bluuebunny/crossref_metadata_2025_split huggingface dataset:
The relationship between self-assessment living standard and mental health among the older in rural China: the mediating role of sleep quality
Authors: Zhang Beibei , Wang Xianwen , Liu Song , Zhang Min , He Xinran , Zhu Weizheng , Ding Hong 
Published: March 2023

Abstract
Background and objective
Mental health imbalance are the main cause of anxiety, depression and happiness reduction in the older. Self-assessment living standard and sleep quality are both influencing factors of mental health. Meantime, self-assessment living standard has an impact on sleep quality. But there’s no research on the relationship between the three, we conducted this study to explore the relationship between self-assessment living standard and mental health and the mediating role of sleep quality among the older in rural areas of China.

Methods
Using typical field sampling method, M County, Anhui Province was selected as the investigation site, and a total of 1223 respondents were selected. With the help of questionnaires enclosing respondents’ sociodemographics information, 12 Items General Health Questionnaire (GHQ-12) and Pittsburgh Sleep Quality Scale (PSQI), face-to-face interviews were used to collect data. Bootstrap test was used for data analysis.

Results
The results showed that the age of the respondents ranged from 60 to 99 years, with an average age of (66.53 ± 6.77) years, the proportion of the older with a tendency to mental health problems was 24.7%. Most of the older people’s self-assessment living standard was normal (average score was 2.89 ± 0.726), accounting for 59.3% of the total. The average sleep quality score was (6.97 ± 4.066), and 2.5% of the respondents reported serious sleep problems. older with low self- assessment living standards were more likely to report a higher propensity for psychological problems (β = 0.420, P < 0.001) and poorer sleep quality (β = 0.608, P < 0.001) than older with high self- assessment living standards. Mental health of the older may be related to sleep quality (β = 0.117, P < 0.001). In addition, the effect of self- assessment living standard on mental health was significantly mediated by sleep quality (β = 0.071, P < 0.001).

Conclusion
Mental health is associated with self-assessment living standard, with this association mediated by sleep quality. A reasonable mechanism needs to be established to improve self-assessment living standard and sleep quality.
Are threat perceptions associated with patient adherence to antibiotics? Insights from a survey regarding antibiotics and antimicrobial resistance among the Singapore public
Authors: Lee Si Yu , Shanshan Yang , Lwin May O. 
Published: March 2023

Abstract
Background
Public health strategies to improve patient adherence to antibiotics rely mostly on raising awareness of the threat of antimicrobial resistance (AMR) and improving knowledge about antibiotics. We aimed to evaluate how adherence to antibiotics relates to knowledge and the threat perceptions proposed by the Protection Motivation Theory (PMT).

Method
A cross-sectional online survey was conducted in September-December 2020 with 1002 participants aged 21-70 years in Singapore. Two items, which were reverse coded, evaluated adherence to antibiotics: ‘how often do you obtain antibiotics that were left over from the previous prescription’ and ‘how often did you treat yourself with antibiotics in the past year’. Questions about the PMT-related constructs, and knowledge regarding antibiotics and AMR knowledge were also included. Hierarchical regression models were performed at a 5% significance level.

Results
Adherence to antibiotics was associated with knowledge level (β = 0.073, p < 0.05), education level (β = − 0.076, p < 0.01), and four of the five PMT constructs: “perceived response cost” (β = 0.61, p < 0.01), “perceived response efficacy of adherence to antibiotic” (β = 0.096, p < 0.01), “perceived susceptibility to AMR” (β = 0.097, p < 0.01), and “perceived severity of AMR” (β = − 0.069, p < 0.01). Knowledge about AMR, perceived self-efficacy in adhering to antibiotics, age, and sex were not associated with adherence.

