bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving equity, efficiency and adherence to referral in Pakistan's eye health programmes: Pre- and post-pandemic onset
Authors: Khan Asad Aslam , Talpur Khalid Iqbal , Awan Zahid , Arteaga Sergio Latorre , Bolster Nigel M. , Katibeh Marzieh , Watts Elanor , Bastawrous Andrew 
Published: July 2022

BackgroundOver one billion people worldwide live with avoidable blindness or vision impairment. Eye Health Programmes tackle this by providing screening, primary eye care, refractive correction, and referral to hospital eye services. One point where patients can be lost in the treatment journey is adherence to hospital referral.ContextPeek Vision's software solutions have been used in Pakistan with the goal of increasing eye health programme coverage and effectiveness. This involved collaboration between health system stakeholders, international partners, local community leaders, social organizers and “Lady Health Workers”.ResultsFrom the beginning of the programmes in November 2018, to the end of December 2021, 393,759 people have been screened, 26% of whom (n = 101,236) needed refractive services or secondary eye care, and so were referred onwards to the triage centers or hospital services. Except for a short period affected heavily by COVID-19 pandemic, the programmes reached an increasing number of people over time: screening coverage improved from 774 people per month to over 28,300 people per month. Gathering and discussing data regularly with stakeholders and implementers has enabled continuous improvement to service delivery. The quality of screening and adherence to hospital visits, gender balance differences and waiting time to hospital visits were also improved. Overall attendance to hospital appointments improved in 2020 compared to 2019 from 45% (95% CI: 42–48%) to 78% (95% CI: 76–80%) in women, and from 48% (95% CI: 45–52%) to 70% (95% CI: 68–73%) in men. These patients also accessed treatment more quickly: 30-day hospital referral adherence improved from 12% in 2019 to 66% in 2020. This approach helped to utilize refractive services more efficiently, reducing false positive referrals to triage from 10.6 to 5.9%. Hospital-based services were also utilized more efficiently, as primary eye care services and refractive services were mainly delivered at the primary healthcare level.DiscussionDespite various challenges, we demonstrate how data-driven decisions can lead to health programme systems changes, including patient counseling and appointment reminders, which can effectively improve adherence to referral, allowing programmes to better meet their community's needs.
Is State-Wise Healthcare Budget Allocation Consistent With the Disease Burden in India? A Quinquennial Account (2015–2019)
Authors: Bagepally Bhavani Shankara , Kumar S. Sajith , Sasidharan Akhil 
Published: July 2022

IntroductionEvidence-based resource allocation may help to achieve immense health gains in resource-limited settings like India. Understanding healthcare expenditure and the corresponding disease burden could provide insights to plan optimal allocation of limited resources. Hence, we aimed to investigate the status and trends of state-wise healthcare budget allocation and the corresponding disease burden.MethodsWe retrieved state-wise healthcare budget allocation information in India for the years 2015 to 2019. Corresponding state-wise disability-adjusted-life-year (DALY) estimates from the Global Burden of Disease, injuries, and Risk Factors Study (GBD) was used to measure disease burden. The allocated budget (in rupees) per DALY was calculated for overall, communicable, and non-communicable diseases (NCDs). Descriptive statistics, correlation and graphical representations were used to identify and evaluate the trends and relationships between state-wise health budget allocation and disease burden.ResultsThe allocated budget per DALY in 2019 was highest for Goa (₹ 34,260 or US$ 486.66) and lowest for Bihar (₹ 2,408 or US $ 34.20). Smaller, less populous states had higher budget allocations per DALY than larger states. Health budget allocation had an inverse relationship with infectious diseases and an identical linear relationship with NCDs. Most state-wise health budget allocations, as well as total disease burden, increased over the years except for Assam, Karnataka, and Himachal Pradesh. Also, such trends are not similar for the injuries and NCD disease burden.DiscussionThe health budget allocation is variable across states as well as between infectious and NCDs. The current increase in the allocated budget is incongruent with the increasing disease burden. There is a need for rapid expansion of healthcare resource allocation guided by evidence in India.
Improving the Communication and Credibility of Government Media in Response to Public Health Emergencies: Analysis of Tweets From the WeChat Official Accounts of 10 Chinese Health Commissioners
Authors: Li Zhigang , Wang Manjia , Zhong Jialong , Ren Yiling 
Published: July 2022

