bluuebunny/crossref_metadata_2025_split huggingface dataset:
Defining pain-validation: The importance of validation in reducing the stresses of chronic pain
Authors: Nicola Melinda , Correia Helen , Ditchburn Graeme , Drummond Peter D. 
Published: October 2022

PurposeTo validate an individual's feelings or behaviour is to sanction their thoughts or actions as worthy of social acceptance and support. In contrast, rejection of the individual's communicated experience indicates a denial of social acceptance, representing a potential survival threat. Pain-invalidation, though ill-defined, appears to be a fundamental component of psychosocial stress for people with chronic pain. As such, the aim of this paper was to define pain-validation and outline its importance for those with chronic pain.MethodsThe pain-validation construct was defined using themes inherent in the narratives of those with chronic pain, as identified in a previously published systematic search and thematic analysis, together with examination of additional literature on pain-validation in the clinical context.ResultsWe present a construct definition, proposing that pain-validation must necessarily include: (i) belief that the pain experience is true for the individual, (ii) acceptability of the individual's expressions of pain, and (iii) communication of belief and acceptability to the individual experiencing pain. Further, we outline the importance of pain-validation as a protective factor and means of reducing many of the psychosocial stresses of chronic pain; for example, by indicating social support for pain-coping, buffering negative emotions, and re-enforcing unity and shared identity.ImplicationsThe role of pain-validation in the current era of pain management intervention is discussed. Adhering to interventions that involve cognitive and behavioural change is often difficult. Acknowledging and validating the acceptability of the patient's pain experience in the early stages of pain management may, therefore, be a key component of intervention that encourages compliance to the treatment plan and achieving therapeutic goals.
Caregiver distress: A mixed methods evaluation of the mental health burden of caring for children with bladder exstrophy
Authors: Spencer Katelyn A. , Ramji Jaishri , Unadkat Pooja , Nadeem Iqra , Lalakia Parth A. , Shah Jay , Reddy Pramod P. , Canning Douglas A. , Pippi-Salle Joao , Merguerian Paul , Kundu Anjana , Weiss Dana A. , Shukla Aseem R. , Joshi Rakesh , Frazier Jennifer R. 
Published: October 2022

IntroductionCaring for children with bladder exstrophy-epispadias complex (BEEC) exacts a long-term emotional toll on caregivers. Previous studies leave a gap in understanding the impact that caring for a child with BEEC has on caregivers in low- and middle-income countries (LMIC). We hypothesize that families and caregivers experience psychological distress that has long gone unaddressed.Materials and methodsFrom 2018 to 2020, researchers conducted a multi-method evaluation of caregiver distress with participants recruited as part of the annual International Bladder Exstrophy Collaboration based in Ahmedabad, Gujarat, India. In 2018, pilot data was collected through cognitive interviews. In 2019, researchers conducted structured interviews predicated on themes from the previous year, which subsequently prompted formal mental health screenings in 2020. Caregivers who reported suicidal thoughts were immediately referred for intervention.ResultsIn 2018, caregivers described the primary source of stigma arose from their village (n = 9, 26.5%). Caregivers also identified long-term concerns (n = 18, 52.9%), including future fertility and marital prospects, as sources of anxiety. In 2019, caregivers substantiated preliminary findings with the primary source of anticipated (n = 9, 31%) and experienced (n = 19, 65.5%) stigma again stemming from their communities. Both cohorts identified the collaboration as a positive source of support (n = 23, 36.5%). In 2020, caregivers stated decreased emotional wellbeing as number of subsequent repairs increased (n = 54, 75%, p = 0.002). Caregivers of children who underwent initial surgery within 5 years of screening reported higher anxiety (n = 46, 63.8%) and this was exacerbated as the number of subsequent repairs increased (p = 0.043).ConclusionComplex, long-term course of care, including additional surgeries, significantly impacts caregiver distress in the LMIC setting. Screening for caregivers of children with complex congenital anomalies, like BEEC, should be an essential element of any comprehensive effort to alleviate the global burden of disease.
Predictors of advanced chronic kidney disease in infancy after definitive vesicoamniotic shunting for congenital lower urinary tract obstruction
Authors: Katsoufis Chryso Pefkaros , DeFreitas Marissa , Leuchter Jessica , Seeherunvong Wacharee , Chandar Jayanthi , Abitbol Carolyn 
Published: October 2022

