bluuebunny/crossref_metadata_2025_split huggingface dataset:
Estimating diet costs: Bridging the gap between food supply price databases and dietary intake data
Authors: Luongo G , Tarasuk V , Yi Y , Mah C L 
Published: October 2020

Abstract

Introduction
The cost of food is a key influence on diet. The majority of diet cost studies match intake data from population-based surveys to a single source of food supply prices such as the Consumer Price Index (CPI). Our aim was to examine the nutritional significance of using food supply data to price dietary intakes in Canada.

Methods
We examined food groups and nutrients in dietary intakes captured by the CPI. For prices, we used 2015 Canadian CPI average monthly item prices. For dietary intakes, we used reported intakes from the 2015 Canadian Community Health Survey (CCHS)-Nutrition, 1st 24-hour recall (n = 20,487). i) 2015 CPI item prices ($/g) were matched to the 156 food items from the 2015 CCHS-Nutrition as full, partial, or non-match; ii) CPI capture (full or partial match) per total intake (g), without water, was calculated for each respondent; iii) descriptive statistics and quantile regression (α = 0.05) were used to compare intakes of Canadian Nutrient File food groups and nutrients by quantile of CPI capture.

Results
The CPI captured on average 74% of total dietary intake (g) without water. A greater proportion of protein and fat intake was captured by the CPI as compared to carbohydrate, sodium, fibre, and sugar intake. Intakes of beef, poultry, sausages, pork, and breakfast foods had among the best match; snack foods, nuts, veal, and alcoholic beverages had among the worst. Individuals in the poorest CPI capture quantile consumed the greatest fibre (g), carbohydrates (g), total sugar (g), fat (g), protein (g), and energy (kcal) as compared to those with best CPI capture.

Conclusions
The poorest quantile of CPI capture reflects individuals with high intakes of nutrients of concern including fat, carbohydrates, and sugar; potential bias in estimating fibre and protein intake was also detected. Researchers and decision makers should attend to differential misclassification bias and opportunities for tailored datasets to price dietary intakes.

Key messages
Given the proliferation of diet cost studies using food supply prices, this novel study highlights the importance of understanding the biases in using food supply data to price dietary intakes. Nutrition researchers and decision makers can use these findings to strengthen food supply price data to support the monitoring of diet costs in relation to diet quality and health outcomes.
Ownership and use of mobile phone and utilization of maternal health services in India
Authors: Gunamany S , Subramanyam M 
Published: October 2020

Abstract
Despite decades of maternal and child health programming, neonatal disorders, undernutrition, and iron deficiency, feature in the top ten causes of premature death or disability in India. With the increasing use of mobile phones, mobile health (mHealth) programs have been implemented to promote MCH services. As no study has examined the role of Indian women's ownership/access to mobile phones on their healthcare utilization, we assess whether ownership and use of mobile phones are associated with the utilization of antenatal care (ANC) and institutional delivery services in India. We analyzed data from a nationally representative household survey from India. Our analytic sample was 12047 women with data on mobile phone ownership. Mobile phone ownership and use (access to internet, texting facility) were the exposure variables. The outcome variables were having at least four ANC visits(ideal) and an institutional delivery. Survey-adjusted logistic regression models adjusted for women's autonomy, socioeconomic indicators, and access to mass media were fit. The unadjusted odds of having an ideal ANC were higher (OR = 1.5; CI = 1.35-1.62) among those who owned a mobile phone versus not. After adjustment for all covariates, mobile phone ownership was not associated with both outcomes. Women with access to the internet had higher odds (OR = 9.24; CI = 6.51-13.2.)of reporting an institutional delivery and of receiving an ideal ANC(OR = 2.99;CI=2.40-3.73). In the fully adjusted model, access to the internet was positively associated with having an institutional delivery (OR = 2.85; CI = 2.82-1.31) whereas ideal ANC was not(OR = 1.7;p=0.07). mHealth interventions targeting women in India, especially the rural, low-income subgroup, are unlikely to be effective unless simultaneous efforts are made to increase access to, and autonomy in, mobile phone use. The need to partner with social scientists during intervention design/implementation as well as other policy-relevant implications are discussed.

