bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inequalities in the utilisation of maternal health Care in Rural India: Evidences from National Family Health Survey III & IV
Authors: Ali Balhasan , Chauhan Shekhar 
Published: March 2020

Abstract
Background
Since the implementation of National Rural Health Mission (NRHM) in 2005, Maternal Mortality Ratio has significantly declined in India through a noticeable improvement in maternal health care services. However, India did not succeed to achieve the target of millennium development goal to reduced maternal mortality ratio by 2015. Also, there is substantial inequality exist at the regional, geographic, economic, and social level, and various socioeconomic factors contribute to the significantly large share in inequality in utilisation of maternal health care in India.

Methods
Using data from the National Family Health Survey (2005 and 2015), this study examined the degree of inequality exist in maternal health care namely full antenatal care (full ANC), skilled attendants at birth (SBA), and postnatal care (PNC) in rural India. Descriptive statistics, concentration index (CI), and Wagstaff decomposition method have been performed to understand the pattern of maternal health care utilisation, and to explain the extent of inequality in maternal health care utilisation.

Results
The study revealed that a substantial gap across socioeconomic groups exist in utilisation of maternal health care has significantly reduced in rural India during 2005–16. The results found a noticeable improvement in maternal health care utilisation, especially in utilisation of skilled attendants at birth (SBA). During this decade, the concentration index for SBA showed a significant decline from 0.28 in 2005–06 to 0.09 in 2015–16, while that of full ANC declined from 0.47 to 0.32 over the same period, and reduction of inequality in full ANC was least. Further, the results of decomposition analysis suggested that secondary and higher education, mass media exposure, and scheduled tribe contributed a significant share to the inequality.

Conclusion
The exposure to mass media is the most significant contributor to inequality, and hence, there is a need for broad dissemination of awareness regarding maternal health care schemes in rural parts of country. Based on findings of study, it is suggested that health scheme related to maternal and child health care under NRHM be continued and focused for lower socioeconomic groups and marginalized mothers to reduce maternal health services inequality, particularly in the component of full ANC.
Associations of self-reported physical activity and anxiety symptoms and status among 7,874 Irish adults across harmonised datasets: a DEDIPAC-study
Authors: Mc Dowell Cillian P. , Carlin Angela , Capranica Laura , Dillon Christina , Harrington Janas M. , Lakerveld Jeroen , Loyen Anne , Ling Fiona Chun Man , Brug Johannes , MacDonncha Ciaran , Herring Matthew P. 
Published: March 2020

Abstract
Background
Anxiety is an adaptive response to an objective or perceived threat; however, when symptoms become severe and chronic it that can become a maladaptive anxiety disorder. Limited evidence suggests that physical activity may be associated with prevention against anxiety. This study uses data from The Irish Longitudinal Study on Ageing (TILDA) and The Mitchelstown Cohort Study to investigate cross-sectional associations between physical activity and anxiety symptoms and status among Irish adults.

Methods
Both datasets were harmonized (n = 7874). The short form International Physical Activity Questionnaire measured physical activity. Participants were classified as meeting World Health Organization physical activity guidelines (≥150 min weekly of moderate intensity physical activity, ≥75 min weekly of vigorous intensity physical activity, or ≥ 600 MET-minutes) or not. They were also divided into three groups based on weekly MET-minutes of moderate-to-vigorous physical activity (Low: 0–599; Moderate: 600–1199; High: ≥1200), and three groups based on weekly minutes of walking (Low: 0–209; Moderate: 210–419; High: 420+). Anxiety symptoms were measured by the Hospital Anxiety and Depression Scale with a score of ≥8 indicating anxiety. Binomial logistic regression, adjusted for relevant confounders examined physical activity–anxiety associations.

Results
Females had higher rates of anxiety than males (28.0% vs 20.0%; p < 0.001). Following adjustment for relevant covariates, meeting physical activity guidelines was associated with 13.5% (95% CI: 2.0–23.7; p = 0.023) lower odds of anxiety. Moderate and High physical activity were associated with 13.5% (− 11.0–32.6; p = 0.254) and 13.6% (1.4–4.2; p = 0.030) lower odds of anxiety compared to Low physical activity, respectively. Moderate and High walking were associated with 2.1% (− 14.5–16.3; p = 0.789) and 5.1% (− 9.3–17.6; p = 0.467) lower odds of anxiety compared to Low walking, respectively.

