bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Experiences of Merging Health Insurance Funds in Turkey, Thailand, South Korea and Indonesia: What lessons can be learned?
Authors: Bazyar Mohammad , Yazdi-Feyzabadi Vahid , Rashidian Arash , Behzadi Anahita 
Published: March 2020

Abstract
Background: Fragmentation in health insurance system can obstruct reaching universal health coverage’ objectives and may lead to inequity in financial and organizational access to health care services. One possible option to overcome this challenge is merging the existing insurance funds together. This article aims to review the experience of Turkey, Thailand, South Korea and Indonesia regarding merging which can be very useful for other countries which are looking for ways of enhancing their health systems. Methods: The present study is a cross-country comparative analysis. The first criterion to choose these countries was with experience of the policy of merging. The second criterion was diversity in health insurance systems. To find the most relevant documents about the subject, different sources of information were searched including books, scientific papers, reports, policy documents and documents published by international organizations such as WHO and World Bank. We followed snowball sampling method to reach out for further documents by checking the reference list of the most relevant documents. We also contacted the authors with the most relevant articles in the selected countries to introduce and provide us with more articles or publications about the subject. Results: The experience of Turkey, Thailand, South Korea and Indonesia show that different reasons may force policy makers to move towards merging and reducing the number of health insurance funds; different stakeholders may support or oppose merging based on the interests they may have in the current fragmented health insurance system; various positive and negative consequences may occur in the health system as the result of merging. The experience of these countries also emphasize that in order to accelerate and facilitate implementation process of merger and face less operational challenges, there should be some prerequisites such as experiencing reliable economic growth to enhance benefit package and support the single national insurance scheme financially after merging. Conclusions: Merging is not the panacea to all problems of health system and other contributing health reforms should be implemented simultaneously or sequentially in other aspects of health system if merging is going to pave the way reaching universal health coverage.
A survey about the contents and features of oncology clinical pharmacy services and self-evaluations of the oncology pharmacists in China
Authors: Wang Yan-Ting , Dai Yuan-Yuan , Yang Jun , Zhou Hai-Yan , Chen Zhe , Li Guo-Hui 
Published: March 2020

Abstract
Background: With the growing number of oncology patients and novel anti-tumor medications, the demand of oncology clinical pharmacy services is increasing rapidly in China. However, the current status of oncology clinical pharmacy services in China were seldom reported. The purpose of the study was to investigate the contents and features of oncology clinical pharmacy services and self-evaluations of the oncology pharmacists in China, and to identify related problems for its further development. Methods: A 55-item online questionnaire was distributed to oncology-related clinical pharmacists in Chinese hospitals in January 2019. Pharmacists answered the questions on the WeChat platform. Data were analyzed using descriptive statistics. Results: The respondents of the 166 valid questionnaires were from 29 provinces (or autonomous regions or municipalities). Their average working experience for clinical pharmacy was 4.86 years. The average duration of their clinical services was 3.27 hours/day. The clinical pharmacy services consist of 15 types and their workload on each service type were identified. Pharmacists thought they were not good at establishing pharmacotherapy protocols, participating in therapeutic drug monitoring, pharmacy consultation and pharmacogenetic/pharmacogenomic service. About 80% (81.33%) of the pharmacists thought other healthcare professionals knew the nature of their work, and some services were very welcomed by clinical departments. The biggest barrier for career development of the pharmacists was insufficiency of professional skills. In most cases, the clinical service accounted for less than 30% of the overall performance evaluation of the pharmacists. Most of the participating pharmacists were not satisfied with their current salary. The overall evaluation score for their career wellbeing was 6.27 out of 10. Conclusions: The value of oncology clinical pharmacists is being increasingly recognized, but advanced services need further expansion. Increasing the time serving in clinical units, optimizing performance evaluation and strengthening their skills are possible ways for pharmacists to provide superior services. This study showed the current service of oncology clinical pharmacists in most parts of China, which may provide reference for policy makers, promote international communications and shed light on future development of oncology clinical pharmacy in China. Key words: Oncology, pharmacist, clinical pharmacy services, self-evaluation, survey, China
Black Women’s Psychosocial Experiences with Seeking Surgical Treatment for Uterine Fibroids: Implications for Clinical Practice
Authors: VanNoy Brianna N , Bowleg Lisa , Marfori Cherie , Moawad Gaby , Zota Ami R. 
Published: March 2020