Conclusions
In Singapore, patient adherence to antibiotics appear to be driven by the perceived costs of visiting a doctor to obtain antibiotics, followed by perceptions of AMR as a threat and to a lesser extent, knowledge about antibiotics. Public health strategies to mitigate antibiotic misuse should consider these patient barriers to medical care.
Associations of accelerometer-based sedentary bouts with adiposity markers among German adults – results from a cross-sectional study
Authors: Voigt Lisa , Ullrich Antje , Groß Stefan , Guertler Diana , Jaeschke Lina , Dörr Marcus , van den Berg Neeltje , John Ulrich , Ulbricht Sabina 
Published: March 2023

Abstract
Background
Long periods of uninterrupted sitting, i.e., sedentary bouts, and their relationship with adverse health outcomes have moved into focus of public health recommendations. However, evidence on associations between sedentary bouts and adiposity markers is limited. Our aim was to investigate associations of the daily number of sedentary bouts with waist circumference (WC) and body mass index (BMI) in a sample of middle-aged to older adults.

Methods
In this cross-sectional study, data were collected from three different studies that took place in the area of Greifswald, Northern Germany, between 2012 and 2018. In total, 460 adults from the general population aged 40 to 75 years and without known cardiovascular disease wore tri-axial accelerometers (ActiGraph Model GT3X+, Pensacola, FL) on the hip for seven consecutive days. A wear time of ≥ 10 h on ≥ 4 days was required for analyses. WC (cm) and BMI (kg m− 2) were measured in a standardized way. Separate multilevel mixed-effects linear regression analyses were used to investigate associations of sedentary bouts (1 to 10 min, >10 to 30 min, and >30 min) with WC and BMI. Models were adjusted for potential confounders including sex, age, school education, employment, current smoking, season of data collection, and composition of accelerometer-based time use.

Results
Participants (66% females) were on average 57.1 (standard deviation, SD 8.5) years old and 36% had a school education >10 years. The mean number of sedentary bouts per day was 95.1 (SD 25.0) for 1-to-10-minute bouts, 13.3 (SD 3.4) for >10-to-30-minute bouts and 3.5 (SD 1.9) for >30-minute bouts. Mean WC was 91.1 cm (SD 12.3) and mean BMI was 26.9 kg m− 2 (SD 3.8). The daily number of 1-to-10-minute bouts was inversely associated with BMI (b = -0.027; p = 0.047) and the daily number of >30-minute bouts was positively associated with WC (b = 0.330; p = 0.001). All other associations were not statistically significant.

Conclusion
The findings provide some evidence on favourable associations of short sedentary bouts as well as unfavourable associations of long sedentary bouts with adiposity markers. Our results may contribute to a growing body of literature that can help to define public health recommendations for interrupting prolonged sedentary periods.

Trial registration
Study 1: German Clinical Trials Register (DRKS00010996); study 2: ClinicalTrials.gov (NCT02990039); study 3: ClinicalTrials.gov (NCT03539237).
Depressive symptoms among Thai male seafarers during the COVID-19 pandemic: a cross-sectional study
Authors: Jonglertmontree Woraluk , Kaewboonchoo Orawan , Morioka Ikuharu , Boonyamalik Plernpit 
Published: March 2023

Abstract
Background
Prevalence of depressive symptoms among seafarers is higher than the general population because of their unique work conditions. Factors that can be changed must be considered and promptly addressed in order to decrease the prevalence of depression. This study aims to clarify the prevalence of depressive symptoms and its related factors among Thai seafarers in an effort to contribute to policies and to prevent depression among Thai seafarers.

Methods
This cross-sectional study was conducted among 381 male seafarers working onboard ocean-going vessels of five Thai shipping companies. The questionnaire items comprised of personal factors, working factors and depressive symptoms. Depressive symptoms were assessed using the Thai version of the Patient Health Questionnaire-9. First, the chi-square test was used for univariate analysis. Then, variables significantly associated by the chi-square test were used for multivariate logistic regression analysis (employing the stepwise method) as independent variables.