Key messages
Explains why it is important to address the disparities and barriers in the use of mobile phones before designing and implementing various mHealth interventions. Why is it important to include social scientists during designing and implementation of various technology-based interventions well as other policy-relevant implications are discussed.
Identification of Master Patient Index Record Challenges from Healthcare Professionals’ Perspectives
Authors: Lintz J 
Published: October 2020

Abstract

Background
A Master Patient Index (MPI) system is essentially a database that is built into an Electronic Health Record (EHR) system to maintain a unique identifier for each patient seen at the organizational or enterprise level. The current study is to identify the gaps between the revenue cycle and patient information functionalities used in Electronic Health Records (EHRs) in collecting and reporting patient information. Additional focus was on perceptions of healthcare professionals who are familiar with MPI systems on the impact of these gaps of ensuring maximum reimbursements and adequacy of services provided. The study also sought to glean their perceptions vis-a-vis key challenges in the EHRs that affect organizational workflow.

Methods
A semi-structured questionnaire was used to collect information from healthcare professionals responsible for the MPI. The population studied is healthcare organizations using EPIC as the Electronic Health Records (EHRs).

Results
This study confirmed systems gaps between EPIC and other downstream systems used by the healthcare organizations to process patient information, as well as the extent of patient matching challenges that healthcare professionals have encountered in the MPI. These challenges include varying methods of matching patient data; lack of data standardization; absence of policies and procedures; frequently changing demographic data; multiple required data points needed for record matching; and default and null values in key-identifying fields.

Conclusions
The study offered evidence found in the literature that implies that duplicate records continue to plague healthcare organizations. Widespread technological interoperability insufficiency among healthcare facilities points to future challenges for federal policy makers as they seek to promote interoperability programs to demonstrate meaningful use of certified electronic health record technology (CEHRT).

Key messages
The study confirmed that despite a low level of duplication in the MPI, the organizations have lost revenue during the last 6 months. Duplicate records in the EHR systems has led to downstream problems in the revenue cycle, including denials and insurance takebacks that impact hospital revenue cycle efficiency.
Do Internet influencers exert positive effects on health behaviours of their followers?
Authors: Szulc K , Duplaga M 
Published: October 2020

Abstract

Background
Internet lifestyle and fitness influencers (ILFI) are able to motive millions of followers. Due to their popularity, they achieve soaring revenues through the distributions of various health- and fitness related. Still, the impact of websites run by ILFI on health behaviours (HB) of their users has not been studied thoroughly yet. The study aimed at the analysis of the association between the use of such websites and HB of young adult women in Poland.

Methods
An online survey was carried out in the representative sample of 1030, 18-35 years old, women. The questionnaire used in the study consisted of 53 items asking about the use of ILFIs' websites, HB, health (HL) and e-health literacy (eHL), and socioeconomic (SE) status. The effects of ILFI on HB were assessed with logistic regression models after adjusting for HL, eHL and SE variables.

Results
The mean age (standard deviation) of respondents was 26.09 (4.85) years. There were 52.52% (n = 541) users of ILFI websites in the study group. The number of active smokers was 37.9% (n = 390) and of e-cigarettes users - 36.6% (n = 377). Of respondents, 42.5% (n = 437) consumed alcohol at least once weekly, 42.5% (n = 437) undertook some form of physical activity at least several times a week, and 43.9% (n = 452) consumed five portions of fruits and vegetables daily at least several times a week. The use of ILFI's websites was associated with higher physical activity (OR, 95%CI: 2.28, 1.66-3.13) and consumption of fruits and vegetables (1.72, 1.29-2.29), but not with smoking (1.04, 0.78-1.40) and alcohol consumption (1.12, 0.84-1.48). Interestingly, the followers of ILFI were more prone to use e-cigarettes (1.58, 1.08-2.31)

Conclusions
Women accessing the websites of ILFI show more favourable patterns of HB than non-users. Although ILFI are driven by economic motivation, they may be seen as allies in achieving health promotion goals.

