bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can smartphone use affect chronic disease self-management among Chinese middle-aged and older adults? A moderated mediation model
Authors: Gong Fangmin , Lei Zhaowen , Min Hewei , Yu Yebo , Huang Zhen , Liu Jingyao , Wu Wenyu , Tang Jingqi , Sun Xinying , Wu Yibo 
Published: December 2022

IntroductionChronic disease self-management is influenced by many factors. Previous studies have linked patients’ media use with chronic disease self-management, but the underlying mechanisms of this relationship are less understood.ObjectivesThe purpose of this study is to explore the mediating role of family health (FH) between frequency of smartphone use (FOSU) and self-management behaviors among middle-aged and older patients with chronic diseases (SBAMAOPWCD) through a moderated mediation model, and whether this indirect relationship is modified by the solitary status of middle-aged and older Chinese patients with chronic disease.MethodsSurveys were collected from 1,424 (N = 1,424; age &gt; 45) middle-aged and older with one or more chronic conditions in China on self-reports of FOSU, FH and Chronic disease self-management behaviors were used to examine the moderated mediation model.ResultsThe results showed that the FOSU was significantly and positively associated with SBAMAOPWCD (β = 0.220, p &lt; 0.001; β = 0.170, p &lt; 0.001; β = 0.167, p &lt; 0.001; β = 0.158, p &lt; 0.001); The Family health resources (FHR) dimension of FH and the Family external social supports (FESS) dimension mediated the relationship between the FOSU and SBAMAOPWCD (β = −0.0758, CI: −0.1402, −0.0236; β = 0.0721, CI: 0.0141, 0.1458), Among them, the FHR dimension mediated mainly among FOSU, exercise and cognitive symptom management practices (CSMP; β = −0.0344, CI: −0.0652, −0.0102; β = −0.0401, CI: −0.0725, −0.0138), the FESS dimension of the FH mediated the relationship between the FOSU and communication with physicians (CWP; β = 0.0376, CI: 0.0116, 0.0705); Solitary state played a moderating role in the relationship between FHR dimension and SBAMAOPWCD (live alone β = −0.2395, CI: −0.4574, −0.0661; not live-alone β = −0.0599, CI: −0.1164, −0.0172). In addition, solitary state played a moderating role in the relationship among FHR dimension and CSMP for middle-aged and older patients (live alone β = −0.1095, CI: −0.1961, −0.0378; not live-alone β = −0.0334, CI: −0.0633, −0.0102). Interestingly, the relationship between FESS dimension and SBAMAOPWCD was moderated only by the non-live alone population (β = 0.0676, CI: 0.0008, 0.1478), and not by the live-alone population (β = 0.1026, CI: −0.1061, 0.3278).Unexpectedly, we found that when their FHR were lower, they reported higher levels of chronic disease self-management, middle-aged and older patients with chronic diseases who live alone are more significant in this impact relationship.ConclusionsThe study further deepens our understanding of the mechanisms linking frequency of smartphone use with chronic disease self-management behaviors, and it helps to develop interventions to improve chronic disease self-management behaviors in middle-aged and older adults.
Diagnostic paths and service needs of children with autism spectrum disorder and with other neurodevelopmental disorders in Bulgaria
Authors: Barokova Mihaela D. , Andreeva-Sapundzhieva Ana , Andonova Elena , Markova-Derelieva Galina , Karpur Arun 
Published: December 2022