BackgroundSevere congenital lower urinary tract obstruction (cLUTO) is associated with poor postnatal outcomes, including chronic and end stage kidney disease, and high mortality. Studies of the impact of fetal intervention through vesicoamniotic shunting are marred by a device malfunction rate of up to 60%. In this study, we delineate the postnatal course and infant kidney function following definitive urinary diversion in utero.Materials and MethodsThis is a retrospective, single-center cohort study of 16 male infants who survived the fetal intervention to birth, from 2010 to 2014 at a single center. All had patent shunts in place at birth. Perinatal and biochemical characteristics were collected with patients followed for one year, or until demise, with serial measures of serum creatinine (SCr) and serum cystatin C (CysC).ResultsOf the 16 males, 81% were non-white (38% black, 43% Hispanic). Shunts were placed at a median of 20 weeks (IQR 19,23) gestation, with median fetal bladder volume of 39 cm3 (IQR 9.9,65). All neonates were born preterm [median 34 weeks (IQR 31,35)] and the majority with low birth weight [median 2340 grams (1,895, 2,600)]. 63% required positive pressure ventilation. Advanced chronic kidney disease stage 4–5 at 1 year of age was predicted by neonatal characteristics: peak SCr ≥2 mg/dl, time to peak SCr &gt; 6 days, discharge SCr ≥1.0 mg/dl, CysC ≥2.5 mg/l, urine protein:creatinine ≥4.8 mg/mg, urine microalbumin:creatinine ≥2.2 mg/mg. In infancy, a nadir SCr ≥0.5 mg/dl occurring before 160 days (5.3 months) of age was also predictive of advanced chronic kidney disease stage 4–5 at 1 year. Three patients died in the neonatal period, with 1 receiving kidney replacement therapy (KRT). Three additional patients required KRT before 12 months of age.ConclusionsEven with definitive vesicoamniotic shunting for cLUTO, postnatal morbidity and mortality remain high, emphasizing the role of renal dysplasia, in spite of urinary diversion, in postnatal kidney dysfunction. Neonatal and infant biochemical parameters exhibit distinct trends that offer families and physicians a better understanding of the prognosis of childhood kidney function.
Transcriptomic analysis of the anti-inflammatory effect of Cordyceps militaris extract on acute gouty arthritis
Authors: Jiao Chunwei , Liang Huijia , Liu Li , Li Shunxian , Chen Jiaming , Xie Yizhen 
Published: October 2022