Abstract
Background
Black women are disproportionately impacted by uterine fibroids and are more likely to undergo surgical treatment for fibroids compared with non-Black women. However, few studies have characterized the psychosocial experiences of Black women seeking treatment for fibroids. This study aimed to identify factors that shape Black women’s fibroid management decisions; explore how discrimination based on race, class, and gender feature in treatment-seeking experiences; and compare experiences by age and socioeconomic status (SES).
Methods
We conducted semi-structured interviews with 37 Black premenopausal women, undergoing either a hysterectomy or myomectomy for fibroids at an academic medical center. We used a thematic analysis to code transcripts and identify themes.
Results
Participants were predominately single, highly educated, and privately insured. Respondents reported that patient-doctor interactions, support from social networks, fertility consequences, and fear of fibroid malignancy influenced their fibroid management decisions. Their knowledge and perceptions of fibroids were also influenced by social and community norms and differed by SES; women of higher SES had greater fibroid awareness than women of lower SES. Discrimination was discussed in the context of historical inequity against Black women, with one participant questioning whether Black women were valued less in clinical settings compared with non-Black women. While several women discussed positive experiences seeking fibroids care, others expressed medical mistrust or said that alternative management options were not offered by clinicians.
Conclusions
Fibroid management decisions were influenced not only by individual-level interactions with clinicians and social networks, and concerns about fertility and fibroid malignancy, but also by broader social and historical conditions. These findings suggest that clinicians should deliver culturally-competent gynecologic care that centers the voices of Black women and acknowledges the diverse perspectives and perceptions that Black women may have when seeking fibroid treatment.
Clinical Characteristics of Patients with 2019 Coronavirus disease in a non-Wuhan area of Hubei Province, China: a retrospective study
Authors: Zhao Xin-Ying , Xu Xuan-Xuan , Yin Hai-Sen , Hu Qin-Ming , Xiong Tao , Tang Yuan-Yan , Yang Ai-Ying , Yu Bao-Ping , Huang Zhi-Ping 
Published: March 2020

Abstract
Background: Since December, 2019, the 2019 Coronavirus disease (COVID-19) from Wuhan, China, has caused outbreak in China with more than 70,000 people infected and more than 2,000 people dead. The clinical characteristics of COVID-19 patients in non-Wuhan areas of Hubei province have not been described. Methods : We retrospectively analyzed the clinical characteristics and treatment progress of 91 patients diagnosed with COVID-19 in Jingzhou Central Hospital. Results: Of the 91 patients diagnosed with COVID-19, 30 (33.0%) cases were severe and two (2.2%) patients died. The severe patients tended to be older (50.5 vs 42.0, P=0.049), and have more chronic disease (40% vs 14.75%, P=0.009), compared to mild group. Only 67.0% of the patients were quantitative polymerase chain reaction (qPCR) positive on their first tests, while typical chest computed tomographic (CT) images were obtained for each patient. The most common complaints were cough (75, 82.4%), fever (59, 64.8%), fatigue (35, 38.5%), and diarrhea (14, 15.4%). Injuries outside the respiratory tract were identified by elevated levels of aspartate aminotransferase (18, 19.8%), creatinine (5, 5.5%) and creatine kinase (14, 15.4%) in laboratory tests. In sum, 28 (30.8%) cases suffered injuries outside the respiratory system, including 50% of the critically ill patients and 21.3% of the mild patients.Conclusions: Overall, the mortality rate of patients in Jingzhou is lower than that of Wuhan. Importantly, we discovered liver, kidney, digestive tract and heart injury in COVID-19 cases besides respiratory problems. Combining Chest CT images with qPCR of throat swab samples would improve the accuracy of COVID-19 diagnose.
Hepatitis B virus infection among men who have sex with men and transgender women living with or at risk for HIV: A cross sectional study in Abuja and Lagos, Nigeria.
Authors: ADEYEMI Olusegun A. , MITCHELL Andrew , SHUTT Ashley , CROWELL Trevor A. , NDEMBI Nicaise , KOKOGHO Afoke , RAMADHANI Habib O. , ROBB Merlin L. , BARAL Stefan D. , AKE Julie A. , CHARURAT Manhattan E. , PEEL Sheila , Nowak Rebecca G 
Published: March 2020