BackgroundCurrently, there are no official statistics about the number of children with developmental disorders in Bulgaria. This is the first systematic investigation of the needs, access to services, and priorities of families of children with developmental disorders in the country.AimsThe study aims to: (1) characterize the needs of children with developmental disorders in Bulgaria; (2) to compare the needs and access to services of children with Autism Spectrum Disorders (ASD) and other neurodevelopmental disorders (oNDD); (3) and to examine the daily burden of their caregivers and how it varies based on their demographic characteristics, such as income and education.MethodsWe used an online family needs assessment survey to collect data from caregivers of children with developmental disorders in Bulgaria between April and July 2020. 195 parents of children with ASD and 73 parents of children with oNDD completed the questionnaire.ResultsChildren with ASD waited longer than children with oNDD to receive a diagnosis. Caregivers in the ASD group also expressed first concerns about their child’s development when their children were older and for different reasons than caregivers in the oNDD group. There were no significant differences between groups in service encounters, including access to and delay of medical, counseling, and educational services, with approximately 50% of all caregivers experiencing some delay and/or difficulties in access to services. There were no associations between access to services and caregiver education and family income, with the exception of higher education being linked to receiving a diagnosis earlier for the oNDD group.DiscussionThis study has three main findings: (1) children with ASD and children with oNDD in Bulgaria have different needs and paths to diagnosis; (2) nevertheless, children in both groups experience similar challenges in accessing medical, counseling, and educational services, regardless of their demographic characteristics; and (3) parents’ priorities focus on education, counseling, and medical support, protecting children’s basic rights, and raising awareness. A comparison of our findings to past research in the region shows a relative improvement in diagnostic services with families not having to travel outside their city to receive a diagnosis. Based on our findings, we provide specific recommendations for changes in services and policy.
Prediction model of all-cause death based on balance ability among middle-aged and older Chinese adults of overweight and obesity
Authors: Xie Kaihong , Han Xiao , Lu Jia , Xu Xiao , Hu Xuanhan 
Published: December 2022

BackgroundAdvances in studies using body indicators to predict death risk. Estimating the balance ability of death risk in middle-aged and older Chinese adults with overweight and obesity is still challenging.MethodsA retrospective analysis of the data from the China Health and Retirement Study from January 2011 to December 2018. A total of 8,632 participants were randomly divided into 7:3 a training group and a verification group, respectively. Univariable Cox analysis was used to prescreen 17 potential predictors for incorporation in the subsequent multivariable Cox analysis. Nine variables were included in the nomogram finally and validated with concordance index (C-index), calibration plots, Hosmer-Lemeshow test, and internal validation population.Results287 participants were death in the training group. One hundred and thirteen participants were death in the verification group. A total of nine indicators were included in the modeling group, including gender, age, marriage, hypertension, diabetes, stroke, ADL, IADL, and balance ability to establish a prediction model. The nomogram predicted death with a validated concordance index of (C-index = 0.77, 95% CI: 0.74–0.80). The inclusion of balance ability variables in the nomogram maintained predictive accuracy (C-index = 0.77, 95% CI: 0.73–0.82). The calibration curve graph and Hosmer-Lemeshow test (P &gt; 0.05 for both the modeling group and the verification group) showed the model has a good model consistency.ConclusionIn the present study, we provide a basis for developing a prediction model for middle-aged and older people with overweight and obesity. In most cases, balance ability is more reversible than other predictors.
Exploring factors influencing the compliance of patients and family carers with infection prevention and control recommendations across Bangladesh, Indonesia, and South Korea
Authors: Park Ji Yeon , Pardosi Jerico Franciscus , Respati Titik , Nurhayati Eka , Islam Md. Saiful , Chowdhury Kamal Ibne Amin , Seale Holly 
Published: December 2022

