bluuebunny/crossref_metadata_2025_split huggingface dataset:
Independent Supported Housing for non-homeless individuals with severe mental illness: Comparison of two effectiveness studies using a randomised controlled and an observational study design
Authors: Adamus Christine , Mötteli Sonja , Jäger Matthias , Richter Dirk 
Published: November 2022

BackgroundNo randomised controlled study (RCT) on the effectiveness of Independent Supported Housing (ISH) vs. housing as usual (HAU) settings for non-homeless individuals with severe mental illness (SMI) has been conducted to date because of limited feasibility. Alternative designs, such as observational studies, might be suitable for providing adequate evidence if well conducted. To test this hypothesis, this article reports on a prospective, direct comparison of the designs of two parallel studies in this field.MethodsA two-centre, parallel-group non-inferiority effectiveness study was conducted at two locations in Switzerland using identical instruments and clinical hypotheses. One centre applied an RCT design and the other an observational study (OS) design with propensity score methods (ClinicalTrials.gov: NCT03815604). The comparability of the two study centres was investigated in terms of participants, procedures, and outcomes. The primary outcome was social inclusion and the secondary outcomes were quality of life and psychiatric symptoms.ResultsThe study included 141 participants (RCT:n= 58; OS:n= 83). Within one year, 27% study dropouts occurred (RCT: 34%; OS: 22%). A similar balance of sample characteristics was achieved in the RCT and the OS using propensity score methods (inverse probability of treatment weighting). After one year, ISH was non-inferior to the control condition regarding social inclusion (mean differences [95% CI]) in the RCT (6.28 [–0.08 to 13.35]) and the OS (2.24 [–2.30 to 6.77]) and showed no significant differences in quality of life (RCT: 0.12 [–0.52 to 0.75]; OS: 0.16 [–0.26 to 0.58]) and symptoms (RCT: –0.18 [–0.75 to 0.40]; OS: 0.21 [–0.17 to 0.60]) in both study centres. However, strong and persistent preferences for ISH in the RCT control group reduced participants’ willingness to participate. Because of several limitations in the RCT, the results of the RCT and the OS are not comparable.ConclusionParticipants were comparable in both study sites. However, there were significant problems in conducting the RCT because of strong preferences for ISH. The OS with propensity score methods provided results of more stable groups of participants and revealed balanced samples and valid outcome analysis. Our results do not support further investment in RCTs in this field.
Awareness and knowledge of autism spectrum disorder in Western China: Promoting early identification and intervention
Authors: Wei Hua , Li Yan , Zhang Yu , Luo Jinmei , Wang Shuang , Dong Qiujun , Tao Yuanyuan , Gong Ling , Feng Yang , Shi Mingmei , Cao Zhenghui , Liu Yongfang , Chen Li , Liu Xiao , Dai Ying , Qu Lingling , Song Zhao , Chen Jie , Li Tingyu , Cheng Qian 
Published: November 2022

PurposeGiven the increasing prevalence of autism spectrum disorder (ASD) and the public health problems it creates; early identification and interventions are needed to improve the prognosis of ASD. Hence, this study surveyed different groups of people who are likely to have early contact with autistic children to provide an informed basis for early detection and effective diagnosis and interventions.MethodsThree groups of people were recruited for the study from Changshou District and Wushan County of Chongqing, in Western China: 269 medical workers, 181 educators, and 188 community residents. Their understanding and knowledge of autism was measured using a self-made questionnaire.ResultsThe positive finding was that the three groups had a certain level of understanding of autism, but they had some misunderstandings of the core problems, and there were significant differences in the understanding of autism among the three groups. Younger medical workers knew more about autism than older ones did. The ability of educators and community residents to identify autistic symptoms was positively related to their level of education and their experience with autistic children. Television and the internet were the main sources of information about autism for participants.ConclusionsThe medical workers, educators, and community residents in the investigated areas in western China may be able to identify early signs of autism but have an inadequate understanding of autism. In areas far from cities, it is necessary to strengthen the training of medical workers in primary health care to promote autism screening and referral in educational institutions and communities. Using internet technology to provide public education and professional training about autism in remote areas could be a very promising method in Western China.
Validation of the sleep disturbance scale for children (SDSC) in infants and toddlers from mainland China
Authors: Chen Xianrui , Xu Ping , Chen Yanhui , Chen Shan , Yao Yonghua , Lin Xiaoxia 
Published: November 2022