Abstract
Background Despite the development of a safe and efficacious hepatitis B vaccine in 1982, the hepatitis B virus (HBV) remains a public health burden in sub-Saharan Africa. Due to shared risk factors for virus acquisition, men who have sex with men (MSM) and transgender women (TGW) living with HIV are at increased risk of HBV. We estimated the prevalence of HBV and associated factors for MSM and TGW living with or without HIV in Nigeria. Methods Since March 2013, TRUST/RV368 has recruited MSM and TGW in Abuja and Lagos, Nigeria using respondent driven sampling. Participants with HIV diagnosis, enrollment as of June 2015, and available plasma were retrospectively tested for hepatitis B surface antigen and HBV DNA. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for factors associated with prevalent HBV infection. Results A total of 717 MSM and TGW had a median age of 25 years (interquartile range [IQR]: 21-27), 5% self-reported HBV vaccination, 61% were living with HIV, 10% had prevalent HBV infection and 6% were HIV-HBV co-infected. HIV mono-infected as compared to HIV-HBV co-infected had a higher median CD4 T cell count [425 (IQR: 284-541) vs. 345 (IQR: 164-363) cells/mm 3 , p=0.03] and a lower median HIV RNA viral load [4.2 (IQR: 2.3-4.9) vs. 4.7 (IQR: 3.9-5.4) log 10 copies/mL, p<0.01]. The only factor independently associated with HBV was self-report of condomless sex at last anal intercourse (OR: 2.2, 95% CI: 1.3, 3.6). HIV infection was not independently associated with HBV (OR: 1.0, 95% CI: 0.7-1.6). Conclusion HBV prevalence was moderately high but did not differ by HIV in this cohort of MSM and TGW. Condomless sex was associated with elevated HBV risk, reinforcing the need to increase communication and education on condom use among key populations in Nigeria. Evaluating use of concurrent HIV antiretroviral therapy with anti-HBV activity may confirm the attenuated HBV prevalence for those living with HIV.
Impact of immediate postpartum insertion of TCu380A on the quantity and duration of lochia discharges in Tanzania
Authors: Muganyizi Projestine Selestine , Kimario Grasiana Festus , Rwegoshora France John , Paul Patrick Ponsian , Makins Anita 
Published: March 2020

Abstract
Background The insertion of Intrauterine Contraceptive Device (PPIUD) for the purpose of contraception immediately after delivery is becoming popular in countries where the use of IUD for contraception has been extremely low. Since 2015, Tanzania implemented the initiative by the International Federation of Gynecology and Obstetrics (FIGO) to institutionalize PPIUD. As a result of capacity building and information delivery under the initiative, there have been increased uptake of the method. Working in this context, the focus of the study was to generate evidence on the effect of TCu380A IUD on amount and duration of lochia and equip service providers with evidence-based knowledge so as to minimize unnecessary interventions and method discontinuation.Objective Establish impact of postpartum TCu380A on amount and duration of lochia.Methods A prospective cohort study of delivered women in two teaching hospitals in Tanzania with immediate insertion of TCu380A or without use of postpartum contraception in 2018. TCu380A models; Optima (Injeflex Co. Brazil) and Pregna (Pregna International, Chakan, India) were used. Follow-up was done by weekly calls and examination at 6 th week. Lochia was estimated by Likert Scale 0-4 relative to the amount of lochia on the delivery day. An estimated 250 women sample (125 each group) would give 80% power to detect a desired difference. Data analysis was by intention to treat using SPSS.Results 275 women were analysed, 142 exposed and 133 unexposed. Medical complaints were reported by 41 (28.9%) exposed and 37 unexposed (27.8%), p=0.655. Lack of dryness by end of 6 th week was to 32 (22.5%) exposed and 8 (6.0%) unexposed, p<0.001. Exposures had higher weekly mean lochia scores throughout with varience most marked in week 5 (F=3.818, p<0.001) and week 6 (F=2.949, p=0.004).Conclusion PPIUD is associated with increased amount of lochia and slows progression to dryness within 6 weeks of delivery. The implications of excess amount and duration of lochia in care of PPIUD clients are discussed.
Quantifying the individual variability in people’s exposure to mosquito bites in Burkina Faso
Authors: Guglielmo Federica , Sanou Antoine , Churcher Thomas S , Ferguson Heather M , Ranson Hilary , Sherrard-Smith Ellie 
Published: March 2020