Key messages
The use of Internet influencers’ websites is related to more favourable health behaviours. Commercial lifestyle and fitness websites may play an important role in the promotion of healthy lifestyle.
Psychotropic drug interactions among drug-dependent people
Authors: Schuelter-Trevisol F , Zapelini do Nascimento D , Moreno Marques G , Trevisol D J 
Published: October 2020

Abstract

Background
Using psychiatric drugs to treat drug dependence and its comorbidities is very common. The objective of this study was to analyze the interactions between prescribed drugs for patients treated at a specialized mental health care center for drug addicts, located in southern Brazil.

Methods
A cross-sectional study was conducted on secondary data collected from 2010 to 2018. We reviewed the medical records of patients aged 18 years or older who took psychotropic drugs and had any type of substance dependence. The analysis of psychotropic drug interactions was conducted in three databases: Medscape, Drug Interactions Checker, and Micromedex.

Results
We included 1,022 of the 2,322 patients attending the care center during the study period. Psychotropic drug interactions were found in 779 (76.4%) study participants, and they presented 2,292 (100%) interactions, out of which 136 (6.0%) had minor clinical risk, 537 (23.4%) had moderate risk, and 1,619 (70.6%) had major risk for the patient, totaling 172 incompatible combinations between two psychotropic drugs. Of the total number of interactions, 128 were pharmacokinetic and 44 were pharmacodynamic.

Conclusions
The high number of psychotropic drug interactions is a serious public health issue. Psychopharmacological treatment should be carefully addressed to be safe for the patient.

Key messages
The implementation of clinical pharmacy services in outpatient clinics, hospitals, and mental health care centers can be considered the most effective alternative to avoid adverse reactions. Pharmacists are ready to assist the entire multidisciplinary team involved in the treatment of patients with mental disorders or substance dependence, and provide pharmacological treatment.
Polysubstance use among adolescents in Tunisia
Authors: Sahli J , Limam M , Zedini C , Ghardallou M , Mtiraoui A , Mellouli M , Ajmi T 
Published: October 2020

Abstract

Background
Poly-substance use is a global public health problem associated with significant adverse social and health effects. Adolescents are increasingly affected by this risky behaviour. The objective of our study was to describe the poly-substance use and to determine the association between the different types of substance use among middle school students in the Region of Kairouan in Tunisia.

Methods
A cross-sectional study was conducted in 2017 among middle school students in the Region of Kairouan in Tunisia using a self-administered questionnaire for data collection.

Results
A total of 494 students participated in the survey. Tobacco, alcohol, cannabis and psychotropic drug uses were reported respectively by 7.9%, 7.3%, 6.3% and 14.3% of the students. Among the surveyed students, the poly-consumption of the four substances: alcohol, tobacco, cannabis and psychotropic medication without medical prescription was reported by 2.83% of the students. Among these poly-consumers, 57.1% were male. Poly substance use was found to increase with the level of study (21.4%, 28.6% and 50% respectively in grades 7, 8 and 9). In our study, among the smokers, 64.1% reported alcohol use, 69.2% reported cannabis use and 43.6% reported psychotropic drug use. Associations between tobacco use and other substances use were significant (p &lt; 10-3). This association was significant for both boys and girls. In addition, 71% and 26% of alcohol users were respectively cannabis and psychotropic drug users. Alcohol use was significantly associated with cannabis and psychotropic drug use (p &lt; 10-3). This association was significant for both boys and girls.

Conclusions
Adolescents are particularly vulnerable to multiple risky behaviors including substance use. Appropriate prevention and control strategies based on a participatory approach involving parents, teaching and medical staff should be put in place to combat this scourge.

