bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gender Self-Confidence as a Protective Factor for Suicide Risk: Analysis of the Sample of Lithuanian Men
Authors: Grigienė Dovile , Skruibis Paulius , Dadašev Said , Rimkevičienė Jurgita , Gailienė Danute 
Published: May 2022

BackgroundAlong with other suicide risk factors, masculinity has been analyzed as an important subject for suicidal behavior in men. This study examines masculinity as a gender self-confidence which is the intensity of an individual's belief that he meets his standards for masculinity. We use Hoffman and her colleague's concept, which provides two theoretical constructs as elements of gender self-confidence: gender self-definition and gender self-acceptance. Gender self-definition relates to how salient masculinity is in one's identity; gender self-acceptance relates to how positively one views his masculinity.MethodsThe quantitative research approach was applied in the study. The survey with a nonprobability quota sampling design was implemented to collect the data. The sample consisted of 562 Lithuanian men from various age groups and regions. The age of participants varied from 18 to 92 years (M = 42.99, SD = 17.18); 40.9% of men were from cities, 28.1% from towns, and 30.8% from rural locations. We used the Hoffman Gender Scale to measure gender self-definition and gender self-acceptance. Suicide risk was estimated with the Suicide Behavior Questionnaire—Revised. Patient Health Questionnaire-2 was used to measure depression symptoms as a controlled variable. Statistical analysis of regression and moderation was used to test the hypothesis.ResultsHigher gender self-definition and higher gender self-acceptance were associated with lower suicide risk. The moderation analysis showed that in men with relatively low gender self-definition, the effect of gender self-acceptance on suicidality was larger than in men with high or moderate gender self-definition.DiscussionWe conclude that a stronger gender self-confidence is an important protective factor in male suicide risk. Both, a smaller part of masculinity in one's identity and a negative view of one's masculinity have a cumulative effect on increased suicide risk. The findings have been discussed in accordance with the theories that explain suicidal behavior through the lenses of self-concept.
Stable Anxiety and Depression Trajectories in Late Adolescence for Oral Contraceptive Users
Authors: Doornweerd Anne Marieke , Branje Susan , Nelemans Stefanie A. , Meeus Wim H. J. , Montoya Estrella R. , Engelhard Iris M. , Baas Joke M. P. , Gerritsen Lotte 
Published: May 2022

BackgroundThe use of oral contraceptives (OCs) has been associated with increased incidences of anxiety and depression, for which adolescents seem to be particularly vulnerable. Rather than looking at singular outcomes, we examined whether OC use is associated with depressive and anxiety symptom trajectories from early adolescence into early adulthood.Materials and MethodsData from 178 girls were drawn from the Research on Adolescent Development and Relationships (RADAR-Y) younger cohort study. We used assessments on 9 waves from age 13 until 24. Developmental trajectories of ratings on the Reynolds Adolescent Depression Scale (RADS-2) and the Screen for Child Anxiety Related Emotional Disorders (SCARED) were compared between never and ever users of OCs.ResultsNever users showed increases in depressive and anxiety symptoms in late adolescence, whereas OC users showed a stable level of symptoms throughout adolescence. This effect remained after adjusting for baseline differences between groups in romantic relationships, sexual debut, educational level, smoking, drinking, and drug use. Age of OC use onset did not significantly predict symptom development.ConclusionsOC use in adolescence was related to an altered developmental trajectory of internalizing symptoms, in which OC users did not show an increase in depressive and anxiety symptoms in late adolescence, whereas never users did. The question remains whether this altered symptom trajectory can be considered a protective effect of OC use on psychopathology. Additional research is needed to improve our understanding of the long-term consequences of OC use on mental health.
Altered Intrinsic Brain Activity in Patients With Late-Life Depression: A Resting-State Functional MRI Study
Authors: Liu Chaomeng , Pan Weigang , Zhu Dandi , Mao Peixian , Ren Yanping , Ma Xin 
Published: May 2022