Conclusion
Meeting physical activity guidelines is associated with lower odds of anxiety, but the strength of associations did not increase considerably with increased physical activity levels.
Impact of sleep problems on daytime function in school life: a cross-sectional study involving Japanese university students
Authors: Kayaba Momoko , Matsushita Toshiko , Enomoto Minori , Kanai Chieko , Katayama Noriko , Inoue Yuichi , Sasai-Sakuma Taeko 
Published: March 2020

Abstract
Background
The aims of this study were 1) to clarify the prevalence of sleep problems (insomnia, insufficient sleep, and delayed sleep-wake phase) among Japanese university students; 2) to examine sociodemographic characteristics, lifestyle, and sleep-related symptoms in each sleep problem; and 3) to evaluate the association between the above-mentioned sleep problems and daytime dysfunction in school life.

Methods
Self-report questionnaire surveys were conducted at eight universities in Japan, and we received 1034 valid answers (78% female). The questionnaire consisted of socio-demographic characteristics, information on lifestyle, sleep pattern, sleep-related symptoms, and daytime dysfunction in school life. Groups with insomnia, behaviorally induced insufficient sleep syndrome (BIISS), delayed sleep-wake phase (DSWP), and BIISS + DSWP were defined. To identify the association between sleep problems and daytime dysfunction in school life, the generalized linear mixed effect model was conducted.

Results
Sleep duration on weekdays was 5.9 ± 1.2 h, and 38.2% of the students had a sleep duration < 6.0 h. About 16% of the students were categorized as evening-type individuals. More than half of the students (56.1%) had excessive daytime sleepiness. Insomnia was associated with tardiness (aOR: 0.8, 95%CI: 0.7–0.9) and falling asleep during class (aOR: 1.6: 95%CI: 1.4–2.0). BIISS was associated with tardiness (aOR: 1.5, 95%CI: 1.1–2.2) and interference with academic achievement (aOR: 1.9, 95%CI: 1.3–2.6). DSWP and BIISS + DSWP were associated with absence (aOR: 3.4, 95%CI: 2.2–5.1 / aOR: 4.2, 95%CI: 3.2–5.6), tardiness (aOR: 2.7, 95%CI: 1.8–4.1 / aOR: 2.2, 95%CI: 1.6–2.8), falling asleep during class (aOR: 2.6, 95%CI: 1.4–4.8 / aOR: 7.6, 95%CI: 3.3–17.2), and interference with academic achievement (aOR: 2.6, 95%CI: 1.7–3.9 / aOR: 2.1, 95%CI: 1.6–2.8).

Conclusions
Students with DSWP and BIISS + DSWP were significantly associated with daytime dysfunction in school life, i.e. absence, tardiness, falling asleep during class and interference with academic achievement. Students displaying BIISS + DSWP were considered to have a relatively more serious condition compared with those with only insomnia, DSWP, or BIISS. It is therefore of utmost importance that university students aim to prevent DSWP and BIISS which were associated with daytime function in school life.
Gender disparities in the education gradient in self-reported health across birth cohorts in China
Authors: Zhu Bowen , Ye Yiwan 
Published: March 2020

Abstract
Background
Variation in the relationship between education and health has been studied intensely over the past few decades. Although there is research on gender disparity and cohort variations in educational effect on health using samples from the U.S. and Europe, research about China’s is limited. Given the specific social changes in China, our study is designed to analyze the gender and cohort patterns in the education-health gradient.

Method
The latent growth-curve modeling was used to analyze the gender and cohort variations in the education gradient in self-rated health among Chinese respondents. The study employed longitudinal and nationally representative data from the Chinese Family Panel Studies from the years 2010 to 2016. Each cohort is specified according to their distinct periods of social change in China. Following the analysis, we used latent growth-curve model to illustrate gender and cohort differences in the age-graded education and health trajectories.

