bluuebunny/crossref_metadata_2025_split huggingface dataset:
Targeting vulnerable groups of health poverty alleviation in rural China— what is the role of the New Rural Cooperative Medical Scheme for the elderly population?
Authors: Wang Nianshi , Li Ye , Ma Meiyan , Jiao Mingli , Wu Qunhong , Hao Yanhua , Shan LingHan , Gao Lijun , Tian Wanxin , Liu Limin , Xia Qi 
Published: March 2020

Abstract
BACKGROUND : Based on the health poverty alleviation policy, we explored whether the New Rural Cooperative Medical System (NRCMS) had effectively reduced the economic burden of the rural elderly population and impoverished vulnerable groups with regard to medical expenses, providing further evidence for increasing the medical insurance system. METHODS: Data were obtained from the 2015 China Health and Retirement Longitudinal Study. The method was adapted from WHO to calculate the catastrophic health expenditure (CHE) and impoverishment by medical expense (IME). The treatment effect model was used to identify the determinants of CHE in the rural elderly residents. RESULTS: The incidence of CHE in rural China for the elderly is 19.65%, and the impoverishment by medical expense has reached 6.94%. The households enrolled in NRCMS suffered higher CHE (21.9%) and IME (8.0%), than unenrolled households (20.6%, 7.7%). The NRCMS did not provide sufficient economic protection from CHE for households with 3 chronic diseases, inpatients, or adults over 65, Risk factors for CHE included education levels, households with inpatients, people over 65 years old, disabilities, and so on. CONCLUSIONS: Although the NRCMS had reduced barriers to the use of household health services while reducing their out of pocket payments, in some respects, it was still not effective to reduce the risk of residents falling into poverty. Our research identifies the characteristics of vulnerable groups that the NRCMS does not provide enough support for, and are at risk of falling into poverty through health impoverishment.
Patient and nurse perspectives of a nurse-led community-based model of HIV care delivery in Malawi: a qualitative study
Authors: Sande Odala , Burtscher Doris , Kathumba Daneck , Tweya Hannock , Phiri Sam , Gugsa Salem 
Published: March 2020

Abstract
Background Differentiated models of care (DMOC) are used to make antiretroviral therapy (ART) accessible to people living with HIV (PLHIV). In Malawi, Lighthouse Trust has piloted various DMOCs aimed at providing quality care while reducing personal and logistical barriers when accessing clinic-based healthcare. One of the approaches was community-based provision of ART by nurses to stable patients. Methods To explore how the nurse-led community ART programme (NCAP) is perceived, we interviewed eighteen purposively selected patients receiving ART through NCAP and the four nurses providing the community-based health care. Information obtained from them was complemented with observations by the study team. Interviews were recorded and transcribed. Data was analysed using manual coding and thematic analysis. Results Through the NCAP, patients were able to save money on transportation and the time it took them to travel to a health facility. Caseloads and waiting times were also reduced, which made patients more comfortable and gave nurses the time to conduct thorough consultations. Closer relationships were built between patients and care providers, creating a space for more open conversations (although this required care providers to set clear boundaries and stick to schedule). Patients’ nutritional needs and concerns related to stigma remain a concern, while operational issues affect the quality of the services provided in the community. Considerations for community-led healthcare programmes include the provision of transportation for care providers; the physical structure of community sites (in regard to private spaces); the timely consolidation of data collected in the field to a central database; and the need for care providers to cover multiple facility-based staff roles. Conclusions The patients interviewed in this study preferred the NCAP approach to the facility-based model of care because it saved them money on transport, reduced waiting-times, and allowed for a more thorough consultation, while continuing to provide quality HIV care. However, when considering a community-level DMOC approach, certain factors – including staff transportation and workload – must be taken into consideration and purposefully planned.
Effect of a free healthy school meal on fruit, vegetables and unhealthy snacks intake in Norwegian 10- to 12-year-old children
Authors: Vik Frøydis Nordgård , Heslien Kaia Elisabeth Paulsen , Lippevelde Wendy Van , Øverby Nina Cecilie 
Published: March 2020