The sleep disturbance scale for children (SDSC) has been validated in the population of Chinese children (aged 5–16 years) and has good psychometric properties. However, valid assessment tools for sleep problems in the population of infants and young children from mainland China are relatively scarce, and rates of screening and management for pediatric sleep problems are low.ObjectiveThis study is to evaluate the reliability and validity of SDSC among infants (aged 6–36 months), and to provide a reference for expanding the application of the SDSC for Chinese infants (SDSC-I).Materials and methodsFrom April to November 2021, parents of infants from Fuzhou, Quanzhou, Longyan, Sanming, and Nanping cities in Fujian Province, China completed the SDSC-I. Several factor analyses were performed to evaluate the reliability and validity of the scale.ResultsOf note, 432 out of 469 samples were valid. After item selections and exploratory factor analyses, the SDSC-I concluded six dimensions (disorders of initiating sleep, disorders of maintaining sleep, sleep hyperhidrosis, sleep breathing disorders, parasomnias, and non-restorative sleep and excessive somnolence) with 23 items. The Cronbach’s α coefficient of the scale was 0.863, and those for the six dimensions were within 0.576–0.835. The values of parameters for content validity of the scale were: IR = 0.87, I-CVI &gt; 0.78, Kappa value &gt; 0.74, S-CVI/UA = 0.87, S-CVI/Ave = 0.98. Principal component analysis revealed that the Kaiser-Meyer-Olkin (KMO) value was 0.84, and the factor loading of items ranged from 0.328 to 0.849, with six factors of eigenvalue more than one, which could explain 58.274% of the total variance. The confirmatory factor analysis results showed that χ2/DF was 3.556, root-mean-square error of approximation (RMSEA) was 0.077, comparative fit index (CFI) was 0.809, and standardized RMR (SRMR) was 0.070.ConclusionOur study provides evidence that the SDSC-I is reliable and valid, and it is effective for the screening and management of sleep disturbances among infants (aged 6–36 months). Compared with other questionnaires such as the Brief Infant Sleep Questionnaire (BISQ), it is worthy of popularization and application in pediatric primary care.
Cervical cancer screening uptake: A randomized controlled trial assessing the effect of sending invitation letters to non-adherent women combined with sending their general practitioners a list of their non-adherent patients (study protocol)
Authors: Teigné Delphine , Banaszuk Anne-Sophie , Grimault Charlotte , Abes Linda , Gaultier Aurélie , Rat Cédric 
Published: November 2022

IntroductionCervical cancer (CC) is the fourth most common cancer among women. It can be cured if diagnosed at an early stage and treated promptly. The World Health Organization suggests that 70% of women should be screened with a high-performance test by the age of 35. This paper reports a protocol to assess the effect of two modalities of organized CC screening programmes on CC screening uptake.Methods and analysisDesign and setting: The design involves a 3-arm randomized controlled study performed in a French geographic area on the west coast. A total of 1,395 general practitioners will be randomized, depending on their general practice surgeries. Participants: The design is based on a total of 94,393 women aged 40 to 65 years who are eligible for CC screening. Intervention: In the “optimized cancer screening” group, the intervention will combine sending invitation letters to non-adherent women with sending general practitioners (GPs) a list of their non-adherent patients. In the “standard cancer screening” group, the intervention will be limited to sending invitation letters to non-adherent women. In the “usual care” group, no letter will be sent either to women or to their GPs. Primary endpoint: CC screening test uptake will be assessed after a 6-month follow-up period. Statistical analysis: The percentage of women who are up-to-date with their screening at 6 months after the intervention will be compared across arms using a generalized mixed linear model.DiscussionA large-scale randomized trial of this nature is unprecedented. The study will enable us to assess a strategy relying on GPs, identified as the coordinators in this screening strategy. The study results should help policy makers to implement organized CC screening programs in the future.Ethics and disseminationThe study was approved was approved by the Ethics Committee of the National College of Teaching General practitioners (IRB00010804). It was recorded in ClinicalTrials.gov on the number NCT04689178 (28 December 2020). The study findings will be used for publication in peer-reviewed scientific journals and presentations in scientific meetings.
Virtual reality for neurorehabilitation: A bibliometric analysis of knowledge structure and theme trends
Authors: Guo Qi-Fan , He Lin , Su Wei , Tan Hui-Xin , Han Lian-Yi , Gui Chen-Fan , Chen Yi , Jiang Han-Hong , Gao Qiang 
Published: November 2022

