bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychotherapeutic Consultation Services in the Workplace: A Longitudinal Analysis of Treatments and Sick Leave Using Health Insurance Data
Authors: Gantner Melanie , Jarzcok Marc Nicolas , Schneider Jürgen , Brandner Stefan , Gündel Harald , von Wietersheim Jörn 
Published: March 2022

BackgroundPsychotherapeutic consultation services in the workplace (PSIW) have been developed to provide collaborative mental health care for employees. The aim of this study was to analyze participant characteristics, the role of PSIW in treatment courses, and the development of sick leave before and after PSIW start.MethodsRoutine data from PSIW and health insurance of 155 participants were analyzed descriptively and by means of a multilevel negative binomial regression.ResultsEighty-four percent of users were male, and 72% were diagnosed with a mental disorder. The number of PSIW consultations varied from 1 to 13 (mean = 4). For 34% of participants, PSIW sessions were sufficient, 33% received a recommendation for outpatient psychotherapy, and 20% for inpatient mental health treatment. While recommendations for inpatient treatment displayed a high adherence rate (74%), recommendations for outpatient treatment were followed by 37%. Compared with the period of a half-year before PSIW, sick-leave days were reduced from the period of the second half-year after PSIW start and in the subsequent observed half-year periods. Trajectories of sick leave by subgroups showed differences.ConclusionsPSIW is a flexible care offer, and results indicate a possible effect of PSIW on sick leave. In future studies, control group designs and inclusion of further variables are needed.
Gaming Disorder Symptom Questionnaire: The Development and Validation of a Screening Tool for ICD-11 Gaming Disorder in Adolescents
Authors: Zhang Lina , Luo Tao , Hao Wei , Cao Yuanyuan , Yuan Ming , Liao Yanhui 
Published: March 2022

BackgroundGaming disorder (GD) has been recognized as an official diagnostic entity in the latest revision of the International Classification of Diseases (ICD-11). However, the majority of previous studies used different instruments, which are not fully consistent with the concept of GD in ICD-11. The development of a screening assessment instrument based on ICD-11 for this new disease entity is very urgent and important.MethodsThe ICD-11 Gaming Disorder Symptom Questionnaire (GDSQ), based on the ICD-11 diagnostic guidelines for GD, was developed by a team of GD experts. A total of 7,790 adolescents were included in this study. Criterion validity was assessed by GDSQ, Video Gaming Dependency Scale (VGDS), weekly game playing time, weekly game video viewing time, and monthly money spent on games. Item structure was measured by factorial analysis. Discrimination between GD and non-GD was examined based on the receiver characteristic curve (ROC).ResultsThe GDSQ was very well described by three symptoms of GD (i.e., impaired control, increasing priority to gaming, and continued use despite the occurrence of negative consequences). The internal consistency was excellent (Cronbach's α = 0.964) with good criterion validity and good discriminatory power. The optimal cutoff point for determining the profile of gamers was found to be ≥62 points. The GDSQ revealed that the prevalence of GD was 2.27% in this adolescent sample.ConclusionThe ICD-11–based GDSQ is a successfully validated measurement scale for GD among adolescents. This study provides a new tool (GDSQ) for us to effectively identify individuals with risk of GD in medical and non-medical settings.
Aquaporin-4, Connexin-30, and Connexin-43 as Biomarkers for Decreased Objective Sleep Quality and/or Cognition Dysfunction in Patients With Chronic Insomnia Disorder
Authors: Yang Shuai , Kong Xiao-Yi , Hu Ting , Ge Yi-Jun , Li Xue-Yan , Chen Jun-Tao , He Shuo , Zhang Ping , Chen Gui-Hai 
Published: March 2022

