bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interdisciplinary and interprofessional communication intervention: How psychological safety fosters communication and increases patient safety
Authors: Dietl Johanna Elisa , Derksen Christina , Keller Franziska Maria , Lippke Sonia 
Published: June 2023

BackgroundEffective teamwork and communication are imperative for patient safety and quality care. Communication errors and human failures are considered the main source of patient harm. Thus, team trainings focusing on communication and creating psychologically safe environments are required. This can facilitate challenging communication and teamwork scenarios, prevent patient safety risks, and increase team performance perception. The sparse research concerning communication interventions calls for an understanding of psychological mechanisms. Therefore, this study investigated mechanisms of an interpersonal team intervention targeting communication and the relation of psychological safety to patient safety and team performance perception based on the applied input–process–output model of team effectiveness.MethodsBefore and after a 4-h communication intervention for multidisciplinary teams, a paper–pencil survey with N = 137 healthcare workers from obstetric units of two university hospitals was conducted. Changes after the intervention in perceived communication, patient safety risks, and team performance perception were analyzed via t-tests. To examine psychological mechanisms regarding psychological safety and communication behavior, mediation analyses were conducted.ResultsOn average, perceived patient safety risks were lower after the intervention than before the intervention (MT1 = 3.220, SDT1 = 0.735; MT2 = 2.887, SDT2 = 0.902). This change was statistically significant (t (67) = 2.760, p =.007). However, no such effect was found for interpersonal communication and team performance perception. The results illustrate the mediating role of interpersonal communication between psychological safety and safety performances operationalized as perceived patient safety risks (α1∗β1 = −0.163, 95% CI [−0.310, −0.046]) and team performance perception (α1∗β1 = 0.189, 95% CI [0.044, 0.370]).DiscussionThis study demonstrates the psychological mechanisms of communication team training to foster safety performances and psychological safety as an important predecessor for interpersonal communication. Our results highlight the importance of teamwork for patient safety. Interpersonal and interprofessional team training represents a novel approach as it empirically brings together interpersonal communication and collaboration in the context of patient safety. Future research should work on follow-up measures in randomized-controlled trials to broaden an understanding of changes over time.
Empathy deficit in male patients with schizophrenia and its relationships with impulsivity and premeditated violence
Authors: Gong Muxin , Yao Lei , Ge Xiaodan , Liu Zhenru , Zhang Caiyi , Yang Yujing , Amdanee Nousayhah , Wang Chengdong , Zhang Xiangrong 
Published: June 2023

ObjectiveTo explore the pattern of empathy characteristics in male patients with schizophrenia (SCH) and to examine whether empathy deficit is associated with impulsivity and premeditated violence.MethodsOne hundred and fourteen male SCH patients were enrolled in this study. The demographic data of all patients were collected and the subjects were divided into two groups, namely, the violent group, including 60 cases, and the non-violent group, comprising 54 cases, according to the Modified Overt Aggression Scale (MOAS). The Chinese version of the Interpersonal Reactivity Index-C (IRI-C) was used to evaluate empathy and the Impulsive/Predicted Aggression Scales (IPAS) was employed to assess the characteristics of aggression.ResultsAmong the 60 patients in the violent group, 44 patients had impulsive aggression (IA) and 16 patients had premeditated aggression (PM) according to the IPAS scale. In the violent group, the scores of the four subfactors of the IRI-C, i.e., perspective taking (PT), fantasy (FS), personal distress (PD), and empathy concern (EC), were significantly lower than in the non-violent group. Stepwise logistic regression showed that PM was independent influencing factor for violent behaviors in SCH patients. Correlation analysis revealed that EC of affective empathy was positively correlated with PM but not with IA.ConclusionSCH patients with violent behavior had more extensive empathy deficits compared with non-violent SCH patients. EC, IA and PM are independent risk factors of violence in SCH patients. Empathy concern is an important index to predict PM in male patients with SCH.
Association between immune cells in peripheral blood and psychiatric symptoms
Authors: Yang Juanjuan , Wang Qian , Jiang Wei 
Published: June 2023