BackgroundPoor compliance with infection prevention and control (IPC) measures has been a longstanding issue globally. To date, healthcare workers (HCWs) have been the primary target for policy and strategy revisions. Recent studies exploring the contributing factors to the spread of COVID-19 across countries in Asia have suggested that the scope of focus should be extended to family carers who provide patient care activities. This study aimed to explore factors affecting patients' and their family carers' IPC compliance in hospitals in Bangladesh, Indonesia, and South Korea.MethodA qualitative study incorporating 57 semi-structured interviews was conducted in five tertiary-level hospitals across the three focus countries between July 2019 and February 2020. Interviews were undertaken with: (1) patients, family carers and private carers; and (2) healthcare workers, including nurses, doctors, and hospital managers. Drawing upon the principles of grounded theory, data were inductively analyzed using thematic analysis.ResultsA total of three main themes and eight subthemes are identified. Key themes focused on the assumptions made by healthcare workers regarding the family/private carers' level of understanding about IPC and training received; uncertainty and miscommunication regarding the roles of family/private carers; variations in carer knowledge toward IPC and healthcare-associated infections, and the impact of cultural values and social norms.ConclusionThis exploratory study offers novel findings regarding the factors influencing IPC compliance among patients and their family/private carers across various cultural settings, irrespective of resource availability. The role of cultural values and social norms and their impact on IPC compliance must be acknowledged when updating or revising IPC policies and guidelines.
An exploration on COVID-19 vaccination motivation patterns from the perspective of the Chaxu culture in metropolis of China: A multi-center study
Authors: Huang Jiaoling , Jiang Zhiyun , Gu Jie , Yang Yuqi , Yan Yuge , Gu Xiaoqing , Bai Yundan , Liang Yan 
Published: December 2022

ObjectivesChaxugeju is a very special Chinese culture following a self-centered and outward expanding social network, which might be a significant culture factor for vaccination behavior. This study aimed to identify the motivation pattern in China, and paid special focus on socio-economic status (SES), region, and migration.MethodsWe used a latent class analysis, with a sample of 12,432 participants collected in China from April to June, to identify the COVID-19 vaccination motivation patterns. Multinomial logistic regression models were utilized to separately explore associations between SES, migration, region, and COVID-19 vaccination motivation patterns.ResultsThree COVID-19 vaccination motivation patterns were identified: Self-protection (41.9%), Trust and Self-protection (38.5%), and Trust and Differential Protection (19.6%). Participants with higher income were more likely to be Trust and Self-protection, and when income is more than 50,000 CNY per month, they are more likely to be self-protection. Professional/white collar were more likely to be Self-protection. Participants from Shenzhen were more likely to be Trust and Differential protection. The moderating effects of gender were found for income and region. Gender does not moderate the associations of occupation or migration and COVID-19 vaccination motivation patterns.ConclusionThree motivational patterns were identified in which the Trust &amp; Differential Pattern followed the traditional self-family-community Chaxu circle. However, the Chaxu motivation pattern was not the dominant one which might be weakened by SES. Migration and Shenzhen preserved the traditional social network, keeping in the trust and differential pattern. All of these factors in various cultural contexts should be considered when promoting vaccines.
Is Chinese Spring Festival a key point for glycemic control of patients with type 2 diabetes mellitus in China?
Authors: Xu Huilin , Cao Li , Li Jun , Zhang Fen , Wang Weijie , Liang Tongtong , Liu Xiaohua , Fu Chaowei 
Published: December 2022

ObjectivesThis study aims to explore the long-term trend of fasting blood glucose (FBG) among urban patients with type 2 diabetes mellitus (T2DM) and the impacts of the Chinese Spring Festival on their glycemic control in urban China.MethodsThe general information and longitudinal monitoring data of patients with T2DM in Minhang District, Shanghai China from 15 December 2006 to 31 December 2015 were collected. The FBG records were grouped into three periods, namely, the preholiday period (2 months right before the Chinese Spring Festival), the holiday period (from 28 December to 7 January of the lunar calendar year), and the postholiday period (2 months after the Chinese Spring Festival). The Mann-Kendall trend test and Cochran-Armitage trend test were occupied to explore the long-term trend, and paired t-test and chi-square (χ2) test were used to determine the differences in glycemic level and control rate between the preholiday and postholiday periods, respectively.ResultsFrom 2007 to 2015, the glycemic control rate in patients with T2DM showed an upward trend (P &lt; 0.001), and the FBG level showed a decreasing trend (P = 0.048). After the Chinese Spring Festival, the glycemic control rate decreased significantly (P &lt; 0.001), and the FBG level increased significantly (P &lt; 0.001) compared to those during the preholiday period. The incidence of hypoglycemia increased during holidays. Patients who were aged 60–69 years, overweight or obese, with hypertension, with a disease duration of &lt;3 years, or with poor glycemic control in one previous year were more likely to be affected by the holiday.ConclusionChinese Spring Festival is a key point for glycemic control of patients with T2DM in China. Intensive holiday-specific diabetic healthcare needs to be further improved, and community-based interventions should be developed and implemented to control the possible holiday effects.
Assessment of inland flood hazard sensitivity to hydrological intensification in coastal watersheds
Authors: Miller Robert L. 
Published: December 2022