ObjectivesTo examine serum concentrations of aquaporin-4 (AQP4), connexin-30 (CX30), connexin-43 (CX43), and their correlations with cognitive function in the patients with chronic insomnia disorder (CID).MethodsWe enrolled 76 subjects with CID and 32 healthy controls (HCs). Serum levels of AQP4, CX30, and CX43 were measured by enzyme-linked immunosorbent assays. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI) and polysomnography, and mood was evaluated with 17-item Hamilton Depression Rating Scale and 14-item Hamilton Anxiety Rating Scale. Cognitive function was evaluated by the Chinese-Beijing Version of Montreal Cognitive Assessment (MoCA-C) and Nine Box Maze Test.ResultsThe serum levels of AQP4, CX43, and CX30 were significantly reduced in the CID group compared to the HCs. Partial correlation analysis showed that the biomarkers showed no significant correlations with PSQI score, AHI, ODI and TS90, but AQP4, CX43, and CX30 were positively associated with the percentage and total time of slow wave sleep in the CID group. Serum concentrations of AQP4 and CX30 were positively associated with MoCA-C score in the CID group, and AQP4 level negatively correlated with spatial working memory errors.ConclusionsSubjects with CID patients have decreased serum levels of AQP4, CX30, and CX43 indicating astrocyte dysfunction, which could be related to poor objective sleep quality and/or cognition dysfunction.
Quality of Life in Internet Use Disorder Patients With and Without Comorbid Mental Disorders
Authors: Dieris-Hirche Jan , te Wildt Bert Theodor , Pape Magdalena , Bottel Laura , Steinbüchel Toni , Kessler Henrik , Herpertz Stephan 
Published: March 2022

IntroductionEvidence from clinical studies on quality of life (QoL) in patients suffering from internet use disorders (IUD) is still limited. Furthermore, the impact of additional mental comorbidities on QoL in IUD patients has rarely been investigated yet.Materials and MethodsIn a cross-sectional clinical study 149 male subjects were analyzed for the presence and severity of an IUD as well as other mental disorders by experienced clinicians. The sample consisted of 60 IUD patients with and without comorbid mental disorders, 34 non-IUD patients with other mental disorders, and 55 healthy participants. Standardized clinical interviews (M.I.N.I. 6.0.0) and questionnaires on IUD symptom severity (s-IAT), QoL (WHOQOL-BREF), depression and anxiety symptoms (BDI-II and BAI), and general psychological symptoms (BSI) were used.ResultsInternet use disorder patients showed significantly reduced QoL compared to healthy controls (Cohen’s d = 1.64–1.97). Furthermore, IUD patients suffering from comorbid mental disorders showed significantly decreased levels of physical, social, and environmental QoL compared to IUD patients without any comorbidity (p &lt; 0.05–0.001). Multiple linear regression analyses revealed that low levels of psychological, social and environmental QoL were mainly predicted by symptoms of depression. IUD factors were only significant predictors for the social and physical QoL.DiscussionInternet use disorder patients with comorbid mental disorder reported the lowest QoL. Depression symptom severity was the most significant predictor of low QoL in IUD. Strategies to reduce depressive symptoms should therefore be considered in IUD treatment to increase patients’ QoL.
Connectivity-Based Brain Network Supports Restricted and Repetitive Behaviors in Autism Spectrum Disorder Across Development
Authors: Zhang Anyi , Liu Lin , Chang Suhua , Shi Le , Li Peng , Shi Jie , Lu Lin , Bao Yanping , Liu Jiajia 
Published: March 2022

IntroductionAutism spectrum disorder (ASD) is a lifelong condition. Autistic symptoms can persist into adulthood. Studies have reported that autistic symptoms generally improved in adulthood, especially restricted and repetitive behaviors and interests (RRBIs). We explored brain networks that are related to differences in RRBIs in individuals with ASDs among different ages.MethodsWe enrolled 147 ASD patients from the Autism Brain Imaging Data Exchange II (ABIDEII) database. The participants were divided into four age groups: children (6–9 years old), younger adolescents (10–14 years old), older adolescents (15–19 years old), and adults (≥20 years old). RRBIs were evaluated using the Repetitive Behaviors Scale-Revised 6. We first explored differences in RRBIs between age groups using the Kruskal–Wallis test. Associations between improvements in RRBIs and age were analyzed using a general linear model. We then analyzed RRBIs associated functional connectivity (FC) links using the network-based statistic method by adjusting covariates. The association of the identified FC with age group, and mediation function of the FC on the association of age-group and RRBI were further analyzed.ResultsMost subtypes of RRBIs improved with age, especially stereotyped behaviors, ritualistic behaviors, and restricted behaviors (p = 0.012, 0.014, and 0.012, respectively). Results showed that 12 FC links were closely related to overall RRBIs, 17 FC links were related to stereotyped behaviors. Among the identified 29 FC links, 15 were negatively related to age-groups. The mostly reported core brain regions included superior occipital gyrus, insula, rolandic operculum, angular, caudate, and cingulum. The decrease in FC between the left superior occipital lobe and right angular (effect = −0.125 and −0.693, respectively) and between the left insula and left caudate (effect = −0.116 and −0.664, respectively) might contribute to improvements in multiple RRBIs with age.ConclusionWe identified improvements in RRBIs with age in ASD patients, especially stereotyped behaviors, ritualistic behaviors, and restricted behaviors. The decrease in FC between left superior occipital lobe and right angular and between left insula and left caudate might contribute to these improvements. Our findings improve our understanding of the pathogenesis of RRBIs and suggest potential intervention targets to improve prognosis in adulthood.
Complexities and Context of Scaling Up: A Qualitative Study of Stakeholder Perspectives of Scaling Physical Activity and Nutrition Interventions in Australia
Authors: Koorts Harriet , Maple Jaimie-Lee , Eakin Elizabeth , Lawrence Mark , Salmon Jo 
Published: March 2022