BackgroundAs an emerging technology, virtual reality (VR) has been broadly applied in the medical field, especially in neurorehabilitation. The growing application of VR therapy promotes an increasing amount of clinical studies. In this paper, we present a bibliometric analysis of the existing studies to reveal the current research hotspots and guide future research directions.MethodsArticles and reviews on the related topic were retrieved from the Science Citation Index Expanded of Web of Science Core Collection database. VOSviewer and Citespace software were applied to systematically analyze information about publications, countries, institutions, authors, journals, citations, and keywords from the included studies.ResultsA total of 1,556 papers published between 1995 and 2021 were identified. The annual number of papers increased gradually over the past three decades, with a peak publication year in 2021 (n = 276). Countries and institutions from North America and Western European were playing leading roles in publications and total citations. Current hotspots were focused on the effectiveness of VR therapy in cognitive and upper limb motor rehabilitation. The clusters of keywords contained the four targeted neurological diseases of VR, while the burst keywords represented that the latest studies were directed toward more defined types of VR therapy and greater study design.ConclusionsOur study offers information regarding to the current hotspots and emerging trends in the VR for rehabilitation field. It could guide future research and application of VR therapy in neurorehabilitation.
Association of visit-to-visit HbA1c variability with cardiovascular diseases in type 2 diabetes within or outside the target range of HbA1c
Authors: Sun Bao , Gao Yongchao , He Fazhong , Liu Zhaoqian , Zhou Jiecan , Wang Xingyu , Zhang Wei 
Published: November 2022

BackgroundAlthough a growing attention has been recently paid to the role of HbA1c variability in the risk of diabetic complications, the impact of HbA1c variability on cardiovascular diseases (CVD) in type 2 diabetes is still debated. The aim of the study is to investigate the association of HbA1c variability with CVD in individuals within or outside the target range of HbA1c.MethodsUsing data from Action in Diabetes and Vascular disease: preterAx and diamicroN-MR Controlled Evaluation (ADVANCE), we enrolled 855 patients with type 2 diabetes in China. The primary outcomes included major macrovascular events and major microvascular events. Visit-to-visit HbA1c variability was expressed as the coefficient of variation (CV) of five measurements of HbA1c taken 3–24 months after treatment. Cox proportional hazard models were used to estimate adjusted hazard ratios (aHR).ResultsAmong 855 patients in the intensive glucose treatment group, 563 and 292 patients were assigned to the group of “within the target range of HbA1c” (WTH) (updated mean HbA1c ≤ 7.0%) and “outside the target range of HbA1c” (OTH) (updated mean HbA1c &gt; 7.0%), respectively. HbA1c variability was positively associated with the risk of major microvascular events in all patients and both the subgroups during a median follow-up period of 4.8 years. Particularly, the risk related to HbA1c variability was higher in patients in WTH group for the new or worsening nephropathy [aHR: 3.35; 95% confidence interval (CI): 1.05–10.74; P = 0.042].ConclusionsThis retrospective cohort study confirmed the positive correlation between HbA1c variability and major microvascular events, especially in subjects in WTH or OTH.
Factors associated with older adults' perception of health risks of hot and cold weather event exposure: A scoping review
Authors: Ratwatte Priyanjali , Wehling Helena , Kovats Sari , Landeg Owen , Weston Dale 
Published: November 2022