Results
Although Chinese men have reported to have better health than women in general, women reported 1.6 percentage points higher in self-reported health for each additional year of schooling compared to that of men (P < 0.001). The latent growth curve model showed women’s extra education benefits were persistent overtime. Compared to the people born during the “Old China” (1908–1938), the education gradient in self-rated health did not change for cohorts born before 1955 and after 1977, but the education-health gap changed significantly in the 1956–1960 (O.R. = 1.038, P < 0.05), 1967–1976 (O.R. = 1.058, P < 0.001), and 1977–1983 (O.R. = 1.063, P < 0.001) cohorts. There was a gender difference for the cohort variations in the education-health gradient. For women, the education effect in the 1956–1960 (O.R. = 1.063, P < 0.05), 1967–1976 (O.R. = 1.088, P < 0.001) and 1977–1983 (O.R. = 1.102, P < 0.001) cohorts was significantly higher than that of the 1908–1938 cohort. On the contrary, the education-health gradient remained the same across all cohorts for men.

Conclusion
Our study suggests that the education-health gradient varies across cohorts for women, but the size of education effect remains consistent for men across cohorts. The findings support the resource-substitution hypothesis and not the rising-importance hypothesis in China. We discussed the potential influences of the unique, social transformation and educational expansion in China.
Analyzing big tobacco’s global youth marketing strategies and factors influencing smoking initiation by Nigeria youths using the theory of triadic influence
Authors: Isip Ukoabasi , Calvert John 
Published: March 2020

Abstract
Background
Major transnational tobacco companies (TTCs) have identified Nigeria, the seventh most populous country in the world, as a market with a significant revenue potential, given its high youth population and growing gross domestic product (GDP). This research analyses tobacco industry-related strategies and activities targeting youth (aged 15 to 24 years) in Nigeria involving existing, but most importantly, future tobacco users. Nigeria is the focus of this study because the tobacco industry has viewed it as a major emerging market since the 1990s. Successful marketing in Nigeria could provide the industry with a template for similar initiatives in other emerging markets in low- and middle-income countries.

Methods
The research began with a systematic review of secondary literature to determine how the tobacco industry has targeted youth globally and factors contributing to youth smoking initiation. It then used the theory of triadic influence as a heuristic framework to categorize the various factors influencing youth smoking initiation and industry strategies related to increasing tobacco use among youths. Quotations from internal tobacco industry documents were organized into the three streams of the theory of triadic influence: biology/personality, social and cultural/environmental streams. A total of 12 interviews were conducted with 6 policymakers and governmental officials, 2 civil society organization representatives, a high school principal, a journalist and 2 researchers to investigate how the tobacco industry had targeted youth in Nigeria.

Results
The findings indicate that TTCs have actively targeted youth in Nigeria since the 1990s, focusing on changing behaviour through the biology/personality, social and environmental/ cultural streams.

Conclusion
The study suggests that Nigeria implement and vigorously enforce its 2015 National Tobacco Control Bill as well as a package of other measures to prevent tobacco companies targeting youth.
A new simple score of chronic cough: cough evaluation test
Authors: Zhan Wenzhi , Zhang Liting , Jiang Mei , Chen Meihua , Yuan Xiaoling , Sun Jianxin , Xu Pusheng , Wu Feng , Zhang Chunlai , Luo Wei , Chen Xiaomei , Li Hu , Lai Kefang 
Published: March 2020

Abstract
Background
Chronic cough has an important impact on physical, social and psychological aspects. A simple and effective method to assess different aspects of chronic cough severity is required. We aimed to develop a simple, self-completed test, Cough Evaluation Test (CET), to evaluate cough severity and its impact on health.

Method
The items of preliminary CET were generated based on literature review and clinical practice. Items reduction was conducted by modified Delphi method. Patients with chronic cough were recruited to complete CET, Cough Visual Analog Scales (VAS), Mandarin Chinese version of the Leicester Cough Questionnaire (LCQ-MC), and Cough Symptom Score (CSS). Reassessments were performed at 1 week apart before treatment, and after more than 2 weeks treatments. Concurrent validation, internal consistency, repeatability, responsiveness and the minimal important difference (MID) were determined.