BackgroundThere are bidirectional associations between immunological dysfunction and psychiatric symptoms. However, the associations between the levels of immune cells in the peripheral blood and psychiatric symptoms remain unclear. The present study aimed to evaluate levels of immune cells in peripheral blood in people with positive psychiatric symptoms.MethodsThis retrospective study analyzed data from routine blood tests and psychopathology and sleep quality assessments. Data were compared between a group of 45 patients with de novo psychological symptoms and 225 matched controls.ResultsPatients with psychiatric symptoms had higher white blood cell and neutrophil counts compared with controls. However, in a subgroup analysis, neutrophil counts were significantly higher than in controls only in patients with multiple psychiatric symptoms. Furthermore, monocyte counts were significantly higher in patients with multiple psychiatric symptoms than in controls. Further, sleep quality was lower in patients with psychiatric symptoms than in controls.ConclusionWhite blood cell and neutrophil counts in the peripheral blood of patients with psychiatric symptoms were significantly higher and sleep quality was significantly lower than in controls. Participants with multiple psychiatric symptoms showed more significant differences in peripheral blood immune cell counts than other subgroups. These results provided evidence for the relationship between psychiatric symptoms, immunity, and sleep.
Participatory systems science for enhancing health and wellbeing in the Indian Ocean territories
Authors: Allender Steven , Munira Syarifah Liza , Bourke Siobhan , Lancsar Emily 
Published: June 2023

ObjectivesCo-creation of diabetes and obesity prevention with remote communities allows local contextual factors to be included in the design, delivery, and evaluation of disease prevention efforts. The Indian Ocean Territories (IOT) comprise the Christmas (CI) and Cocos Keeling Islands (CKI) and are remote Australian external territories located northwest of the mainland. We present results of a co-design process conducted with residents of IOT using realist inquiry and system mapping.MethodsInterviews with 33 community members (17 CI, 14 CKI, 2 off Islands) on causes and outcomes of diabetes (2020/21) comprising community representatives, health services staff, dietitians, school principals and government administrators. Interviews were used to create causal loop diagrams representing the causes of diabetes in the IOT. These diagrams were used in a participatory process to identify existing actions to address diabetes, identify areas where more effort would be valuable in preventing diabetes, and to described and prioritize actions based on feasibility and likely impact.FindingsInterviews identified 31 separate variables categorized into four themes (structural, food, knowledge, physical activity). Using causa loop diagrams, community members developed 32 intervention ideas that included strengthening healthy behaviors like physical activity, improving access to healthy and culturally appropriate foods, and overcoming the significant cost and availability limitations imposed by remoteness and freight costs. Interventions included relatively unique Island issues (e.g., freight costs, limited delivery timing), barriers to healthy food (e.g., limited fresh food availability), physical activity (e.g., transient workforce) and knowledge (e.g., multiple cultural backgrounds and language barriers, intergenerational knowledge).
Status and factors associated with patient activation and its relationship with HIV clinic outcomes among Yi minority people living with HIV in Liangshan, China: a cross-sectional study
Authors: An Wenhong , Tang Xuefeng , Xiao Xueling , Aku Waha , Wang Honghong 
Published: June 2023