IntroductionIntensification of the hydrologic cycle induced by climate variability and landscape modification is expected to increase the frequency of extreme flood events. Multi-jurisdictional approaches to manage inland flood risks at watershed scales demand the ability to objectively assess not only future flood potentials, but to also set priorities based upon multiple factors such as the stream channels most sensitive to hydrologic stress.MethodsThis study presents a method to estimate flood hazard sensitivities to increasing stormwater runoff due to hydrologic intensification (e.g., urbanization, climate effects) on local and watershed scales. The method is demonstrated in the low-gradient inland watershed regions of southwestern coastal Louisiana, USA. Utilizing highly detailed numerical models from the Federal Emergency Management Agency (FEMA), absolute and relative flood sensitivities were calculated for 45 flood-prone stream channels in the Lafayette, LA region. Channel sensitivities to flood hazards induced by changes in the 10-yr (10% annual exceedance probability) flood flows were quantified by analysis of 485 scenarios developed using a downward counterfactual scaling strategy.Results and discussionRelying entirely upon publicly available numerical models and input datasets, the study revealed key information about the relationship between estimable hydraulic characteristics (e.g., conveyance, resistance, and flow) and absolute and relative flood hazard sensitivity measures on a per-channel basis. Information from the subset of detailed numerical models was efficiently leveraged to provide a regional map of relative flood sensitivities. The methodology is robust and can be applied in very general settings to address the concern of hydrologic intensification in practical flood risk management applications.
School performance in youth after a concussion
Authors: DeMatteo Carol A. , Jakubowski Josephine , Randall Sarah , Stazyk Kathy , Lin Chia-Yu , Yakubov Rebecca 
Published: December 2022

ObjectiveThis study aimed to identify school problems and levels of cognitive activity in youths aged 5–18 years with a concussion during the recovery stages of return to school (RTS).Study DesignIn a prospective cohort, participants completed in-person assessments at three time points: First Visit Post-injury, Symptom Resolution Visit, and Follow-Up Visit. These time points varied based on the participants’ recovery progress. The post-concussion symptom scale (PCSS) and a cognitive activity scale were completed every 2 days until symptom resolution was achieved. Participants and their parents completed a school questionnaire detailing how their concussion had impacted their school learning/performance and their level of concern about their injury as well as the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT).ResultsSixty-three percent (N = 44/70) of participants returned to school by the First Visit Post-injury (average 7.7 days following injury), and of these, 50% (N = 22) were experiencing school problems. Sixty-five participants (out of 70) returned to school at the Follow-Up Visit, and of these, 18% reported school problems. There was a significant difference in the school problems reported by parents and youth. At the First Visit Post-injury, the youth reported more problems (p = 0.02), and the In-Person Symptom Resolution Visit with parents reported more problems (p = 0.01). The cognitive activity score increased, while the PCSS score decreased from RTS Stage 1 to Stage 5.ConclusionsThis study identified that 50% of youth experienced school problems at the First Visit Post-injury, whereas only 18% reported school problems at the Follow-Up Visit. There is a significant difference in the perception of school problems reported by youth and their parents at different stages of recovery. The amount and complexity of cognitive activity increased with decreasing symptoms and increasing RTS stage. Findings can guide youth with a concussion and their parents in supporting a cautious return to school with accommodations. Healthcare providers and researchers can use this knowledge to better support youth in their return to school and understand the importance of gathering information from youth and their parents to gain the best insight into recovery.
Economic benefit and social impact derived by a food loss prevention strategy in the vegetable sector: A spatial and temporal analysis at the regional level
Authors: Tonini Pietro , Odina Pere Muñoz , Orsini Francesco , Durany Xavier Gabarrell 
Published: December 2022