Background: Gouty arthritis (GA) is a common inflammatory disease that causes pain due to the deposition of monosodium urate (MSU) crystals into joints and surrounding tissues. Anti-inflammatory drugs have significant clinical anti-inflammatory and analgesic effects, but they have many side effects. Cordyceps militaris is an edible and medicinal fungus, and its extract (CME) has good anti-inflammatory and analgesic effects. This study aimed to investigate the anti-inflammatory effect of CME on GA and its underlying mechanism.Methods: The effect of CME on the expression of related inflammatory factors and histopathological changes in the MSU-induced acute inflammatory gout model in rats was studied by ELISA and HE, and its anti-inflammatory mechanism was analyzed by transcriptome combined with RT-qPCR.Results: CME significantly improved gait scores and joint swelling in GA rats, and reduced MSU-induced inflammatory cell infiltration. CME inhibited MSU-induced inflammatory responses by reducing the levels of pro-inflammatory factors TNF-α, IL-1β, IL-6, and Caspase-1 and increasing the anti-inflammatory factor IL-10. Transcriptome analysis showed that CME significantly altered inflammation-related cytokine pathways, and identified four major genes involved in regulation of inflammation, CCL7, CSF2RB, LIF, and IL-1β. In addition, RT-qPCR was performed to verify these differential genes.Conclusion: CME significantly alleviated the inflammatory progression of GA and ameliorated the onset of GA. The underlying mechanism may be related to triggering the cytokine-cytokine receptor interaction signaling pathway to inhibit the activation of the inflammasome and regulate the immune system. And it regulates the inflammatory response induced by MSU crystals through the genes CCL7, CSF2RB, and IL-1β.
Using electronic admission data to monitor temporal trends in local medication use: Experience from an Australian tertiary teaching hospital
Authors: Woodman Richard J. , Horwood Chris , Kunnel Aline , Hakendorf Paul , Mangoni Arduino A. 
Published: October 2022

Background and aims: Medication usage varies according to prescribing behavior, professional recommendations, and the introduction of new drugs. Local surveillance of medication usage may be useful for understanding and comparing prescribing practices by healthcare providers, particularly in countries such as Australia that are in the process of enhancing nationwide data linkage programs. We sought to investigate the utility of electronic hospital admission data to investigate local trends in medication use, to determine similarities and differences with other Australian studies, and to identify areas for targeted interventions.Methods: We performed a retrospective longitudinal analysis using combined data from a hospital admissions administrative dataset from a large tertiary teaching hospital in Adelaide, South Australia and a hospital administrative database documenting medication usage matched for the same set of patients. All adult admissions over a 12-year period, between 1 January 2007 and 31st December 2018, were included in the study population. Medications were categorized into 21 pre-defined drug classes of interest according to the ATC code list 2021.Results: Of the 692,522 total admissions, 300,498 (43.4%) had at least one recorded medication. The overall mean number of medications for patients that were medicated increased steadily from a mean (SD) of 5.93 (4.04) in 2007 to 7.21 (4.98) in 2018. Results varied considerably between age groups, with the older groups increasing more rapidly. Increased medication usage was partly due to increased case-complexity with the mean (SD) Charlson comorbidity index increasing from 0.97 (1.66) in 2007-to-2012 to 1.17 (1.72) in 2013-to-2018 for medicated patients. Of the 21 medication classes, 15 increased (p &lt; 0.005), including antithrombotic agents; OR = 1.18 [1.16–1.21], proton pump inhibitors; OR = 1.14 [1.12–1.17], statins; OR = 1.12; [1.09–1.14], and renin-angiotensin system agents; OR = 1.06 [1.04–1.08], whilst 3 decreased (p &lt; 0.005) including anti-inflammatory drugs (OR = 0.55; 99.5% CI = 0.53–0.58), cardiac glycosides (OR = 0.81; 99.5% CI = 0.78–0.86) and opioids (OR = 0.82; 99.5% CI = 0.79–0.83). The mean number of medications for all admissions increased between 2007 and 2011 and then declined until 2018 for each age group, except for the 18-to-35-year-olds.Conclusion: Increased medication use occurred in most age groups between 2007 and 2011 before declining slightly even after accounting for increased comorbidity burden. The use of electronic hospital admission data can assist with monitoring local medication trends and the effects of initiatives to enhance the quality use of medicines in Australia.
Relationship between social support and parenting sense of competence in puerperal women: Multiple mediators of resilience and postpartum depression
Authors: Shang Xingchen , Li Lin , Niu Changmin , Liao Yuexia , Gao Shuang 
Published: October 2022

