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Olga Perski|Ann Blandford|Robert West|Susan Michie

Conceptualising engagement with digital behaviour change interventions: a systematic review using principles from critical interpretive synthesis

University College London|University College London|Cancer Research UK|University College London|University College London

engagement digital behaviour change interventions dbcis considered important effectiveness evaluating engagement therefore priority however shared understanding usefully conceptualise engagement lacking review aimed synthesise literature engagement identify key conceptualisations develop integrative conceptual framework involving potential direct indirect influences engagement relationships engagement intervention effectiveness four electronic databases ovid medline psycinfo isi web knowledge sciencedirect searched november 2015 identified 117 articles met inclusion criteria studies employing experimental nonexperimental designs adult participants explicitly implicitly referring engagement dbcis digital games technology data synthesised using principles critical interpretive synthesis engagement dbcis conceptualised terms experiential behavioural aspects conceptual framework proposed engagement dbci influenced dbci content delivery context setting dbci used population using behaviour dbci targeting context mechanisms action may moderate influence dbci engagement engagement turn moderates influence dbci mechanisms action research literature engagement dbcis conceptualised terms experience behaviour sits within complex system involving dbci context use mechanisms action dbci target behaviour

https://doi.org/10.1007/s13142-016-0453-1

Deanna C. Denman|Austin S. Baldwin|Andrea C. Betts|Amy McQueen|Jasmin A. Tiro

Reducing “I Don’t Know” Responses and Missing Survey Data: Implications for Measurement

Southern Methodist University|Southern Methodist University|The University of Texas Southwestern Medical Center|University of Texas Health Science Center at Dallas|Washington University in St. Louis|The University of Texas Southwestern Medical Center

dont know dk responses common health behavior research yet analytic approaches managing dk responses may undermine survey validity researchers ability interpret findingscompare usefulness methodological strategy reducing dk responses 3 analytic approaches 1 excluding dks missing data 2 recoding neutral point response scale 3 recoding dks meanwe used 4group design compare methodological strategy encourages use response scale initial dk response 3 methods analytically treating dk responses examined 1 whether methodological strategy reduced frequency dk responses 2 methodological strategy compared common analytic treatments terms factor structure strength correlations measures constructsthe prompt reduced dk response frequency 557 164 unprompted participants vs 196 102 prompted participants factorial invariance analyses suggested equivalence factor loadings constructs throughout groups compared excluding dks recoding strategies use prompt improved strength correlations constructs prompt resulting strongest correlations 589 benefits intentions 446 perceived susceptibility intentions 329 benefits perceived susceptibilitythis study designed priori test methods addressing dk responses analysis limited intervieweradministered survey interviewers probe reasons dk responsesfindings suggest use prompt reduce dk responses preferable analytic approaches treating dk responses use prompts may improve validity health behavior survey research

https://doi.org/10.1177/0272989x18785159

Shirley S. Travis|Marie Bernard|William J. McAuley|M. Julie Thornton|Tristen Kole

Development of the Family Caregiver Medication Administration Hassles Scale

University of North Carolina at Charlotte

medication administration hassles minor daily irritants family caregivers experience assist dependent family member medication regimens study designed develop test multidimensional measure hassles family caregiver medication administrationthe authors employed multiphase process caregiver focus groups instrument development pilot testing field testing approximately 180 family caregivers representing diverse socioeconomic circumstances racial ethnic backgrounds participated study final version instrument consists 24 items four subscales information seekinginformation sharing 9 items alpha 92 safety issues 5 items alpha 83 scheduling logistics 7 items alpha 90 polypharmacy 3 items alpha 80 overall scale reliability is95 testretest reliability 2 weeks is84caregiver medication administration hassles represent complex multidimensional construct warrants consideration studies contemporary family caregiver stress strain burden

https://doi.org/10.1093/geront/43.3.360

Ingunn Skre|Oddgeir Friborg|Camilla Breivik|Lars Inge Johnsen|Yngvild Arnesen|Catharina Elisabeth Arfwedson Wang

A school intervention for mental health literacy in adolescents: effects of a non-randomized cluster controlled trial

UiT The Arctic University of Norway|UiT The Arctic University of Norway|UiT The Arctic University of Norway|UiT The Arctic University of Norway|UiT The Arctic University of Norway|UiT The Arctic University of Norway

mental health everyone school program mental health literacy prevention aimed secondary schools 1315 yrs main aim investigate whether mental health literacy could improved 3days universal education programme improving naming symptom profiles mental disorder b reducing prejudiced beliefs c improving knowledge seek help mental health problems secondary aim investigate whether adolescent sex age influenced mentioned variables third aim investigate whether prejudiced beliefs influenced knowledge available helpthis nonrandomized cluster controlled trial included 1070 adolescents 539 boys age 14 yrs three schools norwegian town one school n 520 received intervention two schools n 550 formed control group pretest followup three months apart linear mixed models generalized estimating equations models employed analysismental health literacy improved contingent intervention shift towards suggesting primary health care place seek help prejudiced beliefs suggest places seek help mental health problems generally girls older adolescents recognized symptom profiles better lower levels prejudiced beliefsa low cost general school program may improve mental health literacy adolescents gender specific programs attention age maturity students considered mental health literacy programmes designed tried prejudice addressed imparting information mental health issues

https://doi.org/10.1186/1471-2458-13-873

Amy P. Abernethy|Asif Ahmad|S. Yousuf Zafar|Jane L. Wheeler|Jennifer Barsky Reese|H. Kim Lyerly

Electronic Patient-Reported Data Capture as a Foundation of Rapid Learning Cancer Care

Duke University Health System|Duke University Hospital|Duke Medical Center|Johns Hopkins Medicine|Johns Hopkins University|Duke Medical Center

rapid learning healthcare presents new infrastructure support comparative effectiveness research leveraging heterogeneous datasets eg clinical administrative genomic registry research health information technology sophisticated iterative analyses rapid learning healthcare provides realtime framework clinical studies evaluate relative impact therapeutic approaches diverse array measuresthis article describes effort 1 academic medical center demonstrate rapid learning healthcare might look like operation article describes process developing testing components new model integrated clinicalresearch function pilot site academic oncology clinic electronic patientreported outcomes epros foundational datasetsteps included feasibility study epro system validation study epro collection across 3 cancers linking epro datasets implementation stakeholder alignment buy demonstration use casestwo use cases presented participants metastatic breast cancer n 65 gastrointestinal cancer n 113 patients 2 academic medical centers1 patientreported symptom data collected tablet computers patients breast gastrointestinal cancer indicated high levels sexual distress prompted multidisciplinary response design intervention successful application funding study interventions impact 2 system evaluated longitudinal impact psychosocial care program provided patients breast cancer participants used tablet computers complete pro surveys data indicated significant impact psychosocial outcomes notably distress despair despite advanced disease results return clinic allowing iterative update evaluationan eprobased rapid learning cancer clinic feasible providing realtime researchquality data support comparative effectiveness research

https://doi.org/10.1097/mlr.0b013e3181db53a4

Abdur Chowdhury

The Infant Mortality-Fertility Debate: Some International Evidence

aim paper analyze empirically causal relationship infant mortality fertility thirtyfive developing countries focus possible relationships infant mortality rate fertility rate hypothesis infant mortality causes fertility tested possibility reverse causation also analyzed onesided distributed lag test proposed grangeris employed results analyzed light several versions mortalityfertility proposition including demographic transition theory choice theory ricardian theory modern economic theory population

https://doi.org/10.2307/1059010

Janet L. Williams|Alanna Kulchak Rahm|Doris T. Zallen|Heather L. Stuckey|Kara Fultz|Audrey L. Fan|Michele Bonhag|Lynn Feldman|Michael M. Segal|Marc S. Williams

Impact of a Patient?Facing Enhanced Genomic Results Report to Improve Understanding, Engagement, and Communication

Virginia Tech|Penn State Milton S. Hershey Medical Center|Philadelphia Department of Public Health|Second Genome (United States)|SimulConsult|SimulConsult

objective study test effectiveness enhanced genomic report patientcentered outcome domains including communication engagement satisfaction study design utilized prospective randomized mixedmethods desctiptive study whole genome sequencing results report genomecompass accessed providers electronic health record patients associated patient portal study set integrated healthcare delivery system central pennsylvania eightyfour parents 46 children undiagnosed intellectual disability autism spectrum disorder andor multiple congenital anomalies participated previous study offering whole genome sequencing affected child invited enroll fiftytwo parents enrolled following traditional genetics results informing visit study coordinator stratified families diagnostic result uninformative result randomized families within group intervention arm receive genomecompass report usual care arm receive summary letter medical geneticist letter inviting enrollment included baseline survey returned constituted enrollment surveys administered 3 months postgenetics visit 6 months usual care arm crossed receive intervention administered additional survey 3 months qualitative interviews conducted following survey completion augment survey data regarding patient centered outcomes interest patient reported outcomes including communication engagement empowerment satisfaction intervention arm genomecompass reports released 14 families n 28 parents 21 75 returned 3 month surveys usual care arm 12 families n 24 parents received usual care summary letters 20 83 returned 3 month surveys crossover genomecompass reports released 20 individuals 15 75 returned 3 month surveys qualitative interviews conducted 5 individuals use genomecompass report reported small group parents improve communication providers nonhealth professionals educators therapists led increased engagement high satisfaction providers others involved childrens care also endorsed reports effectiveness reports addressed negative findings ie uninformative results found useful although number users small study supports customizable template reports may provide useful durable source information support enhance information provided genetics professionals traditional facetoface encountersclinicaltrialsgov record 20130594

https://doi.org/10.1007/s10897-017-0176-6

Sulaman Hafeez Siddiqui|Muhammad Shahbaz Khan

SMEs Intention towards Use and Adoption of Digital Financial Services

Islamia University of Bahawalpur|Islamia University of Bahawalpur

purpose study analyses smes owners managers intention towards use adoption digital financial services south punjab pakistsan smes considered key contributors economic activity keysource employment growth invention smes perform significant role system national financial regulation world jobs creation contributing modernization financial regulation significant exertions achieve ecological sustainability growth access finance access finance emerging countries one core issue development sme sector well obstacle economic growth microfinance institutions considered good manifesto enhance access inclusive finance well stressfree access finance financial literacy smes support economic growth pakistan obtain finances easy smes sectors smes unfortunately still struggling due lack inclusive finance financial literacy recently financial institution introduced digital financial services micro level provide access financial services every citizen country without restriction accomplish purpose research data acquired smes owners mangers sample 232 chosen randomly south punjab pakistan research study merged two best theories theory planned behavior technology acceptance model used describe behavior multiple statistical tests run check normality using shapirowilk test reliability multicollinearity data test assumptions regression correlation finally results intended study revealed moderate significant positive relationship smes owners managers intention towards use adoption digital financial services government pakistan create finance related awareness program training technical institution make rules regulation study suggests researchers focus internal well external factors smes pakistan

https://doi.org/10.26710/sbsee.v1i1.1007

Lesia Zastavetska|????? ????????????|K. D. Dudarchuk|I. Illiash

The use of SMART technologies in censuses: world experience and prospects for Ukraine

Ternopil Volodymyr Hnatiuk National Pedagogical University|Ternopil Volodymyr Hnatiuk National Pedagogical University|Ternopil Volodymyr Hnatiuk National Pedagogical University|West Ukrainian National University

current records population ukraine carried systematically relevant bodies departments statistics various levels provides opportunity quickly obtain main statistical characteristics population short time however important parameters countrys population ethnic structure literacy education property status important indicators take account installed census article analyzes results censuses countries world decided introduce innovative technologies smartphones internet resources process study revealed advantages disadvantages census format course scientific research statistical indicators censuses using innovative technologies conducted respective years usa canada lithuania estonia brazil australia analyzed basic normative provisions concerning census procedure ukraine covered main legislative documents well materials institute demography social research named v ptukha national academy sciences ukraine develops program questionnaire censuses country swot analysis use smart technologies census conducted identify advantages disadvantages well outline prospects threats census using innovative technologies benefits include ability quickly collect organize information low census costs compared traditional option main disadvantages latest census mantioned need develop expensive software high degree personal data protection well complexity fully transitioning census online platform studying experience countries already conducted population censuses using innovative technologies indicates importance legally binding participation census questionnaire either electronically traditionally possibility conducting two stages population census ukraine 2020 indicated online mode traditional format approach census procedure allow coverage respondents regions settlements ukraine

https://doi.org/10.15421/112118

Andrew Zieffler|Joan Garfield|Robert C. delMas|CHRIS READING

A FRAMEWORK TO SUPPORT RESEARCH ON INFORMAL INFERENTIAL REASONING5

University of Minnesota System|University of Minnesota System|University of Minnesota System

informal inferential reasoning relatively recent concept research literature several research studies defined type cognitive process slightly different ways paper working definition informal inferential reasoning based analysis key aspects statistical inference research educational psychology science education mathematics education presented based literature reviewed working definition suggestions made types tasks used study nature development informal inferential reasoning suggestions future research offered along implications teachingx0d first published november 2008 statistics education research journal archives

https://doi.org/10.52041/serj.v7i2.469

Dirk Tempelaar|Sybrand Schim van der Loeff|Wim Gijselaers

A STRUCTURAL EQUATION MODEL ANALYZING THE RELATIONSHIP OF STUDENTS’ ATTITUDES TOWARD STATISTICS, PRIOR REASONING ABILITIES AND COURSE PERFORMANCE

Maastricht University|Maastricht University|Maastricht University

recent research statistical reasoning focused developmental process students learning statistical reasoning skills study investigates statistical reasoning perspective individual differences manifestation heterogeneity students prior attitudes toward statistics measured extended survey attitudes toward statistics sats used schau stevens dauphinee amp devecchio 1995 students statistical reasoning abilities identified statistical reasoning assessment sra instrument garfield 1996 1998a 2003 aim study investigate relationship attitudes reasoning abilities estimating full structural equation model instructional implications model teaching statistical reasoning discussedx0d first published november 2007 statistics education research journal archives

https://doi.org/10.52041/serj.v6i2.486

Randall E. Groth|Jennifer A. Bergner

PRE-SERVICE ELEMENTARY SCHOOL TEACHERS’ METAPHORS FOR THE CONCEPT OF STATISTICAL SAMPLE

Salisbury University|Salisbury University

study describes nature preservice teachers idiosyncratic metaphors concept statistical sample metaphors investigated potential provide insight individuals content knowledge content knowledge enacted teaching personal metaphors elicited 54 preservice teachers writing prompts writing prompt responses revealed seven different categories thinking instances preservice teachers struggled construct metaphor concept sample majority cases constructed metaphor sample discussed relationship knowledge concept categories thinking highlight aspects concept sample teacher educators need attend course instruction also point directions research related metaphorical thinking statistical content interaction teaching practicex0d first published november 2005 statistics education research journal archives

https://doi.org/10.52041/serj.v4i2.513

Robert C. delMas|Joan Garfield|Ann Ooms|Beth Chance

ASSESSING STUDENTS’ CONCEPTUAL UNDERSTANDING AFTER A FIRST COURSE IN STATISTICS

University of Minnesota System|University of Minnesota System|California Polytechnic State University

paper describes development caos test designed measure students conceptual understanding important statistical ideas across three years revision testing content validation realiability analysis results reported large scale class testing item responses compared pretest posttest order learn areas students demonstrated improved performance beginning end course well areas showed improvement decreased performance items showed increase students misconceptions particular statistical concepts also examined paper concludes discussion implications students understanding different statistical topics followed suggestions researchx0d first published november 2007 statistics education research journal archives

https://doi.org/10.52041/serj.v6i2.483

Jane Watson

EXPLORING BEGINNING INFERENCE WITH NOVICE GRADE 7 STUDENTS

University of Tasmania

study documented efforts facilitate ideas beginning inference novice grade 7 students design experiment allowed modified teaching opportunities light observation components framework adapted developed pfannkuch teaching informal inference box plots box plots replaced hat plots feature available software tinkerplotstm data tinkerplots files analyzed four occasions observed responses tasks categorized using hierarchical model observed outcomes provided evidence change students appreciation beginning inference four sessions suggestions change made use framework association intervention software enhance understanding beginning inferencex0d first published november 2008 statistics education research journal archives

https://doi.org/10.52041/serj.v7i2.470

Arthur Bakker|Phillip Kent|Jan Derry|Richard Noss|Celia Hoyles

STATISTICAL INFERENCE AT WORK: STATISTICAL PROCESS CONTROL AS AN EXAMPLE

Universidad de Londres|Universidad de Londres|Universidad de Londres|Universidad de Londres|Universidad de Londres

characterise statistical inference workplace paper compares prototypical type statistical inference work statistical process control spc type statistical inference better known educational settings hypothesis testing although similarities reasoning structure involved hypothesis testing spc point key characteristics statistical inference general also crucial differences come fore characterise statistical inference within call space reasons conglomerate reasons implications evidence conclusions causes effectsx0d first published november 2008 statistics education research journal archives

https://doi.org/10.52041/serj.v7i2.473

Christian Büscher

DESIGN PRINCIPLES FOR DEVELOPING STATISTICAL LITERACY IN MIDDLE SCHOOLS

TU Dortmund University

statistical literacy skill required students limited insights exist developed middle schools research required identifies design principles provides didactic materials developing statistical literacy actual middle school classrooms meaning classrooms statistics seen small part mathematics study conceptualizes statistical literacy ability read given statistical information also ability imagine often unreported data underlying assumptions information allows design research study identify design principles developing statistical literacy students actively engage conflicting statistical information data working mechanisms design principles illustrated didactic materials student responses show design principles used develop statistical literacy middle schools

https://doi.org/10.52041/serj.v21i1.80

Katja Schladitz|Elena Caroline Weitzel|Margrit Löbner|Bettina Soltmann|Frank Jessen|Jochen Schmitt|Andrea Pfennig|Steffi G. Riedel?Heller|Uta Gühne

Demands on Health Information and Clinical Practice Guidelines for Patients from the Perspective of Adults with Mental Illness and Family Members: A Qualitative Study with In-Depth Interviews

Leipzig University|Leipzig University|Leipzig University|TU Dresden|University Hospital Cologne|University of Cologne|University Hospital Carl Gustav Carus|TU Dresden|TU Dresden|Leipzig University|Leipzig University

