bluuebunny/crossref_metadata_2025_split huggingface dataset:
Survey and analysis of the availability and affordability of essential drugs in Hefei based on WHO / HAI standard survey methods
Authors: Dong Zuojun , Tao Qiucheng , Sun Guojun 
Published: September 2020

Abstract
Background
The 2018 edition of the National Essential drugs List came into effect in September 2018. Relevant policies require that all primary medical and health institutions should supply national essential drugs, while secondary and tertiary medical and health institutions should supply a certain percentage of essential drugs.

Methods
Our research used the standard methods of WHO and HAI, selected 50 basic drugs, combined with the actual situation of Hefei City, selected 30 medical institutions and 30 pharmacies, conducted drug availability and affordability studies.

Results
The availability of the lowest-price generics (LPGs) of essential drug in Hefei is much higher than that of the Originator brands (OBs); the overall affordability is better, but there is a large gap between the affordability levels of OBs and LPGs. OBs are relatively poorly affordable.

Conclusion
The implementation of the national essential drug system in Hefei has achieved certain results, but there is still a gap from the expected target. It is recommended to update and adjust the list of essential drugs in accordance with the demand for clinical medicines, ensure that medical and health institutions at all levels supply essential drugs, popularize knowledge of essential drugs, and moderately adjust the price of OBs to reduce the medication burden.
Spatial access inequities and childhood immunisation uptake in Kenya
Authors: Joseph Noel K. , Macharia Peter M. , Ouma Paul O. , Mumo Jeremiah , Jalang’o Rose , Wagacha Peter W. , Achieng Victor O. , Ndung’u Eunice , Okoth Peter , Muñiz Maria , Guigoz Yaniss , Panciera Rocco , Ray Nicolas , Okiro Emelda A. 
Published: September 2020

Abstract
Background
Poor access to immunisation services remains a major barrier to achieving equity and expanding vaccination coverage in many sub-Saharan African countries. In Kenya, the extent to which spatial access affects immunisation coverage is not well understood. The aim of this study was to quantify spatial accessibility to immunising health facilities and determine its influence on immunisation uptake in Kenya while controlling for potential confounders.

Methods
Spatial databases of immunising facilities, road network, land use and elevation were used within a cost friction algorithim to estimate the travel time to immunising health facilities. Two travel scenarios were evaluated; (1) Walking only and (2) Optimistic scenario combining walking and motorized transport. Mean travel time to health facilities and proportions of the total population living within 1-h to the nearest immunising health facility were computed. Data from a nationally representative cross-sectional survey (KDHS 2014), was used to estimate the effect of mean travel time at survey cluster units for both fully immunised status and third dose of diphtheria-tetanus-pertussis (DPT3) vaccine using multi-level logistic regression models.

Results
Nationally, the mean travel time to immunising health facilities was 63 and 40 min using the walking and the optimistic travel scenarios respectively. Seventy five percent of the total population were within one-hour of walking to an immunising health facility while 93% were within one-hour considering the optimistic scenario. There were substantial variations across the country with 62%(29/47) and 34%(16/47) of the counties with < 90% of the population within one-hour from an immunising health facility using scenarios 1 and 2 respectively. Travel times > 1-h were significantly associated with low immunisation coverage in the univariate analysis for both fully immunised status and DPT3 vaccine. Children living more than 2-h were significantly less likely to be fully immunised [AOR:0.56(0.33–0.94) and receive DPT3 [AOR:0.51(0.21–0.92) after controlling for household wealth, mother’s highest education level, parity and urban/rural residence.

Conclusion
Travel time to immunising health facilities is a barrier to uptake of childhood vaccines in regions with suboptimal accessibility (> 2-h). Strategies that address access barriers in the hardest to reach communities are needed to enhance equitable access to immunisation services in Kenya.
Deep learning based feature-level integration of multi-omics data for breast cancer patients survival analysis
Authors: Tong Li , Mitchel Jonathan , Chatlin Kevin , Wang May D. 
Published: September 2020