ObjectivesTo investigate the altered intrinsic brain activity (IBA) in patients suffering from late-life depression (LLD) using a percent amplitude of fluctuation (PerAF) method.MethodsIn total, fifty patients with LLD and 40 non-depressed controls (NCs) were recruited for the present research. Participants underwent the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) test and resting-state functional MRI (rs-fMRI) scans. The RBANS test consists of 12 sub-tests that contribute to a total score and index scores across the following five domains: immediate memory, visuospatial/constructional, language, attention, and delayed memory. The PerAF method was used for data analysis to detect changes in neural activity in the relevant brain regions. A receiver operating characteristic (ROC) curve was conducted to evaluate the ability of the RBANS test and proposed the PerAF method in distinguishing the two groups. The relationships between altered IBA and neuropsychologic deficits were determined by the Pearson correlation analysis.ResultsA significant difference existed in RBANS total score, immediate memory, visuospatial/constructional, language, attention, and delayed memory between groups (P &lt; 0.05). Compared with the NCs group, the LLD group demonstrated decreased PerAF differences in the bilateral superior frontal gyrus, orbital part (Frontal_Sup_Orb), and bilateral anterior cingulate cortex (ACC). The PerAF method and RBANS test exhibited an excellent discriminatory power with the area under curve (AUC) values in distinguishing the two groups. In addition, the attention score of the RBANS test positively correlated with the PerAF values of the bilateral Frontal_Sup_Orb and bilateral ACC.ConclusionThe changes of PerAF in the bilateral Frontal_Sup_Orb and bilateral ACC are related to an increased risk of developing LLD. Moreover, the PerAF method could be used as an underlying sensitivity biomarker to identify the psychiatric disorder.
Improved Safety of Hybrid Electroconvulsive Therapy Compared With Standard Electroconvulsive Therapy in Patients With Major Depressive Disorder: A Randomized, Double-Blind, Parallel-Group Pilot Trial
Authors: Zhang Jing-ya , Xu Shu-xian , Zeng Lun , Chen Li-chang , Li Jia , Jiang Zhao-yun , Tan Bai-jian , Gu Chen-long , Lai Wen-tao , Kong Xiao-ming , Wang Jian , Rong Han , Xie Xin-hui 
Published: May 2022

ObjectivesECT is a rapid and effective treatment for depression. While efficacy is often remarkable over the initial 3–4 sessions, the efficacy of later sessions is less rapid, and the side-effects, especially cognitive impairment limit its use. To preliminarily compare the efficacy and acceptability of a novel hybrid-ECT (HECT) protocol for patients with major depressive disorder (MDD) with standard ECT, we conducted this pilot trial.MethodsThirty patients were randomly assigned to ECT or HECT. Both arms received three ECT sessions (phase 1) but, in phase 2, the HECT arm received low-charge electrotherapy instead of ECT. The primary outcome was the change in 24-item Hamilton depression rating scale (HAMD-24) scores between baseline and the end of treatment. Cognitive function was assessed by repeatable battery for the assessment of neuropsychological status (RBANS), Stroop color word, and orientation recovery tests (ORT). Safety was measured by the drop-out rate and adverse events (AEs). Four visits were conducted at baseline, post-phase 1, post-phase 2, and at 1-month follow-up. Trial registration: Chinese Clinical Trial Registry (http://www.chictr.org.cn/), identifier: ChiCTR1900027701.ResultsPatients in both arms showed significant within-group improvements in HAMD-24, but the between-group differences were non-significant. Participants in the HECT arm outperformed ECT patients for most cognitive tests at the end of treatment or at follow-up. There was a significantly lower AE rate and shorter ORT in phase 2 of the HECT ar.ConclusionIn this pilot trial, HECT was associated with fewer AEs and better cognitive function including executive and memory function, but its possible similar antidepressive efficacy needs to be further investigated in future.
Effectiveness of a Parent-Focused Intervention Targeting 24-H Movement Behaviors in Preschool-Aged Children: Study Protocol for a Randomized Controlled Trial
Authors: Feng Jie , Huang Wendy Yajun , Sit Cindy Hui-Ping 
Published: May 2022