Results
The average age of participants in this study was 36.4 years. Prevalence of depressive symptoms was 19.5%. One half of the participants (58.3%) reported subjective sleep problems, and most (75.1%) experienced poor coping behaviors. Two thirds (67.5%) were officers, and 10.1% of participants reported that they sometimes or never performed occupational safety behaviors. Regarding work environments, 62.2% reported that their work was disturbed from performing repetitive tasks. Multivariate logistic regression analysis showed two personal factors; sleep problems (Adjusted Odds Ratio (AOR) = 7.97, 95% Confidence interval (CI) = 3.52–18.05) and poor coping behaviors (AOR = 4.46, 95%CI = 1.61–12.34), and three working factors; job assignment (AOR = 2.50, 95%CI = 1.33–4.70), inadequate occupational safety behaviors (AOR = 4.51, 95%CI = 1.85–11.01) and performing repetitive task (AOR = 2.27, 95%CI = 1.16–4.45), were significantly associated with depression.

Conclusion
During COVID-19 pandemic, 19.5% of Thai male seafarers had depressive symptoms. Personal and working factors including subjective sleep problems, poor coping behaviors, job assignment, performing inadequate occupational safety behaviors and performing repetitive tasks were risk factors of depressive symptoms among Thai male seafarers. Monitoring work environment rigorously and coping with work-related stress of the occupational safety behaviors program should be suggested.
The good, the bad, and the blameless in parenting: a thematic analysis of discussions of childhood obesity on an internet forum
Authors: Koivumäki Terhi , Jallinoja Piia 
Published: March 2023

Abstract
Background
Childhood obesity is affecting an increasing percentage of families globally. For families, obesity is often a tense issue, not least because of the negative stigma and cultural perceptions associated with it. Discussions around childhood obesity do not take place only at home or in healthcare, but increasingly on social media, such as Internet discussion forums. Our aim was to analyse how childhood obesity is discussed on a Finnish online discussion forum by parents of children with obesity and other commenters.

Method
We gathered and analysed 16 discussion threads on childhood obesity taken from a Finnish Internet discussion forum, vauva.fi, between 2015 and 2021 (a total of 331 posts). For the analysis, we chose threads where the parents of a child with obesity took part. The parents’ and other commenters’ discussions were analysed and interpreted with inductive thematic analysis.

Results
In the online discussions, childhood obesity was discussed mostly in the context of parenting, parental responsibility and lifestyle choices within the family. We identified three themes that were used to define parenting. In the theme of proving good parenting, parents and commenters listed healthy elements in their family’s lifestyle to show their responsibility and parenting skills. In the theme of blaming bad parents, other commenters pointed out mistakes in the parents’ behaviour or offered them advice. Moreover, many acknowledged that some factors causing childhood obesity were outside the parents’ influence, forming the theme of lifting the blame from parents. In addition, many parents brought up that they were genuinely ignorant of the reasons for their child’s overweight.

Conclusions
These results are in line with previous studies suggesting that in Western cultures obesity – including childhood obesity – is typically seen as the individual’s fault and is associated with negative stigma. Consequently, counselling parents in healthcare should be expanded from supporting a healthy lifestyle to strengthening parents’ identity as being good enough parents who are already making many health enhancing efforts. Situating the family in a wider context of the obesogenic environment could ease the parents’ feelings that they have failed at parenting.
Mapping of national population-based surveys for better reporting of health-related indicators in the Eastern Mediterranean Region
Authors: Riazi-Isfahani Sahand , Victor Doctor Henry , Aly Eman Abdelkreem , Basha Hanem Mohamed , Majdzadeh Reza , Rashidian Arash 
Published: March 2023