BackgroundScaling up population health interventions is a context-orientated, dynamic and multi-stakeholder process; understanding its influences is essential to enhance future scaling efforts. Using physical activity and nutrition interventions in Australia as case examples, the aim of this paper is to identify core influences involved in scaling up physical activity and nutrition interventions, and how these may differ by context and stakeholder.MethodsA qualitative study involving semi-structured telephone interviews with individuals representing academic, government and non-government organizations with involvement in scaling up state and national physical activity and nutrition interventions. Interview questions were derived from the WHO report “20 Questions for Developing a Scaling up Case Study”, and mapped against four key principles and five core areas in the WHO ExpandNet framework for scaling up: (1) The innovation; (2) User organization; (3) Environment; (4) Resource team and; (5) Scale up strategy. Data were analyzed thematically.ResultsNineteen interviews were conducted (government = 3; non-government = 5; and academic = 11 sectors) involving eight scaled up interventions, targeting nutrition (n = 2), physical activity (n = 1) or a combination (n = 5). Most themes aligned to the “Environment”, including: (i) political (e.g., personal agendas); (ii) social (e.g., lack of urgency); and (iii) sector/workforce (e.g., scale up accountability) factors. Themes relating to “Scale up strategy” (e.g., flexibility and evaluation transparency) were next most commonly occurring. Whilst themes were broadly consistent across participants, government participants had a more policy-oriented perspective on the scale up process. Academics discussed a tension between the generation and use of evidence, and the influence of political climates/interest on scale up decisions.ConclusionAttributes of the “Environment” and “Scale up strategy” consistently featured as major influences on successful outcomes, while the role of evidence differed greatly between participant groups. A multisector scale up strategy for future interventions may enable the complexities of environmental and political contexts to be incorporated into scale up planning.
Predictors of Weight Loss and Weight Loss Maintenance in Children and Adolescents With Obesity After Behavioral Weight Loss Intervention
Authors: Weiland Alisa , Nannette Lena Kasemann , Zipfel Stephan , Ehehalt Stefan , Ziser Katrin , Junne Florian , Mack Isabelle 
Published: March 2022

ObjectivePredictors of body weight loss (BWL) and body weight loss maintenance (BWLM) after behavioral weight loss intervention are well-investigated in adults. Less is known for children and adolescents and a systematic overview on the topic for this age group was aim of the review.MethodsA systematic research according to PRISMA guidelines using several databases was performed. The outcome was the BMI z-Score of longitudinal studies. The extracted predictors were classified in clusters (Physiology, Behavior, Psychology, Environment) and compared with a theory-driven model based on international guidelines and known predictors for adults.ResultsOut of 2,623 articles 24 met the eligibility criteria, 23 investigating BWL and 8 BWLM. The expected key predictor in research for adults “Behavior” was hardly investigated in children. The most examined cluster was “Physiology” with the most significant predictors, in particular genetics (BWL) and blood parameters (BWLM). Factors in the cluster “Psychology” also predicted BWL and BWLM. The cluster “Environment,” which was highlighted in most intervention guidelines, was neglected in studies regarding BWLM and hardly investigated in studies with BWL.ConclusionThe comparison with the theory-driven children model outlined research gaps and differences between predictors for adults and children providing further direction of research.Systematic Review Registrationhttp://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42020200505.
Comparison of Psycho-Social Factors Associated With Suicidal Ideation and Suicide Attempts Among People Living With HIV in Central West China
Authors: Wang Xuelian , Yan Chuanyuan , Tong Yongsheng , Gao Juan , Zhou Wei , Lan Zhichao , Wu Jianlan , Li Hongbing , Yin Yi , Wang Yuehua , Liu Nancy H. , Deng Feng 
Published: March 2022