BackgroundMaternal role competence is an important marker of achievement in the role of the mother, but parenting sense of competence (PSOC) among puerperal women is not high. Psychosocial factors, particularly social support, postnatal depression and resilience, have been identified as significant predictors of maternal role competence. However, information is limited regarding the mechanisms through which these psychosocial factors affect maternal role competence.ObjectiveTo evaluate the multiple mediators of resilience and postpartum depression (PPD) in the relationship between social support and PSOC in puerperal women.MethodsA cross-sectional study was performed in a tertiary general hospital in Yangzhou, China. A total of 234 puerperal women at 6–8 weeks after birth completed the socio-demographic questionnaires, Social Support Rating Scale, Connor–Davidson Resilience Scale, Edinburgh Postnatal Depression Scale, and PSOC Scale.ResultsResilience and PPD mediated the relationship between social support and PSOC. The mediation effect of resilience and PPD and the total mediation effect were significant, individually accounting for 22.96, 21.70, and 44.65%, respectively, of the total effect. Moreover, pairwise contrast between the two indirect effects was not significant. The difference between the two pathways suggests that resilience and PPD play different roles in the relationship between social support and PSOC.ConclusionsThis study showed that social support may exert its effects on PSOC in puerperal women with multiple mediators of resilience and PPD. This therefore highlights potential intervention targets to improve PSOC.
Acceptability of prepayment, social solidarity and cross-subsidies in national health insurance: A mixed methods study in Western Kenya
Authors: Maritim Beryl , Koon Adam D. , Kimaina Allan , Goudge Jane 
Published: October 2022

IntroductionMany low- and middle-income countries are attempting to finance healthcare through voluntary membership of insurance schemes. This study examined willingness to prepay for health care, social solidarity as well as the acceptability of subsidies for the poor as factors that determine enrolment in western Kenya.MethodsThis study employed a sequential mixed method design. We conducted a cross-sectional household survey (n = 1,746), in-depth household interviews (n = 36), 6 FGDs with community stakeholders and key informant interviews (n = 11) with policy makers and implementers in a single county in western Kenya. Social solidarity was defined by willingness to make contributions that would benefit people who were sicker (“risk cross-subsidization”) and poorer (“income cross-subsidization”). We also explored participants' preferences related to contribution cost structure – e.g., flat, proportional, progressive, and exemptions for the poor.ResultsOur study found high willingness to prepay for healthcare among those without insurance (87.1%) with competing priorities, low incomes, poor access, and quality of health services, lack of awareness of flexible payment options cited as barriers to enrolment. More than half of respondents expressed willingness to tolerate risk and income cross-subsidization suggesting strong social solidarity, which increased with socio-economic status (SES). Higher SES was also associated with preference for a proportional payment while lower SES with a progressive payment. Few participants, even the poor themselves, felt the poor should be exempt from any payment, due to stigma (being accused of laziness) and fear of losing power in the process of receiving care (having the right to demand care).ConclusionAlthough there was a high willingness to prepay for healthcare, numerous barriers hindered voluntary health insurance enrolment in Kenya. Our findings highlight the importance of fostering and leveraging existing social solidarity to move away from flat rate contributions to allow for fairer risk and income cross-subsidization. Finally, governments should invest in robust strategies to effectively identify subsidy beneficiaries.
Built environment approaches: Extension personnel's preferences, barriers, and facilitators
Authors: Balis Laura E. , Grocke-Dewey Michelle 
Published: October 2022