BackgroundA significant public health emergency has appeared worldwide since the beginning of 2020. The spread of negative information about COVID-19 on social media poses a challenge and threat to public health disposition and the credibility of government public opinion.ObjectiveThis study aimed to analyze the rules and characteristics of government media in disseminating information on public emergencies. In addition, find ways and means to improve government media's communication power and credibility.MethodBased on relevant theories and measures of information econometrics, 10 WeChat official accounts of the Chinese government were taken as examples. The Python crawler tool was used to collect data of 10 WeChat official accounts-related tweets. In addition, this study used various tools, such as ROST, UCINET, and SPSS, for statistical analysis and co-word analysis of the data.ResultFrom January 17 to March 31, 2020, 6,612 COVID-19-related tweets were published by 10 WeChat official accounts, which broadcast epidemic overview, epidemic prevention and control, science and disinformation, epidemic assistance, epidemic impact, and negative impact. By analyzing the posting time and content of the tweets, we found that changes in the number of articles posted by the WeChat and changes in content and the progress of the COVID-19 pandemic are nearly synchronized, and most tweets are published at 8:00 am. Furthermore, based on the analytics of high dissemination index and high-frequency words, we propose that there is a significant correlation between the strength of independence and the credibility of the WeChat official account.ConclusionThe three elements of WeChat communication (value, interest, and moving) and the degree of independent innovation of public numbers impact the communication power and credibility of government media. First, if the articles published by the WeChat official account are valuable, interesting, and moving, the communication power of the WeChat official account would get more powerful. Second, increased ability for independent innovation has a positive impact on enhancing the WeChat official account's credibility. Third, government media can improve its governance effects of public health emergencies by enhancing their communication power and credibility.
The effectiveness of Facebook as a social network intervention to increase physical activity in Chinese young adults
Authors: Lau Patrick W. C. , Wang J. J. , Ransdell Lynda L. , Shi Lei 
Published: July 2022

IntroductionFacebook, one of the worlds' most popular online social networks, is easy to access and cost-effective. Its use to enhance individual's physical activity (PA) participation should be examined. This research reviews the effectiveness and successful features of Facebook for influencing PA behaviors in young adults (Study 1), and empirically examines the efficacy of the features purported in increase PA via a Facebook intervention (Study 2).MethodsIn Study 1, PubMed, Medline, SPORT Discus, ERIC, and Embase were searched for articles that identified successful features and effectiveness of Facebook PA interventions published between January 2005 and February 2022. In Study 2, a 4-week Facebook PA intervention with University students was conducted using features identified in Study 1. The PA behaviors with objective (ActiGraph) and subjective (questionnaire) measures, perceived PA level, stage of readiness, effectiveness, and efficiency of Facebook were examined.ResultsStudy 1 concluded that the most effective strategies for producing significant PA changes in young adults using a PA Facebook intervention included the following: Adding behavior modification (goal setting and self-monitoring), using influence agents, recruiting members of an existing network with the snowball technique, being attentive to group size, enhancing social support with motivational quotes, interactive posts, opinion polls, increasing tailored feedback, and providing educational information. Study 2 found no significant difference in PA between the intervention and the control groups, as measured objectively, but the subjective reporting of PA behavior was higher in the intervention group. Compared to the control group, the Facebook PA intervention group reported more positive change in perceived stage of readiness in PA participation, commuting type, sport type, sport venue, sport emotion, and fast breathing or sweating. When features were ranked by the Facebook PA intervention group, motivation (supports from your friends) and tailored feedback (the responses from your friends are really personal and fits you) were the top two ranked features.ConclusionThe use of influence agents in the Facebook PA intervention could address exercise preference and facilitate higher program engagement. Significant differences related to commuting type, sport types, sport venue barriers, and exercise intensity across groups were noteworthy and warrant additional investigation in the future.
Flexible Assertive Community Treatment in Rural and Remote Areas: A Qualitative Study of the Challenges and Adaptations of the Model
Authors: Trane Kristin , Aasbrenn Kristian , Rønningen Martin , Odden Sigrun , Lexén Annika , Landheim Anne Signe 
Published: July 2022