Abstract
BackgroundThe Cascades Region, Burkina Faso, has high malaria burden despite reported high insecticide treated bed net (ITN) use. Human and vector activities outside the hours when indoor interventions offer direct protection from infectious bites potentially increase exposure risk to bites from malaria-transmitting Anopheles mosquitoes. We investigate the degree of variation in human behaviour both between individuals and through time (season) to quantify how it impacts exposure to malaria vectors.MethodsPatterns in human overnight activity (18:00-06:00) to quantify time spent using an ITN across 7 successive nights in two rural communities, Niakore (N = 24 participants) and Toma (71 participants), were observed in the dry and rainy seasons, between 2017-2018. Hourly human landing Anopheles mosquito catches were conducted in Niakore specifically, and Cascades Region generally, between 2016-2017. Data were statistically combined to estimate seasonal variation in time spent outdoors and Anopheles bites received per person per night (bpppn).ResultsSubstantial variability in exposure to outdoor Anopheles bites was detected within and between communities and across seasons. In October, when Anopheles densities are highest, an individual’s risk of Anopheles bites ranged from 2.2 to 52.2 bpppn within the same week with variable risk dependent on hours spent indoors. Comparably higher outdoor human activity was observed in April and July but, due to lower Anopheles densities estimated bpppn were 0.2 – 4.7 bpppn, and 0.5 – 32.0 respectively. Males and people aged over 21 years were predicted to receive more bites in both sentinel villages.ConclusionThis work presents one of the first clear descriptions of the degree of heterogeneity in time spent outdoors between people and across the year. Appreciation of sociodemographic, cultural and entomological activities will help refine approaches to vector control.
The association between dyslipidemia and the incidence of chronic kidney disease in the general Zhejiang population: a retrospective study
Authors: Liang Xudong , Ye Meiyu , Tao Mei , Zheng Danna , Cai Ruyi , Zhu Yifan , Jin Juan , He Qiang 
Published: March 2020

Abstract
Background According to the "lipid nephrotoxicity hypothesis", there is now significant research being conducted in this area. By studying the role of hyperlipidemia in chronic kidney disease in the general Zhejiang population, we aimed to explore the correlation between changes in blood lipid levels and chronic kidney disease.Methods We collected and analyzed clinical data from ordinary residents who participated in the annual comprehensive physical examination with no overt kidney disease in Zhejiang Provincial People's Hospital, China from January 2011 to December 2016. According to triglyceride, total cholesterol and low-density lipoprotein levels, participants were respectively divided into 4 groups. Statistical methods were used to evaluate the correlation between different blood lipid profiles and chronic kidney disease.Results 5,183 participants were included in our study. During the six-year follow-up period, 227 participants (4.4%) developed chronic kidney disease. The odds ratio for incident chronic kidney disease was 3.14 (95%CI: 1.53–6.43) in Q3, 3.84 (95%CI: 1.90–7.76) in Q4 according to the total cholesterol group and 1.17 (95%CI: 1.04–1.32) in Q3, 1.40 (95%CI: 1.11–2.48) in Q4 according to the low-density lipoprotein group, respectively, after multivariable-adjusted analyses. According to the triglyceride grouping, the odds ratio for incident chronic kidney disease was 2.88 (95%CI: 1.29-6.43) in Q2, 2.92 (95%CI: 1.44–6.57) in Q3 and 3.08 (95%CI: 1.11–6.69) in Q4, after multivariable-adjusted analyses.Conclusion Increased triglycerides and high levels of total cholesterol and low-density lipoprotein were independently associated with an increased likelihood of eGFR decline and development of incident chronic kidney disease in the general Zhejiang population.
Adaptation and psychometric testing of the Hoarding Rating Scale (HRS): A self-administered screening scale for epidemiological study in Chinese population
Authors: Liu Tai Wa , LAM Simon Ching , Chung Man Hon , Ho Ken Hok Man 
Published: March 2020