Results
CET consists of five items with a 5-point Likert scale (1–5 scaling of items, 5–25 score range). The Cronbach’s alpha values for CET was 0.80. CET showed a stronger correlation with LCQ-MC (r = − 0.74) compared to that between LCQ-MC with VAS (r = − 0.61). CET also showed a stronger correlation with VAS (r = 0.70) compared to that between VAS with other measures. Intraclass correlation coefficients for CET was 0.84. In patients undergoing treatment, CET scores significantly changed (p < 0.0001). The MID of CET was 2.

Conclusion
Cough Evaluate Test is a reliable, valid and responsive tool to simply evaluate impact of cough on physical, social and psychological aspects.
Analysis of by high-throughput sequencing: Helicobacter pylori infection and salivary microbiome
Authors: Ji Yingjie , Liang Xiao , Lu Hong 
Published: March 2020

Abstracts
Background
There have been reports of Helicobacter pylori (H. pylori) in the oral cavity and it has been suggested that the oral cavity may be a reservoir for H. pylori reflux from the stomach. High-throughput sequencing was used to assess the structure and composition of oral microbiota communities in individuals with or without confirmed H. pylori infection.

Methods
Saliva samples were obtained from 34 H. pylori infected and 24 H. pylori uninfected subjects. Bacterial genomic DNA was extracted and examined by sequencing by amplification of the 16S rDNA V3-V4 hypervariable regions followed by bioinformatics analysis. Saliva sampling was repeated from 22 of the 34 H. pylori infected subjects 2 months after H. pylori eradication.

Results
High-quality sequences (2,812,659) clustered into 95,812 operational taxonomic units (OTUs; 97% identity). H. pylori was detected in the oral cavity in infected (12/34), uninfected (11/24) and eradicated (15/22) subjects by technique of high-throughput sequencing, occupying 0.0139% of the total sequences. Alpha diversity of H. pylori infected subjects was similar to that of uninfected subjects (Shannon: 1417.58 vs. 1393.60, p > 0.05, ACE: 1491.22 vs. 1465.97, p > 0.05, Chao 1: 1417.58 vs. 1393.60, p > 0.05, t-test). Eradication treatment decreased salivary bacterial diversity (Shannon, p = 0.015, ACE, p = 0.003, Chao 1, p = 0.002, t-test). Beta diversity analysis based on unweighted UniFrac distances showed that the salivary microbial community structure differed between H. pylori infected and uninfected subjects (PERMANOVAR, pseudo-F: 1.49, p = 0.033), as well as before and after H. pylori eradication (PERMANOVAR, pseudo-F: 3.34, p = 0.001). Using LEfSe analysis, 16 differentially abundant genera were defined between infected and uninfected subjects, 12 of which had a further alteration after successful eradication.

Conclusions
Our study using high-throughput sequencing showed that H. pylori was present commonly in the oral cavity with no clear relation to H. pylori infection of the stomach. Both H. pylori infection and eradication therapy caused alterations in community and structure of the oral microbiota.

Trial registration
clinicaltrials.gov, NCT03730766. Registered 2 Nov 2018 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/ NCT03730766.
A phenomenological study of nurses experience about their palliative approach and their use of mobile palliative care teams in medical and surgical care units in France
Authors: Engberink Agnès Oude , Mailly Maryse , Marco Valerie , Bourrie Daniele , Benezech Jean-Pierre , Chevallier Josyane , Vanderhoeven Sandrine , Crosnier Remy , Bourrel Gérard , Lognos Béatrice 
Published: March 2020

Abstract
Background
Despite a broad consensus and recommendations, numerous international reports or studies have shown the difficulties of implementing palliative care within healthcare services. The objective of this study was to understand the palliative approach of registered nurses in hospital medical and surgical care units and their use of mobile palliative care teams.