1 background patient health information promote health literacy patient guidelines sub group reflect current evidence illnesses treatment options adapted needs laypersons little known factors promoting hindering use people affected mental illness relatives 2 methods telephone interviews n 15 n 4 adults affected mental illness n 5 relatives n 6 applicable conducted according srensen model health literacy data recorded transcribed contentanalyzed following mayring 3 results health information used regularly individuals affected mental illness relatives patient guidelines largely unknown yet great willingness use main barriers lack statistical knowledge complexity healthrelated topics cognitive impairment sometimes accompanying mental illnesses target grouporiented adaptation well transparent evenhanded presentation disadvantages treatment options increase trust 4 conclusions health information guidelines help affected persons relatives make treatment decisions conveying unbiased uptodate knowledge target groupspecific adaptations made psychiatric illnesses features specific mental illnesses compared physical illnesses included clinical practice guidelines must distributed widely increase impact

https://doi.org/10.3390/ijerph192114262

Sue Ann Sarpy|Michael J. Burke

An Evaluation of Safety Training for a Diverse Disaster Response Workforce: The Case of the Deepwater Horizon Oil Spill

Tulane University

1 background case study examined safetytrainingrelated experiences individuals six racialethnic groups asians vietnamese blacks hispanics isleos native americans whites involved cleanup deepwater horizon oil spill 2 methods assessed via survey 495 disaster response trainees reactions design delivery training learning safety performance injury illness experience 3 results results showed statistically significant racialethnic group differences respect reactions training components learning ie cognitive skill affective safety performance ie use personal protective equipment engaging safe work practices communicating safety information exercising employee rights responsibilities general asians isleos group members lower reactions training selfreported learning safety performance additionally found safety climate interacted learning positively affect safety performance 4 conclusions discuss implications findings improving quality safety training relation addressing language literacy concerns developing training useful engaging volunteer cleanup workers contaminated region promoting positive safety climate enhance training transfer

https://doi.org/10.3390/ejihpe11040116

Marta Estrela|María Teresa Herdeiro|Pedro Lopes Ferreira|Fátima Roque

The Use of Antidepressants, Anxiolytics, Sedatives and Hypnotics in Europe: Focusing on Mental Health Care in Portugal and Prescribing in Older Patients

University of Aveiro|University of Coimbra|University of Aveiro|University of Coimbra|Instituto Politécnico da Guarda|University of Beira Interior

1 background mental disorders growing concern 21st century prevalent common mental disorders include depression anxiety predicted half population point lives experience one mental disorders although common mental disorders highly prevalent significant related problems wide treatment gap excessive use antidepressants anxiolytics sedativeshypnotics especially among older patients 2 methods study aimed analyze mental health care portugal focus consumption antidepressants anxiolytics sedatives hypnotics among older patients 3 results use antidepressants anxiolytics sedatives hypnotics increased overall across europe portugal downward trend sedatives hypnotics consumption observed anxiolytics antidepressants hand increasing patients aged 60 years old consume half aforementioned drugs 4 conclusions mental health policies designed improve conscientious use antidepressants anxiolytics sedatives hypnotics particularly among older adults

https://doi.org/10.3390/ijerph17228612

Leena Paakkari|Minna Torppa|James E. Mazur|Zuzana Boberová|Gorden Sudeck|Michal Kalman|Olli Paakkari

A Comparative Study on Adolescents’ Health Literacy in Europe: Findings from the HBSC Study

University of Jyväskylä|University of Jyväskylä|University of Zielona Góra|University of Pavol Jozef Šafárik|University of Tübingen|Palacký University Olomouc|University of Jyväskylä

1 background need studies populationlevel health literacy hl identify current state hl within countries report comparative findings 10 european countries austria belgium fl czechia england estonia finland germany macedonia poland slovakia adolescents hl associations gender family affluence fas selfrated health srh 2 methods representative data n 14590 age 15 drawn hbsc health behavior schoolaged children study associations hl gender fas srh examined via path models 3 results countries exhibited differences hl means range scores within countries positive associations found fas hl hl srh country gender associated differences hl three countries hl acted mediator gender srh four countries fas srh country 4 conclusions findings confirm differences hl levels within european countries hl contribute differences srh hl taken account devising evidenceinformed policies interventions promote health adolescents

https://doi.org/10.3390/ijerph17103543

Sarah E. Cprek|Corrine M. Williams|Ibitola O. Asaolu|Linda Alexander|Robin C. Vanderpool

Three Positive Parenting Practices and Their Correlation with Risk of Childhood Developmental, Social, or Behavioral Delays: An Analysis of the National Survey of Children’s Health

University of Kentucky|University of Kentucky|University of Kentucky|University of Kentucky|University of Kentucky

1 investigate relationship three specific positive parenting practices pppreading children engaging storytelling singing eating meals together familyand parentreported risk developmental behavioral social delays among children ages 15 years us 2 determine combination parenting practices effect outcomechi square multiple logistic regression analyses used analyze crosssectional data national survey childrens health 20112012 regards relationship three individual ppp well total ppp score childs risk developmentally socially behaviorally delayed n 21527 risk delay calculated using parents evaluation developmental status questionnaire parental selfreport measure correlated diagnosed child delays analyses controlled poverty parental education analyses completed using sas version 93a strong correlation found three ppp well total ppp score childs risk developmental social behavioral delays p 005 test associations found doseresponse relationship p 005 one analysisdaily engagement ppp could possibly reduce childrens risk delay specifically engaging three ppp may greater benefit

https://doi.org/10.1007/s10995-015-1759-1

Abdul Habeeb Adil|Sumaiya Zabin Eusufzai|Aimi Kamruddin|Wan Muhamad Amir W Ahmad|Nafij Bin Jamayet|Mohmed Isaqali Karobari|Mohammad Khursheed Alam

Assessment of Parents’ Oral Health Literacy and Its Association with Caries Experience of Their Preschool Children

Hospital Universiti Sains Malaysia|Hospital Universiti Sains Malaysia|Hospital Universiti Sains Malaysia|Hospital Universiti Sains Malaysia|Hospital Universiti Sains Malaysia|Hospital Universiti Sains Malaysia|Al Jouf University

1 purpose assess oral health literacy ohl parents association caries experience preschool children attending hospital university sains malaysia husm kota bharu kelantan malaysia 2 materials methods descriptive crosssectional study involving systematic random sampling method using sample 230 parentpreschool child dyads among 230 parents 24 males 206 females mean age 3143 582 among 230 children 92 boys 138 girls mean age 482 104 attending pedodontics clinic husm participated met inclusion criteria structured selfadministered oral health literacy questionnaire including sociodemographic factors used study childs oral examination performed check dmft decayed missing filled teeth status statistical analysis done using descriptive spearmans correlation analysis multivariate regression analysis 3 results mean dmft score children relation ohl level parents showed significant difference p 000 mean dmft score children relation ohl level parents showed following relationships inadequate 749 410 followed marginal 328 267 adequate 055 155 incidence caries amongst children relation parental employment associated unemployed parents 611 443 employed parents 279 365 caries experience amongst children relation education parents revealed significant difference p 0001 mean dmft score high amongst preschool children primary school qualified parents 107 410 followed high school 704 368 vocational 581 357 diploma 261 281 university 129 227 respectively results revealed valid significant difference negative correlation rs 0753 ohl parents dmft score preschool children age gender parents significantly associated ohl whereas ethnicity positive correlation rs 0283 education positive correlation rs 0865 employment negative correlation rs 0490 found significant conclusion conclude significant association ohl parents dmft score preschool children logistic regression showed adjustment sociodemographic factors parents gender 0067 95 ci 00120360 parents employment status 3247 95 ci 089711754 parents ohl score 0042 95 ci 00160114 child age 2195 95 ci 12493857 significantly associated dental caries children study concluded parents employment status age gender ohl childs age significantly associated caries experience preschool children

https://doi.org/10.3390/children7080101

Lisa Ross DeCamp|Kathryn M. Leifheit|Harita Shah|Doris Valenzuela-Araujo|Elizabeth Sloand|Sarah Polk|Tina L. Cheng

Cross-cultural validation of the parent-patient activation measure in low income Spanish- and English-speaking parents

Johns Hopkins Medicine|Johns Hopkins University|Johns Hopkins Medicine|Johns Hopkins University|Johns Hopkins Medicine|Johns Hopkins University|Johns Hopkins Medicine|Johns Hopkins University|Johns Hopkins University|Johns Hopkins Medicine|Johns Hopkins University|Johns Hopkins Medicine|Johns Hopkins University

1 measure healthcare activation among lowincome parents language englishspanish 2 assess psychometrics parentpatient activation measure ppam study populationwe surveyed parentsguardians publiclyinsured children established patients pediatrics clinic 6months surveys included parentpatient activation measure ppam 13item measure adapted wellvalidated patient activation measure pamof 316 surveys 68 completed spanish mean activation score englishlanguage survey group 791 sd 162 mean score spanishlanguage group 707 sd 179 p0001 scale reliability high english 090 spanish 093 ppam acceptable testretest reliability previously reported pam factor structure fit study data adequately either languagehealthcare activation among lowincome parents greater parents surveyed english compared surveyed spanish ppam acceptable reliability validity english spanish different factor structure pamactivation measured ppam may associations impact healthhealthcare outcomes pediatrics compared adults owing possible measure differences ppam pam

https://doi.org/10.1016/j.pec.2016.07.003

Alexis Cambanis|Andy Ramsay|Mohammed A. Yassin|Luís E. Cuevas

Duration and associated factors of patient delay during tuberculosis screening in rural Cameroon

Liverpool School of Tropical Medicine|Liverpool School of Tropical Medicine|Liverpool School of Tropical Medicine

determine patient delay time onset symptoms presentation health facility causes patients undergoing sputum smear examination cameroon ii compare results previous study ethiopiaa crosssectional study 243 consecutive patients using structured questionnairemedian interquartile range patient delay cameroon 20 14 weeks shorter 43 213 week delay ethiopia significantly fewer patients delayed 1 2 3 months cameroon ethiopia p 0001 delays cameroon significantly associated main income earner belief tb stigmatizing use traditional medicine latter factor significant studiesengaging traditional healers tb control programs reducing stigma education could help reduce patient delays accelerate diagnosis improve clinical outcomes reduce disease transmission results placed context national human development indices suggest economic development investment health care literacy may involved improving access tb services subsaharan africa

https://doi.org/10.1111/j.1365-3156.2007.01925.x

Krishna D. Rao|David H. Peters|Karen Bandeen?Roche

Towards patient-centered health services in India—a scale to measure patient perceptions of quality

Johns Hopkins University

develop reliable valid scale measure inpatient outpatient perceptions quality india ii identify aspects perceived quality large effects patient satisfactioncrosssectional survey health facilities patients clinicsprimary health centers community health centers district hospitals female district hospitals state uttar pradesh north indiainternal consistency validity factor structure scale evaluated association patient satisfaction perceived quality dimensions examineda 16item scale good reliability validity developed five dimensions perceived quality identifiedmedicine availability medical information staff behavior doctor behavior hospital infrastructure patient perceptions quality public health facilities slightly better neutral multivariate regression analysis results indicate outpatients doctor behavior largest effect general patient satisfaction followed medicine availability hospital infrastructure staff behavior medical information inpatients staff behavior largest effect followed doctor behavior medicine availability medical information hospital infrastructurethe scale developed used measure perceived quality range facility types outpatients inpatients perceived quality public facilities marginally favorable leaving much scope improvement better staff physician interpersonal skills facility infrastructure availability drugs largest effect improving patient satisfaction public health facilities

https://doi.org/10.1093/intqhc/mzl049

Parambir S. Dulai|Corey A. Siegel|Marla Dubinsky

Balancing and Communicating the Risks and Benefits of Biologics in Pediatric Inflammatory Bowel Disease

Dartmouth–Hitchcock Medical Center|Dartmouth–Hitchcock Medical Center|Cedars-Sinai Medical Center

antitumor necrosis factor agents considered vital component treatment algorithm pediatric inflammatory bowel disease despite clear benefit agents realignment treatment goals achieve early mucosal healing decision initiate therapy often delayed due uncertainties regarding risks benefits purpose review summarize currently available data regarding antitumor necrosis factor agents pediatric inflammatory bowel disease specifically review expected efficacy crohns disease ulcerative colitis likelihood side effects associated agents addition address barriers physicians face communicating data help identify pediatric patients parents involved shared decisionmaking process creation new decision aid option grid hope allow clear line communication bedside helping patients parents make difficult treatment decisions

https://doi.org/10.1097/mib.0b013e31829aad16

William R. Carpenter|Paul A. Godley|Jack A. Clark|James A. Talcott|Timothy Finnegan|Merle H. Mishel|Jeannette T. Bensen|Walter Rayford|L. Joseph Su|Elizabeth T.H. Fontham|James L. Mohler

Racial differences in trust and regular source of patient care and the implications for prostate cancer screening use

University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|Edith Nourse Rogers Memorial Veterans Hospital|Boston University|Massachusetts General Hospital|Harvard University|University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|University of Tennessee Health Science Center|Louisiana State University Health Sciences Center New Orleans|Louisiana State University Health Sciences Center New Orleans|University at Buffalo, State University of New York|Roswell Park Comprehensive Cancer Center|University of North Carolina at Chapel Hill

nonmedical factors may modify biological risk prostate cancer pca contribute differential use early detection curative care ultimately greater racial disparities pca mortality study authors examined patients usual source care continuity care mistrust physicians association racial differences pca screening study nurses conducted inhome interviews 1031 africanamerican men caucasianamerican men aged 50 years north carolina louisiana within weeks pca diagnosis medical records abstracted data used conduct bivariate multivariate analyses compared african americans caucasian americans exhibited higher physician trust scores greater likelihood reporting physician office usual source care seeing physician regular medical encounters historically using pca screening seeing physician regular care associated greater trust screening use men reported usual source care physician office hospital clinic veterans administration facility likely report prior pca screening men multivariate regression analysis seeing provider remained associated prior screening use whereas race trust lost association prior screening current results indicated systems factors including differ among different sources care associated continuity care may provide tangible targets address disparities use pca early detection may attenuate racial differences pca screening use may contribute reduced racial disparities pca mortality cancer 2009 published 2009 american cancer society

https://doi.org/10.1002/cncr.24539

Desiree Byrd|Robert P Fellows|Susan Morgello|Donald Franklin|Robert K. Heaton|Reena Deutsch|J. Hampton Atkinson|David B. Clifford|Ann C. Collier|Christina M. Marra|Benjamin B. Gelman|J. Allen McCutchan|Nichole A. Duarte|David M. Simpson|Justin C. McArthur|Igor Grant

Neurocognitive Impact of Substance Use in HIV Infection

Icahn School of Medicine at Mount Sinai

determine serious confound substance use su might studies hivassociated neurocognitive disorder hand examined relationship su history neurocognitive impairment nci participants enrolled central nervous system hiv antiretroviral therapy effects research study excluding cases behavioral evidence acute intoxication histories factors independently could account nci eg stroke baseline demographic medical su neurocognitive data analyzed 399 participants potential su risk nci determined following criteria lifetime su diagnostic statistical manual mental disorders fourth edition diagnosis selfreport marked lifetime su positive urine toxicology participants divided 3 groups follows su n 134 nonsyndromic su n 131 syndromic su n 134 matched literacy level nadir cd4 depressive symptoms although approximately 50 participants diagnosed hand multivariate analysis covariance neurocogntive summary scores covarying urine toxicology revealed significant effect su status correlational analyses indicated weak associations lifetime heroin dosage poor recall working memory cannabis cocaine use better verbal fluency data indicate hiv neurocognitive effects seen frequency without historic substance abuse cases equated factors might contribute nci therefore studies neuroaids treatment need exclude cases however effects acute su current su disorders hand require study

https://doi.org/10.1097/qai.0b013e318229ba41

Maria Unwin|Leigh Kinsman|Scott Rigby

Why are we waiting? Patients’ perspectives for accessing emergency department services with non-urgent complaints

University of Tasmania|University of Tasmania

background emergency departments worldwide report service demands exceed resource availability themes crowding nonurgent presentations ambulance diversion access block linked complications care poorer patient outcomes increased morbidity staff burnout people attending emergency department problems perceived nonurgent frequently attributed blame increased service demand yet little known patients perspective method project utilised descriptive crosssectional waiting room survey nonurgent patients identify factors contributing decision making process access ed services regional hospital tasmania australia data analysed using statistical software package comparison made sample population groups determine broad representation results patients decision making processes found influenced convenience perceived need referral health care provider cost present significant factor high incidence patients 25 years age identified musculoskeletal complaints common complaint across age groups conclusion consideration required determine best meet service demand facilitate provision right service right time right patient

https://doi.org/10.1016/j.ienj.2016.09.003

Hedwig Neels|Jean?Jacques Wyndaele|Wiebren A.A. Tjalma|Stefan De Wachter|Michel Wyndaele|Alexandra Vermandel