Key messages
Despite a relatively low prevalence of poly-substance use among the surveyed students, a particular attention should be drawn to the phenomenon of psychotropic drug use without medical prescription. There is an urgent need for the implementation of an effective substance use prevention program in school settings in Tunisia where monitoring is one of its core components.
Validation of the disease experience questionnaire for working age adults with chronic conditions
Authors: Galardi M , Houkes I , de Rijk A 
Published: October 2020

Abstract

Background
Working age adults diagnosed with chronic diseases are growing in prevalence and not all of them manage to stay at work. Chronic conditions need a long-term response from the (occupational) health care system, which, however, is structured mostly around acute episodes. The aim was to develop and validate a questionnaire tapping working age patients' lived experiences with their chronic disease.

Methods
Based on a qualitative study, the 13-item Disease Experience Questionnaire (DEQ) was developed for persons in working age. DEQ taps 3 types of disease experiences: 1) Disruption: hopelessness and irreparable loss; 2) Meaningful: an opportunity to set new life priorities; 3) Episode: an inconvenient period to be overcome. Items were filled out online by 2,028 persons diagnosed with chronic headache, autism, HIV, neurofibromatosis, CKD or sarcoidosis. Several proxy variables and demographics were measured. Data were analyzed with PCA, reliability analysis, correlations with criterion variables and ANOVA to compare levels of disease experiences across groups differing in age, education and work status.

Results
Disruption was valid for all disease groups. Lower educated and non-working persons had significantly higher Disruption levels. Meaningful was valid for the total sample, the autism, HIV and sarcoidosis groups. Cronbach's alphas were .755 and .661 respectively. Episode was only valid for the HIV group (Cronbach's alpha .632). Levels of Meaningful and Episode did not differ in relation to age, education or work status. Correlations with criterion variables were in the expected directions.

Conclusions
DEQ is a valid tool for identifying disease experiences in working age adults with diverse chronic diseases. The disease experience of persons with HIV, for which also the Episode subscale can be helpful, differs from that of persons with other chronic diseases. The Disruption and Meaningful subscales can help to tailor (occupational) health care to patient needs.

Key messages
The Disease Experience Questionnaire (DEQ) is a valid tool to identify disease experiences in the working age population with chronic diseases. The DEQ Disruption and Meaningful subscales can help to tailor (occupational) health care to patient needs.
Breast cancer mortality rates trends by race in São Paulo, Brazil
Authors: Vale D B , Gozzi B , Marcelino A C , Oliveira J F , Cardoso-Filho C , Cunha G T , Batista P , Zeferino L C 
Published: October 2020

Abstract

Background
Breast cancer is the main cause of female death by neoplasia in Brazil. Although half of the Brazilian population is black/brown (BB), socio-economic disparities translate in a vulnerable situation to those women. Access to health care is an important barrier to improve the health of BB women. This study aims to investigate trends in breast cancer mortality rates regarding race and age.

Methods
This is a population-based study of trends evaluation on breast cancer mortality in São Paulo state, Brazil, from 2000 to 2017. The absolute number of deaths and population figures (including race) by age-groups and years were available online from government data. Data on race were not available by ten-year age-groups, so the figures were projected according to the female age structure by year. Total rates by year and race were age-adjusted to the 'World Population (2000)'. For trend analysis, linear regression was used, with 5% level of significance.

Results
In the period were observed 60,940 breast cancer deaths, 76.7% in white and 17.5% in BB women. The absolute number of deaths in white and BB women was respectively 2,095 and 333 in 2000, and 3,076 and 999 in 2017. The total age-adjusted mortality rates per 100,000 women of white and BB in 2000 were respectively 16.4, 17.2 and 7.5. In 2017 rates were 14.6, 16.6 and 16.1. There was a trend towards reducing the mortality rates of white women (P = 0.002) and in their age-groups from 40 to 79 years (P &lt; 0.03). There was a trend towards increasing the mortality rates of BB women (P &lt; 0.001) and in all their age-groups (P &lt; 0.02).