AbstractBackgroundBreast cancer is the most prevalent and among the most deadly cancers in females. Patients with breast cancer have highly variable survival lengths, indicating a need to identify prognostic biomarkers for personalized diagnosis and treatment. With the development of new technologies such as next-generation sequencing, multi-omics information are becoming available for a more thorough evaluation of a patient’s condition. In this study, we aim to improve breast cancer overall survival prediction by integrating multi-omics data (e.g., gene expression, DNA methylation, miRNA expression, and copy number variations (CNVs)).MethodsMotivated by multi-view learning, we propose a novel strategy to integrate multi-omics data for breast cancer survival prediction by applying complementary and consensus principles. The complementary principle assumes each -omics data contains modality-unique information. To preserve such information, we develop a concatenation autoencoder (ConcatAE) that concatenates the hidden features learned from each modality for integration. The consensus principle assumes that the disagreements among modalities upper bound the model errors. To get rid of the noises or discrepancies among modalities, we develop a cross-modality autoencoder (CrossAE) to maximize the agreement among modalities to achieve a modality-invariant representation. We first validate the effectiveness of our proposed models on the MNIST simulated data. We then apply these models to the TCCA breast cancer multi-omics data for overall survival prediction.ResultsFor breast cancer overall survival prediction, the integration of DNA methylation and miRNA expression achieves the best overall performance of 0.641 ± 0.031 with ConcatAE, and 0.63 ± 0.081 with CrossAE. Both strategies outperform baseline single-modality models using only DNA methylation (0.583 ± 0.058) or miRNA expression (0.616 ± 0.057).ConclusionsIn conclusion, we achieve improved overall survival prediction performance by utilizing either the complementary or consensus information among multi-omics data. The proposed ConcatAE and CrossAE models can inspire future deep representation-based multi-omics integration techniques. We believe these novel multi-omics integration models can benefit the personalized diagnosis and treatment of breast cancer patients.
An app for supporting older people receiving home care – usage, aspects of health and health literacy: a quasi-experimental study
Authors: Göransson Carina , Wengström Yvonne , Hälleberg-Nyman Maria , Langius-Eklöf Ann , Ziegert Kristina , Blomberg Karin 
Published: September 2020

Abstract
Background
During the last decade, there has been an increase in studies describing use of mHealth, using smartphones with apps, in the healthcare system by a variety of populations. Despite this, few interventions including apps are targeting older people receiving home care. Developing mobile technology to its full potential of being interactive in real time remains a challenge. The current study is part of a larger project for identifying and managing health concerns via an app by using real-time data. The aim of the study was to describe older people’s usage of an app and to evaluate the impact of usage on aspects of health and health literacy over time.

Methods
A quasi-experimental design was employed. Seventeen older people self-reported health concerns via Interaktor twice a week for 3-months and answered questionnaires at baseline, the end of the intervention and at a 6–month follow-up. Logged data on app usage and data on Sense of Coherence, Health Index, Nutrition Form for the Elderly, Geriatric Depression Scale-20, Swedish Communicative and Critical Health Literacy and Swedish Functional Health Literacy were collected and analysed using descriptive and non-parametric inferential statistics.

Results
The median usage of the app as intended was 96%. Pain was one of the most reported health concerns and was also the health concern that triggered an alert (n = 33). The older people’s communicative and critical health literacy improved significantly over time. Regarding the scores of Sense of Coherence, Health Index, Nutritional Form for the Elderly, Geriatric Depression Scale-20 and Swedish Functional Health Literacy scale, there were no significant differences over time.

Conclusions
The high app usage showed that an app may be a suitable tool for some older people living alone and receiving home care. The results indicate that the usage of Interaktor can support older people by significantly improving their communicative and critical health literacy. Aspects of health were not shown to be affected by the usage of the app. Further research with larger sample is needed for evaluation the effect on health literacy, and which aspects of health of importance to support by an app.
Personal selling in health and medicine: using sales agents to engage audiences
Authors: Elrod James K. , Fortenberry John L. 
Published: September 2020

Abstract
Background
Personal selling—the use of sales agents to personally deliver messages to target audiences—is often not the first conveyance pathway that comes to mind when thinking about marketing communications in the health services industry. This is not surprising given that sales force roles are not as public and prominent as other promotional avenues, such as advertising and public relations. Further, the titles held by those in sales-oriented roles in the health services industry are usually more discreet, carrying designations such as community liaison, business development officer, and the like. Regardless of title, sales roles involve personally interacting with desired audiences to compel some sort of action, adding a vital form of communication that bolsters engagement opportunities.

Discussion
Personal selling plays a critical role in the promotion of health services organizations. Perhaps most obviously, it is distinguished from its counterparts in the marketing communications mix by its use of people to deliver messages to desired audiences. Associated titles, duties, and expectations vary widely between and among those healthcare entities which make use of personal selling, as there is no pat formula for deployment within health services environments. To shed light on personal selling, this article presents an associated overview through the lens of Willis-Knighton Health System, sharing practical insights and experiences which can assist peer healthcare establishments in understanding, shaping, and honing sales roles within their own facilities.