IntroductionInterventions that modify the built environment can increase population physical activity levels and prevent chronic disease. The national Cooperative Extension System is poised to implement built environment approaches (i.e., pedestrian/bicycle infrastructure and enhanced access to physical activity spaces), but implementation strategies (i.e., methods or techniques to move research to practice) are needed to improve uptake. Effective implementation strategies address relevant barriers and capitalize on facilitators. The purpose of this study was to understand 1) barriers and facilitators to implementing built environment approaches in two state Extension systems, 2) preferences for built environment approaches, and 3) preferences for implementation strategies.MethodsA cross-sectional online survey was used to understand Extension personnel's preferences for and barriers and facilitators to built environment approaches through a mixed-methods study design. This work was informed by anthropological inquiry as the overall research philosophy, and by the Health Impact Pyramid, Leeman et al.'s classification of implementation strategies, and the Consolidated Framework for Implementation Research as the theoretical frameworks. The survey was distributed to eligible Extension personnel (n = 42) in two states. Quantitative data analysis consisted of numbers/proportions and Friedman tests. Qualitative analysis was completed through a rapid deductive approach to quickly produce actionable results.ResultsFourteen respondents (33%) completed the survey. Most had not implemented physical activity interventions in their communities or had implemented only individual-level interventions, though were interested in implementing built environment approaches. Benches, playground improvements, and crosswalks were the most desired approaches, while facilitation, assessing community strengths and needs, and technical assistance were desired implementation strategies. The most common barriers were relative priority and available resources; facilitators were external policy and incentives and implementation climate.DiscussionExtension personnel are receptive to built environment approaches and engaged with community coalitions. Yet, invested parties prefer individual-level interventions, and agents perceive a lack of resources for implementation. Implementation strategies that build capacity in both the Extension system and community coalitions may address these barriers through increasing relative priority and sharing existing resources. This work is a first step toward compiling implementation strategies to address relevant barriers to built environment approaches in community settings.
Influence of job environment on the online teaching anxiety of college teachers in the online teaching context: The mediating role of subjective well-being
Authors: Zhang Xu , Li Suqi , Wang Shuwen , Xu Jinlei 
Published: October 2022

BackgroundOnline education has been conducted widely in higher education in recent years. While online teaching brings many opportunities, it also poses numerous challenges and issues. This is especially true for college teachers, for whom teaching is considered to be a profession with a high level of burnout and anxiety. The large-scale application of online teaching methods has put teachers in an even more challenging context, which may lead to teaching anxiety affecting their mental health. In online teaching contexts, the question of what factors affect college teachers' online teaching anxiety is worth exploring to help reduce their online teaching anxiety so as to promote their work performance. In this study, therefore, we conducted a survey of college teachers to develop a model of job environment (job demands and job resources), subjective well-being, and online teaching anxiety, and to explore the influences of job environment and subjective well-being on their online teaching anxiety, as well as the mediating effects of subjective well-being between job environments and online teaching anxiety.MethodOf the 1,060 college teachers who participated, 524 were male (49.4%) and 536 were female (50.6%). An online questionnaire was sent to the teachers in January, 2022. Online teaching anxiety, subjective well-being, and job environment scales were adapted and developed. Descriptive analysis, reliability and validity analysis, and structural equation modelling were used to analyse the collected data.ResultsThe study model showed an adequate fit (χ2 = 440.983, RMSEA = 0.070, GFI = 0.942, AGFI = 0.914, NFI = 0.949, and CFI = 0.956), confirming the relationships of job demands and online teaching anxiety (β = 0.310, p &lt; 0.001), job resources and online teaching anxiety (β = – 0.086, p &lt; 0.01), job demands and subjective well-being (β = – 0.411, p &lt; 0.001), job resources and subjective well-being (β = 0.204, p &lt; 0.001), and subjective well-being and online teaching anxiety (β = – 0.435, p &lt; 0.001). Meanwhile, the results also proved the effects of the mediating role of subjective well-being between job demands (95% CI = [– 0.138, – 0.225]), job resources (95% CI = [– 0.119, – 0.064]), and online teaching anxiety. The model accounted for 33.8% (f2 = 0.401) of online teaching anxiety.ConclusionThe results of this study indicated that it is important to reduce job demands and increase job resources to alleviate college teachers' online teaching anxiety to maintain good mental health; while maintaining a high level of college teachers' subjective well-being is also helpful for promoting their work performance. Furthermore, the indirect effects of job demands and job resources on online teaching anxiety mediated by college teachers' subjective well-being were also significant.