BackgroundFlexible assertive community treatment (FACT) is an innovative model for providing long-term treatment to people with severe mental illness. The model was developed in the Netherlands but is now used in other countries, including Norway, which has a geography different from the Netherlands, with many rural and remote areas. Implementation of innovations is context dependent. The FACT model's potential in rural and remote areas has not been studied. Therefore, we aimed to gain knowledge regarding the challenges and modifications of the model in rural and remote contexts and discuss how they can affect the model's potential in such areas. This knowledge can improve the understanding of how FACT or similar services can be adapted to function most optimally in such conditions. We sought to address the following questions: Which elements of the FACT model do team leaders of the rural FACT teams find particularly challenging due to the context, and what modifications have the teams made to the model?MethodsDigital interviews were conducted with five team leaders from five rural FACT teams in different parts of Norway. They were selected using purposive sampling to include team leaders from some of the most rural teams in Norway. The interviews were analyzed using thematic text analysis.ResultsThe following three themes described elements of the FACT model that were experienced particularly challenging in the rural and remote context: multidisciplinary shared caseload approach, intensive outreach and crisis management. The following eight themes described the modifications that the teams had made to the model: intermunicipal collaboration, context-adaptive planning, delegation of tasks to municipal services, part-time employment, different geographical locations of staff, use of digital tools, fewer FACT board meetings, and reduced caseload.ConclusionsRural and remote contexts challenge the FACT model's potential. However, modifications can be made, some of which can be considered innovative modifications that can increase the model's potential in such areas, while others might move the teams further away from the model.
The Temporal Lagged Relationship Between Meteorological Factors and Scrub Typhus With the Distributed Lag Non-linear Model in Rural Southwest China
Authors: Liao Hongxiu , Hu Jinliang , Shan Xuzheng , Yang Fan , Wei Wen , Wang Suqin , Guo Bing , Lan Yajia 
Published: July 2022

Background:Meteorological factors can affect the emergence of scrub typhus for a period lasting days to weeks after their occurrence. Furthermore, the relationship between meteorological factors and scrub typhus is complicated because of lagged and non-linear patterns. Investigating the lagged correlation patterns between meteorological variables and scrub typhus may promote an understanding of this association and be beneficial for preventing disease outbreaks.MethodsWe extracted data on scrub typhus cases in rural areas of Panzhihua in Southwest China every week from 2008 to 2017 from the China Information System for Disease Control and Prevention. The distributed lag non-linear model (DLNM) was used to study the temporal lagged correlation between weekly meteorological factors and weekly scrub typhus.ResultsThere were obvious lagged associations between some weather factors (rainfall, relative humidity, and air temperature) and scrub typhus with the same overall effect trend, an inverse-U shape; moreover, different meteorological factors had different significant delayed contributions compared with reference values in many cases. In addition, at the same lag time, the relative risk increased with the increase of exposure level for all weather variables when presenting a positive association.ConclusionsThe results found that different meteorological factors have different patterns and magnitudes for the lagged correlation between weather factors and scrub typhus. The lag shape and association for meteorological information is applicable for developing an early warning system for scrub typhus.
The need for location-specific biometeorological indexes in Taiwan
Authors: Wong Ho Ting , Nguyen Tuan Duong 
Published: July 2022

ObjectiveAs most available biometeorological indexes were developed decades ago in western countries, the benefit of using these indexes to study the effect of weather on human health in modern eastern countries is questionable. This study aimed to reconfirm the effectiveness of applying these biometeorological indexes when analyzing demand for daily emergency ambulance services (EAS) in Taipei.MethodsMore than 370,000 EAS usage records were analyzed in this study. The records were first allotted into different time-series data by age, gender, triage level, and case nature (trauma/non-trauma) in order to represent different kinds of daily EAS demand. They were then regressed on biometeorological indexes [Apparent Temperature (AT) and Net Effective Temperature (NET)]; the indexes' additional descriptive power to describe the daily EAS demand over traditional weather factors was then assessed.ResultsNo significant difference was observed in the descriptive powers in terms of effect on daily EAS demand of the biometeorological indexes and traditional weather factors. The largest improvement on the regression models' adjusted-R2 using NET and AT was only 0.008.ConclusionIt may not be a good idea to make direct use of the biometeorological indexes developed in western countries decades ago. Taiwan should have a tailor-made biometeorological index for a better representation of its unique situation.
Mask-wearing behavior during COVID-19 in China and its correlation with e-health literacy
Authors: Zhang Wei , Chen Shu-Fan , Li Kun-Kun , Liu Huan , Shen Hai-Chen , Zhang Xian-Cui 
Published: July 2022