Knowledge of the pelvic floor in nulliparous women

University of Antwerp|Antwerp University Hospital|University of Antwerp|Antwerp University Hospital|University of Antwerp|Antwerp University Hospital|University of Antwerp|Antwerp University Hospital|University of Antwerp|University of Antwerp|Antwerp University Hospital

purpose proper pelvic floor function important avoid serious dysfunctions including incontinence prolapse sexual problems current study evaluated knowledge young nulliparous women pelvic floor identified additional information wanted subjects methods crosssectional survey validated 36 item questionnaire distributed 212 nulliparous women questionnaire addressed demography pelvic floor muscles pelvic floor dysfunction possible information sources descriptive statistics generated variables stability validity testing performed using kappa statistics intra class correlation coefficients define agreement question study approved ethics committee b300201318334 results using vas scale 0 10 women rated knowledge pelvic floor mean 24 sd 201 total 93 women insufficiently informed requested information 25 concerns developing urinary incontinence 14 fecal incontinence many women unaware pelvic floor training meant conclusion significant lack knowledge pelvic floor function among nulliparous women majority nulliparous women expressed need education might offer way reduce dysfunction

https://doi.org/10.1589/jpts.28.1524

Robert Prince|Arlene Archer

Quantitative Literacy as situated social practice in Higher Education

mathematical literacy soon introduced subject south african schools generated numerous debates various educational arenas tertiary institutions professional bodies paper looks differences mathematics quantitative literacy ql examines implicit ql demands conventionalized ql practices higher education curricula although certain practices highly valued necessarily explicitly taught students especially nondominant disadvantaged positions power structures university society paper explores ways implicit quantitative literacy demands made explicit used provide rich environment facilitate mathematical statistical concept acquisition look conventionalized practices academic disciplines focusing analysis use charts propose number principles curriculum design

https://doi.org/10.18848/1447-9494/cgp/v12i07/47938

Janet L. Brody|Jeanne Dalen|Robert D. Annett|David G. Scherer|C. W. Turner

Conceptualizing the Role of Research Literacy in Advancing Societal Health

Oregon Research Institute|Oregon Research Institute|University of New Mexico|University of Massachusetts Amherst|Oregon Research Institute

research literacy proposed key concept advancing societal health examine whether improvements research literacy would affect knowledge ethical participation research parents young children received brief educational intervention designed enhance understanding child research results demonstrated intervention improved researchrelated knowledge increased parents comfort research participation decisions moreover enhanced understanding child volition increased parents willingness enrol children research proposed research literacy model identifies methods enhance population knowledge appreciation research strengthening links scientific advancement health

https://doi.org/10.1177/1359105311425273

Magdalene M. Assimon|Jennifer E. Flythe

Thirty-Day Hospital Readmissions in the Hemodialysis Population

University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill

problem well put halfsolved john dewey 18591952 recent years united states policymakers made 30day hospital readmission reduction centerpiece efforts curb medicare costs general medicare population 15 patients readmitted hospital within 30 days discharge 1 unplanned rehospitalizations cost 20 billion per year 2 fiscal year 2013 medicare began levying financial penalties hospitals higher expected readmission rates via affordable care acts hospital readmissions reduction program readmission problem even dire among individuals receiving maintenance dialysis 30day hospital readmission rates 35 vulnerable group 3 incentivize readmission reduction dialysis population centers medicare medicaid services implemented standardized readmission ratio pay performance quality measure outpatient dialysis clinics 2017 performancebased policies created urgency broader united states health care system dialysis community prompting efforts describe quantify readmissions importantly identify modifiable populationspecific risk factors using variety data sources investigators identified range readmission risk factors hemodialysis population patientrelated factors including comorbid conditions heart failure 4 myocardial infarction 4 malignancy 45 depression 6 biochemical markers anemia 7 hypoalbuminemia 5 dialysisrelated factors shorter vintage 8 catheter vascular access 5 associate increased 30day readmission odds hospitalrelated factors including prior hospitalization history 5 weekend day discharge 5 also associate increased readmission odds finally providerrelated factors erythropoietinstimulating agent adjustment 7 frequent provider visits posthospitalization 9 associate decreased readmission odds although identified risk factors readily modifiable point highrisk subpopulations potentially target interventions issue clinical journal american society nephrology chan et al 10 provide insights 30day unplanned readmission rates predictors among united states patients hemodialysis without medical insurance using data 2013 nationwide readmissions database nrd publicly available data source contains information community hospital discharges 21 states authors 1 describe rate 30day unplanned hospital readmissions 2 evaluate concordance primary discharge diagnoses index hospital admissions subsequent readmissions 3 identify predictors readmission among individuals receiving maintenance hemodialysis 390627 eligible index hospitalizations identified 87302 22 resulted least one unplanned 30day readmission primary causes index hospitalizations corresponding readmissions basis agency healthcare research quality clinical classification software ccs categorization often disparate approximately 80 index hospitalizationreadmission pairs discordant primary discharge diagnoses notably patients three readmissions 30day period index hospitalization constituted 2 patients accounted 20 readmissions several comorbid conditions eg drug abuse history heart failure diabetes depression associated increased 30day readmission odds study strengths include large sample size use nrd unique data source facilitated assessment 30day unplanned readmissions hemodialysis cohort without restriction insurance status authors used nrdbased population weights generalize 21state sample nationally representative cohort inclusion patients without insurance ability distinguish elective nonelective admissions differentiate nrd medicarebased us renal data system usrds commonly used united states dialysis data repository chan et al 10 acknowledge several study limitations including lack data previously identified hospital readmission predictors race dialysis vintage vascular access type missed dialysis treatments laboratory results hospital discharge day additionally categorization diagnosis codes ccs groups may misclassified related index hospitalizationreadmission discharge diagnosis pairs discordant example index hospitalizations acute myocardial infarction ccs code 100 considered discordant readmissions chest pain ccs code 102 finally nrd contain information competing risk hospital death precluding appropriate analytic handling individuals died within 30 days index hospitalization discharge without readmission patients could identified nrd classified readmission data limitations highlight challenges using single data source studying complex multifaceted phenomenon hospital readmission date majority investigators relied administrative claimsbased usrds study readmissions among united states patients hemodialysis 48911 others used electronic health record ehr data including dialysis provider hospital ehr databases 57 study results must always considered context data source limitations example administrative data like usrds nrd collected billing reimbursement purposes may diagnostic outcome validity shortcomings affect clinical risk prediction addition administrative data sources contain information known readmission risk factors including dialysis treatment characteristics laboratory test results comorbid condition severity socialbehavioral characteristics compared administrative claims data ehr data granular less likely influenced reimbursementrelated coding decisions ehrs offer highly detailed account patients clinical data medical histories ehrs united states standardized making data synthesis across health care systems difficult additionally provider notes ehrbased text fields may contain pertinent prognostic information however extracting meaningful information unstructured data large scale challenging requires specialized tools natural language processing software hospital ehrs include key information hospitalbased complications well laboratory diagnostic test results typically lack detailed information longitudinal esrd care outpatient dialysis treatments dialysis provider ehrs however contain outpatient dialysisrelated information laboratory results unfortunately dialysis provider ehrs link hospital ehrs preventing simultaneous consideration potential outpatient inpatientderived readmission risk factors finally ehr systems offer potential warehousing patientreported data health literacy social support factors shown associate readmission among patients dialysis 6 however data captured routinely greater attention patientreported data collection needed although multiple observational studies identified 30day hospital readmission risk factors using diverse data sources surprisingly little published data evaluating interventions designed reduce readmissions wingard et al 12 recently reported findings nonrandomized intervention included structured posthospital followup care coordination centralized call system provider information exchange 26 dialysis clinics authors showed modest overall 30day readmission declines found statistical difference pre postintervention readmission change intervention control clinics assessing effect reimbursement policies readmissions erickson et al 11 found 2004 medicare payment reform incentivizing face face provider visits patients dialysis affect allcause readmission rates somewhat disappointing findings underscore need innovative integrative data analytics readmission risk modeling greater emphasis testing refining readmission prevention strategies model improvement suggests using series rapid plandostudyact pdsa cycles test adapt health care change interventions directed readmission reduction populationspecific data integral feature pdsa steps used plan analyze iteratively refine interventions figure 1 given noted limitations singledata source reliance multiple opportunities improve risk prediction dialysis population example integrating data multiple sources including administrative claims inpatient outpatient ehrs supplementing traditional sources unique linkages data wearable healthmonitoring devices us census national centers environmental information would facilitate simultaneous consideration array potential patient dialysis hospital provider socioeconomic environmentalrelated readmission risk factors additionally application advanced predictive analytics including realtime risk modeling machine learning may improve risk prediction ultimately facilitating individualized service provision hospital dischargefigure 1 using diverse integrated data multiple sources inform steps pdsa quality improvement action cycles may improve risk prediction intervention implementation refinement ultimately reduce 30day hospital readmissions among individuals receiving maintenance dialysis ehr electronic health record pdsa plandostudyactthus far quest reduce 30day hospital readmissions among patients dialysis nephrology community spent much time planning phase however pdsa cycles action essential make inroads esrd readmission problem must implement analyze improve interventions accepting pdsa cycles iterative require continuous refinement must informed population systemspecific data fortunately anticipate emerging data integrated care models like esrd seamless care organizations highly informative accelerate rapid cycle quality improvement directed reducing readmissions findings chan et al 10 others shed light potential readmission reduction strategies bring forward phase examples include 1 targeting individualized discharge services select subpopulations depression substance abuse poor social support low health literacy 2 performing timeupdated risk stratification accounting changes patients medical social functional status 3 establishing collaborative data exchanges enhance communication across health care providers settings american philosopher john dewey said problem well put halfsolved problem 30day hospital readmissions among individuals receiving maintenance hemodialysis increasingly well put next step see problem also well solved disclosures mma jef received investigatorinitiated research funding renal research institute new york new york subsidiary fresenius medical care north america jef received speaking honoraria dialysis clinic incorporated nashville tennessee renal ventures denver colorado american renal associates beverly massachusetts american society nephrology washington district columbia baxter deepark illinois national kidney foundation new york new york multiple universities

https://doi.org/10.2215/cjn.08810817

Naphop Namjaidee|Phrakru Dhammapissamai

An Online Program for Teacher Learning to Enhance Students' Media Literacy Skills

online program teacher learning enhance students media literacy skills product employing research development rampd methodology consisted teachers learning development project utilized teachers learning outcomes student development project first project yielded six teachers learning handbooks whereas second project composed one action handbook utilized teachers learning outcomes foster student development handbooks evaluated school represented opportunity expansion schools commission basic education experimental research model designed one group pretestposttest experimental group 12 teachers 59 students results revealed invented online program effective consistent studys assumptions findings illustrated following 1 postexperimental test teachers met standard 9090 2 teachers posttest mean scores statistically significantly higher experiment 3 experiment students mean score media literacy skills assessment statistically significantly higher experiment addition results verified created online program would appropriate dissemination target opportunity expansion schools office basic education commission throughout country

https://doi.org/10.31014/aior.1993.05.02.518

Helen Herrman|Vikram Patel|Christian Kieling|Michael Berk|Claudia Buchweitz|Pim Cuijpers|Toshi A Furukawa|Ronald C. Kessler|Brandon A. Kohrt|Mario Maj|Patrick McGorry|Charles F. Reynolds|Myrna M. Weissman|Dixon Chibanda|Christopher Dowrick|Louise M. Howard|Christina W. Hoven|Martín Knapp|Helen S. Mayberg|Brenda W. J. H. Penninx|Shuiyuan Xiao|Madhukar H. Trivedi|Rudolf Uher|Lakshmi Vijayakumar|Miranda Wolpert

Time for united action on depression: a Lancet–World Psychiatric Association Commission

Orygen Youth Health|University of Melbourne|Harvard Global Health Institute|Harvard University|Sangath|Hospital de Clínicas de Porto Alegre|Universidade Federal do Rio Grande do Sul|Deakin University|Universidade Federal do Rio Grande do Sul|Vrije Universiteit Amsterdam|Kyoto University|Harvard University|George Washington University|University of Campania "Luigi Vanvitelli"|Orygen Youth Health|University of Melbourne|University of Pittsburgh|New York Psychoanalytic Society and Institute|Columbia University|London School of Hygiene & Tropical Medicine|University of Zimbabwe|University of Liverpool|King's College London|New York Psychoanalytic Society and Institute|Columbia University|London School of Economics and Political Science|Icahn School of Medicine at Mount Sinai|Vrije Universiteit Amsterdam|Amsterdam University Medical Centers|Central South University|The University of Texas Southwestern Medical Center|Dalhousie University|Voluntary Health Services Hospital|Wellcome Trust

depression disorder mood mysteriously painful elusive way becomes known selfto mediating intellectas verge close beyond description thus remains nearly incomprehensible experienced extreme modewilliam styron darkness visible 1990

https://doi.org/10.1016/s0140-6736(21)02141-3

Silke Schicktanz|Mark Schweda|Brian Wynne

The ethics of ‘public understanding of ethics’—why and how bioethics expertise should include public and patients’ voices

University of Göttingen|University of Göttingen|Lancaster University|Genomics (United Kingdom)

ethics used label new kind expertise field science technology time clear ethical expertise consists political status modern democracies starting participatory turn recent social research policy argue bioethical reasoning include public views attitudes towards biomedicine sketch outlines bioethical conception public understanding ethics addressing three different issues methodological relevance moral questions problems raised lay persons everyday life regarding biomedicine technology b normative relevance lay moralities justification ethical decisions c necessity public deliberation context finally draw conclusions view concepts methods conception public understanding ethics employ

https://doi.org/10.1007/s11019-011-9321-4

Anuj Mubayi|Carlos Castillo-Chávez|Gerardo Chowell|Christopher M. Kribs-Zaleta|Niyamat Ali Siddiqui|Narendra Kumar|Pradeep Das

Transmission dynamics and underreporting of Kala-azar in the Indian state of Bihar

Cancer Prevention Institute of California|The University of Texas at Arlington|Arizona State University|Arizona State University|Santa Fe Institute|Arizona State University|The University of Texas at Arlington|Rajendra Memorial Research Institute of Medical Sciences|Rajendra Memorial Research Institute of Medical Sciences|Rajendra Memorial Research Institute of Medical Sciences

kalaazar indian visceral leishmaniasis vectorborne infectious disease affecting communities tropical subtropical areas world bihar state india one highest prevalence mortality reported levels kalaazar yet magnitude problem difficult assess cases handled private health providers required report ministry health impact underreporting using districtlevel reported incidence data state bihar main goal manuscript derive expressions compute estimates kalaazars reproduction numbers indirect measure disease prevalence levels underreporting 21 affected districts bihar average reproduction number number secondary cases generated per infective estimates bihar range 13 2003 21 2005 districts estimates mean values lower one model estimates using available data modelderived expression show proportion underreported cases declined average 88 2003 73 2005 however eight districts 2003 five districts 2005 90 levels underreporting model estimates used generate underreporting adjusted incidence rates analysis finds reported data misidentify four eight 2003 three nine 2005 districts classified highrisk fact seven 2003 five 2005 affected kalaazar districts classified lowrisk reported incidence data used

https://doi.org/10.1016/j.jtbi.2009.09.012

Joseph A. Hill

Medical misinformation: vet the message!

mrs jones based risk factors heart attack recommend start statin thank doctor ive read many scary things drugs internet plus worry profession make recommendations reasons personal financial gain also found online undoubtedly majority cardiologists numerous conversations like urging patient take statin powerful cholesterollowering drugs robust mortality benefit part reason oftentimes brainer recommendations rejected derives widely disseminated incorrect information vastly overstates risks drugs course like anything life statin use entirely riskfree application always entail thoughtful analysis risks versus benefits patients recognize benefits statin use invisible didnt heart attack stroke past year whereas small typically reversible risks eg muscle pain readily apparent many patients would benefit statin use take cardiovascular disease 1 killer men women around world robust scientific advances published pages journals fostered significant improvements benefit individuals society yet cardiovascular disease continues transform emerging new forms heart failure struggle shifted new battlefields successes derive armamentarium powerful tools medicines devices awareness lifestylerelated hazards high blood pressure high cholesterol smoking sadly however take full advantage tools disposal one significant cause suboptimal utilization prodigious tool chest medical misinformation hyped internet television chat rooms social media many instances celebrities activists politicians convey false information uncommonly authors purely venal motives participate point numerous examples including entirely unfounded concerns regarding vaccinations notion mmr measles mumps rubella vaccination causes autism based single flawed study long since refuted publication retracted seventeen much larger properly controlled studies proven otherwise nevertheless internet shouts unfounded warnings celebrities actors activists politicians specific knowledge training use fame promote message causes serious harm individuals neither physicians scientists often specific agenda outsized influence lives dispute scientific evidence without ever studied it1 recognizing impossible prove never scientists appropriately couch statements statistical terms may come across public waffling nuanced voices scientists often resonate public much strident alarms sounded people fame speaking absolute terms scientists appropriately skeptical individual scientist study wrong common apt yet science ultimately selfcorrects scientist gets wrong happens people sometimes vilify entire selfcorrecting scientific enterprise trust aeronautical science board airplane trust science buried within cell phones trust mechanical engineering science cross bridge yet many uniquely skeptical biological science sadly cannot exclude professions science medicine act based motives driven financial considerations incomplete declarations potential conflict interest persist2 recent examples dramatic price hikes important medications reinforced notion indeed many physicians conversations patients believe recommendations stem least part prospect personal financial gain editorsinchief major cardiovascular scientific journals around globe sound alarm human lives stake pointing 2 examples elaborated people decline use statin recommended doctor parents withhold vaccines children put lives harms way media must better job unacceptable position false equivalents discussions often done foster debate controversy easy find rogue voice inappropriate suggest voice carries weight emerging mainstream science easily point examples outside medical domain well climate change evolution nutraceuticals gmo foods false equivalents frequently posited furthermore recent evidence suggests misinformation travels faster social networks truth3 must work enhance science literacy world one place start better job teaching scientific method schools lay public aware science accomplished fits starts end gets right purveyors social media must responsible content disseminate longer acceptable hide behind cloak platform editors charged evaluating validity science presented us possible publication work hard fulfill heady responsibility recognizing lives stake reach thoughtleading experts evaluate veracity report receive challenge social media leverage ready availability scienceconversant expertise disseminating content may reliable without exaggeration significant harm society individuals derives wanton spread medical misinformation high time stop lay feet purveyors internet social media content responsibility fix joseph hill md phd editorinchief circulation behalf following heart group signatories stefan agewall md phd editorinchief european heart journal cardiovascular pharmacotherapy stefanagewallmedisinuiono adrian baranchuk md editorinchief journal electrocardiology baranchakghkarinet george w booz phd editorinchief journal cardiovascular pharmacology gboozumcedu jeffrey borer md editorinchief cardiology jsborer1gmailcom paolo g camici md editorinchief international journal cardiology camicipaolohsrit pengsheng chen md editorinchief heartrhythm chenppiuedu anna f dominiczak dbe md editorinchief hypertension annadominiczakglasgowacuk etin erol md phd editorinchief anatolian journal cardiology ctnerolyahoocom cindy l grines md editorinchief journal interventional cardiology cgrinesyahoocom cgrinesbeaumontedu robert gropler md editorinchief circulation cardiovascular imaging groplerrmirwustledu tomasz j guzik md phd editorinchief cardiovascular research tomaszguzikglasgowacuk markus k heinemann md phd editorinchief thoracic cardiovascular surgeon mheinemaunimainzde ami e iskandrian md editorinchief journal nuclear cardiology aiskanduabedu bradley p knight md editorinchief pace eplab digest bradleyknightnmorg barry london md phd editorinchief journal american heart association barrylondonuiowaedu thomas f lscher md editorinchief european heart journal cardiotomluescherch thomasluescherzhhch marco metra md editorinchief european journal heart failure marcometraunibsit kiran musunuru md phd mph editorinchief circulation genomic precision medicine kiranmusunurugmailcom brahmajee k nallamothu md mph editorinchief circulation cardiovascular quality outcomes bnallamoumichedu andrea natale md sanjeev saksena md editor inchief journal interventional cardiac electrophysiology cmenjaolcom drnatalegmailcom michael h picard md editorinchief journal american society echocardiography mhpicardmghharvardedu sunil v rao md editorinchief circulation cardiovascular interventions sunilraodukeedu willem j remme md phd robert rosenson md editorsinchief cardiovascular drugs therapy wjremmegmailcom robertrosensonmssmedu nancy k sweitzer md phd editorinchief circulation heart failure nancysweitzershcarizonaedu adam timmis md editorinchief european heart journal quality care clinical outcomes adamtimmismaccom christiaan vrints md phd editor chief european heart journal acute cardiovascular care pg camici consultant servier rs rosenson reports research grants institutions akcea amgen astra zeneca medicines company regeneron rs rosenson reports speaking engagements amgen kowa research consulting akcea regeneron royalties uptodate inc stock holdings medimergent authors report conficts interest

https://doi.org/10.1111/pace.13616

Joseph A. Hill|Stefan Agewall|Adrián Baranchuk|George W. Booz|Jeffrey S. Borer|Paolo G. Camici|Peng Sheng Chen|Anna F. Dominiczak|Çetin Erol|Cindy L. Grines|Robert J. Gropler|Tomasz J. Guzik|Markus Heinemann|Ami E. Iskandrian|Bradley P. Knight|Barry London|Thomas F. Lüscher|Marco Metra|Kiran Musunuru|Brahmajee K. Nallamothu|Andrea Natale|Sanjeev Saksena|Michael H. Picard|Sunil V. Rao|Willem J. Remme|Robert S. Rosenson|Nancy K. Sweitzer|Adam Timmis|Christiaan Vrints