Conclusions
Although breast cancer figures of death and mortality rates in BB women have more than doubled in 18 years, rates reached almost the same figures of white women in the period. Changes in behaviour risk factors may explain this result. However, it is very likely that access to health care to these women has been improved, reducing the disparities in the health system.

Key messages
Breast cancer mortality rates in black/brown women have reached almost the same figures as white women from 2000 to 2017 in São Paulo, Brazil. Access to health care in black women may have improved in São Paulo, Brazil.
The survival of mankind requires WATER centers & Water Quality and Quantity Index (WQQI)
Authors: Kozicki Z A , Baiyasi-Kozicki S J S 
Published: October 2020

Abstract

Issue
By 2025, half of the world's population will be living in water-stressed areas. Managing water quality and quantity is a worldwide concern that will require investing in WATER Centers and monitoring systems to improve the safety of drinking water and contribute to water conservation worldwide. Without reliable water policy climate change will threaten human survival.

Problem
There is no single measure that can describe overall water quality for any one body of water, let alone at a global level. Seven assessment methods used to measure water quality either on a national or global level, were reviewed and indexed. This index was examined and compared by objective, use, distribution and global location. Water centers need to review community water process, outcomes and outputs and also provide user populations with a Water Quality and Water Quantity Index (WQQI).

Results
United Nations Environment Programme UNEP research has revealed that “although there is no globally accepted composite index of water quality, some countries and regions have used, or are using, aggregated water quality data in the development of water quality indices.” 'Most water quality indices rely on normalizing, or standardizing data by parameter according to expected concentrations and some interpretation of 'good' versus 'bad' concentrations”.

Lessons
The survival of the human population requires policy changes regarding water management. The feedback humans need to survive can best be described as a Water Quality and Quantity Index (WQQI). With the growing scarcity of drinking water worldwide, proactive strategic thinking and planning is necessary. Message: Investing in WATER Centers ensures that the public health and economic benefits for all things related to water is optimized. The WQQI could also be useful in longitudinal and cross-sectional epidemiological studies.

Key messages
The survival of the human population requires policy changes regarding water management. Mankind needs real-time feedback about water quality to respond to threats to the water supply.
The impact of the policy of expanding coverage for 4 major diseases on out-of-pocket payments
Authors: Lee G R , Lee J H 
Published: October 2020

Abstract
In South Korea, Cancers, cardiac disease, cerebrovascular diseases and rare incurable disease cause high medical expenses which are putting a heavy burden on the household economy. They are called '4 Major Severe Diseases'. The government has established the plan of Expanding Coverage for Four Major Severe Diseases. The Policy of Expanding Coverage for the 4 Major Severe Diseases is to apply the necessary medical services including coverage for uncovered services to national health insurance payments in stages. This study aims to evaluate the effects of the policy implemented from 2013 to 2015 by comparing the changes in the out-of-pocket payments before and after the policy. Using the data from the Korea Health Panel(2012, 2016), the policy effect was evaluated by the Difference-In-Difference analysis. A total of 4,686 patients (2,343 in 2012 and 2,343 in 2016) were included, who are enrolled in National Health Insurance, and have at least one chronic disease. People who are under 20 years old were excluded. In addition, severity of disease was adjusted by CCI(Charson's comorbidity index). Compared to before the policy was implemented, the Out-of-pocket payments significantly decreased. In addition, there were significant differences in gender, types of health care system, disabled, economic activity, income level, and CCI. According to previous studies, the policy of Expanding health insurance coverage since 2005 has been criticized for its low effectiveness. However, It is revealed that the Policy of Expanding Coverage for 4 Major Severe Diseases has an effect in this study. Given that the policy needs time to work, this study showed the effect of the policy more comprehensively compared to previous studies evaluating the effectiveness for just one year.

Key messages
Due to the Policy of Expanding Coverage for 4 Major Severe Diseases, the out-of-pocket health expenditure were reduced in the policy group. Given that the policy needs time to work, this study has shown more comprehensive results than previous studies that evaluated the effect of policy carried out over a short period.