IntroductionHot and cold weather events are increasingly becoming a global burden resulting in premature and preventable morbidity and mortality, particularly in vulnerable groups such as older people and people with chronic health conditions. However, risk perception regarding weather is generally poor among vulnerable groups which often acts as a barrier to the uptake of critical health-protective behaviours. A more cohesive understanding of determinants of risk perception is needed to inform public health risk communication and behaviour change interventions that promote protective health behaviours. This scoping literature review aimed to understand factors influencing perception of personal health risks in vulnerable groups as a result of exposure to hot and cold weather events.MethodsA five-stage scoping review framework was followed. Searches were run across Medline, PsychInfo, Web of Science and EMBASE. Papers were included if they provided rationale for risk perceptions in vulnerable groups in indoor/domestic environments and focussed on samples from OECD countries.ResultsIn total, 13 out of 15,554 papers met the full inclusion criteria. The majority of papers focused on hot weather events: one study exclusively examined cold weather events and one study addressed both cold and hot weather events. Included papers focused on older adults aged 65+ years. The papers identified eight factors that were associated with older adults' personal health risk perception of hot and cold weather events: (1) Knowledge of the relationship between hot/cold weather and health risks, (2) presence of comorbidities, (3) age and self-identity, (4) perceived weather severity, (5) Beliefs associated with regional climate, (6) past experience with weather, (7) misconceptions of effectiveness of protective behaviours, and (8) external locus of control.ConclusionsFuture research should explore risk communication methods by implementing the identified risk perception determinants from this review into health protection interventions targeting older adults. Further understanding is needed regarding risk perceptions in non-elderly vulnerable groups, for examples individuals with chronic diseases or disabilities.
Village doctors' dilemma in China: A systematic evaluation of job burnout and turnover intention
Authors: Chen Yuquan , You Yanwei , Shen Yaying , Du Zifei , Dai Tao 
Published: November 2022

BackgroundVillage doctors (VDs) in China undertook arduous primary healthcare missions. However, they received little attention in comparison to doctors in urban public secondary and tertiary hospitals. There is an urgent need to explore the overall situation of turnover intention and job burnout among VDs to evaluate and adjust current health manpower policy.MethodsIn this study, seven databases like PubMed, EMBASE, Web of Science (WOS), WanFang, China Science and Technology Journal Database (VIP), Chinese BioMedical Literature Database (CBM), and China National Knowledge Infrastructure (CNKI) were systematically searched, relevant experts were consulted, and empirical research on job burnout and turnover intention among VDs in international publications was evaluated. Therefore, we evaluated the prevalence of job burnout among VDs in general, across all dimensions and different severity levels, as well as the scores of each category. For turnover intention, we assessed the prevalence of different groups and their overall situation and also identified significant contributors.ResultsIn this study, we integrated 20 research evidences on job burnout and turnover intention among 23,284 VDs from almost all provinces in China, and the prevalence of turnover intention among VDs in China was as high as 44.1% [95% confidence interval (CI): 34.1–54.2], which was two to four times that of primary health workers in high-income countries, but not much different from some developing countries. Simultaneously, VDs with the highest risk of turnover intention were men [odds ratio (OR): 1.22 (1.05–1.43)], those with a monthly income below USD 163.4 [OR: 0.88 (0.78–0.98)], those with a high educational level [OR: 0.88 (0.78–0.98)], and those &lt;40 years old [OR: 1.27 (1.16–1.40)]. Similarly, the detection rate of job burnout toward them was 59.8% (95% CI: 38.7–79.1) with the MBI-GS score being 44.44 (95% CI: 37.02–51.86) in a total of 90, while the detection rate of job burnout in moderate and above almost reached 20%. The most significant contributor that affects job burnout was low personal accomplishment (LPA), and the detection rate for moderate and higher severity was 65.2% (95% CI: 58.7–71.7).ConclusionAttention should be paid to the high turnover intention and severe job burnout of primary health workers in rural areas of developing countries, and targeted measures should be taken to improve the situation. Health policymakers should increase financial subsidies for VDs, set a reasonable workload, improve various health policies such as pension insurance for VDs, and encourage “targeted training” for medical students to enrich and expand their team.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42021289139.
Sustainability in pediatric hospitals: An exploration at the intersection of quality improvement and implementation science
Authors: Malone Sara , Newland Jason , Kudchadkar Sapna R. , Prewitt Kim , McKay Virginia , Prusaczyk Beth , Proctor Enola , Brownson Ross C. , Luke Douglas A. 
Published: November 2022