Medical misinformation: Vet the message!

mrs jones based risk factors heart attack recommend start statinno thank doctor ive read many scary things drugs internet plus worry profession make recommendations reasons personal financial gain also found online undoubtedly majority cardiologists conversations like urging patient take statin powerful cholesterollowering drug robust mortality benefit part reason oftentimes brainer recommendations rejected derives widely disseminated incorrect information vastly overstates risks drugs course like anything life statin use entirely riskfree application always entail thoughtful analysis risks vs benefits patients recognize benefits statin use invisible didnt heart attack stroke past year whereas small typically reversible risks eg muscle pain readily apparent many patients would benefit statin use take cardiovascular disease 1 killer men women around world robust scientific advances published pages journals fostered significant improvements benefit individuals society yet cardiovascular disease continues transform emerging new forms heart failure struggle shifted new battlefields successes derive armamentarium powerful toolsmedicines devicesand awareness lifestylerelated hazards high blood pressure high cholesterol smoking sadly however take full advantage tools disposal one significant cause suboptimal utilization prodigious tool chest medical misinformation hyped internet television chat rooms social media many instances celebrities activists politicians convey false information uncommonly authors purely venal motives participate point numerous examples including entirely unfounded concerns regarding vaccinations notion mmr measles mumps rubella vaccination causes autism based single flawed study long since refuted publication retracted seventeen much larger properly controlled studies proven otherwise nevertheless internet shouts unfounded warnings celebrities actors activists politicians specific knowledge training use fame promote message causes serious harm individuals neither physicians scientists often specific agenda outsized influence lives dispute scientific evidence without ever studied it1offit pa bad advice celebrities politicians activists arent best source health information columbia university press new york2018crossref google scholar recognizing impossible prove never scientists appropriately couch statements statistical terms may come across public equivocation nuanced voices scientists often resonate public much strident alarms sounded people fame speaking absolute terms scientists appropriately skeptical individual scientist study wrong yet science ultimately selfcorrects scientist gets wrong happens people sometimes vilify entire selfcorrecting scientific enterprise trust aeronautical science board airplane trust science buried within cell phones trust mechanical engineering science cross bridge yet many uniquely skeptical biological science sadly cannot exclude professions science medicine act based motives driven financial considerations incomplete declarations potential conflict interest persist2orenstein c thomas k top cancer researcher fails disclose corporate financial ties major research journals new york times september 8 2018httpswwwnytimescom20180908healthjosebaselgacancermemorialsloanketteringhtmlgoogle scholar recent examples dramatic price hikes important medications reinforced notion indeed many physicians conversations patients believe recommendations stem least part prospect personal financial gain editorsinchief major cardiovascular scientific journals around globe sound alarm human lives stake pointing 2 examples elaborated people decline use statin recommended doctor parents withhold vaccines children put lives harms way media must better job unacceptable posit false equivalents discussions often done foster debate controversy easy find rogue voice inappropriate suggest voice carries weight emerging mainstream science easily point examples outside medical domain well climate change evolution nutraceuticals gmo foods false equivalents frequently posited furthermore recent evidence suggests misinformation travels faster social networks truth3vosoughi roy aral spread true false news onlinescience 2018 359 11461151crossref pubmed scopus 2859 google scholar must work enhance science literacy world one place start better job teaching scientific method schools lay public aware science accomplished fits starts end gets right purveyors social media must responsible content disseminate longer acceptable hide behind cloak platform editors charged evaluating validity science presented us possible publication work hard fulfill heady responsibility recognizing lives stake reach thoughtleading experts evaluate veracity report receive challenge social media leverage ready availability scienceconversant expertise disseminating content may reliable without exaggeration significant harm society individuals derives wanton spread medical misinformation high time stops lay feet purveyors internet social media content responsibility fix

https://doi.org/10.1016/j.hrthm.2018.12.030

Nattakun Chobjai|Wirot Sanrattana

Online Program to Enhance Teacher Learning to Develop Students' Information Literacy Skills

Mahamakut Buddhist University|Mahamakut Buddhist University

online program enhance teacher learning develop students information literacy skills expected result implementation research development following concept begins teacher learning development teachers incorporate learning outcomes student development firstly result implementing r1ampd1 r4ampd4 process six sets teacher learning manuals one teacher workshop manual implementing learning outcomes student development created secondly r5ampd5 phase manuals evaluated 157 teachers 2613 students using onegroup pretestposttest experimental model schools affiliated office basic education commission experimental results revealed teachers scores postexperimental test met standard 9090 mean scores statistically significantly higher preexperimental test furthermore findings implementing teachers learning outcomes student development illustrated postexperimental mean score information literacy skills assessment statistically significantly higher preexperimental score taken together findings confirmed developed online program proven effective according established research hypothesis moreover study results also demonstrated developed online program could distributed schools office basic education commission

https://doi.org/10.31014/aior.1993.05.02.507

Chris Wild

STATISTICAL LITERACY AS THE EARTH MOVES

University of Auckland

times achangin says old bob dylan song times achangin statistical literacy earth moving feet apologies carole king seismic forces new forms communication discourse ii new forms data data display human interaction data upheavals worlds communication data ongoing anything pace change accelerating means statistically literate also changing tell important air enduring themes guiding principlesx0d first published may 2017 statistics education research journal archives

https://doi.org/10.52041/serj.v16i1.211

Viney Gupta

Utility values among glaucoma patients: an impact on the quality of life

All India Institute of Medical Sciences

ascertain utility values associated quality life different severity duration glaucoma among indian patients bmethodsb utility values 105 consecutive patients primary glaucoma least 12 months duration evaluated cross sectional study utility values ascertained five groups using timetrade standard gamble methods group 1 best corrected visual acuity better eye 69 better group 2 best corrected visual acuity better eye 618 612 group 3 best corrected visual acuity better eye 636 to624 group 4 best corrected visual acuity better eye 360 660 group 5 best corrected visual acuity better eye 360 worse bresultsb mean utility value glaucoma group whole 064 sd 069 95 confidence interval ci 058 070 timetrade method 086 sd 100 95 ci 081 090 standard gamble method gamble death 097 sd 100 95 ci 094 099 gamble blindness mean utility results timetrade method follows group 1 066 group 2 066 group 3 062 group 4 055 group 5 061 utility value much lower 046 formal education primary education compared postgraduate education 075 p 0038 patients glaucoma less 5 years duration utility score 062 glaucoma 10 years score 074 p 040 bconclusionsb visual acuity loss occurring secondary glaucoma associated substantial decrease patient utility value quality life developing country like india utility value directly dependent degree visual acuity loss associated disease educational status duration disease number medications visual field indices

https://doi.org/10.1136/bjo.2005.068858

Y.S. Yew

Knowledge and beliefs on corneal donation in Singapore adults

National University of Singapore

baimb assess knowledge willingness singapore adults towards corneal donation bmethodsb study population consists cluster random sample population living bedok north area eastern part singapore study population comprised residents aged 2165 years living 675 randomly sampled housing units participation rate 659 544825 participants interviewed face face questionnaire formulated according modified horton horton model knowledge values attitudes spiritual beliefs participants assessed evaluate willingness donate corneas bresultsb 670 participants willing donate corneas ethnicity chinese religion christians hindus religion associated increased willingness donate corneas greater knowledge increased altruistic values also associated increased willingness donate corneas bconclusionb proportion participants willing donate corneas awareness corneal donation high specific knowledge increased among adults

https://doi.org/10.1136/bjo.2004.057372

Christopher Morris

Who best to make the assessment? Professionals' and families' classifications of gross motor function in cerebral palsy are highly consistent

University of Oxford

baimb determine reliability family assessment gross motor function classification system gmfcs children cerebral palsy uk bmethodsb families complete geographically defined population children cerebral palsy 6 12 years old identified i4childi epidemiological database postal surveys conducted families childs health professionals nominated families bresultsb families 129314 eligible children took part study 41 indices agreement reliability families professionals also equivalent observed professionals 05 icc 09 reliability coefficients higher professionals classified children using direct observation rather reviewing clinical records bconclusionsb despite excellent reliability families professionals always agree exactly childs gmfcs level classifications may differ due childrens varying performance different environments case families almost certainly know childrens ability broader range settings indices reliability family assessment gmfcs meet recommended criteria use individuals groups indicating method suitable use research studies clinical practice

https://doi.org/10.1136/adc.2005.090597

Shajith Anoop

Maternal depression and low maternal intelligence as risk factors for malnutrition in children: a community based case-control study from South India

Christian Medical College & Hospital

baimsb determine whether current postpartum maternal depression low maternal intelligence risk factors malnutrition children bmethodsb rural south india 72 children malnutrition identified central register 72 controls matched age gender residence bresultsb major depression postpartum period 50 95 ci 10 240 current major depression 32 95 ci 11 95 low maternal intelligence 38 95 ci 13 111 associated malnutrition child low birth weight 29 95 ci 12 68 also significantly associated infant malnutrition conditional logistic regression adjusting determinants yielded following results major depression postpartum period 78 95 ci 16 3851 current major depression 31 95 ci 09 97 low maternal intelligence 46 95 ci 15 141 low birth weight 27 95 ci 25 68 interactions current maternal depression low birth weight postpartum depression low maternal intelligence statistically significant level maternal intelligence associated nutritional status severity malnutrition also significantly associated major depression postpartum period low maternal intelligence bconclusionb evidence association postpartum maternal depression low maternal intelligence low birth weight malnutrition children aged 612 months

https://doi.org/10.1136/adc.2002.009738

Saelle Hendry

Minor illness and injury: factors influencing attendance at a paediatric accident and emergency department

Bristol Royal Hospital for Children

baimsb gather information children minor illness injury presenting paediatric accident emergency aampe department decision making process leading attendance bmethodsb prospective questionnaire based survey 465 children selected systematic sampling aampe attenders allocated lowest triage category bresultsb study population statistically representative total population aampe attenders lower deprivation categories represented educational attainment childcare experience parental coping skills important relation aampe attendance children attended injury opposed illness significant demographic differences children presented directly aampe made prior contact gp half study population made contact general practitioner gp attending aampe majority children directly referred aampe point gps referred equivalent numbers children illness injury bconclusionsb parents gps view paediatric aampe departments appropriate place seek treatment children minor illness injury

https://doi.org/10.1136/adc.2004.049502

Mandal Nk|Suman Mallik|R P Roy|Mandal Sb|Sujoy Dasgupta|Arpita Mandal

Impact of religious faith & female literacy on fertility in a rural community of west Bengal

bbackground b role different social factors fertility control evident different studies impact religious faith female literacy fertilitybrb objectives b study role religious faith female literacy fertility regulation rural community west bengalbrb methods b cross sectional study rural field practice area department community medicine nrs medical college kolkata based interview married women reproductive age group total 671 filled schedules analyzed epi info packagebrb results b average number pregnancies ever occurred among muslim mothers 28 higher comparison hindu mothers 168 regarding current fertility live births last 2 yrs among muslim mothers 252 compared counterparts among hindu community 124 cases differences found statistically significant female literacy found impact fertility whole stratified positive role evident among hindu mothers among muslim mothersbrb conclusions b factors made differences fertility two religious groups properly assessed duly addressed better fertility control community

https://doi.org/10.4103/0970-0218.53382

Jiménez-Corona Me

Gender differentials of pulmonary tuberculosis transmission and reactivation in an endemic area

Instituto Nacional de Salud Pública

bbackgroundb low income countries twice many cases tuberculosis tb reported among men among women difference commonly attributed biological epidemiological characteristics well socioeconomic cultural barriers access health care world health organization encouraged gender specific comparisons tb rates determine whether women tb less likely men tb diagnosed reported treated study undertaken identify gender based differences patients pulmonary tb use information improve tb control efforts bmethodsb individuals cough 2 weeks southern mexico screened march 1995 april 2003 clinical mycobacteriological information isolation identification drug susceptibility testing isi6110i based genotyping spoligotyping collected bacteriologically confirmed pulmonary tb patients treated accordance official norms followed ascertain treatment outcome retreatment vital status bresultsb 623 patients pulmonary tb enrolled malefemale incidence rate ratio overall reactivated recently transmitted disease 158 95 ci 134 186 164 95 ci 136 198 141 95 ci 101 196 respectively men likely women default treatment adjusted 330 95 ci 146 743 retreated hazard ratio hr 315 95 ci 138 722 die tb hr 223 95 ci 125 399 bconclusionsb higher rates transmitted reactivated disease poorer treatment outcomes among men indicators gender differentials diagnosis treatment pulmonary tb suggest specific strategies endemic settings

https://doi.org/10.1136/thx.2005.049452

Prakash Patel

Mass drug administration coverage evaluation survey for lymphatic Filariasis in Bagalkot and Gulbarga districts

Sri Devaraj Urs Medical College

bbackgroundb lymphatic filariasis lf endemic 83 countries territories billion people risk infection view global elimination mass drug administration mda single dose diethylcarbamazine albendazole tablets carried eligible population bagalkot gulbarga districts bobjectiveb assess coverage mda lf bagalkot gulbarga districts bmaterials methodsb crosssectional coverage evaluation survey one urban three rural clusters selected randomly district data collected pretested performa computed analyzed using spss10 calculate frequencies proportions bresultsb total eight clusters two districts resulted total study population 1228 individuals overall compliance rate bagalkot district 786 gulbarga district 388 prime reason noncompliance fear side effects received tablets bconclusionb urgent need effective drug delivery strategies improve compliance districts

https://doi.org/10.4103/0970-0218.96095

Paul Montgomery

The relative efficacy of two brief treatments for sleep problems in young learning disabled (mentally retarded) children: a randomised controlled trial

bbackgroundb settling night waking problems particularly prevalent persistent generally considered difficult treat children learning disability although intervention trials scarce resources however limit access proven behavioural treatments baimsb investigate efficacy media based brief behavioural treatment sleep problems children comparing 1 facetoface delivered treatment versus control 2 booklet delivered treatment versus controls bmethodsb parents 66 severely learning disabled children aged 28 years settling andor night waking problems took part randomised controlled trial waitlist control group behavioural treatments presented either conventionally facetoface means 14 page easy read illustrated booklet composite sleep disturbance score derived sleep diaries kept parents bresultsb forms treatment almost equally effective compared controls two thirds children taking 30 minutes settle five times per week waking night 30 minutes four times per week improved average settling night waking problems minutes twice per week h 34174 df 2 plt0001 improvements maintained six months bconclusionsb booklet delivered behavioural treatments sleep problems effective facetoface treatment children population

https://doi.org/10.1136/adc.2002.017202

Neerja Chowdhary|Vikram Patel

The effect of spousal violence on women's health: Findings from the Stree Arogya Shodh in Goa, India

Sangath|Sangath|London School of Hygiene & Tropical Medicine

bbackgroundb spousal violence wideranging effects physical reproductive sexual psychological health women longitudinal studies describe association developing countries baimb test hypothesis spousal violence independent risk factor broad range adverse health outcomes women bsetting designb populationbased cohort study women living catchment area primary health center north goa two thousand four hundred ninetyfour 3000 randomly selected women recruited 1750 married women included paper bmaterials methodsb participant assessed baseline structured interview assessment exposure spousal violence verbal physical sexual two time periods lifetime recent past three months interview collected data gynecological complaints revised clinical interview schedule used diagnosis depressive disorder laboratory tests anemia sexually transmitted infections sti carried longitudinal data collected six 12 months outcomes addition baseline measures nutritional status menstrual health also obtained bstatistical analysisb univariate analyses carried crosssectional longitudinal data assess association type spousal violence health outcome multivariate analyses adjusted age literacy household per capita income logistic regression used analyses stata version 10 bresultsb lifetime spousal violence reported 290 166 95ci149184 women recent violence reported 230 130 95ci116148 crosssectional data showed association violence range selfreported gynecological complaints low body mass index depressive disorder attempted suicide longitudinal analyses confirmed associations sti attempted suicide bconclusionb spousal violence specifically associated independent risk factor two adverse womens health outcomes viz sti attempted suicide public health clinical programs targeting outcomes must specifically address spousal violence

https://doi.org/10.4103/0022-3859.43514

Vivek Gupta|Kapil Yadav|K Anand

Patterns of tobacco use across rural, urban, and urban-slum populations in a North Indian community