Abstract
Background Norwegian children have a lower intake of fruit, vegetables, and a higher intake of unhealthy snacks compared to dietary guidelines. Such dietary inadequacies may be detrimental for their current and future health. Schools are favorable settings to establish healthy eating practices. Still, no school meal arrangement is provided in Norway, and most children typically bring packed lunches from home. The aim of this study was to investigate whether serving a free healthy school meal for one year resulted in a higher intake of fruit and vegetables and a lower intake of unhealthy snacks in total among 10-12-year-olds in Norway.Methods The School Meal Project in Southern Norway was a non-randomized trial in two elementary schools in rural areas in the school year 2014/2015. The study sample consisted of 10- to 12-year-old children; an intervention group (N=55) and a control group (N=109) resulting in a total of 164 school children at baseline. A food frequency questionnaire was completed by the children at baseline, at five months follow-up and after one year to assess fruit, vegetable and snacks intake. Multiple linear regression analyses were performed to assess intervention effects on overall intake of fruit and vegetables and unhealthy snacks.Results Serving of a free healthy school meal for one year resulted in a higher weekly intake of vegetables on sandwiches in the intervention group compared to the control group, adjusted for baseline intake (B: 1.11 (95% CI: .38, 1.85)) at the end of the intervention. No other significant intervention effects were found for the remaining fruit and vegetables measures. Serving of a free healthy school meal did not result in a lower weekly intake of unhealthy snacks (i.e. potato chips, candy and sugar sweetened beverages) in the intervention group compared to the control group.Conclusions A free healthy school meal resulted in a higher weekly intake of vegetables on sandwiches but did not significantly change any other investigated dietary behaviors. However, given the inadequate intake of vegetables among children and that even moderate improvements have public health relevance, a free healthy school meal for all school children could be beneficial.
Dose-response association of sleep quality with anxiety symptoms in Chinese rural population: the Henan Rural Cohort
Authors: Shen Jiali , Zhang Haiqing , Wang Yan , Abdulai Tanko , Niu Miaomiao , Luo Zhicheng , Wang Yikang , Li Ruiying , Wang Fang , Wang Chongjian , zhenxing Mao 
Published: March 2020

Abstract
Objectives The epidemiological evidence on the effect of sleep quality on anxiety symptoms has been inconclusive. This study aimed at exploring the relationship between sleep quality and anxiety symptoms in rural China and further validating the association utilizing a meta-analysis.Methods A total of 27,911 participants aged 18–79 years from the Henan Rural Cohort Study completed assessments of sleep quality. Logistic regression and restricted cubic spline analysis was conducted to evaluate the sleep quality with anxiety symptoms. A meta-analysis was used to validate the result of the cross-sectional study.Results Altogether, 6087(21.80%) were poor sleepers and 1557(5.58%) had anxiety symptoms. The odds of anxiety were increased with increment of Pittsburgh Sleep Quality Index (PSQI) score after fitting restricted cubic splines. And the poor sleep qualitywas associated with a higher possibility of anxiety symptoms OR(95%CI) (4.61, 3.71-5.73) in men, and (3.56, 3.10-4.10) in women on multivariable analysis. Further stratified analyses showed that the effect of sleep quality and anxiety symptoms could be modified by age, marital status, lifestyle and chronic disease. The meta-analysis showed that pooled OR of anxiety symptoms was significantly higher for poor sleepers (1.49, 1.41-1.56, I 2 =98.9%, P <0.001).Conclusions These findings indicate that poor sleep quality was associated with increased odds of anxiety symptoms. In addition, relationship between poor sleep quality and anxiety symptoms was observed in this rural population, especially in participants aged ≥60 years and those with unhealthy habits or had a chronic disease.
Introducing a health, nutrition and sanitation program within microfinance groups: a systems-level mixed methods analysis from rural India
Authors: Irani Laili , Schooley Janine , . Supriya , Chaudhuri Indrajit 
Published: March 2020