BackgroundPrevious studies have described the correlation of suicidal ideation (SI) or suicide attempts (SA) in people living with HIV (PLWH), whereas few studies compare the correlation between SI and SA in PLWH. Understanding specific risk factors for SI and SA among PLWH will help with developing tailored and effective suicide prevention strategies among this high-risk group.MethodsA cross-sectional study was conducted from December 2020 to April 2021 in Baoji municipality, Shaanxi Province. The PLWH registered with the Baoji Municipal Center for Disease Control and Prevention (CDC) were recruited and interviewed. Questionnaires and interviews for this study consisted of socio-demographic variables, mental health history, and psychosocial characteristics. The HIV-related clinical features were obtained from CDC medical records. The PLWH included were divided into three groups, i.e., those with a history of suicide attempts (SA group), those with suicidal ideation only (SI group), and those without any suicidal behavior (NSB group). Multinomial logistic regression was used for three-way comparisons among these three groups of PLWH.ResultsIn total, 995 PLWH were interviewed. The prevalence of probable depression, probable anxiety, SI, and SA in PLWH after being diagnosed as HIV+ was 18.6%, 13.5%, 26.7%, and 3.2%, respectively. Compared with the NSB group, the SI or SA groups were more likely to report probable depression [adjusted odds ratio (AOR) = 2.43, 4.44, respectively], probable anxiety (AOR = 2.80, 5.62, respectively), and high HIV-related stigma (AOR = 2.05, 2.65, respectively). The SI group was more likely to experience high HIV-related stress (AOR = 1.91) and lower quality of life (AOR = 0.56) than the NSB group. Social support and HIV-related clinical features were not associated with SI or SA in this sample. The SA group did not differ from the SI group on any of the psychosocial or HIV-related clinical features.ConclusionsMental health problems are serious in community residents identified with having an HIV infection in a Central West China municipality. It is important to deliver low-cost and effective psychological services tailored for PLWH that are focused on reducing mental health problems. Future studies should utilize sensitive screening measures and further clarify factors potentially associated with the transition from SI to SA in PLWH.
Applying Implementation Mapping to Expand a Care Coordination Program at a Federally Qualified Health Center
Authors: Dickson Kelsey S. , Holt Tana , Arredondo Elva 
Published: March 2022

BackgroundA large and growing percentage of medically underserved groups receive care at federally qualified health centers (FQHCs). Care coordination is an evidence-based approach to address disparities in healthcare services. A partnered FQHC established a care coordination model to improve receipt and quality of healthcare for patients most at risk for poor health outcomes. This care coordination model emphasizes identification and support of behavioral health needs (e.g., depression, anxiety) and two evidence-based behavioral health programs needs were selected for implementation within the context of this care coordination model. Implementation Mapping is a systematic process for specifying the implementation strategies and outcomes. The current case study describes the application of Implementation Mapping to inform the selection and testing of implementation strategies to improve implementation of two behavioral health programs in a Care Coordination Program at a partnered FQHC.MethodsWe applied Implementation Mapping to inform the development, selection and testing of implementation strategies to improve the implementation of two evidence-based behavioral health programs within a care coordination program at a partnered FQHC.ResultsResults are presented by Implementation Mapping task, from Task 1 through Task 5. We also describe the integration of additional implementation frameworks (The Consolidated Framework for Implementation Research, Health Equity Implementation Framework) within the Implementation Mapping process to inform determinant identification, performance and change objectives development, design and tailoring of implementation strategies and protocols, and resulting evaluation of implementation outcomes.ConclusionsThe current project is an example of real-world application of Implementation Mapping methodology to improve care outcomes for a high priority population that is generalizable to other settings utilizing similar care models and health equity endeavors. Such case studies are critical to advance our understanding and application of innovative implementation science methods such as Implementation Mapping.
Association Between Exposure to Per- and Polyfluoroalkyl Substances and Birth Outcomes: A Systematic Review and Meta-Analysis
Authors: Gui Si-Yu , Chen Yue-Nan , Wu Ke-Jia , Liu Wen , Wang Wen-Jing , Liang Huan-Ru , Jiang Zheng-Xuan , Li Ze-Lian , Hu Cheng-Yang 
Published: March 2022