All India Institute of Medical Sciences|All India Institute of Medical Sciences|All India Institute of Medical Sciences

bbackgroundb tobacco leading cause mortality globally india magnitude pattern tobacco consumption likely influenced geographical setting rapid urbanization india need study differential pattern baimb aim study rural urban urbanslum differences patterns tobacco use bsettingsb study conducted ballabgarh block faridabad district haryana communitybased crosssectional study bmaterials andb bmethodsb study conducted years 20032004 using steps approach 7891 participants approximately equal number males females selected using multistage sampling urban urbanslum rural strata bstatistical analysisb analysis done using spss 120 statistical package spss inc chicago il usa direct standardization world standard population done chisquare anova tests used comparison across three study settings bresultsb selfreported tobacco use among males follows urban 352 urbanslums 483 rural 526 ipi value 005 selfreported tobacco use among females follows urban 35 urbanslums 119 rural 177 ipi value 005 males reported daily bidi tobacco wrapped temburini leaf smoking urban 178 urbanslums 367 rural 446 cigarette use urban 96 urbanslums 63 rural 29 females using smoked tobacco almost exclusively using bidis urban 17 79 11 rural daily chewed tobacco use urban urbanslum rural gradients 12 105 68 males respectively use low females bconclusionb antitobacco policies india need focus bidis antitobacco campaigns program activities must find ways reach rural urbanslum populations

https://doi.org/10.4103/0970-0218.66877

Sameer Valsangkar|Trupti N Bodhare|Samir Bele|Surendranath K Sai

An evaluation of the effect of infertility on marital, sexual satisfaction indices and health-related quality of life in women

Institute of Medical Sciences|Institute of Medical Sciences|Institute of Medical Sciences|Institute of Medical Sciences

bbackgroundb effect infertility marital sexual functioning healthrelated quality life qol acceptability treatment modalities poorly researched area india baims objectivesb measure compare impact infertility marital adjustment sexual functioning qol acceptability various treatment modalities infertility bdesign settingb hospitalbased crosssectional controlled study bmaterials methodsb data regarding infertility sociodemographic characteristics treatment acceptability obtained via semistructured questionnaire validated standardized scales used measure marital adjustment abbreviated dyadic adjustment scale sexual functioning abbreviated sexual functioning questionnaire cases controls quality life fertiqol cases data 106 women attending tertiary infertility centers met definition primary infertility 212 controls attending medical outpatient department centers obtained bresultsb body mass index socioeconomic status significant ipi 0006 00001 respectively infertility fertilityenhancing regimens adoption highest acceptability wide dispersion range adoption least acceptance sperm egg embryo donation surrogate motherhood logistic regression analysis revealed significant effect size infertility marital adjustment nagelkerke r sup2sup 0725 cohens 086 sexual functioning nagelkerke r sup2sup 073 cohens 0815 qol showed decrease mean scores fertiqol scale similar normative data bconclusionsb effective counseling reassurance measures reduce impact condition marital sexual life overall qol needed impart holistic treatment infertility

https://doi.org/10.4103/0974-1208.86088

S. S. Islam|Tulika Goswami Mahanta|Ratna Sarma|Hiranya Saikia

Nutritional status of under 5 children belonging to tribal population living in riverine (Char) areas of Dibrugarh district, Assam

Assam Medical College|Assam Medical College|Assam Medical College|Assam Medical College

bcontextb assams main lifeline brahmaputra river braided nature created numerous sand bars islands known charssapories home 3 million people 90 cultivated land river islands floodprone flood leaves islands completely separated mainland preventing access health infrastructure services aims assess nutritional status 5 children residing char areas dibrugarh district identify factors influencing nutritional status bsettings designb communitybased crosssectional study conducted riverine areas dibrugarh district assam bmaterials methodsb nutritional status assessed using anthropometry undernutrition classified using world health organization recommended z score system data collection done house house visit chars using proportionate allocation bstatistical analysis usedb rates ratios proportions chisquare test bresultsb overall prevalence underweight stunting wasting 29 304 216 respectively prevalence underweight stunting less prevalence underweight 364 stunting 465 assam prevalence wasting assam 137 observed national family health survey3 significant association observed prevalence undernutrition socioeconomic status literacy status parents infant young child feeding practices size family ipi 005 bconclusionsb special focus needed nutritional improvement 5 living char areas prevent preventable morbidities achieve optimum development

https://doi.org/10.4103/0970-0218.137155

Quyen Bach|Vandan Kasar|Francesco Chiappelli

Implications and applications of systematic reviews for evidence-based dentistry and comparative effectiveness research: A sample study on antibiotics for oro-facial cellulitis treatment

Research Network (United States)|University of California, Los Angeles|University of California, Los Angeles

bintroductionb comparative effectiveness efficacy research analysis practice ceerap performed assess effects penicillinbased versus erythromycinbased antibiotic treatments patients skin soft tissue infections sstis including cellulitis impetigo erysipelas sstis especially orofacial cellulitis volatile infectious diseases lifethreatening nature research efficacious remedies necessary bmethodsb stringent bibliome yielded three systematic reviews examined quality research synthesis protocol clinical relevance bresultsb sample size three rendered statistical analyses cumulative metaanalysis problematic bconclusionb systematic review outlined aid increasing clinical awareness improving patient health literacy promoting consensus best evidence base beb mitigate threat sepsis potential death caused cellulitis infections

https://doi.org/10.4103/2155-8213.170639

Kajua B. Lor|Julie Truong|Eric J. Ip|Mitchell J. Barnett

A Randomized Prospective Study on Outcomes of an Empathy Intervention among Second-year Student Pharmacists

Touro University California|Keck Graduate Institute|Touro University California|Touro University California

bobjectiveb determine impact single 3day intervention empathy levels measured validated jefferson scale empathyhealth profession students version jsehps bmethodsb forty secondyear student pharmacists recruited participate nonblinded prospective study subjects randomized intervention group n20 control group n20 completed jsehps baseline 7 days postintervention 90 days postintervention intervention group consisted 3day simulation day including designated activity loss dominant hand usage vision speech bresultsb 3day simulation increased empathy levels intervention group compared control group 7 days postintervention ipi0035 however effects empathy levels 90 days postintervention ipi038 bconclusionb empathy scores increased sustained longterm 3day empathy intervention

https://doi.org/10.5688/ajpe79218

Corinne Peek?Asa

When one is not enough: prevalence and characteristics of homes not adequately protected by smoke alarms

Iowa City Public Library

bobjectiveb national fire protection association nfpa specific recommendations number location type smoke alarms needed provide maximum protection household previous studies examined whether homes completely protected according guidelines authors describe prevalence home characteristics associated compliance recommendations smoke alarm installation nfpa bdesign setting subjectsb data baseline onsite survey randomized trial measure smoke alarm effectiveness trial housed longitudinal cohort study rural iowa county 1005 homes invited 691 688 participated bmain outcome measuresb information smoke alarm type placement function well home occupant characteristics collected onsite household survey bresultsb although 860 homes least one smoke alarm 223 homes approximately one five adequately protected according nfpa guidelines fourteen percent homes functioning smoke alarms half homes smoke alarms enough installed incorrectly 424 homes alarms least one alarm operate homes least one high school graduate nearly four times likely fully protected homes multiple levels basement cluttered poorly cleaned significantly less likely fully protected bconclusionb findings indicate consumers may knowledgeable number alarms need properly install occupants also adequately maintaining alarms installed

https://doi.org/10.1136/ip.2005.009175

Stefano Vicari

Do children with developmental dyslexia have an implicit learning deficit?

Bambino Gesù Children's Hospital

bobjectiveb purpose study investigate effects specific types tasks efficiency implicit procedural learning presence developmental dyslexia dd bmethodsb sixteen children dd mean sd age 116 14 years 16 matched normal reader controls mean age 114 19 years administered two tests serial reaction time test mirror drawing test implicit knowledge gradually acquired across multiple trials although tests analyse implicit learning abilities tap different competencies serial reaction time test requires development sequential learning little procedural learning whereas mirror drawing test involves fast repetitive processing visuospatial stimuli acquisition sequences bresultsb children dd impaired implicit learning tasks suggesting learning deficit observed dyslexia depend material learned without motor sequence response action implicit nature learning characterises tasks bconclusionb individuals dd impaired implicit procedural learning

https://doi.org/10.1136/jnnp.2004.061093

Jay G. Silverman|Michele R. Decker|Nitin Kapur|Jhumka Gupta|Anita Raj

Violence against wives, sexual risk and sexually transmitted infection among Bangladeshi men

Harvard University|Harvard University|Harvard University|Harvard University|Boston University

bobjectiveb assess relationship mens reported violence wives sexual risk behaviours sexual health bdesign setting participantsb crosssectional analyses survey nationally representative householdbased sample married men bangladesh n 3096 bmain outcome measuresb physical sexual violence wives previous 12 months assessed examined relations mens extramarital sexual behaviours sexually transmitted infection sti symptoms diagnosis period well mens disclosure infection wives condom use infected bresultsb 1 3 3684 married bangladeshi men reported physically andor sexually abusing wives past year men perpetrating violence likely report premarital extramarital sex partners orsubadjsubs 180345 95 ci 120 823 reporting physical violence likely report sti symptoms diagnosis past year orsubadjsubs 168252 95 ci 124 373 men perpetrating physical violence contracting sti somewhat likely fail disclose infection status wives orsubadjsub 158 95 ci 093 270 infected men reporting abuse bconclusionsb violence wives common among bangladeshi men men perpetrate abuse represent increased risk regarding wives sexual health likely participate extramarital sexual behaviour contract sti compared nonabusive husbands given growing epidemic hiv infection among monogamous south asian women based intercourse infected nonmonogamous husbands research intervention regarding mens violence marriage implications behaviour womens sexual health prioritised

https://doi.org/10.1136/sti.2006.023366

VijayR Thawani|SmitaN Mali|Kunda Gharpure|Viraj Uttamrao Shingade|Ganesh Dakhale|NarendraP Bachewar

Comparison of safety, efficacy, and cost effectiveness of benzyl benzoate, permethrin, and ivermectin in patients of scabies

Government Medical College|Government Medical College|Government Medical College|Government Medical College|Government Medical College|ACPM Dental College and Hospital

bobjectiveb compare three treatment modalities scabies safety efficacy economy local population nagpurbrbmaterials methodsb prospective randomized comparative clinical trial conducted 103 participants randomly allocated three groups first group received benzyl benzoate bb 25 lotion second group received permethrin 5 cream whereas third group received tablet ivermectin 200 gkg single dose participants recalled one week followup evaluation signs cure intervention repeated participants followed two weeks cure rate adverse drug reaction adr monitoring postintervention observation followup stopped two weeksbrbstatisticsb fischers exact test using graph pad instat v 305brbresultsb ivermectin showed 100 cure rate two weeks treatment permethrin decreased pruritus 76 end one week significantly better cure rate ivermectin end two weeks treatment finding reversed cure rate ivermectin group 100 costeffectiveness analysis treatment regimens formulated hypothetically comparison markov population tree decision analysis found bb ivermectin consecutively two weeks cost effective regimens giving complete cure four weeks ivermectin fastest regimen giving results two weeksbrbconclusionb benzyl benzoate first line intervention ivermectin remaining gave best costeffective results study patients scabies

https://doi.org/10.4103/0253-7613.48882

Brendan Dineen|Rupert Bourne|Zahid Jadoon|S P Shah|Muhammad Asghar Khan|Allen Foster|Clare Gilbert|Mohammad Daud Khan

Causes of blindness and visual impairment in Pakistan. The Pakistan national blindness and visual impairment survey

London School of Hygiene & Tropical Medicine

bobjectiveb determine causes blindness visual impairment adults 30 years old pakistan explore sociodemographic variations cause bmethodsb multistage stratified cluster random sampling survey used select nationally representative sample adults subject interviewed visual acuity measured underwent autorefraction fundusoptic disc examination visual acuity lt612 either eye underwent detailed ophthalmic examination causes visual impairment classified according accepted world health organization methodology exploration demographic variables conducted using regression modeling bresultsb sample 16 507 adults 955 enumerated examined cataract common cause blindness 515 defined lt360 better eye presentation followed corneal opacity 118 uncorrected aphakia 86 glaucoma 71 posterior capsular opacification accounted 36 blindness among moderately visually impaired lt618 660 refractive error common cause 43 followed cataract 42 refractive error cause severe visual impairmentblindness significantly higher rural dwellers urban dwellers odds ratio 35 95 ci 11 117 significant provincial differences also identified overall estimate 855 causes avoidable 904 000 adults pakistan cataract lt660 requiring surgical intervention bconclusionsb comprehensive survey provides reliable estimates causes blindness visual impairment pakistan despite expanded surgical services cataract still accounts half cases blindness pakistan one eight blind adults visual loss sequelae cataract surgery services refractive errors need expanded integrated eye care services particularly serving rural populations

https://doi.org/10.1136/bjo.2006.108035

Manju Rani

Tobacco use in India: prevalence and predictors of smoking and chewing in a national cross sectional household survey

bobjectiveb estimate prevalence socioeconomic demographic correlates tobacco consumption india bdesignb cross sectional nationally representative population based household survey bsubjectsb 315 598 individuals 15 years older 91 196 households sampled national family health survey2 199899 data tobacco consumption elicited household informants bmeasures methodsb prevalence current smoking current chewing tobacco used outcome measures simple two way cross tabulations multivariate logistic regression analysis main analytical methods bresultsb thirty per cent population 15 years older47 men 14 womeneither smoked chewed tobacco translates almost 195 million people154 million men 41million women india however prevalence may underestimated almost 11 15 chewing tobacco among men women respectively 5 05 smoking among men women respectively use household informants tobacco consumption significantly higher poor less educated scheduled castes scheduled tribe populations prevalence tobacco consumption increased age 50 years levelled declined prevalence smoking chewing also varied widely different states strong association individuals sociocultural characteristics bconclusionb findings study highlight agenda improve health outcomes among poor india must include effective interventions control tobacco use failure would likely result doubling burden diseasesboth communicable noncommunicableamong indias teeming poor need periodical surveys using consistent definitions tobacco use eliciting information different types tobacco consumed study also suggests need adjust prevalence estimates based household informants

https://doi.org/10.1136/tc.12.4.e4

James Macinko

Evaluation of the impact of the Family Health Program on infant mortality in Brazil, 1990-2002

New York University

bobjectiveb use publicly available secondary data assess impact brazils family health program state level infant mortality rates imr 1990s bdesignb longitudinal ecological analysis using panel data secondary sources analyses controlled state level measures access clean water sanitation average income womens literacy fertility physicians nurses per 10 000 population hospital beds per 1000 population additional analyses controlled immunisation coverage tested interactions family health program proportionate mortality diarrhoea acute respiratory infections bsettingb 13 years 19902002 data 27 brazilian states bmain resultsb 1990 2002 imr declined 497 289 per 1000 live births period average family health program coverage increased 0 36 10 increase family health program coverage associated 45 decrease imr controlling health determinants plt001 access clean water hospital beds per 1000 negatively associated imr female illiteracy fertility rates mean income positively associated imr examination interactions family health program coverage diarrhoea deaths suggests programme may reduce imr least partly reductions diarrhoea deaths interactions deaths acute respiratory infections ambiguous bconclusionsb family health program associated reduced imr suggesting important although unique contributor declining infant mortality brazil existing secondary datasets provide important tool evaluation effectiveness health services brazil

https://doi.org/10.1136/jech.2005.038323

Tazeen H. Jafar|Muhammed Islam|Julian Hatcher|Saman K. Hashmi|Rasool Bux|Aamir Hameed Khan|Neil Poulter|S H Badruddin|Nish Chaturvedi

Community based lifestyle intervention for blood pressure reduction in children and young adults in developing country: cluster randomised controlled trial

Nutrition Sciences (Belgium)|Aga Khan University|Aga Khan University|Aga Khan University|Aga Khan University|Aga Khan University|Aga Khan University|Aga Khan University|Lung Institute|Imperial College London|Nutrition Sciences (Belgium)

bobjectiveb assess effectiveness community based lifestyle intervention blood pressure children young adults developing country setting bdesignb cluster randomised controlled trial bsettingb 12 randomly selected geographical census based clusters karachi pakistan bparticipantsb 4023 people aged 539 years binterventionb three monthly family based home health education delivered lay health workers bmain outcome measureb change blood pressure randomisation end followup 2 years bresultsb analysed using intention treat principle change systolic blood pressure adjusted age sex baseline blood pressure significant increased 15 95 confidence interval 11 19 mm hg control group 01 03 05 mm hg home health education group p difference groups002 findings diastolic blood pressure similar change 15 mm hg greater control group intervention group p0002 bconclusionsb simple family based home health education delivered trained lay health workers significantly ameliorated usual increase blood pressure age children young adults general population pakistan low income developing country strategy potentially feasible upscaling within existing healthcare systems indoasia btrial registrationb clinical trials nct00327574

https://doi.org/10.1136/bmj.c2641

Lisa M. Schwartz|Steven Woloshin|Ashley Andrews|Thérèse A. Stukel

Influence of medical journal press releases on the quality of associated newspaper coverage: retrospective cohort study

Dartmouth Institute for Health Policy and Clinical Practice|White River Junction VA Medical Center|Dartmouth Institute for Health Policy and Clinical Practice|White River Junction VA Medical Center|Dartmouth Institute for Health Policy and Clinical Practice|University of Toronto|Institute for Clinical Evaluative Sciences

bobjectiveb determine whether quality press releases issued medical journals influence quality associated newspaper stories bdesign bretrospective cohort study medical journal press releases associated news stories bsettingb reviewed consecutive issues going backwards january 2009 five major medical journals iannals internal medicinei ibmji ijournal national cancer institutei ijamai inew england journal medicinei identify first 100 original research articles quantifiable outcomes generated newspaper coverage unique stories 100 words long identified 759 associated newspaper stories using lexis nexis factiva searches 68 journal press releases using eurekalert journal website searches two independent research assistants assessed quality journal articles press releases stratified random sample associated newspaper stories n343 using structured coding scheme presence specific quality measures basic study facts quantification main result harms limitations bmain outcome bproportion newspaper stories specific quality measures adjusted whether quality measure present journal articles abstract editor note bresultsb recorded median three newspaper stories per journal article range 172 343 stories analysed 71 reported articles medical journals issued press releases 9 stories quantified main result absolute risks information press release 53 press release relative risk 60 95 confidence interval 23 154 20 press release issued 22 083 61 133 39 stories reported research describing beneficial interventions 24 mentioned harms specifically declared harms harms mentioned press release 68 mentioned press release 28 11 74 36 press release issued 15 049 44 256 75 stories reported research important limitations 16 reported limitations limitations mentioned press release 48 mentioned press release 30 15 62 21 press release issued 13 050 36 bconclusionb high quality press releases issued medical journals seem make quality associated newspaper stories better whereas low quality press releases might make worse

https://doi.org/10.1136/bmj.d8164

Karen Ritchie|Isabelle Carrière|Craig Ritchie|Claudine Berr|Sylvaine Artéro|Marie-Laure Ancelin