Abstract
Background: Bihar has been lagging behind Indian national averages in maternal, neonatal and child health development indicators, primarily due to lack of knowledge on healthy lifesaving practices and where to seek services. Hence, a successful pilot project was scaled up as the JEEViKA Technical Support Program (JTSP), to support the state rural livelihood mission, JEEViKA, to increase demand for and link rural families to existing health, nutrition and sanitation (HNS) services. Program activities were geared in reaching those engaged in JEEViKA’s microfinance-based self-help groups (SHGs). This paper presents the results of the output evaluation following 18 months of program implementation. Methods: A mixed-methods study was conducted from August-November 2017. Sixty-five in-depth interviews were conducted with program, state, district and block-level officials. Quantitative surveys (678) were carried out among lower level staff, including village-based community mobilizers (CMs) who convene SHG meetings and support SHG-related activities.Results: JEEViKA layered HNS onto its existing system. The block health, nutrition and sanitation integrator (BHNSI) was introduced within JEEViKA to support the layering of HNS work at the block level. CMs were being trained on HNS topics to be shared during SHG meetings. JEEViKA funded the trainings and paid additional remuneration to trained CMs. HNS indicators were routinely collected by CMs and data were analyzed and used across JEEViKA. JEEViKA was supporting new mechanisms for SHG families to procure food while linking them to existing health and nutrition schemes and services. CMs with HNS trainings were more likely to have higher levels of knowledge on HNS topics and were more likely to carry out HNS-related activities, such as interacting with BHNSI for guidance and support, collecting HNS data routinely and spending time weekly on HNS activities. Conclusions: There is greater awareness within JEEViKA on the importance of addressing HNS issues to assist families in reducing economic shocks from health emergencies, improve nutrition and raise families out of poverty. Stronger integration of HNS programming within JEEViKA will be possible through the presence of decentralized staff to solely support these activities and a closer examination of the CMs’ time to integrate HNS activities more coherently.
Are we equipped with serving the right care? Implications for program responses regarding gender-based violence
Authors: Tin Khaing Nwe , Oung Myitzu Tin , Yin Su Su , Htet Kyaw Ko Ko , Hein Kyaw Thu , Einda Hla Mya Thway , Than Kyu Kyu 
Published: March 2020

Abstract
Background Globally, 35% of women have experienced gender-based violence (GBV) which seriously affects all aspects of women’s health. While health sector must play a key role in response, there are many barriers for GBV survivors to access health services, especially in developing countries including Myanmar. Limitations of health sector in provision of quality services to GBV survivors, healthcare providers’ knowledge, attitude, experience and service availability and readiness, should be explored as an initial step for the improvement of health care response to GBV survivors. Methods This study was a cross-sectional descriptive study conducted in four purposively selected townships with higher number GBV cases. Face-to-face interviews were done to all health care providers (n=233) from public health facilities using a structured questionnaire. The findings were described as frequency and percentage for categorical data and mean and standard deviation for continuous data. Results Lady Health Visitors and Midwives were mainly involved (88.0%). About two-thirds had heard GBV without probing. Types of violence they mostly described were physical (81.1%) and sexual violence (8.5%). One-third wanted women to be patient to their partners’ violence to maintain family ties. Nearly two-third assumed conflict between husband and wife was not a matter that someone should involve. About 70% had given care to GBV survivors and they provided only injury treatment (76.1%). A quarter of them experienced sexual violence cases, but only 4.9% and 1.2% provided emergency contraception and Sexually Transmitted Infection treatment. Although nearly two third mentioned about psychological counseling in GBV management, 20% provided counseling services to survivors. Absence of standard GBV management guideline, trained and skilled staff for GBV and counseling room at health facilities were issues mostly stated by the respondents. Conclusions Inadequate knowledge, misconceptions and unfavorable attitudes of GBV among health care providers might deter the effectiveness of GBV management at the health sector. In addition, poor management practice together with no standard management guideline, limited skilled staff, inadequate drug supplies and absence of counseling facilities indicated insufficient readiness to provide quality health care responses to GBV surviours in Myanmar.
Recognition and Stigma of Prescription Drug Abuse Disorder: Personal and Community Determinants
Authors: Shupp Robert , Loveridge Scott , Skidmore Mark , Green Brandn , Albrecht Don 
Published: March 2020