Conclusions
Taking advantage of the utility afforded by direct, personal interactions with audiences, personal selling provides a helpful communications resource that better enables healthcare providers to connect proficiently with target markets. It supplements other forms of marketing communication, operating synergistically to help healthcare institutions achieve their conveyance goals. Prudent deployment of this unique marketing communications method affords health and medical institutions with a capable conveyance asset that can provide great assistance in achieving communicative ambitions.
Direct marketing in health and medicine: using direct mail, email marketing, and related communicative methods to engage patients
Authors: Elrod James K. , Fortenberry John L. 
Published: September 2020

Abstract
Background
Direct marketing—the delivery of messages via mail, the Internet, and similar routes directly to consumers—is used extensively by healthcare organizations to attract and inform current and prospective patients of health and medical offerings and opportunities. Examples of direct marketing include direct-mail marketing, telemarketing, and Internet marketing, with routes being selected on the basis of their ability to reach desired audiences. The various avenues offered by direct marketing afford options to address most any sought group.

Discussion
Direct marketing is one of the most recognized forms of marketing communication, thanks in large part to its widespread use and direct engagement of consumers. While some applications clearly have the potential to irritate consumers (e.g., junk mail in post boxes, spam in email inboxes), direct marketing can be deployed in manners respectful of recipients and, in such cases, it can prove to be a helpful communications asset. To aid others in understanding this particular conveyance method, this article presents an overview of direct marketing and shares deployment insights and experiences from Willis-Knighton Health System.

Conclusions
Direct marketing provides a useful communications pathway, permitting health and medical institutions to educate and enlighten desired audiences. Given instances of overuse and misuse by organizations, however, great care must be taken to design and deploy direct marketing initiatives inoffensively. If well designed and respectfully implemented, direct marketing affords significant communications utility, earning a valued place in the marketing communications arsenals of healthcare establishments.
Foundational elements of communication in health and medicine: avenues for strengthening the marketing communications mix
Authors: Elrod James K. , Fortenberry John L. 
Published: September 2020

AbstractBackgroundWhen one thinks of opportunities to engage patients, the marketing communications mix often is the first thing that comes to mind. Its five components of advertising, personal selling, sales promotion, public relations, and direct marketing represent tried and true pathways for establishing productive dialogues with customers of healthcare institutions. But in formulating and deploying the marketing communications mix, health and medical establishments must not neglect foundational elements which play vital communicative roles, impacting the perspectives of patients and influencing associated patronage.DiscussionMany things communicate on behalf of healthcare organizations, including the people employed by them, the places in which they deliver services, and the brands that represent them. As foundational elements of communication, these must be addressed prior to formulating the marketing communications mix, as they influence and impact an institution’s entire communicative potential. Their initial development, however, is just the beginning, as these elements must be managed and maintained continually over the course of organizational life. This article profiles foundational elements of communication and discusses their importance in healthcare marketing, generally, and marketing communications, specifically, providing useful insights for maximizing communicative synergies.ConclusionsGiven the importance of engaging current and prospective patients, healthcare establishments must take steps to ensure exceptional prowess in this area, with communicative skills and abilities being of paramount importance. Proficient deployment of the marketing communications mix is essential, but healthcare providers must also be certain to direct attention toward foundational elements, ensuring that given institutions realize their full communicative potential.
Integrated marketing communications: a strategic priority in health and medicine
Authors: Elrod James K. , Fortenberry John L. 
Published: September 2020

Abstract
Background
Healthcare establishments portray themselves to their patient populations using many communicative mechanisms. Perhaps the first avenues that come to mind are the outward conveyances of the marketing communications mix, including advertising, personal selling, sales promotion, public relations, and direct marketing. But other prominent communicators also exist, including the people employed by healthcare institutions, the places in which services are delivered, and the brands that represent given establishments. This wide variety of communicative mechanisms is somewhat of a mixed blessing, affording myriad options, but also necessitating extra care and attention in developing associated marketing communications.

Discussion
Now more than ever, health and medical establishments have at their disposal communications options capable of addressing most any conveyance want or need. The marketing communications mix, once somewhat limited due to industry tradition, is now fully accessible and widely used in the health services industry, providing immense opportunities to connect with patients. Options for signage, building designs, servicescape amenities, employee uniforms, and the like also are teeming, providing myriad avenues for making positive impressions. But burgeoning options while beneficial also intensify obligations for ensuring that marketing communications are properly integrated, with this particular article describing this imperative need and its implications for communicative success in the healthcare industry.