Designing prevention programmes to reduce incidence of dementia: prospective cohort study of modifiable risk factors

Neuropsychiatry Epidemiological and Clinical Research|Inserm|University of Montpellier|St Mary's Hospital|Neuropsychiatry Epidemiological and Clinical Research|Inserm|University of Montpellier|St Mary's Hospital|Neuropsychiatry Epidemiological and Clinical Research|Inserm|University of Montpellier|Neuropsychiatry Epidemiological and Clinical Research|Inserm|University of Montpellier|Neuropsychiatry Epidemiological and Clinical Research|Inserm|University of Montpellier

bobjectiveb estimate percentage reduction incidence dementia would obtained specific risk factors eliminated bdesignb prospective seven year cohort study bsettingb general population montpellier france bparticipantsb 1433 people aged 65 mean baseline age 725 sd 51 years bmain outcome measuresb diagnosis mild cognitive impairment dementia established standardised neurological examination bresultsb cox models constructed derive hazard ratios determine confounding interaction effects potentially modifiable risk factors dementia mean percentage population attributable fractions calculated 95 confidence intervals derived bootstrapping seven year incidence mild cognitive impairment dementia final model retained crystallised intelligence population attributable fraction 1811 95 confidence interval 1091 2542 depression 1031 366 1717 fruit vegetable consumption 646 015 1306 diabetes 488 187 798 apolipoprotein e 4 allele 711 244 1198 bconclusionsb increasing crystallised intelligence fruit vegetable consumption eliminating depression diabetes likely biggest impact reducing incidence dementia outweighing even effect removing principal known genetic risk factor although causal relations cannot concluded certainty study suggests priorities may inform public health programmes

https://doi.org/10.1136/bmj.c3885

Hamed Khalili|Ashwin N. Ananthakrishnan|Gauree G. Konijeti|Xiaoyun Liao|L M Higuchi|Charles S. Fuchs|Donna Spiegelman|James M. Richter|Joshua R. Korzenik|Andrew T. Chan

Physical activity and risk of inflammatory bowel disease: prospective study from the Nurses' Health Study cohorts

Massachusetts General Hospital|Harvard University|Massachusetts General Hospital|Harvard University|Massachusetts General Hospital|Harvard University|Harvard University|Boston Children's Hospital|Harvard University|Dana-Farber Cancer Institute|Harvard University|Brigham and Women's Hospital|Harvard University|Massachusetts General Hospital|Harvard University|Brigham and Women's Hospital|Massachusetts General Hospital|Harvard University|Brigham and Women's Hospital

bobjectiveb examine association physical activity risk ulcerative colitis crohns disease bdesignb prospective cohort study bsettingb nurses health study nurses health study ii bparticipantsb 194 711 women enrolled nurses health study nurses health study ii provided data physical activity risk factors every two four years since 1984 nurses health study 1989 nurses health study ii followed 2010 bmain outcome measureb incident ulcerative colitis crohns disease bresultsb 3 421 972 person years followup documented 284 cases crohns disease 363 cases ulcerative colitis risk crohns disease inversely associated physical activity p trend 002 compared women lowest fifth physical activity multivariate adjusted hazard ratio crohns disease among women highest fifth physical activity 064 95 confidence interval 044 094 active women least 27 metabolic equivalent task met hours per week physical activity 44 reduction hazard ratio 056 95 confidence interval 037 084 risk developing crohns disease compared sedentary women lt3 met hwk physical activity associated risk ulcerative colitis p trend 046 absolute risk ulcerative colitis crohns disease among women highest fifth physical activity 8 6 events per 100 000 person years compared 11 16 events per 100 000 person years among women lowest fifth physical activity respectively age smoking body mass index cohort significantly modify association physical activity risk ulcerative colitis crohns disease p interaction gt035 bconclusionb two large prospective cohorts us women physical activity inversely associated risk crohns disease ulcerative colitis

https://doi.org/10.1136/bmj.f6633

Chris Salisbury|Alicia O’Cathain|Clare Thomas|Louisa Edwards|Daisy Gaunt|Padraig Dixon|Sandra Hollinghurst|Jon Nicholl|Shirley Large|Lucy Yardley|Tom Fahey|Alexis Foster|Katy Garner|Kimberley Horspool|Mei?See Man|Anne Rogers|Catherine Pope|Alan Montgomery

Telehealth for patients at high risk of cardiovascular disease: pragmatic randomised controlled trial

University of Bristol|University of Sheffield|University of Bristol|University of Bristol|University of Bristol|University of Bristol|University of Bristol|University of Sheffield|University of Southampton|Royal College of Surgeons in Ireland|University of Sheffield|University of Bristol|University of Sheffield|University of Bristol|University of Southampton|University of Southampton|Queen's Medical Centre

bobjectivebnbspto assess whether nonclinical staff effectively manage people high risk cardiovascular disease using digital health technologies bdesignbnbsppragmatic multicentre randomised controlled trial bsettingbnbsp42 general practices three areas england bparticipantsbnbspbetween 3 december 2012 23 july 2013 recruited 641 adults aged 40 74 years 10 year cardiovascular disease risk 20 previous cardiovascular event least one modifiable risk factor systolic blood pressure 140 mm hg body mass index 30 current smoker access telephone internet email participants individually allocated intervention n325 control n316 groups using automated randomisation stratified site minimised practice baseline risk score binterventionsbnbspintervention healthlines service alongside usual care comprising regular telephone calls trained lay health advisors following scripts generated interactive software advisors facilitated self management supporting participants use online resources reduce risk factors sought optimise drug use improve treatment adherence encourage healthier lifestyles control group comprised usual care alone bmain outcome measuresbnbspthe primary outcome proportion participants responding treatment defined maintaining reducing cardiovascular risk 12 months outcomes collected six 12 months randomisation analysed masked participants masked bresultsbnbsp50 148295 participants intervention group responded treatment compared 43 124291 control group adjusted odds ratio 13 95 confidence interval 10 19 number needed treat13 difference possibly due chance p008 intervention associated reductions blood pressure difference mean systolic 27 mm hg 95 confidence interval 47 06 mm hg mean diastolic 28 40 16 mm hg weight 10 kg 18 03 kg body mass index 04 06 01 cholesterol 01 02 00 smoking status adjusted odds ratio 04 02 10 overall cardiovascular risk continuous measure 04 12 03 intervention associated improvements diet physical activity drug adherence satisfaction access care treatment received care coordination one serious related adverse event occurred participant admitted hospital low blood pressure bconclusionsbnbspthis evidence based telehealth approach associated small clinical benefits minority people high cardiovascular risk overall improvement average risk healthlines service however associated improvements risk behaviours perceptions support access care btrial registrationbnbspcurrent controlled trials isrctn 27508731

https://doi.org/10.1136/bmj.i2647

Anna?Clara Hollander|Henrik Dal|Glyn Lewis|Cecilia Magnusson|James Kirkbride|Christina Dalman

Refugee migration and risk of schizophrenia and other non-affective psychoses: cohort study of 1.3 million people in Sweden

Karolinska Institutet|Stockholm County Council|University College London|Stockholm County Council|Karolinska Institutet|University College London|Stockholm County Council|Karolinska Institutet

bobjectivebnbspto determine whether refugees elevated risk schizophrenia nonaffective psychotic disorders relative nonrefugee migrants similar regions origin swedishborn population bdesignbnbspcohort study people living sweden born 1 january 1984 followed 14th birthday arrival sweden later diagnosis nonaffective psychotic disorder emigration death 31 december 2011 bsettingbnbsplinked swedish national register data bparticipantsbnbsp1 347 790 people including people born sweden two swedishborn parents 1 191 004 884 refugees 24 123 18 nonrefugee migrants 132 663 98 four major refugee generating regions middle east north africa subsaharan africa asia eastern europe russia bmain outcome measuresbnbspcox regression analysis used estimate adjusted hazard ratios nonaffective psychotic disorders refugee status region origin controlling age risk sex disposable income population density bresultsbnbsp3704 cases nonaffective psychotic disorder identified 89 million person years followup crude incidence rate 385 95 confidence interval 372 399 per 100 000 person years swedishborn population 804 727 889 per 100 000 person years nonrefugee migrants 1264 1031 1548 per 100 000 person years refugees refugees increased risk psychosis compared swedishborn population adjusted hazard ratio 29 95 confidence interval 23 36 nonrefugee migrants 17 13 21 adjustment confounders increased rate refugees compared nonrefugee migrants pronounced men likelihood ratio test interaction sup2sup df2 z135 p0001 present refugees regions except subsaharan africa refugees nonrefugee migrants subsaharan africa similarly high rates relative swedishborn population bconclusionsbnbsprefugees face increased risk schizophrenia nonaffective psychotic disorders compared nonrefugee migrants similar regions origin nativeborn swedish population clinicians health service planners refugee receiving countries aware raised risk psychosis addition mental physical health inequalities experienced refugees

https://doi.org/10.1136/bmj.i1030

Sara Ahmadi?Abhari|Maria Guzman-Castillo|Piotr Bandosz|Martin J. Shipley|Graciela Muniz?Terrera|Archana Singh?Manoux|Mika Kivimäki|Andrew Steptoe|Simon Capewell|Martín O’Flaherty|Eric J. Brunner

Temporal trend in dementia incidence since 2002 and projections for prevalence in England and Wales to 2040: modelling study

University College London|University of Liverpool|Gda?sk Medical University|University of Liverpool|University College London|University of Edinburgh|Hôpital Paul-Brousse|Inserm|University College London|University of Helsinki|University College London|University College London|University of Liverpool|University of Liverpool|University College London

bobjectivebnbspto forecast dementia prevalence dynamic modelling approach integrates calendar trends dementia incidence mortality cardiovascular disease bdesignbnbspmodelling study bsettingbnbspgeneral adult population england wales bparticipantsbnbspthe english longitudinal study ageing elsa representative panel study six waves data across 200213 men women aged 50 years selected randomly cohabiting partners recruited first wave elsa 200203 11392 adults participated response rate 67 maintain representativeness refreshment participants recruited study subsequent waves total analytical sample constituted 17 906 people constant objective criteria based cognitive functional impairment used ascertain dementia cases wave bmain outcome measuresbnbspto estimate calendar trends dementia incidence correcting bias due loss followup study participants joint model longitudinal timetoevent data fitted elsa data forecast future dementia prevalence probabilistic markov model impactbam impactbetter ageing model developed impactbam models transitions population aged 35 years states cardiovascular disease cognitive functional impairment dementia death enables prediction dementia prevalence accounting growing pool susceptible people result increased life expectancy competing effects due changes mortality incidence cardiovascular disease bresultsbnbspin elsa dementia incidence estimated 143 per 1000 person years men 1701000 person years women aged 50 2010 dementia incidence declined relative rate 27 95 confidence interval 24 29 year 200213 using impactbam estimated approximately 767 000 95 uncertainty interval 735 000 797 000 people dementia england wales 2016 despite decrease incidence age specific prevalence number people dementia projected increase 872 000 1 092 000 1 205 000 2020 2030 2040 respectively sensitivity analysis without incidence decline gave much larger projected growth 19 million people dementia 2040 bconclusionsbnbspage specific dementia incidence declining number people dementia england wales likely increase 57 2016 2040 increase mainly driven improved life expectancy

https://doi.org/10.1136/bmj.j2856

Valerie L. Ruehter|Cameron C. Lindsey|Maqual R. Graham|Linda Garavalia

Use of Online Modules to Enhance Knowledge and Skills Application During an Introductory Pharmacy Practice Experience

University of Missouri–Kansas City|University of Missouri–Kansas City|University of Missouri–Kansas City|University of Missouri–Kansas City

bobjectivesb implement assess effectiveness online instructional modules increase consistency learning outcomes related students patientcare practice knowledge skills application confidence across introductory pharmacy practice experience ippe sites bdesignb twenty online modules created provide uniform delivery instructional content complemented classroom instruction introduce students common pharmacypractice skills patientcare arena bassessmentb quantitative data collected means survey pre postmodule quizzes completed students assess knowledge 85 students applied ippe skills course students confidence increased significantly areas 1 13 competencies 70 students agreed strongly agreed competencies met bconclusionsb online instructional modules patient care effectively increase students knowledge skills application confidence improve consistency achieving outcomes instructional content activities across diverse practice settings

https://doi.org/10.5688/ajpe76469

Avijit Hazra|Sushanta Roy Choudhury|Suvajit Das

Survey of knowledge-attitude-practice concerning insulin use in adult diabetic patients in eastern India

Institute of Post Graduate Medical Education and Research|Institute of Post Graduate Medical Education and Research|West Bengal University of Health Sciences

bobjectivesb study conducted assess knowledge attitude practice regarding insulin use among diabetic patients tertiary care hospitals br bmaterials methodsb type 1 2 diabetic patients aged 18 years attending medicineendocrinology outpatient department admitted inpatients three hospitals around kolkata enrolled pretested structured questionnaire comprising 51 items administered facetoface interview responses 385 subjects analyzed br bresultsb higher educational higher economic standards associated better understanding insulin use longer duration diabetes treatment oral antidiabetic drugs insulin associated better knowledge parameters female subjects less aware hba sub1csub monitoring tool among current insulin users 70 never used glucometer 2733 carried simple carbohydrates use hypoglycemic attacks 32 failed rotate sites insulin injection br bconclusionb knowledge attitude satisfactory whole deficiencies practice pronounced potentially removed appropriate counseling

https://doi.org/10.4103/0253-7613.135957

Syed Faiz-Ul-Hassan Rizvi

Status of rheumatic heart disease in rural Pakistan

Shaikh Zayed Medical College and Hospital

bobjectivesb determine community based prevalence rheumatic heart disease rhd rural population district rahim yaar khan pakistan bsubjects methodsb representative sample rural population rahim yaar khan district selected rhd screened physical examination diagnosis confirmed echocardiographic doppler studies sociodemographic data screened person collected bresultsb 54 cases rhd found among 9430 people screened prevalence 57 1000 95 confidence interval 42 72 females significantly likely affected significant relation factors studied education crowding socioeconomic status less 20 found rhd aware diagnosis participation study three affected people 8 taking rheumatic prophylaxis bconclusionsb high prevalence rhd among rural population pakistan prevalence declined past three decades nearly people rhd including know diagnosis receive benefit potentially life saving secondary prevention measures

https://doi.org/10.1136/hrt.2003.025981

J Bogaerts

Sexually transmitted infections among married women in Dhaka, Bangladesh: unexpected high prevalence of herpes simplex type 2 infection

International Centre for Diarrhoeal Disease Research

bobjectivesb document prevalence reproductive tract infections rti sexually transmitted infections sti among women attending basic healthcare clinic dhaka bangladesh identify risk factors associated diseases estimate incidence syphilis hepatitis c hcv hepatitis b hbv herpes simplex type 2 hsv2 infection bmethodsb cross sectional sample 2335 consecutive women examined 19968 women interviewed risk factors rtisti tested ineisseria gonorrhoeaei ichlamydia trachomatisi itrichomonas vaginalisi itreponema pallidumi hiv hcv hbv hsv1 hsv2 infection well vaginal candidosis bacterial vaginosis women antibodies pallidumi retested regular intervals one year ending study seroconversion syphilis hbv hcv hsv2 infection detected among women initially negative respective diseases bresultsb overall prevalence rate gonorrhoeaei ic trachomatisi vaginalisi pallidumi infection 05 19 20 29 respectively overall 35 women antibodies hepatitis b core antigen 09 hcv 12 hsv2 infection risk factors gonorrhoeaic trachomatisi infection husband living home suspected unfaithful hsv2 infection associated risk factors polygamous marriage prevalence hsv2 infection among women risk 23 hiv infection diagnosed repeated serological examination indicated 32 women serological evidence syphilis active disease seroincidences hbv hcv hsv2 003 0007 0009 per person year seroconversion syphilis observed

https://doi.org/10.1136/sti.77.2.114

Richard A. Crosby|William L. Yarber|Stephanie A. Sanders|Cynthia A. Graham|Kimberly R. McBride|Robin R. Milhausen|Janet N. Arno

Men with broken condoms: who and why?