IntroductionPatient activation is determined by an individual’s knowledge, skills and confidence in managing his/her health. It is vital for people living with HIV (PLWH) to enhance their self-management skills and health outcomes, especially those from low- and middle-income regions, since they are at higher risk of worse health outcomes. However, literature from those regions is limited, especially in China.ObjectivesThis study aimed to explore the status and factors associated with patient activation among Yi minority PLWH in Liangshan, China and to determine whether patient activation is associated with HIV clinic outcomes.MethodsThis cross-sectional study included 403 Yi minority people living with HIV in Liangshan between September and October 2021. All participants completed an anonymous survey measuring sociodemographic characteristics, HIV-related information, patient activation and illness perception. Multivariate linear regression and multivariate binary logistic regression were used to explore factors associated with patient activation and the association between patient activation and HIV outcomes, respectively.ResultsThe Patient Activation Measure (PAM) score was low (mean = 29.8, standard deviation = 4.1). Participants with negative illness perception, low income, and self-rated antiretroviral therapy (ART) effect based on self-perception were most likely to have a lower PAM score (β = −0.3, −0.2, −0.1, respectively; all p &lt; 0.05); those with having disease knowledge learning experiences and an HIV-positive spouse were more likely to have a higher PAM score (β = 0.2, 0.2, respectively; both p &lt; 0.001). A higher PAM score (AOR=1.08, 95% CI: 1.02, 1.14) was associated with viral suppression, mediated by gender (AOR=2.25, 95% CI: 1.38, 3.69).ConclusionLow patient activation level among Yi minority PLWH impacts HIV care. Our findings indicate patient activation is associated with viral suppression for minority PLWH in low- and middle-income settings, suggesting that tailored interventions enhancing patient activation may improve viral suppression.
The roles of community nutrition scholars in changing mothers' child feeding, food preparation, and hygiene practices in southern Bangladesh
Authors: Kawarazuka Nozomi , Ibrahim Farhana , Rahaman Ebna Habib Md. Shofiur , Prain Gordon 
Published: June 2023

IntroductionThis qualitative study evaluates a nutrition and hygiene education program led by trained community nutrition scholars for 5,000 mothers of small children in the Khulna and Satkhira districts in southern Bangladesh. The objectives of this study are as follows: (1) understanding the processes and reasonings behind mothers' improvement in child feeding, food preparation, hygiene, and homestead garden production, (2) understanding men's roles in facilitating women's behavioral changes, and (3) assessing the degree of changes in subjective notions of self-confidence, decision-making, and recognition among mothers and nutrition scholars.MethodsData were collected through 14 focus group discussions with 80 participants and in-depth interviews with 6 women community nutrition scholars. Data was then analysed qualitatively by drawing on direct quotes from focus group discussions and interviews with detailed interpretation and account for respondents' behaviors and perceptions.ResultsOverall findings confirm behavior changes by women, their spouses, and other family members. Many women were able to independently decide to change food allocation and child feeding practices after gaining self-confidence through the training. Men performed vital roles, such as purchasing nutritious food in local markets, providing labor for land preparation of homestead gardens, and defending the women from the resistance to change by their mothers-in-law.DiscussionWhile the study supports the literature that women's bargaining power in food/resource allocation is critical in child health and nutrition, the evaluation found that this process involves negotiations among family members. Engaging men and mothers-in-law in nutrition interventions have great potential to make nutrition interventions more effective.
The role of hypertension in bone mineral density among males older than 50 years and postmenopausal females: evidence from the US National Health and Nutrition Examination Survey, 2005–2010
Authors: Li Shuna , Li Li , Feng Aozi , Huang Tao , Chen Chong , He Ningxia , Huang Liying , Lyu Jun 
Published: June 2023

BackgroundHypertension is a significant chronic disease that has been linked with bone mineral density (BMD) in various studies. However, the conclusions are contradictory. The purpose of our study was to identify the bone mineral density (BMD) of postmenopausal females and males older than 50 years with hypertension.MethodsThis cross-sectional study of 4,306 participants from the 2005–2010 US National Health and Nutrition Examination Survey explored the relationship between BMD and hypertension. Participants who had a mean systolic blood pressure (SBP) ≥140 mmHg, or a mean diastolic blood pressure (DBP) ≥90 mmHg, or were taking any prescribed medicine for high blood pressure were defined as having hypertension. BMD values were measured at the femoral neck and lumbar vertebrae as the primary outcome. Weight general linear model was used to describe the status of BMD in patients with hypertension. Weighted multivariate regression analysis was conducted to demonstrate the association between hypertension and BMD. Weighted restricted cubic spline (RCS) was used to assess the relationship between BMD and SBP and DBP.ResultsOur study found that there was a positive association between hypertension and lumbar BMD and the lumbar BMD was significantly higher in the presence of hypertension than in the control group in both males (1.072 vs. 1.047 g/cm2) and females (0.967 vs. 0.938 g/cm2; both p &lt; 0.05), but a similar pattern was not found in the femoral neck. Meanwhile, lumbar BMD was positively associated with SBP and negatively associated with DBP both in males and females. The prevalence of low bone mass and osteoporosis at the lumbar vertebrae was lower in male patients with hypertension than in the control group. However, no difference was observed among postmenopausal females between the hypertension and control groups.ConclusionsHypertension was associated with higher BMD at the lumbar vertebrae in both males older than 50 years and postmenopausal females.
Passive smoking as a risk factor among older adults: an ordered probability approach for Türkiye
Authors: Ünver Şeyda , Tekmanli Hasan Hüseyin , Alkan Ömer 
Published: June 2023