Methods
Qualitative study using individual in depth semi-structured interviews and focus group of registered nurses. Data were analyzed using a semiopragmatic phenomenological analysis.
Expert nurses of mobile palliative care team carried out this study. 20 registered nurses from three different hospitals in France agreed to participate.

Results
Nurses recognize their role as being witnesses to the patient’s experience through their constant presence. This is in line with their professional values and gives them an “alert role” that can anticipate a patient-centered palliative approach. The physician’s positioning on palliative care plays a key role in its implementation. The lack of recognition of the individual role of the nurse leads to a questioning of her/his professional values, causing inappropriate behavior and distress.
According to nurses, “rethinking care within a team environment” allows for the anticipation of a patient-centered palliative approach. Mobile Palliative Care Team highlights the major role of physicians-nurses “balance” while providing personal and professional support.

Conclusions
The Physician’s positioning and attitude toward palliative approach sets the tone for its early implementation and determines the behavior of different staff members within healthcare service. “Recognition at work”, specifically “recognition of the individual role of nurse” is an essential concept for understanding what causes the delay in the implementation of a palliative approach. Interprofessional training (physicians and nurses) could optimize sharing expertise. Registered nurses consider MPCT as a “facilitating intermediary” within the healthcare service improving communication. Restoring a balance in sharing care and decision between physicians and other caregivers lead care teams to an anticipated and patient-centered palliative approach according to guidelines.
Clarifying how to deploy the public interest criterion in consent waivers for health data and tissue research
Authors: Schaefer G. Owen , Laurie Graeme , Menon Sumytra , Campbell Alastair V. , Voo Teck Chuan 
Published: March 2020

Abstract
Background
Several jurisdictions, including Singapore, Australia, New Zealand and most recently Ireland, have a public interest or public good criterion for granting waivers of consent in biomedical research using secondary health data or tissue. However, the concept of the public interest is not well defined in this context, which creates difficulties for institutions, institutional review boards (IRBs) and regulators trying to implement the criterion.

Main text
This paper clarifies how the public interest criterion can be defensibly deployed. We first explain the ethical basis for requiring waivers to only be granted to studies meeting the public interest criterion, then explore how further criteria may be set to determine the extent to which a given study can legitimately claim to be in the public interest. We propose an approach that does not attempt to measure magnitude of benefit directly, but rather takes into account metrics that are more straightforward to apply. To ensure consistent and justifiable interpretation, research institutions and IRBs should also incorporate procedural features such as transparency and public engagement in determining which studies satisfy the public interest requirement.

Conclusion
The requirement of public interest for consent waivers in secondary biomedical research should be guided by well-defined criteria for systematic evaluation. Such a criteria and its application need to be periodically subject to intra-committee and intra-institution review, reflection, deliberation and amendment.
Public health nursing education viewed through the lens of superdiversity: a resource for global health
Authors: Dupin Cécile-Marie , Pinon Mélanie , Jaggi Karine , Teixera Celina , Sagne Aurèle , Delicado Noelia 
Published: March 2020

Abstract
Background
Nurses are increasingly confronted with the challenge of globalization and the acceleration of migratory flows. This reality affects the notion of culture and its influence on health-related behaviors. The state of health of the population in the Canton of Geneva, where there is a wide diversity of origins, is characterized by significant differences. The term “superdiversity” is used to describe the increasing complexity in ethnic diversity due to migration and social stratification. Nursing education in Geneva, influenced by the Bologna Process, appears appropriate for superdiverse contexts of care, with the development of dedicated competencies.

Aim
This discussion paper aims to examine the academic curricula implemented in Geneva in the light of the concept of superdiversity.

Main text
In Geneva, nursing education and curricula in public health are based on a competence framework for nursing care divided into 7 roles and educational tracks. Bachelor’s-level nurses know how to assess a care problem quickly and solve it effectively by setting relevant priorities, and do so based on evidence. The curricula aim to teach nurses to design population and individual interventions in their superdiverse context.

Discussion
Education should enable students to develop their role as health promoters for the well-being of patients and communities, taking into account cultural complexity.

Conclusions
Superdiverse contexts highlight the role of nurse educators in preparing future generations of public health nurses.