BackgroundInterventions targeting single behaviors of preschool-aged children have been mainstream for some time, but integrated interventions targeting all three 24-h movement behaviors (physical activity [PA], sedentary behavior [SB], and sleep hygiene) are less studied. The aims of this study will be to test the feasibility, acceptability, and effectiveness of a parent-focused intervention for preschool-aged children targeting multiple 24-h movement behaviors.MethodsThis three-arm randomized controlled trial will comprise a 12-week intervention and a 12-week follow-up. A total of 150 parent-child dyads will be recruited and randomly allocated to one of three arms: (1) a PA + SB group (dyadic approach), (2) a PA + SB + sleep group (integrated approach), and (3) a wait-list control group. The theory of planned behavior and behavioral change techniques will guide the development of the intervention via workshops, education materials, interactive questionnaires, and reminders. The intervention strategies for the integrated group will be the same as for the dyadic approach except that the intervention will also target sleep hygiene in addition to PA and SB. The primary outcomes will be preschoolers' 24-h movement behaviors (e.g., activity sleep index, compositional data of PA, SB, screen time, and sleep duration). The secondary outcomes will be preschoolers' sleep quality, weight status, cognitive function, and parents' movement behaviors. The feasibility and acceptability of the intervention will also be evaluated.DiscussionThe proposed study will be a theory-based, parent-focused intervention designed to improve all three 24-h movement behaviors among preschoolers. The trial is expected to improve preschoolers' movement behaviors and health outcomes, as well as their parents' movement behaviors. Given the urgent need to promote active lifestyles, our findings will help to determine best practices for movement behavior change among young children.Trial RegistrationThe study is prospectively registered at the Chinese Clinical Trial Registry (ChiCTR2200055958).
Nutritional Characterization of Street Food in Urban Turkmenistan, Central Asia
Authors: Albuquerque Gabriela , Sousa Sofia , Lança de Morais Inês , Gelormini Marcello , Motta Carla , Gonzales Gerard Bryan , Ovezov Azat , Damasceno Albertino , Moreira Pedro , Breda João , Lunet Nuno , Padrão Patrícia 
Published: May 2022

ObjectiveDescribing the availability and nutritional composition of the most commonly available street foods in Ashgabat, Turkmenistan.MethodsOne hundred sixty-one street food vending sites (six public markets) were assessed, through a collection of data on vending sites' characteristics and food availability, and samples of commonly available foods (21 homemade; 11 industrial), for chemical analysis.ResultsFruit, beverages, and food other than fruit were available in 6.8, 29.2, and 91.9% of all vending sites, respectively. Regarding the latter, 52.7% of the vending sites sold only homemade products (main dishes, snacks, cakes, biscuits and pastries, bread, ice-cream chocolate and confectionery, savory pastries and sandwiches), 37.2% only industrial (ice-cream, chocolate and confectionery, cakes, biscuits and pastries, snacks, bread and savory pastries) and 10.1% both. Homemade foods presented significantly higher total fat [homemade 11.6 g (range 6.6–19.4 g); industrial 6.2 g (range 4.0–8.6 g), p = 0.001], monounsaturated, polyunsaturated and trans-fat, and sodium and potassium content per serving. Industrial wafers presented the highest mean saturated (11.8 g/serving) and trans-fat (2.32 g/serving) content. Homemade hamburgers presented the highest mean sodium content (1889 mg/serving).ConclusionsStrategies to encourage the production and sales of healthier street foods, especially homemade, are needed to promote healthier urban food environments in urban Turkmenistan.
Intensity-Modulated Radiotherapy and Three-Dimensional Conformal Radiotherapy Combined with Intracavitary Posterior Radiotherapy for the Treatment of Medium-Term and Advanced Cervical Cancer: Efficacy, Safety and Prognostic Factors
Authors: Yu Kewen , Zhou Liping 
Published: May 2022