Background/aimOlder adults represent a significant proportion of the population of many societies, and being one of the disadvantaged groups, they struggle with various difficulties in their social lives. Undoubtedly, passive smoking is one of these difficulties. Passive smoking among older adults, which is an important public health problem, is an issue that needs to be investigated. The aim of this study is to determine the relationship between the demographic and socio-economic characteristics of adults aged 60 and older in Türkiye and their exposure to secondhand smoke (SHS).MethodsIn this study, a microdata set of the 2016 and 2019 Turkey Health Survey conducted by the Turkish Statistical Institute (TUIK) was used. This survey was conducted by TUIK in the relevant years using a stratified sampling method to best represent the whole of Turkey. The study considered only demographic and socio-economic characteristics to investigate passive smoking. Since all the variables used in the study were categorical, the relationship between the dependent variable and the independent variables was first investigated using chi-square tests. In addition, since the dependent variable has an ordered-categorical probability form, the generalized ordinal logit model was used for the analysis of passive smoking and related factors.ResultsThe rate of exposure to tobacco smoke of older adults who participated in the study in 2016 was 16%, while the rate of those who participated in the study in 2019 was 21%.ConclusionAccording to the findings of the study, older, uneducated, and uninsured smokers carry a more serious SHS risk. It may be beneficial for society for policy makers to carry out studies by considering these features a priority and focusing on policies in this context. Expanding smoke-free areas to cover older adult, increasing penalties as a deterrent, facilitating education, increasing state support for education, increasing education and public service announcements about tobacco harms, and facilitating social security are the main examples. This study’s findings are crucial as a source of information for the development of policies and programs aimed at preventing the exposure of older adults to tobacco smoke.
Associations between air pollution, intracellular-to-extracellular water distribution, and obstructive sleep apnea manifestations
Authors: Tsai Cheng-Yu , Huang Huei-Tyng , Liu Ming , Cheng Wun-Hao , Hsu Wen-Hua , Kuan Yi-Chun , Majumdar Arnab , Lee Kang-Yun , Feng Po-Hao , Tseng Chien-Hua , Chen Kuan-Yuan , Kang Jiunn-Horng , Lee Hsin-Chien , Wu Cheng-Jung , Liu Wen-Te 
Published: June 2023