Abstract
Background: Hoarding disorder is a chronic and debilitating illness associated with restrictions on activities of daily living, compromised social and occupational functioning, and adverse health outcomes. However, researchers lack a brief and self-administered screening measurement to assess compulsive hoarding in the Chinese speaking population. This study aimed to adapt and validate the Hoarding Rating Scale-Interview (HRS-I) to as a tool for screening compulsive hoarding behavior in Chinese population.Methods: This study comprised two phases. During Phase 1, the English-language HRS-I was translated into Chinese (CHRS) (comprehensible for most Chinese speaking population, e.g., Cantonese & Mandarin) and subjected to an equivalence check. In Phase 2, the CHRS was validated by examining internal consistency, stability, and construct validity. Different samples were used appropriately to verify the items and reflect the psychometric properties. Results: In Phase 1, the CHRS yielded satisfactory content (CVI/AVE = 0.93) and face validity ratings (comprehensibility = 100%, N = 20 participants of general public with age 18-72) and the English and Chinese versions were found to be equivalent (ICC = 0.887; N = 60 university students and staff). Phase 2 revealed satisfactory levels of internal consistency (α=0.86; corrected item-total correlation = 0.60–0.74; N = 820 participants of general public), 2-week test-retest reliability (ICC = 0.78; N = 60 university students), and construct validity (one-factor CFA solution matched with the hypothesized model, χ2/d.f. = 2.26, CFI = 0.99, NFI = 0.99, RMSEA = 0.049, IFI = 0.99; n = 520 participants of general public). Conclusions: This study provides sufficient evidence of the reliability and validity of the CHRS for compulsive hoarding behavior screening in the Chinese population through self-administered method.
Newborn Behavioral Observation, maternal stress, depressive symptoms and the mother-infant relationship: Results from the Northern Babies Longitudinal Study (NorBaby).
Authors: Høifødt Ragnhild Sørensen , Nordahl Dag , Landsem Inger Pauline , Csifcsák Gábor , Bohne Agnes , Pfuhl Gerit , Rognmo Kamilla , Braarud Hanne C. , Goksøyr Arnold , Moe Vibeke , Slinning Kari , Wang Catharina Elisabeth Arfwedson 
Published: March 2020

Abstract
Background Families can experience the postpartum period as overwhelming and many report a special need for support. The Newborn Behavioral Observation (NBO) aims to promote a positive parent-infant relationship by sensitising parents to the infant’s signals. This article evaluates the NBO as a universal preventive intervention within the regular well-baby clinic service on measures of maternal depressive symptoms, parental stress, the mother-infant relationship and satisfaction/benefit of the postpartum follow-up.Methods This investigation is part of a larger longitudinal study comprising 220 women and 130 of their partners recruited between 2015 and 2017. The study had a non-randomised cluster-controlled design with 6 measurement points. This article is based on a sample of 196 women using data from T1 (gestational weeks 13-39), T4 (5-15 weeks postpartum) and T5 (3-9 months postpartum). Participants were allocated to a group receiving the NBO (n=82) and a care as usual comparison group (n=114). We measured maternal depressive symptoms and parental stress using the Edinburgh Postnatal Depression Scale (EPDS) and the Parenting Stress Index (PSI). The mother-infant relationship was assessed with the Parental Reflective Functioning Questionnaire (PRFQ), the Maternal Postnatal Attachment Scale (MPAS) and the Maternal Confidence Questionnaire (MCQ). Participants also answered questions about satisfaction/benefit of the postpartum follow-up.Results Multivariate analyses of covariance (MANCOVA) and repeated measures ANCOVA found no significant differences between the groups for the mother-infant relationship domains and few differences in depressive symptoms and parental stress. The repeated measures ANCOVA found that participants in the NBO-group scored slightly higher on parental stress, although the difference was small. A Mann-Whitney U test indicated that participants in the NBO-group learned significantly more than the comparison group from the follow-up about the baby’s signals in relation to sleep/sleep patterns, social interaction and crying/fuzziness.Conclusions The results indicate that the NBO-group learned more than the comparison group about reading their child’s signals in important everyday situations. However, the benefits of the NBO were limited for depressive symptoms, parental stress and mother-infant relationship measures. The study sample was generally well-functioning, and the results indicate that the benefits of the NBO may be limited within a well-functioning sample.Trial registration: ClinicalTrials, NCT02538497, Registered 2 September 2015, https://clinicaltrials.gov/ct2/show/NCT02538497?term=northern+babies&draw=1&rank=1