ObjectiveTo explore the efficacy, safety, and prognostic factors of intensity modulated radiation therapy (IMRT) and three dimensional conformal radiation therapy (3D-CRT) combined with intracavitary posterior radiotherapy for medium-term and advanced cervical cancer.MethodsRetrospectively analyze the clinical data of 104 patients with medium-term and advanced cervical cancer who were treated in the radiotherapy department of our hospital from September 2015 to March 2017. According to the different radiotherapy techniques, they were divided into the IMRT combined with intracavitary posterior radiotherapy group (n = 52) and the 3D-CRT combined with intracavitary posterior radiotherapy group (n = 52). Observe and compare the short-term efficacy, occurrence of adverse reactions and overall survival rate of the two groups. The clinicopathological characteristics of the survival group and the death group were compared, and univariate analysis and multiple logistic regression models were used to analyze the relationship between the clinicopathological characteristics and the patient’s prognosis.ResultsThe total effective rate of IMRT combined with intracavitary posterior radiotherapy group was 96.15%, which was higher than that of 3D-CRT combined with intracavitary posterior radiotherapy group (88.46%), but the difference was not statistically significant (p &gt; 0.05). The incidence of digestive system injury, thrombocytopenia, and radiation proctitis in the IMRT combined intracavitary posterior radiotherapy group was lower than that of the 3D-CRT combined intracavitary posterior radiotherapy group, and the differences were statistically significant (p &lt; 0.05). The prognosis and survival of the two groups of patients were similar, and the difference was not statistically significant (p &gt; 0.05). Pathological classification, clinical stage, and lymph node metastasis are independent influencing factors of 3-year prognosis in patients with medium-term and advanced cervical cancer (p &lt; 0.05).ConclusionIMRT combined with intracavitary posterior radiotherapy is equivalent to 3D-CRT combined with intracavitary posterior radiotherapy, but it can reduce the incidence of adverse reactions in patients with medium-term and advanced cervical cancer, and has higher safety. Pathological typing, clinical staging, Lymph node metastasis were independent factor affecting the prognosis of patients. In clinical treatment, IMRT combined with intracavitary posterior radiotherapy is more recommended as a treatment plan for patients with medium-term and advanced cervical cancer.
Food Media and Dietary Behavior in a Belgian Adult Sample: How Obtaining Information From Food Media Sources Associates With Dietary Behavior
Authors: Proesmans Viktor Lowie Juliaan , Vermeir Iris , de Backer Charlotte , Geuens Maggie 
Published: May 2022

Objective: We aim to relate Flemish adults’ main food information sources (e.g., celebrity chefs, experts) with their dietary behavior.Methods: A cross-sectional online survey among 1115 Flemish adults who regularly cook, measured the food information sources the respondents used to obtain recipes, their dietary intake and dietary restrictions. Ordinal and logistic regression were used to investigate the relation between food media, dietary intake and dietary restrictions.Results: Celebrity chefs were mentioned most often (37%) as main food information source, followed by family and acquaintances (21%) and lifestyle gurus (12%). Using lifestyle gurus as a source of dietary information is associated with more dietary restrictions and a higher intake frequency of plant-based food groups, whereas using celebrity chefs or experts is associated with a different (but less unequivocal vegetarian or healthy) dietary intake.Conclusion: Media icons like lifestyle gurus and celebrity chefs appear to be among people’s main sources of food information. There is a significant association between using them as a source of food information and dietary behavior. Further research on the influence of media on diet is required.
GPs’ perspectives on diagnosing childhood urinary tract infections: a qualitative study
Authors: Boon Hanne Ann , Van den Bruel Ann , Verbakel Jan Y 
Published: May 2022