University of Kentucky|Indiana University Bloomington|Indiana University Bloomington|Science Oxford|Indiana University Bloomington|University of Windsor|Indiana University – Purdue University Indianapolis

bobjectivesb identify 1 prevalence condom breakage demographic sexualityrelated differences among young men sex women reporting reporting event 2 condomspecific behaviours associated breakage bmethodsb young men n 278 attending clinic treatment sexually transmitted infections stis responded anonymous questionnaire aided cd recording questions samples screened include men used condom penilevaginal sex least three times past 3 months condomspecific behaviours including breakage assessed using last three acts condom use recall period correlates achieving bivariate significance subjected multivariate analysis bresultsb nearly one third 313 men reported recent breakage breakage rate 15 three correlates significantly distinguished men report breakage men past stis likely report breakage adjusted odds ratio aor 208 men also reported condom slippage aor 272 less selfefficacy correct condom use also significantly associated breakage aor 107 three condomspecific behaviours significantly associated breakage allowing condoms contact sharp objects aor 26 experiencing problems fit feel condoms aor 23 squeezing air receptacle tip aor 20 bconclusionsb breakage may common may occur larger context difficulties condoms sti clinics could potentially benefit men providing instructions correct use condoms

https://doi.org/10.1136/sti.2006.021154

Catherine M. Calvin|G. David Batty|Geoff Der|Clare Brett|Adele M. Taylor|Alison Pattie|Iva ?uki?|Ian J. Deary

Childhood intelligence in relation to major causes of death in 68 year follow-up: prospective population study

Warneford Hospital|University of Oxford|University of Edinburgh|University College London|University of Edinburgh|University of Edinburgh|MRC/CSO Social and Public Health Sciences Unit|University of Glasgow|Liverpool John Moores University|University of Edinburgh|University of Edinburgh|University of Edinburgh|University of Edinburgh|University of Edinburgh

bobjectivesbnbspto examine association intelligence measured childhood leading causes death men women life course bdesignbnbspprospective cohort study based whole population participants born scotland 1936 linked mortality data across 68 years followup bsettingbnbspscotland bparticipantsbnbsp33 536 men 32 229 women participants scottish mental survey 1947 sms1947 could linked cause death data december 2015 bmain outcome measuresbnbspcause specific mortality including coronary heart disease stroke specific cancer types respiratory disease digestive disease external causes dementia bresultsbnbspchildhood intelligence inversely associated major causes death age sex adjusted hazard ratios 95 confidence intervals per 1 sd 15 points advantage intelligence test score strongest respiratory disease 072 070 074 coronary heart disease 075 073 077 stroke 076 073 079 notable associations plt0001 observed deaths injury 081 075 086 smoking related cancers 082 080 084 digestive disease 082 079 086 dementia 084 078 090 weak associations apparent suicide 087 074 102 deaths cancer related smoking 096 093 100 confidence intervals included unity suggestion childhood intelligence somewhat strongly related coronary heart disease smoking related cancers respiratory disease dementia women men p value interactions lt0001 002 lt0001 002 respectivelybbchildhood intelligence related selected cancer presentations including lung 075 072 077 stomach 077 069 085 bladder 081 071 091 oesophageal 085 078 094 liver 085 074 097 colorectal 089 083 095 haematopoietic 091 083 098 sensitivity analyses representative subsample cohort observed small attenuation estimated effect intelligence 1026 adjustment potential confounders including three indicators childhood socioeconomic status replication sample scotland similar birth year cohort followup period smoking adult socioeconomic status partially attenuated 1658 association intelligence outcome rates bconclusionsbnbspin whole national population year birth cohort followed life course age 11 age 79 higher scores well validated childhood intelligence test associated lower risk mortality ascribed coronary heart disease stroke cancers related smoking particularly lung stomach respiratory diseases digestive diseases injury dementia

https://doi.org/10.1136/bmj.j2708

Tanja A. J. Houweling

Mortality inequalities in times of economic growth: time trends in socioeconomic and regional inequalities in under 5 mortality in Indonesia, 1982-1997

Erasmus University Rotterdam|Erasmus MC

bstudy objectiveb examine time trends socioeconomic regional inequalities 5 mortality indonesia almost two decades economic growth bdesignb 5 mortality calculated total population subgroups maternal education household wealth ruralurban residence island group using 1987 1991 1994 1997 indonesian demographic health surveys inequalities calculated using cox proportional hazards analysis bsettingb indonesia 19821997 bmain participantsb 18 205 33 907 39 433 37 533 children respectively aged 5 years born women included mentioned surveys bmain resultsb 5 mortality declined substantially 1980s 1990s educational inequalities 5 mortality decreased although statistically significantly hazard ratio 200 95ci 160 250 152 95ci 127 182 inequalities urban electrified rural areas increased 184 95ci 148 228 218 95ci 170 280 inequalities outer islands central islands javabali increased 116 95ci 092 146 143 95ci 117 174 irregular time trends seen inequalities household wealth trends health care use fairly similar low high educated bconclusionsb results education show socioeconomic inequalities 5 mortality inevitably rise times rapid economic growth widening narrowing health inequalities times economic growth might depend equally growth distributed

https://doi.org/10.1136/jech.2005.036079

Trisha Greenhalgh|Jeremy Howick|Neal Maskrey

Evidence based medicine: a movement in crisis?

Queen Mary University of London|University of Oxford|Keele University

btrisha greenhalgh colleaguesb argue although evidence based medicine many benefits also negative unintended consequences offer preliminary agenda movements renaissance refocusing providing useable evidence combined context professional expertise individual patients get optimal treatment

https://doi.org/10.1136/bmj.g3725

Abhishek Singh|Vikas Gupta|Deepika Agrawal|Pooja Goyal|Mitasha Singh|Shveta Lukhmana

A cross-sectional study to investigate the impact of focused group discussion on menstrual hygiene among rural school girls of Southern Haryana, India

Government Medical College|Government Medical College|Santosh University|ESIC Hospital|ESIC Hospital|Vardhman Mahavir Medical College & Safdarjung Hospital

brbintroductionb menstruation natural phenomenon among women experience shedding blood 17 days every month usually starts age 11 14 years continues menopause 51 years age important maintain menstrual hygiene poor practices increase vulnerability reproductive urinary tract infections present study conducted aim investigate impact focused group discussion fgd compared didactic lectures dls menstrual hygiene knowledge practicesbrbmethodsb present crosssectional study conducted among 649 school girls january august 2019 using convenience sampling technique collecting baseline information using pretested predesigned standardized questionnaire participants control intervention groups exposed dls fgd respectively 1 month intervention questionnaire selfadministered participants tests performed 5 level significance using spss version 220brbresultsb baseline characteristics groups participants mean age mean age menarche mothers literacy status religion type family socioeconomic status comparable difference knowledge practice mean score participants control group pre postintervention highly statistically significant ipi 0001brbconclusionsb study reveals menstrual hygiene far satisfactory among school girls dls fgd improved menstrual hygiene knowledge practices among school girlsbr

https://doi.org/10.4103/jehp.jehp_475_20

Rehana A Salam|Anadil Faqqah|Nida Sajjad|Zohra S Lassi|Jai K Das|Miriam Kaufman|Zulfiqar A. Bhutta

Improving Adolescent Sexual and Reproductive Health: A Systematic Review of Potential Interventions

Aga Khan University|Aga Khan University|Aga Khan University|University of Adelaide|Aga Khan University|SickKids Foundation|University of Toronto|Hospital for Sick Children|Hospital for Sick Children|SickKids Foundation|Aga Khan University

h2abstracth2 adolescents special sexual reproductive health needs whether sexually active married review assesses impact interventions improve adolescent sexual reproductive health including interventions prevent female genital mutilationcutting fgmc prevent intimate violence review findings suggest sexual reproductive health education counseling contraceptive provision effective increasing sexual knowledge contraceptive use decreasing adolescent pregnancy among interventions prevent fgmc community mobilization female empowerment strategies potential raise awareness adverse health consequences fgmc reduce prevalence however need conduct methodologically rigorous intervention evaluations limited inconclusive evidence effectiveness interventions prevent intimate partner violence studies rigorous designs longer term followup standardized validated measurement instruments required maximize comparability results future efforts directed toward scalingup evidencebased interventions improve adolescent sexual reproductive health low middleincome countries sustain impacts time ensure equitable outcomes

https://doi.org/10.1016/j.jadohealth.2016.05.022

Paul Wicks|Dorothy L. Keininger|Michael P. Massagli|Christine de la Loge|Catherine A. Brownstein|Jouko Isojärvi|James Heywood

Perceived benefits of sharing health data between people with epilepsy on an online platform

PatientsLikeMe (United States)|UCB Pharma (Belgium)|PatientsLikeMe (United States)|UCB Pharma (Belgium)|PatientsLikeMe (United States)|PatientsLikeMe (United States)

h2abstracth2 epilepsy community developed patientslikemecom share data patients improve outcomes finding patients like 14day response period 221 patients epilepsy mean age 40years sd 12 range 1772 66 female completed survey benefits perceived prior using site third respondents 30 know anyone else epilepsy could talk 63 least one patient could connect perceived benefits included finding another patient experiencing symptoms 59 gaining better understanding seizures 58 learning symptoms treatments 55 number benefits associated number relationships patients ifi42168173 ipi0001 patients epilepsy reported array perceived benefits similar reported populations diseases controlled sharing health data may potential improve disease selfmanagement people epilepsy

https://doi.org/10.1016/j.yebeh.2011.09.026

Nienke van Atteveldt|Elia Formisano|Rainer Goebel|Leo Blomert

Integration of Letters and Speech Sounds in the Human Brain

Maastricht University|Maastricht University|Maastricht University|Maastricht University

h2abstracth2 people acquire literacy skills remarkable ease even though human brain evolutionarily adapted relatively new cultural phenomenon associations letters speech sounds form basis reading alphabetic scripts investigated functional neuroanatomy integration letters speech sounds using functional magnetic resonance imaging fmri letters speech sounds presented unimodally bimodally congruent incongruent combinations analysis singlesubject data group data aligned basis individual cortical anatomy revealed letters speech sounds integrated heteromodal superior temporal cortex interestingly responses speech sounds modalityspecific region early auditory cortex modified simultaneously presented letters results suggest efficient processing culturally defined associations letters speech sounds relies neural mechanisms similar naturally evolved integrating audiovisual speech

https://doi.org/10.1016/j.neuron.2004.06.025

Marcia C. Inhorn|Pasquale Patrizio|Gamal I. Serour

Third-party reproductive assistance around the Mediterranean: comparing Sunni Egypt, Catholic Italy and multisectarian Lebanon

Yale University|Yale University|International Islamic Center for Population Studies and Research|Al Azhar University

h2abstracth2 article examines religious legal restrictions thirdparty reproductive assistance three mediterranean countries sunni egypt catholic italy multisectarian lebanon egypt assisted reproduction treatments permitted third parties banned rest sunni islamic world italy became similar egypt 2004 law ending thirdparty reproductive assistance multisectarian lebanon however sunnicatholic ban thirdparty reproductive assistance lifted shia rulings emanating iran today thirdparty reproductive assistance provided lebanon muslims christians unlike neighbouring egypt italy comparisons point need understanding complex interactions law religion local moralities reproductive practices global bioethics article examines religious legal restrictions sperm donation egg donation surrogacy three mediterranean countries sunni islamic egypt catholic italy multisectarian lebanon egypt assisted reproductive technologies ivf permitted donor technologies banned rest sunni islamic world italy became similar egypt 2004 law ending forms donation surrogacy multisectarian lebanon however sunnicatholic ban donation surrogacy lifted shia islamic rulings emanating iran today donation surrogacy provided lebanon muslims christians unlike neighbouring egypt italy comparisons point need understanding complex interactions law religion local moralities reproductive practices global bioethics

https://doi.org/10.1016/j.rbmo.2010.09.008

Luba Nakhutina|Jeffrey S. Gonzalez|Seth A. Margolis|Ashley Spada|Arthur C. Grant

Adherence to antiepileptic drugs and beliefs about medication among predominantly ethnic minority patients with epilepsy

SUNY Downstate Medical Center|Albert Einstein College of Medicine|Yeshiva University|Yeshiva University|SUNY Downstate Medical Center|John Jay College of Criminal Justice|SUNY Downstate Medical Center

h2abstracth2 current study examined beliefs medication association adherence antiepileptic drugs aeds among predominantly ethnic minority lowincome patients epilepsy pwe seventytwo pwe completed standardized questionnaires beliefs medicines questionnaire used assess perceptions aeds medications general adherence measured morisky 4item scale via participant selfrating morisky scale 63 patients endorsed least one item nonadherence forgetfulness often endorsed 50 significant relationship seizure frequency adherence morisky iri033 ipi0006 selfrating iri035 ipi0003 patients lower selfrated adherence expressed greater concerns aeds iri025 ipi0036 beliefs medications general may intrinsically harmful iri026 ipi0032 minimally beneficial iri036 ipi0002 compared adherent patients findings inform future educational interventions population pwe

https://doi.org/10.1016/j.yebeh.2011.08.007

Charles H. Hillman|Matthew B. Pontifex|Lauren B. Raine|Darla M. Castelli|Eric E. Hall|A.F. Kramer

The effect of acute treadmill walking on cognitive control and academic achievement in preadolescent children

University of Illinois Urbana-Champaign|University of Illinois Urbana-Champaign|University of Illinois Urbana-Champaign|University of Illinois Urbana-Champaign|Elon University|University of Illinois Urbana-Champaign

h2abstracth2 effect acute bout moderate treadmill walking behavioral neuroelectric indexes cognitive control attention applied aspects cognition involved schoolbased academic performance assessed withinsubjects design included 20 preadolescent participants age9505 years eight female assess exerciseinduced changes performance modified flanker task wide range achievement test 3 resting session consisted cognitive testing followed cardiorespiratory fitness assessment determine aerobic fitness exercise session consisted 20 min walking motordriven treadmill 60 estimated maximum heart rate followed cognitive testing heart rate returned within 10 preexercise levels results indicated improvement response accuracy larger p3 amplitude better performance academic achievement test following aerobic exercise relative resting session collectively findings indicate single acute bouts moderatelyintense aerobic exercise ie walking may improve cognitive control attention preadolescent children support use moderate acute exercise contributing factor increasing attention academic performance data suggest single bouts exercise affect specific underlying processes support cognitive health may necessary effective functioning across lifespan

https://doi.org/10.1016/j.neuroscience.2009.01.057

Lyndsay A. Nelson|Kenneth A. Wallston|Lyndsay A. Nelson|Lauren M. LeStourgeon|Sarah E. Williamson|Lindsay S. Mayberry

Assessing barriers to diabetes medication adherence using the Information-Motivation-Behavioral skills model

Vanderbilt University Medical Center|Vanderbilt University Medical Center|Vanderbilt University|Vanderbilt University Medical Center|Vanderbilt University Medical Center|Vanderbilt University Medical Center|Vanderbilt University Medical Center

h2abstracth2h3aimsh3 medication nonadherence prevalent costly problem among patients type 2 diabetes applications theory inform improve adherence promotion interventions used new assessment based informationmotivationbehavioral skills imb model adherence assess patientreported barriers test theoretical model h3methodsh3 participants n 237 completed card sorting task identify barriers adherence survey hemoglobin a1c hba1c test identified commonly reported adherence barriers examined associations patient characteristics barriers mapped onto imb constructs used structural equation modeling test imb model determine barriers reported measure predict patients selfreported diabetes medication adherence turn hba1c levels h3resultsh3 frequently reported barriers forgetting doses thinking brand name medicine works better generic medicine seeing immediate benefit feeling burned taking diabetes medicine younger age lower health literacy associated higher barrier scores imb model constructs information social motivation barriers affected adherence via behavioral skills barriers indirect effects 019 ci 033 009 024 ci 037 014 respectively imb barrier constructs explained 44 variance diabetes medication adherence turn significantly associated explained 8 variance hba1c ipi 001 h3conclusionsh3 results suggest assessment task identify patientspecific barriers diabetes medication adherence interventions targeting patientspecific barriers using assessment could improve adherence hba1c

https://doi.org/10.1016/j.diabres.2018.05.046

Xhyljeta Luta|Stefanie Hayoz|Corinna Krause|Kathrin Sommerhalder|Eva Roos|Pasquale Strazzullo|Sigrid Beer?Borst

The relationship of health/food literacy and salt awareness to daily sodium and potassium intake among a workplace population in Switzerland

Institute of Social and Preventive Medicine|University of Bern|Institute of Social and Preventive Medicine|University of Bern|Institute of Social and Preventive Medicine|University of Bern|Bern University of Applied Sciences|Folkhälsans Forskningscentrum|University of Helsinki|Institute of Social and Preventive Medicine|University of Bern

h2abstracth2h3background aimsh3 high sodium na low potassium k intake associated hypertension cvd risk study explored associations health literacy hl food literacy fl salt awareness salt intake k intake nak ratio workplace intervention trial switzerland h3methods resultsh3 study acquired baseline data 141 individuals mean age 446 years na k intake estimated single 24h urine collection applied validated instruments assess hl fl salt awareness multiple linear regression used investigate association explanatory variables salt intake k intake nak mean daily salt intake 89 g k 31 g nak 118 salt intake associated sex ipi 0001 k intake sex ipi 0001 age ipi 002 waisttoheight ratio ipi 003 nak hl index fl score significantly associated salt k intake awareness variable salt content impacts foodmenu choice associated salt intake ipi 0005 h3conclusionh3 achieve established targets population na k intake healthrelated knowledge abilities skills related nasalt k intake need promoted combined educational structural interventions clinical trials registry number drks00006790 23092014

https://doi.org/10.1016/j.numecd.2017.10.028

Felcita Lavina Cuthino|Melita Sheilini|Ramesh Chandrababu

The comparison of health literacy between health science and non-health science members-A cross sectional study of multifaceted public health affair

Manipal Academy of Higher Education|Manipal Academy of Higher Education|Sri Ramachandra Institute of Higher Education and Research

h2abstracth2h3backgroundobjectivesh3 health literacy global concern varied across general population means enhance public access health information services objective study compare health literacy among health science nonhealth science members identify barriers health literacy h3methodsh3 crosssectional study conducted among faculty health sciences health sciences teaching institutes total 230 samples included using stratified proportionate sampling health literacy questionnaire hlq tool perceived barriers health literacy used collect data h3resultsh3 health literacy among health sciences people better compared nonhealth sciences people p 005 domains cohens effect size showed difference statistically significant effect size 02 08 top four barriers health literacy identified home remedies preferred medicines minor ailments failure meet doctors due job timings inability take care selfdue busy working hours priority health family members ones health h3conclusionh3 health literacy important factor helps every individual make healthcare decisions enhances ones ability get right information evaluating barriers health literacy gives us specific areas concern relevant measures must implemented improve knowledge health literacy lead better health outcomes

https://doi.org/10.1016/j.cegh.2021.100893

Saskia C. Sanderson|Sabrina A. Suckiel|Micol Zweig|Erwin P. Böttinger|Ethylin Wang Jabs|Lynne D. Richardson

Development and preliminary evaluation of an online educational video about whole-genome sequencing for research participants, patients, and the general public

Icahn School of Medicine at Mount Sinai|Icahn School of Medicine at Mount Sinai|Icahn School of Medicine at Mount Sinai|Icahn School of Medicine at Mount Sinai|Icahn School of Medicine at Mount Sinai|Icahn School of Medicine at Mount Sinai

h2abstracth2h3backgroundh3 wholegenome sequencing wgs increases availability wgs educational aids needed research participants patients general public aim therefore develop accessible scalable wgs educational aid h3methodsh3 engaged multiple stakeholders iterative process 1year period culminating production novel 10minute wgs educational animated video whole genome sequencing httpsgooglhv8ezj presented animated video 281 onlinesurvey respondents videoinformation group also two comparison groups writteninformation group ini 281 noinformation group ini 300 h3resultsh3 videoinformation group 79 reported video easy understand satisfaction scores high mean 400 15 scale 5high satisfaction knowledge increased significantly significant differences knowledge compared noinformation group differences compared writteninformation group intention receive personal results wgs decisional conflict response hypothetical scenario differ three groups h3conclusionsh3 educational animated video whole genome sequencing well received sample onlinesurvey respondents work needed evaluate utility aid informed decision making wgs populations

https://doi.org/10.1038/gim.2015.118

Tetyana Shippee|Katy B. Kozhimannil|Kathleen Rowan|Beth A Virnig

Health Insurance Coverage and Racial Disparities in Breast Reconstruction After Mastectomy