Abstract
Background: Prescription drug abuse (PDA) disorders continue to contribute to the current American opioid crisis. Within this context, our study seeks to improve understanding about stigma associated with, and symptom recognition of, prescription drug abuse. Aims: Model the stigma and symptom recognition of PDA in the general population.Methods: A randomized, nation-wide, online, vignette-focused survey of the general public (N = 631) was implemented with an oversample for rural counties. Logit estimation was used for analysis, with regional and county-level sociodemographic variables as controls. Results: Individual respondents that self-identify as having or having had “a prescription drug abuse issue” were less likely to correctly identify the condition and were 4 times more likely to exhibit stigma. Males were approximately half as likely to correctly identify PDA as females while older (55+) were more likely to correctly identify PDA, relative to those aged 35-54. Being both male and younger was associated with slightly more stigma, in that they were less likely to disagree with the stigma statement. Conclusions: In light of the continued risks that individuals with PDA behaviors face in potentially transitioning to illicit opioid use, the findings of this survey suggested a continued need for public education and outreach. Of particular note is the perspective of those who have self-identified with the condition, as this population faces the largest risks of adverse health outcomes from illicit drug use within the survey respondents.
Lung cancer awareness and palliative care interventions implemented in Africa: A systematic scoping review’
Authors: Nwagbara Ugochinyere Ijeoma , Ginindza Themba G , Hlongwana Khumbulani W 
Published: March 2020

Abstract
Background: Lung cancer is the most common cancer and cause of cancer-related deaths, responsible for nearly one in five deaths across the globe. In low and middle-income countries (LMICs), lung cancer is often diagnosed at a late stage due to poor public knowledge and awareness of the signs and symptoms of lung cancer. It is believed that increasing the awareness about lung cancer is key to reducing the diagnosis and treatment delays. Early implementation of palliative care has also been reported to improve a patient’s quality of life, symptom burden, and even survival. The aim of this paper was to map evidence on lung cancer awareness and palliative care interventions implemented in Africa.Methods: A scoping review was performed following the method of Arksey and O’Malley. Systematic searches were performed using EBSCOhost platform. A keyword search from the following electronic databases were conducted: PubMed/MEDLINE, Google Scholar, Science Direct, World Health Organization (WHO) library, and grey literature. The screening was guided by the inclusion and exclusion criteria. The quality of the included studies was determined by Mixed Method Appraisal Tool (MMAT). A thematic content analysis was used to present the narrative account of the reviews, and NVivo version 11 was employed to extract themes from all included studies.Results: A total of 2886 articles were screened, and 236 met the eligibility criteria. Furthermore, 167 articles were also excluded following abstract screening. Sixty-nine (69) articles were selected for full-article screening by two researchers with 9 being selected for independent detailed data extraction for this synthesis. These studies were also subjected to methodological quality assessment. Of the nine included studies, eight studies described at least one lung cancer warning signs and symptoms, while one study described the effectiveness of palliative care for lung cancer. Eight articles recognized the level of lung cancer knowledge, risk factors and awareness of warning signs and symptoms in LMICs, mostly Africa and Asia.Conclusions: Most of the participants were aware of tobacco use as a risk factor for lung cancer, but the majority still had limited knowledge on the other pre-disposing risk factors. There is limited evidence on the palliative treatment of symptoms, and majority of patients continued to suffer from uncontrolled symptoms and unmet needs. Therefore, the urgent need for timely access to palliative care to be introduced from diagnosis to end of life to improve the quality of life of the lung cancer patients and their families.
The association of family structure with health behavior, mental health, and perceived academic achievement among adolescents: A 2018 Korean nationally representative survey
Authors: Lee Kang-Sook , Park Hanul 
Published: March 2020