BackgroundDuring the Coronavirus (COVID-19) pandemic, wearing masks became crucial for preventing infection risk and maintaining basic health. Therefore, it is necessary to understand the behavioral characteristics of the mask-wearing public to provide theoretical reference for the prevention and control of COVID-19.MethodsWe conducted a nationwide survey on the mask-wearing behavior of the public and their health literacy levels by distributing electronic questionnaires. Univariate and logistic regression analyses were performed to determine the factors influencing mask-wearing behavior. Pearson's correlation was used to analyze the correlation between mask-wearing behaviors and e-health literacy.ResultsA total of 1,972 valid questionnaires were collected; 99.8% of the public wore masks when going out and 59.2% showed good mask-wearing behavior. Most people choose to wear disposable medical masks (61.3%), followed by medical surgical masks (52.9%). All participants indicated that they had understood the information on how to use masks, and most obtained it through social media (61.8%). The average of the e-health literacy scores of those with good mask-wearing behavior was significantly higher than those with poor mask-wearing behavior (P &lt; 0.05), and each item score of the former's e-health literacy was significantly higher than the latter (P &lt; 0.05). Further, there was a positive correlation between mask-wearing behavior and e-health literacy (R = 0.550, P &lt; 0.05). Logistic regression analysis showed that seven factors are related to mask-wearing behavior, including gender, place of residence, educational level, work or living environment, marital status, flu symptoms, and whether living with people in home quarantine (P &lt; 0.01).ConclusionThe overall compliance of the public's mask-wearing behavior in China during COVID-19 is good. However, there are shortcomings regarding the selection, use, and precautions. The differences in mask-wearing behavior are related to factors including gender, place of residence, educational level, work or living environment, marital status, presence of flu symptoms, and whether living with people in home quarantine. Higher levels of e-health literacy indicated better mask-wearing behavior. Therefore, it is necessary to strengthen the public's popularization and education regarding the prevention and control of COVID-19.
Prevalence and risk factors associated with self-reported psychological distress among college students during the omicron outbreak in Shanghai
Authors: Li Wei 
Published: July 2022

BackgroundMore and more attention has been paid to the mental health of students in higher education. The Omicron outbreak has brought renewed attention to this vulnerable group.ObjectiveTo understand the prevalence and influencing factors of anxiety symptoms and depression symptoms of college students in a closed state.MethodsThis large cross-sectional study using data from a survey on the mental health of college students in Shanghai (China), conducted by using a stratified cluster random sampling method between March 15th and April 15th, 2022. To estimate results related to regional location, only data from students with Internet protocol addresses and current addresses in Shanghai were included. The main outcome was self-reported psychological distress (including depressive symptoms, anxiety symptoms, and self-assessment of health), measured using the epidemiologic studies depression scale (CES-D), the Spielberger state-trait anxiety inventory (STAI) and self-rated mental health (SRMH), respectively. Moreover, the Simplified Coping Style Scale (SCSS) was also used to assess how participants coped with negative emotions.ResultsAmong 13,000 college students who completed the survey, 12,124 students were included in the final analysis, and the total effective rate was 93.3%. The prevalence of depressive symptoms and anxiety symptoms were 14.1 and 9.8%, respectively. By using Multivariate logistics regression analysis, we found that being male and negative coping were risk factors for depressive symptoms and anxiety symptoms, while positive coping, such as study or learning, were protective factors. Moreover, linear regression analysis showed that learning or study improved the overall mental health index by improving anxiety or depressive symptoms, and played a partial mediating role.ConclusionsThese findings suggest that a significant number of college students, especially boys, will experience emotional problems during the course of closed schools. Therefore, we need to give them proper attention and advise them to adopt positive coping strategies, such as learning or study, to resist bad emotions.
The impact of social support and stress on academic burnout among medical students in online learning: The mediating role of resilience
Authors: Liu Yue , Cao Zhe 
Published: July 2022

BackgroundAs the COVID-19 pandemic continues, online learning and long-term isolation from social and clinical settings has exacerbated mental health problems and symptoms of academic burnout among medical students. However, few studies have discussed symptoms of academic burnout as a result of reduced social support, and increased stress among medical students during the process of online learning. To fill this gap, this study investigated the influencing factors and mechanism of academic burnout in medical students' online learning process. Both the positive inhibition effect of positive factors such as social support, and the negative aggravation effect of negative factors such as stress were explored, while the mediating and protecting role of resilience is also discussed.MethodWe collected survey data from a total of 817 medical students from a medical school in China who participated in online learning during the fall 2021 semester. An online questionnaire was sent to the students in January, 2022. Items adapted from the DASS Scale developed by Lovibond and Lovibond were used to measure medical students' stress levels. The perceived social support of medical students was assessed by the Gregory MSPSS. Resilience was evaluated by the 10-Item Connor–Davidson Resilience Scale (CD-RISC). Items from the Maslach Burnout Inventory–Student Survey (MBI-SS) were used to calculate students' academic burnout. Descriptive analysis, correlation analysis, hierarchical linear regression analysis and structural equation modeling were used to analyze the collected data.ResultsThe results identified that in the context of online learning there was a positive correlation between medical students' stress and academic burnout, and their resilience played a partial mediating role. However, social support did not directly affect academic burnout, but inhibited the prevalence of academic burnout through resilience. In addition, stress was negatively related to resilience, while social support was positively related to resilience. Resilience was found to be negatively related to medical students' academic burnout in online learning.ConclusionThe results of this study can provide a reference for the future development of appropriate educational strategies and coping measures to ameliorate the academic burnout of medical students.