IntroductionReduction of food loss in the horticultural sector is critical to simultaneously support the transition toward a diet with higher consumption of vegetables and the achievement of policy goals aimed at halving the quantity of wastage by 2030. However, the lack of precise information and the presence of múltiple interconnected factors makes it difficult to assess the potential socioeconòmic benefits and therefore the decision-making process of food loss reduction strategies.MethodsA case study approach has been used to assess the econòmic loss and nutrional impact of food loss in the horticulture primary production. The selection of the main vegetable products was based on an historical series while econòmic and nutritional impact were estimated starting from national and European indicator.ResultsThe food loss correspond to 26% of the total production and 14% of the total agricultural production econòmic value. The social analysis confirm the possibility of redistributing food loss among the population even in the most critical months and areas.DiscussionThe combination of social and econòmic indicator resulted essential to provide key information at the decision-making level to pave the way for the elaboration of short- and long-term food loss reduction strategies. Indeed, no single-bullet strategy can be applied to overcome the problem of food loss as many actor with different needs are involved.
Current treatment strategies for primary upper extremity deep venous thrombosis; a retrospective observational multicenter case series
Authors: de Kleijn R. J. C. M. F. , Schropp L. , Westerink J. , Nijkeuter M. , van Laanen J. , Teijink J. , Ünlu C. , Vos A. W. F. , van Hattum E. S. , Petri B. J. , de Borst G. J. 
Published: December 2022

IntroductionCurrent treatment strategies for primary upper extremity deep venous thrombosis (pUEDVT) range from conservative treatment with anticoagulation therapy to invasive treatment with thoracic outlet decompression surgery (TOD), frequently combined with catheter directed thrombolysis, percutaneous transluminal angioplasty, or stenting. Due to a lack of large prospective series with uniform data collection or a randomized trial, the optimal treatment strategy is still under debate. We conducted a multicenter observational study to assess the efficacy and safety of both the conservative and invasive treatment strategies for patients with pUEDVT.MethodsWe retrospectively collected data from patients treated in five vascular referral and teaching hospitals in the Netherlands between 2008 and 2019. Patients were divided into a conservative (Group 1), an invasive treatment group (Group 2) and a cross-over group (Group 3) of patients who received surgical treatment after initial conservative therapy. Follow-up consisted of outpatient clinic visits and an electronic survey. Primary outcome was symptom free survival defined as absence of any symptom of the affected arm reported at last follow-up regardless of severity, or extent of functional disability. Secondary outcomes were incidence of bleeding complications, recurrent venous thromboembolism, surgical complications, and reinterventions.ResultsA total of 115 patients were included (group 1 (N = 45), group 2 (N = 53) or group 3 (N = 27). The symptom free survival was 35.6%, 54.7% and 48.1% after a median follow-up of 36, 26 and 22 months in groups 1, 2 and 3 respectively. Incidence of bleeding complications was 8.6%, 3.8% and 18.5% and recurrent thrombosis occurred in 15.6%, 13.2% and 14.8% in groups 1–3 respectively.ConclusionIn this multicenter retrospective observational cohort analysis the conservative and direct invasive treatments for pUEDVT were deemed safe with low percentages of bleeding complications. Symptom free survival was highest in the direct surgical treatment group but still modest in all subgroups. Perioperative complications were infrequent with no related long term morbidity. Of relevance, pUEDVT patients with confirmed VTOS and recurrent symptoms after conservative treatment may still benefit from TOD surgery. However, symptom free survival of this delayed TOD seems lower than direct surgical treatment and bleeding complications seem to occur more frequently.