BackgroundExposure to air pollution may be a risk factor for obstructive sleep apnea (OSA) because air pollution may alter body water distribution and aggravate OSA manifestations.ObjectivesThis study aimed to investigate the mediating effects of air pollution on the exacerbation of OSA severity through body water distribution.MethodsThis retrospective study analyzed body composition and polysomnographic data collected from a sleep center in Northern Taiwan. Air pollution exposure was estimated using an adjusted nearest method, registered residential addresses, and data from the databases of government air quality motioning stations. Next, regression models were employed to determine the associations between estimated air pollution exposure levels (exposure for 1, 3, 6, and 12 months), OSA manifestations (sleep-disordered breathing indices and respiratory event duration), and body fluid parameters (total body water and body water distribution). The association between air pollution and OSA risk was determined.ResultsSignificant associations between OSA manifestations and short-term (1 month) exposure to PM2.5 and PM10 were identified. Similarly, significant associations were identified among total body water and body water distribution (intracellular-to-extracellular body water distribution), short-term (1 month) exposure to PM2.5 and PM10, and medium-term (3 months) exposure to PM10. Body water distribution might be a mediator that aggravates OSA manifestations, and short-term exposure to PM2.5 and PM10 may be a risk factor for OSA.ConclusionBecause exposure to PM2.5 and PM10 may be a risk factor for OSA that exacerbates OSA manifestations and exposure to particulate pollutants may affect OSA manifestations or alter body water distribution to affect OSA manifestations, mitigating exposure to particulate pollutants may improve OSA manifestations and reduce the risk of OSA. Furthermore, this study elucidated the potential mechanisms underlying the relationship between air pollution, body fluid parameters, and OSA severity.
Prevalence of anisometropia and influencing factors among school-age children in Nantong, China: a cross-sectional study
Authors: Zhou Yue , Zhang Xiao Fang , Chen Xiao Juan , Wang Min , Cai Jian Ru , Xiong Yao Jia , Song Yu , Sun Zhi Min 
Published: June 2023

ObjectiveTo investigate the prevalence of anisometropia and associated parameters among school-aged children in Nantong, China.MethodsThis school-based, cross-sectional study examined students from primary schools, junior high schools, and senior high schools in an urban area of Nantong, China. Univariate and multivariate logistic regression analyses were used to investigate the specific correlations between anisometropia and related parameters. Non-cycloplegic autorefraction was assessed for each student. Anisometropia was defined as the spherical equivalent refraction (SE) difference ≥ 1.0 D between eyes.ResultsA total of 9,501 participants were validated for analyses, of which 53.2% (n = 5,054) were male, and 46.8% (n = 4,447) were female. The mean of age was 13.32 ± 3.49 years, ranging from 7–19 years. The overall prevalence of anisometropia was 25.6%. Factors such as myopia, scoliosis screening positive, hyperopia, female sex, older age, and higher weight had a significantly higher risk of anisometropia (p &lt; 0.05).ConclusionThere was a high prevalence of anisometropia in school-age children. Some physical examination parameters are closely related to children’s anisometropia, especially myopia and scoliosis. Preventing myopia and controlling its progression may be the most important ways to reduce the prevalence of anisometropia. Correcting scoliosis may be an important factor in controlling the prevalence of anisometropia, and maintaining good reading and writing posture may be helpful in controlling the prevalence of anisometropia.
Heavy social media use and psychological distress among adolescents: the moderating role of sex, age, and parental support
Authors: Mougharbel Fatima , Chaput Jean-Philippe , Sampasa-Kanyinga Hugues , Hamilton Hayley A. , Colman Ian , Leatherdale Scott T. , Goldfield Gary S. 
Published: June 2023

BackgroundDespite increasing evidence that social media use is associated with adolescents’ mental well-being, little is known about the role of various factors in modifying the effect of this association during adolescence. This study examined the association between social media use and psychological distress among adolescents and explored whether sex, age, and parental support moderate this association.MethodsData came from a representative sample of middle and high school students in Ontario, Canada. Cross-sectional analyses included 6,822 students derived from the 2019 Ontario Student Drug Use and Health Survey.ResultsOur results showed that 48% of adolescents used social media for 3 h or more per day, and 43.7% had moderate to severe psychological distress, with a higher prevalence among females (54%) than males (31%). After adjustment for relevant covariates, heavy social media use (≥3 h/day) was associated with increased odds of severe psychological distress [odds ratio (OR): 2.01; 95% confidence interval (CI):1.59–2.55]. The association of social media use with psychological distress was modified by age (p &lt; 0.05) but not sex or parental support. The association was stronger among younger adolescents.ConclusionHeavy social media use is associated with higher levels of psychological distress, with younger adolescents being the most vulnerable. Longitudinal studies are recommended for future research to examine in more depth the role of sex, age, and parental support in the association between social media use and psychological distress to better determine the strength and of the association.