AbstractBackgroundPopulation-based surveys are the main data source to generate health-related indicators required to monitor progress toward national, regional and global goals effectively. Although the Eastern Mediterranean Region of World Health Organization (WHO) member states conduct many population-based surveys, they are not led regularly and fail to provide relevant indicators appropriately. Therefore, this study aims two-fold: to map out population-based surveys to be conducted data for the health-related indicators in the Region and propose a timetable for conducting national population-based surveys in the Region.MethodsThe study was conducted in six phases: 1) Selecting survey-based indicators; 2) Extracting and comparing relevant survey modules; 3) Identifying sources of data for the indicators; 4) Assessing countries' status in reporting on core health indicators; 5) Review and confirmation of the results by the experts.ResultsPopulation-based surveys are the sources of data for 44 (65%) out of 68 regional core health indicators and two (18%) out of 11 health-related Sustainable Development Goals (SDG) 3 indicators. The Health Examination Survey (HES) could cover 65% of the survey-based indicators. A total of 91% of survey-based indicators are obtained by a combination of HES, Demographic and Health Survey (DHS), Multiple Indicator Cluster Survey (MICS) and Global School-based Student Health Survey (GSHS).ConclusionIn order to effectively report health-related indicators, HES, DHS/MICS and GSHS are considered essential in national survey timetables. Each country needs to devise and implement a plan for population-based surveys by considering factors such as national health priorities, financial and human capacities, and previous experiences.
The correlation analysis of WeChat usage and depression among the middle-aged and elderly in China: the mediating role of social participation
Authors: Wang Gaoling , Duan Jing , Kan Qianqian , Zhou Yuqin , Cheng Zhaopeng , Tang Shaoliang 
Published: March 2023

Abstract
Background
We aimed to explore the association between WeChat usage and depression in the Chinese middle-aged and elderly and the role of social participation.

Methods
Data were obtained from China Health and Retirement Longitudinal Study (CHARLS) of 2018. The dependent variable was depressive symptoms, measured with the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10). We used the propensity score matching (PSM) to match the WeChat users with the non-WeChat users. Correlations between WeChat usage and depressive symptoms were verified by using logistic regression and linear regression, and the mediating role of social participation was verified by using stepwise regression and KHB method.

Results
Four thousand five hundred forty-five samples were ultimately matched for analysis in this study. After including all control variables, results of logistic regression showed that WeChat usage was significantly associated with a lower prevalence of depression (aOR:0.701,95% CI: 0.605–0.812). And the results of linear regression showed that WeChat usage was associated with lower levels of depression which was significant (p < 0.001). The results of the stepwise regression and the KHB method showed a mediating role of social participation in WeChat usage and depressive symptoms. Among the four types of social participation, the mediating effect of recreational activities was significant, while the mediating effects of voluntary activities, cultural activities, and other activities were not significant. Meanwhile, the effect of WeChat usage on depression and the mediating effect of social participation were heterogeneous because of differences in age and gender.

Conclusion
Social participation partly mediated the effect between WeChat usage and depression in middle-aged and older adults. Among the four types of social participation, only recreational activities had a mediating effect. Encouraging more active social participation and other types of social activities should be considered to improve the mental health of the middle-aged and older adults in China through social media usage.
Psychotropic consumption before and during COVID-19 in Asturias, Spain
Authors: García María Luisa Nicieza , Martínez Paula Fernández , Bretón Eva Fernández , Martínez Alfonso Marta M. , Gil Patricio Suárez 
Published: March 2023

Abstract
Background
Spain as multiple other countries has been experiencing an increasing and sustained trend in the use of psychotropic medications since the mid 90s. Recent studies show public health measures implemented to control SARS-Cov2, such as mobility restrictions and the shutdown of nonessential activities increased mental suffering, even contributing to a higher number of anxiety, depression and insomnia disorders that could lead to an increase in the consumption of psychotropics.
The aims were: 1) Evaluate the temporal trend in psychotropic consumption by pharmacological subgroup, sex, and age group 2) Estimate the effect of the COVID-19 pandemic in the use of psychotropic drugs.