Minnesota Department of Health|Minnesota Department of Health|Minnesota Department of Health|Minnesota Department of Health

h2abstracth2h3backgroundh3 breast reconstruction mastectomy offers clinical cosmetic psychological benefits compared mastectomy alone although reconstruction rates increased racialethnic disparities breast reconstruction persist insurance coverage facilitates access care studies examined whether health insurance ameliorates disparities h3methodsh3 used nationwide inpatient sample 2002 2006 examine relationships health insurance coverage raceethnicity breast reconstruction rates among women underwent mastectomy breast cancer examined reconstruction rates function interaction race primary payer selfpay private health insurance government controlling patient comorbidity used generalized estimating equations account clustering hospital characteristics h3findingsh3 minority women lower breast reconstruction rates white women adjusted odds ratio aor 057 african american aor 070 hispanic aor 045 asian ipi 001 uninsured women aor 033 public coverage less likely undergo reconstruction aor 035 ipi 001 privately insured women racialethnic disparities less prominent within insurance types minority women whether privately publicly insured lower odds undergoing reconstruction white women among without insurance reconstruction rates differ raceethnicity h3conclusionsh3 insurance facilitates access care eliminate racialethnic disparities reconstruction rates findingswhich reveal persistent health care disparities explained patient health statusshould prompt efforts promote access use beneficial covered services women breast cancer

https://doi.org/10.1016/j.whi.2014.03.001

Jean L. Raphael|Anna Rueda|K. Casey Lion|Thomas P. Giordano

The Role of Lay Health Workers in Pediatric Chronic Disease: A Systematic Review

Baylor College of Medicine|Baylor College of Medicine|University of Washington|Baylor College of Medicine

h2abstracth2h3backgroundh3 children chronic diseases represent highcost resourceintensive population children continued gaps chronic disease management persistent fragmentation health care system stakeholders seeking new strategies address needs children h3objectiveh3 sought systematically assess effectiveness lay health worker interventions improving health care utilization symptom management family psychosocial outcomes children chronic conditions h3data sourceh3 pubmed psycinfo web science january 1961 february 2013 h3study eligibility criteria participants interventionsh3 developed strategy search citations identify relevant articles search terms included randomized controlled trial rct lay worker parent mentor peer mentor peer educator community health workers community health aids patient advocate patient facilitator patient liaison promotorases care ambassadors patient navigator nonprofessional additional studies identified searching reference lists retrieved articles contacting clinical experts rcts lay health worker interventions children chronic conditions included studies restricted concentrated children 018 years age chronic illnesses h3study appraisal synthesis methodsh3 abstracts independently screened 2 reviewers articles relevant abstracts underwent full text review evaluated inclusion criteria structured tool used abstract data selected articles heterogeneous interventions outcomes conduct metaanalysis h3resultsh3 search yielded 736 unique articles 17 met inclusion criteria interventions focused specific conditions asthma type diabetes obesity failure thrive interventions heterogeneous frequency mode duration interactions lay health workers subjects several interventions multifaceted including oneonone group interactions improved outcomes commonly reported reduced urgent care use decreases symptoms fewer missed work school days increased parental quality life one study demonstrated lay health worker interventions costeffective h3conclusionsh3 lay health workers interventions children chronic conditions may lead modest improvements urgent care use symptoms parental psychosocial outcomes interventions may also costeffective future research focus interventions targeted toward chronic conditions sickle cell disease cystic fibrosis medically complex children whose conditions noncategorical

https://doi.org/10.1016/j.acap.2013.04.015

Partha Pratim De|Nandita Chattopadhyay

Effects of malnutrition on child development: Evidence from a backward district of India

Indian Statistical Institute|Burdwan Medical College & Hospital

h2abstracth2h3backgroundh3 india undernutrition among poor children imposes greater burden rural areas particularly rural children vulnerable malnutrition receive foods low nutritional values along discriminatory distribution food within household also early childhood due lack appropriate care suffer recurrent infections multiple diseases either causing delayed development fatal effect demographic socioeconomic factors influence nutritional status neurodevelopment vulnerable children h3methodsh3 aim present study assess nutritional status developmentally challenged children less five years zscores heightforage weightforheight weightforage demographic characteristics backward district state west bengal india indices nutritional status calculated based child growth standards h3result conclusionh3 observed gender differences age group variations nutritional status children developmentally challenged undernutrition major problem vulnerable children rural area suffer developmental delay

https://doi.org/10.1016/j.cegh.2019.01.014

Alan Wigg|Sumudu Narayana|Günter Härtel|Linda Medlin|Greg Pratt|Elizabeth E. Powell|Paul J. Clark|Jane Davies|Kirsty Campbell|Maree Toombs|Michael Larkin|Patricia C. Valery

Hepatocellular carcinoma amongst Aboriginal and Torres Strait Islander peoples of Australia

Flinders University|Women's and Children's Health Network|Flinders University|Women's and Children's Health Network|QIMR Berghofer Medical Research Institute|Children’s Health Queensland Hospital and Health Service|QIMR Berghofer Medical Research Institute|University of Queensland|Translational Research Institute|Princess Alexandra Hospital|Mater Adult Hospital|Royal Darwin Hospital|Menzies School of Health Research|Royal Darwin Hospital|University of Queensland|Aboriginal Health Council of South Australia|QIMR Berghofer Medical Research Institute

h2abstracth2h3backgroundh3 liver disease hepatocellular carcinoma hcc important contributors mortality gap indigenous nonindigenous australians however lack population based high quality data assessing differences hcc epidemiology outcomes according indigenous status aim study therefore perform large epidemiological study hcc investigating differences indigenous nonindigenous australians hcc h3methodsh3 study design retrospective cohort study data linkage methodology used link data cancer registries hospital separation summaries across three australian jurisdictions 20002017 cumulative survival kaplanmeier differences survival multivariable coxregression indigenous status assessed h3findingsh3 total 229 indigenous 3587 nonindigenous hcc cases included analyses significant epidemiological differences identified indigenous hcc cases included younger age onset higher proportion females higher rurality lower socioeconomic status higher comorbidity burden ipi 0001 distribution cofactors also significantly different indigenous australians including higher prevalence alcohol misuse hepatitis b diabetes frequent presence multiple hcc cofactors ipi 0001 indigenous australians received curative hcc therapies less frequently 66 vs 145 ipi 0001 poorer 5year survival 100 vs 173 ipi 0001 unadjusted hazard ratio hr 142 96ci 121165 compared nonindigenous australians strength association indigenous status survival weaker statistically nonsignificant adjusting rurality comorbidity burden lack curative therapy adjustedhr120 95ci 097147 h3interpretationh3 data provide call action help design implement health literacy liver management hcc surveillance programs indigenous people help close liver cancer mortality gap h3fundingh3 work supported unrestricted educational grant gastroenterology society australia patricia valery elizabeth powell supported metro south health indigenous health research grants

https://doi.org/10.1016/j.eclinm.2021.100919

Amy Steinkellner|William Chen|Shannon E. Denison

Adherence to Oral Contraception in Women on Category X Medications

h2abstracth2h3backgroundh3 6 women become pregnant taking teratogenic medications contraceptive counseling appears occur suboptimal rates adherence contraception important component preventing unwanted pregnancy evaluated population undertook pharmacy claimsbased analysis evaluate degree women childbearing age receive category x medications adhere oral contraception h3methodsh3 evaluated prescription medication claims 6 million women age 1844 years prescription benefits administered pharmacy benefits manager women 2 claims category x medication 2 claims oral contraception evaluated detail adherence oral contraception measured analyzing pharmacy claims multivariable logistic regression performed identify factors associated adherence h3resultsh3 146758 women childbearing age received category x medications 26136 also took oral contraceptive medication women received category x medications prescribed oral contraception 18 rates similar others childbearing age 17 women prescribed category x oral contraception demonstrated adherence similar overall population age class category x medication number medications prescribers specialty ethnicity correlated lower adherence rates h3conclusionsh3 despite added risk associated unintended pregnancy many women receive category x medications refill patterns suggesting nonadherence oral contraception compared women age 1844 years women receiving teratogenic medications better adherence oral contraception

https://doi.org/10.1016/j.amjmed.2010.05.009

Jodi Thrasher|Joyce Baker|Kathleen M. Ventre|Sara Martin|Joseph Dawson|Roberta Cox|Heather M. Moore|Sarah Brethouwer|Sharon Sables-Baus|Christopher D. Baker

Hospital to Home: A Quality Improvement Initiative to Implement High-fidelity Simulation Training for Caregivers of Children Requiring Long-term Mechanical Ventilation

Children's Hospital Colorado|University of Colorado Denver|Children's Hospital Colorado|University of Colorado Denver|Baystate Medical Center|Children's Hospital Colorado|University of Colorado Denver|Children's Hospital Colorado|University of Colorado Denver|Children's Hospital Colorado|University of Colorado Denver|Children's Hospital Colorado|University of Colorado Denver|Children's Hospital Colorado|University of Colorado Denver|Children's Hospital Colorado|University of Colorado Denver|Colorado College|Children's Hospital Colorado|University of Colorado Denver

h2abstracth2h3backgroundh3 preparing families children requiring longterm mechanical ventilation ltmv manage medical emergencies home challenging opportunities family caregivers rehearse crisis management controlled setting discharge limited h3objectiveh3 aimed create multimodal discharge preparedness curriculum incorporating highfidelity simulation training prepare family caregivers children complex medical conditions requiring longterm mechanical ventilation sought determine curricular elements helpful whether curriculum impacted rate readmissions within 7 days hospital discharge h3methodsh3 curriculum included instructional videos printed handouts cardiopulmonary resuscitation training two mandatory high fidelity simulation scenarios depicting tracheostomy ventilatorrelated emergencies teams one three family caregivers per patient managed scenario videobased debriefing focused identifying closing performance gaps participants rated perceptions regarding curricular element relative impact preparedness discharge h3resultsh3 87 family caregivers completed curriculum simulationenhanced curriculum wellreceived participants participants reported postsimulation debriefing beneficial component observed trend toward reduced readmissions within 7 days discharge since implementation revised curriculum h3conclusionh3 simulation training incorporated discharge training families children requiring ltmv rehearsal emergency management simulated clinical setting increases caregiver confidence assume care ventilatordependent child

https://doi.org/10.1016/j.pedn.2017.08.028

Tami Borneman|Marianna Koczywas|Virginia Sun|Barbara F. Piper|Gwen Uman|Betty Ferrell

Reducing Patient Barriers to Pain and Fatigue Management

City of Hope|City of Hope|City of Hope|University of Arizona|Scottsdale Community College|Vital Research|City of Hope

h2abstracth2h3contexth3 pain fatigue recognized critical symptoms impact quality life cancer patients barriers pain fatigue relief classified three categories patient professional system barriers h3objectivesh3 overall objective trial test effects passport comfort intervention reducing barriers pain fatigue management ambulatory care cancer patients h3methodsh3 quasiexperimental comparative study uses phase 1 control group usual care followed sequentially phase 2 intervention group educational systemchange efforts directed toward improved pain fatigue management sample 187 cancer patients breast lung colon prostate cancers pain andor fatigue rating 4 moderate severe recruited patients intervention group received four educational sessions painfatigue assessment management whereas patients control group received usual care pain fatigue barriers patient knowledge measured baseline one month three months postaccrual h3resultsh3 patients intervention group experienced significant improvements pain fatigue measures immediately postintervention improvements sustained time h3conclusionh3 passport comfort intervention effective reducing patient barriers pain fatigue management well increasing patient knowledge regarding pain fatigue intervention demonstrates innovation translating evidencebased guidelines pain fatigue developed national comprehensive cancer network practice

https://doi.org/10.1016/j.jpainsymman.2009.08.007

Marianne Jensen Hjermstad|Peter Fayers|Dagny Faksvåg Haugen|Augusto Caraceni|G W Hanks|Jon H. Loge|Robin L. Fainsinger|Nina Aass|Stein Kaasa

Studies Comparing Numerical Rating Scales, Verbal Rating Scales, and Visual Analogue Scales for Assessment of Pain Intensity in Adults: A Systematic Literature Review

Oslo University Hospital|Norwegian University of Science and Technology|University of Aberdeen|Norwegian University of Science and Technology|Haukeland University Hospital|Norwegian University of Science and Technology|Fondazione IRCCS Istituto Nazionale dei Tumori|At Bristol|Oslo University Hospital|Norwegian University of Science and Technology|University of Alberta|Oslo University Hospital|University of Oslo|St Olav's University Hospital|Norwegian University of Science and Technology

h2abstracth2h3contexth3 use unidimensional pain scales numerical rating scale nrs verbal rating scale vrs visual analogue scale vas recommended assessment pain intensity pi literature review studies specifically comparing nrs vrs andor vas unidimensional selfreport pi performed part work european palliative care research collaborative pain assessment h3objectivesh3 investigate use performance unidimensional pain scales specific emphasis nrss h3methodsh3 systematic search performed including citations april 2010 abstracts evaluated two persons according specified criteria h3resultsh3 fiftyfour 239 papers included postoperative pi frequently studied six studies cancer eight versions nrs nrs6 nrs101 used 37 studies total 41 nrss tested twentyfour different descriptors 15 nrss used anchor extremes compared vas vrs nrss better compliance 15 19 studies reporting recommended tool 11 studies basis higher compliance rates better responsiveness ease use good applicability relative vasvrs twentynine studies gave preference many studies showed wide distributions nrs scores within category vrss overall nrs vas scores corresponded exceptions systematically higher vas scores h3conclusionh3 nrss applicable unidimensional assessment pi settings whether variability anchors response options directly influences numerical scores needs empirically tested aid work toward consensusbased standardized measure

https://doi.org/10.1016/j.jpainsymman.2010.08.016

Frida Hjalte|Anna-Carin Berggren|H. T. G. Bergendahl|Catharina Hjortsberg

The Direct and Indirect Costs of Opioid-Induced Constipation

Swedish Institute for Health Economics|Mundipharma (Sweden)|Karolinska University Hospital|Swedish Institute for Health Economics

h2abstracth2h3contexth3 treatment strong opioids connected frequent problematic side effects one common side effects opioidinduced constipation oic discomfort oic limit effectiveness pain therapy constipation typically persists long opioid therapy administered effects quality life qol patients need taken seriously data published studies cost implications oic however scarce h3objectivesh3 estimate direct indirect costs oic defined patient population treatment strong opioids h3methodsh3 study based patient data swedish noninterventional study uppsikt cost analysis based 197 patients treated strong opioids sixmonth period direct indirect costs article calculated per patientmonth cost oic estimated difference mean costs months without constipation h3resultsh3 total costs per patientmonth patients severe constipation significantly higher patients mild moderate constipation patients severe constipation highest total costs euro eur 1525 per patientmonth whereas patients mild moderate problems cost eur 1196 eur 1088 eur 1034 respectively h3conclusionh3 opioid use costly society costs vary oic severity oic discomforting affects qol patients limit effective pain therapy

https://doi.org/10.1016/j.jpainsymman.2010.02.019

Marc P. Freiman|Jack A. Clark|Christopher G. Slatore|Michael K. Gould|Steven Woloshin|Lisa M. Schwartz|Renda Soylemez Wiener

Patients’ Knowledge, Beliefs, and Distress Associated with Detection and Evaluation of Incidental Pulmonary Nodules for Cancer: Results from a Multicenter Survey

Boston Medical Center|University Medical Center|Boston University|Boston University|Edith Nourse Rogers Memorial Veterans Hospital|VA Portland Health Care System|Oregon Health & Science University|Kaiser Permanente|Dartmouth Institute for Health Policy and Clinical Practice|Dartmouth Institute for Health Policy and Clinical Practice|Edith Nourse Rogers Memorial Veterans Hospital|Boston Medical Center|University Medical Center|Boston University

h2abstracth2h3introductionh3 pulmonary nodules detected 1 million americans year prior qualitative work suggests detection incidental pulmonary nodules burdensome patients whether findings generalize broader sample patients unknown categorized patients knowledge beliefs distress associated detection evaluation pulmonary nodule well impressions clinician communication h3methodsh3 administered crosssectional survey adults incidental pulmonary nodule recruited rural medical center urban safety net hospital veterans affairs hospital h3resultsh3 490 individuals mailed surveys 244 50 responded median nodule size 7 mm mean patient age 67 years 29 respondents female 86 white quarter respondents 26 reported clinically significant distress related nodule primary outcome measured impact event scale patients reported multiple concerns including uncertainty nodules cause 78 possibility cancer 73 possible need surgery 64 25 patients accurately estimated lung cancer risk within 15 actual risk overall correlation perceived actual risk iri 0007 ipi 093 23 patients receive information cancer risk provider likely find information reassuring 16 scary 7 h3conclusionh3 quarter patients incidental pulmonary nodules experienced clinically significant distress knowledge cancer risk evaluation poor clinician communication may help bridge knowledge gaps alleviate distress patients

https://doi.org/10.1016/j.jtho.2016.01.018

José Azevedo|Patrícia Padrão|Maria João Gregório|Carla Almeida|Nuno Moutinho|Nanna Lien|Renata Barros

A Web-Based Gamification Program to Improve Nutrition Literacy in Families of 3- to 5-Year-Old Children: The Nutriscience Project

Universidade do Porto|i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto|Universidade do Porto|i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto|Universidade Nova de Lisboa|Universidade do Porto|Universidade do Porto|Universidade do Porto|University of Oslo|Universidade do Porto|i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto

h2abstracth2h3objectiveh3 assess impact webbased gamification program nutrition literacy families explore differences impact socioeconomic status h3designh3 quasiexperimental h3settingh3 thirtyseven kindergartens portugal h3participantsh3 eight hundred seventyseven families h3interventionh3 webbased social network participants interactions educational materials apps nutritional challenges focused fruit vegetables sugar salt h3main outcome measuresh3 parental nutrition literacy selfreported survey 4 dimensions nutrients food portions portuguese food wheel groups food labeling h3analysish3 general linear model repeated measures used analyze effect nutrition literacy score h3resultsh3 families uploaded 1267 items recipes photographs challenges educators uploaded 327 items photographs videos onto interactive platform intervention group n 106 final mean sd score nutrition literacy significantly higher baseline 788 156 vs 727 162 ipi 001 regardless parental education perceived income status significant differences scores control group n 83 observed final 678 161 vs initial 664 156 ipi 364 h3conclusions implicationsh3 gamified digital interactive platform seems useful easily adapted educational tool healthy eating learning process future implementations program benefit longer time intervention assessment eating habits families intervention

https://doi.org/10.1016/j.jneb.2018.10.008