BackgroundDiagnosis and management of childhood urinary tract infection (UTI) is challenging in general practice because of a range of factors.AimTo explore GPs’ perspectives concerning the barriers to and facilitators for diagnosis and management of childhood UTI.Design and settingQualitative study in general practice in Belgium.MethodSemi-structured interviews with 23 GPs from January 2021 to June 2021 were carried out. Interviews were video-recorded and audio-recorded, transcribed verbatim, and analysed using a thematic approach.ResultsThe barriers to early diagnosis of UTI were the assumption of low UTI prevalence and aspecific presentation of UTI in children, difficulties in urine collection, and diagnostic uncertainty. All GPs indicated that they sampled urine in either children with specific UTI features (for example, dysuria, abdominal pain) or unexplained fever. Facilitators for UTI screening were instructional material for parents, skill training for GPs, additional nursing staff, novel non-invasive convenient collection methods, online decision support informing parents when to bring a urine sample to the consultation, and an accurate, easy-to-use point-of-care test for UTI. Empirical antibiotic treatment was initiated based on dipstick test results, clinical features suggestive of UTI, severity of illness, gut feeling, long duration of fever, time of the day, and parents’ ability to judge disease severity.ConclusionThe assumption of a low UTI prevalence, absence of obvious UTI features, and difficult urine sampling might cause childhood UTIs to go undetected in general practice. Diagnostic uncertainty makes appropriate treatment challenging.
Implementing video group consultations in general practice during COVID-19: a qualitative study
Authors: Papoutsi Chrysanthi , Shaw Sara , Greenhalgh Trisha 
Published: May 2022

BackgroundGroup consultations have been gaining ground as a novel approach to service delivery. When in-person care was restricted owing to COVID-19, general practice staff began delivering group consultations remotely over video.AimTo examine how multiple interacting influences underpinned implementation and delivery of video group consultations (VGCs).Design and settingQualitative study in general practice in England.Methoda) 32 semi-structured interviews with patients, clinical, and non-clinical staff (from eight GP surgeries in total), NHS policymakers and programme managers, and other stakeholders; b) observation in relevant training and operational meetings; and c) three co-design workshops (21 participants). Thematic analysis was informed by the Planning and Evaluating Remote Consulting Services (PERCS) framework.ResultsIn the first year of the pandemic, VGCs focused on supporting those with long-term conditions or other shared health and social needs. Most patients welcomed clinical and peer input, and the opportunity to access their practice remotely during lockdown. However, not everyone agreed to engage in group-based care or was able to access IT equipment. At practice level, significant work was needed to deliver VGCs, such as setting up the digital infrastructure, gaining team buy-in, developing new patient-facing online facilitation roles, managing background operational processes, protecting online confidentiality, and ensuring professional indemnity cover. Training provided nationally was seen as instrumental in capacity building for VGC implementation.ConclusionSmall scale VGC implementation addressed unmet need during the pandemic. However, embedding VGCs in routine care requires rethinking of operational, infrastructural, and clinical processes. Additional research on costs and benefits at service and patient level is needed.
Communication skills of general practitioners in Nairobi, Kenya: a descriptive observational study
Authors: Mohamoud Gulnaz , Mash Robert 
Published: May 2022

BackgroundHigh-quality primary care needs to be person-centred, and GPs must communicate effectively to ensure continuity and coordination of care. In Kenya, there is little knowledge about the quality of communication in consultations by GPs.AimTo evaluate the quality of communication in consultations by GPs.Design & settingDescriptive, observational study of 23 GP consultations in 13 private sector primary care facilities in Nairobi, Kenya.MethodOne consultation with a randomly selected adult patient was recorded per GP, and 16 communication skills evaluated with the Stellenbosch University Observation Tool (SUOT). A total percentage score was calculated per consultation, and compared with the GPs’ demographics and the consultation complexity and duration using the Statistical Package for Social Sciences (SPSS, version 25).ResultsThe GPs’ median age was 30.0 years (interquartile range [IQR] 29.0–32.0) and median consultation time was 7.0 minutes (IQR 3.0–9.0). Median overall score was 64.3% (IQR 48.4–75.7). GPs demonstrated skills in gathering information, making and explaining the diagnosis, and suggesting appropriate management. GPs did not make an appropriate introduction, explore the context or patients‘ perspectives, allow shared decision making, or provide adequate safety netting. There was a positive correlation between the scores and duration of the consultations (r = 0.680; P = 0.001). The score was higher in consultations of moderate complexity (78.1, IQR 57.1–86.7) versus low complexity (52.2, IQR 45.1–66.6) (P = 0.012).ConclusionConsultations were brief and biomedical by young GPs. GPs need further training in communication skills, particularly with regard to delivering person-centred consultations. Deploying family physicians to the primary care setting would also improve the overall quality of service delivery.