Methods
We conducted a retrospective observational study, retrieving all prescriptions of anxiolytics, hypnotics and sedatives, and antidepressants dispensed in pharmacies of Asturias (Northern Spain) for Primary Care patients for the period 2018–2021.
We presented the data expressed in Daily Defined Doses (DDDs) for 1000 persons/day (DHD). To estimate changes in DHDs by year and age group we conducted two multiple linear regressions (one for males and one for females) for every pharmacological subgroup studied. Changes were considered statistically significant when the regression coefficient was p < 0.05. We used the Software R 4.1.0.

Results
For the studied period, the highest DHDs are for antidepressants, although all of the subgroups experienced an increase in consumption rates.
Women consumed more psychotropic drugs than men. In 2021, 372 out of every 1000 women were taking daily 1 DDD of these drugs versus 184 out of every 1000 men.
Consumption rates for all psychotropic drugs progressively increases with age. Conversely, the biggest increases in consumption were among the youngest age groups (0–14 and 15–29 years) for women, while for men there is more variability.
The regression models suggest an upward trend in psychotropic consumption during all the period, especially remarkable from 2020, for both genders and all age groups.

Conclusions
- The consumption of psychotropic drugs has gradually increased over the last 4 years, with a significant boost starting in 2020 for both sexes, matching the start of the SARS-COV2 pandemic and the implementation of strict Public Health measures to contain it.
- The increase observed on children and adolescents is a matter of concern.
Impact of national-scale targeted point-of-care symptomatic lateral flow testing on trends in COVID-19 infections, hospitalisations and deaths during the second epidemic wave in Austria (REAP3)
Authors: Reitzinger Stephanie , Czypionka Thomas , Lammel Oliver , Panovska-Griffiths Jasmina , Leber Werner 
Published: March 2023

Abstract
Background
In October 2020, amidst the second COVID-19 epidemic wave and before the second-national lockdown, Austria introduced a policy of population-wide point-of-care lateral flow antigen testing (POC-LFT). This study explores the impact of this policy by quantifying the association between trends in POC-LFT-activity with trends in PCR-positivity (as a proxy for symptomatic infection), hospitalisations and deaths related to COVID-19 between October 22 and December 06, 2020.

Methods
We stratified 94 Austrian districts according to POC-LFT-activity (number of POC-LFTs performed per 100,000 inhabitants over the study period), into three population cohorts: (i) high(N = 24), (ii) medium(N = 45) and (iii) low(N = 25). Across the cohorts we a) compared trends in POC-LFT-activity with PCR-positivity, hospital admissions and deaths related to COVD-19; b) compared the epidemic growth rate before and after the epidemic peak; and c) calculated the Pearson correlation coefficients between PCR-positivity with COVID-19 hospitalisations and with COVID -19 related deaths.

Results
The trend in POC-LFT activity was similar to PCR-positivity and hospitalisations trends across high, medium and low POC-LFT activity cohorts, with association with deaths only present in cohorts with high POC-LFT activity. Compared to the low POC-LFT-activity cohort, the high-activity cohort had steeper pre-peak daily increase in PCR-positivity (2.24 more cases per day, per district and per 100,000 inhabitants; 95% CI: 2.0–2.7; p < 0.001) and hospitalisations (0.10; 95% CI: 0.02, 0.18; p = 0.014), and 6 days earlier peak of PCR-positivity. The high-activity cohort also had steeper daily reduction in the post-peak trend in PCR-positivity (-3.6; 95% CI: -4.8, -2.3; p < 0.001) and hospitalisations (-0.2; 95% CI: -0.32, -0.08; p = 0.001). PCR-positivity was positively correlated to both hospitalisations and deaths, but with lags of 6 and 14 days respectively.

Conclusions
High POC-LFT-use was associated with increased and earlier case finding during the second Austrian COVID-19 epidemic wave, and early and significant reduction in cases and hospitalisations during the second national lockdown. A national policy promoting symptomatic POC-LFT in primary care, can capture trends in PCR-positivity and hospitalisations. Symptomatic POC-LFT delivered at scale and combined with immediate self-quarantining and contact tracing can thus be a proxy for epidemic status, and hence a useful tool that can replace large-scale PCR testing.