Conclusions
By integrating marketing communications, health and medical providers are able to create synergies between and among selected conveyance mechanisms, amplifying performance and increasing the likelihood of reaching communicative goals. Achieving such cohesion requires devoted planning in an effort to coordinate verbal and visual manifestations to express desired imagery and appeals to target audiences. As extensive benefits are derived from integrated marketing communications, healthcare establishments should consider associated pursuits to be a strategic priority.
The training and support needs of 22 programme directors of community-based childhood obesity interventions based on the EPODE approach: an online survey across programmes in 18 countries
Authors: Slot-Heijs Jorien J. , Collard Dorine C. M. , Pettigrew Simone , Vinck Jan , Edell Dennis , Barriguete Armando , Visscher Tommy L. S. 
Published: September 2020

Abstract
Background
Tackling childhood obesity is complex and requires a community-based approach implemented in multiple environments. It is known from literature that knowledgeable and skilled professionals are essential to implement such an approach successfully. The aim of the present study was to assess the need for training and support among a global network of programme directors implementing a Community-Based Childhood Obesity Intervention (CBCOI) based on the EPODE approach, in order to assist them in optimising the implementation process.

Methods
An online survey was sent to 40 programme directors representing programmes implementing a CBCOI based on the EPODE approach. The survey consisted of statements on a 5-point Likert scale and multiple-choice questions about attitude towards and usefulness of training and support, and preferences for some predefined training types and training topics. In total, 22 programme directors responded to the survey (55% response rate). Data were analysed using descriptive statistics to describe the need for support in order to improve successful implementation.

Results
Respondents strongly agreed that continually updating skills and learning how to make their programmes more effective and sustainable at the start and during the implementation was important. On-site training was preferred most at the commencement of a programme, while a 2-day training course was most valued during implementation. Monitoring, measuring and programme evaluation was identified as the most valuable training topic.

Conclusions
The results indicate a continuing and significant need for support and training among programme directors implementing a CBCOI. The findings give directions regarding topics and types of training and support in order to improve the implementation process.
The trend of caesarean birth rate changes in China after ‘universal two-child policy’ era: a population-based study in 2013–2018
Authors: Yan Jie , Wang Long , Yang Ying , Zhang Ya , Zhang Hongguang , He Yuan , Peng Zuoqi , Wang Yuanyuan , Wang Qiaomei , Shen Haiping , Zhang Yiping , Yan Donghai , Ma Xu , Yang Huixia 
Published: September 2020

Abstract
Background
The universal two-child policy in China which was announced in October 2015 might affect the caesarean birth rate. Few studies reported the caesarean birth rate affected by the policy especially after the universal two-child policy period. This study aimed to demonstrate the caesarean birth rate changes before and after the universal two-child policy and further elaborate the underlying influencing factors.

Methods
This nationwide, retrospective, population-based study was based on National Free Pre-Pregnancy Check-ups Project (NFPCP). Couples planning to conceive in next 6 months were encouraged to participate in NFPCP. Baseline information was collected using a standardized questionnaire with a face-to-face interview, and medical examinations were conducted. Two rounds of follow-up interviews were then conducted by trained nurses to update pregnancy status and outcomes. NFPCP participants who completed deliveries before December 31, 2018, were included in the current study. We used marginal effect of year to examine the trend of caesarean birth rate over time and interrupted time series (ITS) analysis to determine impacts of the universal two-child policy on the trend of caesarean birth rate.

Results
A total of 9,398,045 participants were included in the final analysis. High-risk factors to increase caesarean birth rate were identified. In the current study, the standardized caesarean birth rate declined from 34.1% in 2013 to 31.8% in 2015 and increased to 35.6% in 2018. ITS analysis showed the caesarean birth rate decreased by 0.1% (95% CI 0.1–0.1) per month before the release of universal two-child policy, 1.3% (95% CI 0.6–2.1%) absolute drop during the policy release month, and increased by 0.2% (95% CI 0.1–0.2%) per month after the policy implementation. For the period after the policy release, the increasing trends were observed in rural participants and urban primiparas. The prevalence of caesarean birth rates within China varied regionally.

Conclusions
The decreasing trend of caesarean birth rate was reported after immediate release of the universal two-child policy. An increasing trend of caesarean birth rate was observed 2–3 years after the policy. It reminds us that the caesarean birth rate control is a long-lasting process and all the strategies need to be continually reinforced.