BackgroundA large body of emerging evidence suggests that per- and polyfluoroalkyl substances (PFAS) affect birth outcomes in various pathways, but the evidence is inconsistent. Therefore, this study aimed to systematically review the epidemiological evidence on PFAS exposure and birth outcomes.MethodsThree electronic databases were searched for epidemiological studies through February 13, 2021. We used random-effects meta-analysis for eight birth outcome indicators to calculate summary effect estimates for various exposure types. The risk of bias and the overall quality and level of evidence for each exposure-outcome pair were assessed.ResultsThe initial search identified 58 potentially eligible studies, of which 46 were ultimately included. Many PFAS were found to have previously unrecognized statistically significant associations with birth outcomes. Specifically, birth weight (BW) was associated with PFAS, with effect sizes ranging from −181.209 g (95% confidence interval (CI) = −360.620 to −1.798) per 1 ng/ml increase in perfluoroheptanesulfonate (PFHpS) to −24.252 g (95% CI = −38.574 to −9.930) per 1 ln (ng/ml) increase in perfluorodecaoic acid (PFDA). Similar patterns were observed between other PFAS and birth outcomes: perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) with birth length (BL) and ponderal index (PI), PFOS and perfluorododecanoic acid (PFDoDA) with head circumference (HC), PFHpS with gestational age (GA), and perfluorononanoic acid (PFNA) and PFHpS with preterm birth (PTB). Additionally, PFDA showed a statistically significant association with small for gestational age (SGA). The level of the combined evidence for each exposure-outcome pair was considered to be “moderate”.ConclusionThis study showed that PFAS exposure was significantly associated with increased risks of various adverse birth outcomes and that different birth outcome indicators had different degrees of sensitivity to PFAS. Further studies are needed to confirm our results by expanding the sample size, clarifying the effects of different types or doses of PFAS and the time of blood collection on birth outcomes, and fully considering the possible confounders.
Professional Identity of 0.24 Million Medical Students in China Before and During the COVID-19 Pandemic: Three Waves of National Cross-Sectional Studies
Authors: Yu Chen , Liu Qiao , Wang Weimin , Xie Ana , Liu Jue 
Published: March 2022

BackgroundProfessional identity (PI) influences the doctor's thoughts and behaviors. Thus, PI formation (PIF) plays an important role in medical students' education. Major changes to the learning environment could impact PIF, but the influence of the novel coronavirus disease 2019 (COVID-19) pandemic on medical students' PI had confusing conclusions in previous studies. We aimed to compare PI of medical students by using the data from three waves of national cross-sectional surveys conducted in China in 2019, 2020, and 2021, and to examine factors that influence PIF.MethodWe used data from the China Medical Student Survey (CMSS) which has conducted three national cross-sectional surveys. From 2019 to 2021, CMCC retrieved data on PI from a nationally representative sample of medical students from 33, 121, and 123 colleges, respectively. We analyzed the data using Chi-square test, analysis of variance, and multivariable logistic regression according to sociodemographic characteristics, pre-university experience, college characteristics, and college experience.ResultsA total of 244,040 medical students in China participated in the surveys. The overall score of PI increased from 3.80 in 2019 to 3.85 in 2021. Medical students with family medical background, high intrinsic and extrinsic motivation of major selection, teachers' positive role model, and high personal comprehensive quality ranking were more likely to have higher PI (all p &lt; 0.05). The more attention students paid to the COVID-19 pandemic, the higher PI they would have (aOR 1.93, 95% CI 1.67–2.24 for more attention; aOR 2.31, 95% CI 2.00–2.68 for the most attention). However, parents' participation on the front lines of COVID-19 pandemic negatively influenced the PI of medical students (aOR 0.72, 95% CI 0.57–0.93).ConclusionsPI of medical students increased during the COVID-19 pandemic. The impact of the pandemic on PI was complex. To improve the PI of medical students, the education sector, health sector and the society need to make concerted efforts.