BackgroundAlthough new evidence-based practices are frequently implemented in clinical settings, many are not sustained, limiting the intended impact. Within implementation science, there is a gap in understanding sustainability. Pediatric healthcare settings have a robust history of quality improvement (QI), which includes a focus on continuation of change efforts. QI capability and sustainability capacity, therefore, serve as a useful concept for connecting the broader fields of QI and implementation science to provide insights on improving care. This study addresses these gaps in understanding of sustainability in pediatric settings and its relationship to QI.MethodsThis is a cross-sectional observational study conducted within pediatric academic medical centers in the United States. Clinicians surveyed worked with one of three evidence-based clinical programs: perioperative antimicrobial stewardship prescribing, early mobility in the intensive care unit, and massive blood transfusion administration. Participants completed two assessments: (1) the Clinical Sustainability Assessment Tool (CSAT) and (2) a 19-question assessment that included demographics and validation questions, specifically a subset of questions from the Change Process Capability Questionnaire, a QI scale. Initial descriptive and bivariate analyses were conducted prior to building mixed-effects models relating perceived QI to clinical sustainability capacity.ResultsA total of 181 individuals from three different programs and 30 sites were included in the final analyses. QI capability scores were assessed as a single construct (5-point Likert scale), with an average response of 4.16 (higher scores indicate greater QI capability). The overall CSAT score (7-point Likert scale) was the highest for massive transfusion programs (5.51, SD = 0.91), followed by early mobility (5.25, SD = 0.92) and perioperative antibiotic prescribing (4.91, SD = 1.07). Mixed-effects modeling illustrated that after controlling for person and setting level variables, higher perceptions of QI capabilities were significantly related to overall clinical sustainability.ConclusionOrganizations and programs with higher QI capabilities had a higher sustainability capacity, even when controlling for differences at the individual and intervention levels. Organizational factors that enable evidence-based interventions should be further studied, especially as they relate to sustainability. Issues to be considered by practitioners when planning for sustainability include bedside provider perceptions, intervention achievability, frequency of delivery, and organizational influences.
Efficacy analysis of 26 cases of ejaculatory duct obstruction treated by prostatic utricle neck endoscopy
Authors: Lv Kun-Long , Sun Wen-Gong , Zhang Tian-Biao , Zheng Tao , Nan Yong-Hao , Liu Yong-Fei , Zhou Yi-Fan , Wang Rui 
Published: November 2022

ObjectiveTo evaluate the safety and efficacy of transvesical incision in the treatment of ejaculatory duct obstruction.MethodsThe clinical data of 26 male infertile patients with ejaculatory duct obstruction were retrospectively analysed at the First Affiliated Hospital of Zhengzhou University from June 2020 to August 2021. All patients were treated with seminal vesicle neck incision for ejaculatory duct obstruction. The general clinical characteristics, intraoperative conditions and postoperative effects on the patients were recorded, and the therapeutic effect was evaluated.ResultsThe ejaculatory duct was found through fenestration, and the seminal vesicle gland was smoothly entered in 25 patients (96.2%). Among them, 22 cases underwent bilateral endoscopy and three underwent unilateral endoscopy. Sperm appeared in 23 cases (88.5%) 3 months after surgery. The sperm concentration and motility postoperatively at 6 months were higher than that at 3 months postoperatively. No postoperative complications, such as epididymitis or retrograde ejaculation, occurred.ConclusionSearching for the ejaculatory duct via the neck of the prostatic utricle, assisted by a low-energy holmium laser, is a new method for the treatment of ejaculatory duct obstruction. Microscopic vision is clear using this approach and the postoperative complications are few, which has high value for clinical application.