree programs reported an interest in more ethics education and 92% noted that an understanding of medical ethics was important to their future career. Over a quarter of students (28%) were interested in pursuing graduate-level training in medical ethics, with case-based discussions, small group peer settings and ethics guest lectures being the most desired teaching methods. Conclusions : The future physician, nursing and physical therapist workforce in our medical community demonstrated an unmet need and strong interest for more formal medical ethics education within their current coursework. Integration of interprofessional training in medical ethics may serve as a vital curricular approach to improving the training of ethically competent healthcare professionals and overcoming the current hierarchical clinical silos.