Abstract
Background Adolescence is a period during which physical, social, and mental abilities are rapidly developed, and during this time the family environment plays an important role. Differences in health behaviors, mental health, and academic achievement by family structure may affect future families, income, and employment. The purpose of the study was to investigate the association of family structure with health behaviors, mental health, and academic achievement in Korean adolescents. Method Data from the 2018 Korean Youth Risk Behavior Web-based Survey were analyzed. The study sample was comprised of 59,096 adolescents. Logistic regression, t-tests, and a variance analysis of a complex sample general linear model were used to examine the association of family structure with health behaviors, mental health, and academic achievement. The significance level was set at P < 0.05.Results Non-intact families (single-mother families, single-father families, and restructured families) had higher odds ratios of health behaviors such as smoking, drinking, Internet use, physical activity, and sexual experience, and mental health issues such as depression, suicidal ideation, perceived stress, and poor perceived health status than intact families (two-parent families). Also, non-intact families were significantly related to low perceived academic achievement compared to intact ones.Conclusion This study showed that family structure is a significant factor in adolescent health behavior, mental health, and perceived academic achievement. Adolescents who experience a transition in their family structure may be more vulnerable to health risks and exhibit lower academic achievement than those in an intact family.
Knowledge, Attitude and Practice of Mothers on Prevention and Control of Intestinal Parasitic Infection in Sekota Town, Wag-Himra Zone, Ethiopia
Authors: Kassaw Mesfin Wudu , Abebe Ayele Mamo , Abate Biruk Beletew , Zemariam Alemu Birara , Kassie Ayelign Mengesha 
Published: March 2020

Abstract
Background: Intestinal parasites were a major public health problem in many developing countries. It accounts for 1.5 billion infections with one or more causative agents. The national prevalence of helminthiasis in Ethiopia was 29.8% with considerable variability across the different regions. Young children had a high infection rate and suffered with a substantial worm burden of A. lumbricoides, trichuris trichiura and schistosomes . Parasitic infection has also serious consequences on human health, such as hepatomegaly, bleeding, esophageal varices, delay in physical development. It also decreases the immunity system, level of intelligence, and labor productivity. Therefore, this study was intended to assess mothers’ knowledge, attitude and practice on prevention and control of intestinal parasitic infection among their preschool children in Sekota town, Waghimra zone, Ethiopia Methods: A cross sectional study was carried out on 378 mothers who had under six years but over two years old children. Although, 384 mothers were selected using sample size calculation in the year 2019, the data was collected from 378 mother-child pairs. A face to face interview was performed using pretested and structured questionnaire in the urban villages, Sekota town. The level of maternal knowledge, attitude and practice were presented in percentage, frequence and table. In each step standard operational procedures were followed. Results: The overall level of good knowledge or knoledgable, positive attitude and good practice of mothers towards intestinal parasites prevention and control in considering their preschool children in Sekota town was 45.2%, 55.3% and 51.1% respectively. Seventy-seven 77(20.4%) respondents reported that they knew Ascaris Lumbricoids , 62 (16.4%) participants wash vegetables as a means of intestinal prevention, and 252 (66.7%) of participants stated that their children had at least one stool examination previously. Conclusions: The overall level of optimum knowledge, attitude and practice of mothers on prevention and control of intestinal parasites is low. In particular, the level of optimal knowledge is very low in this study. According to the median parameter, 50% and above of mothers had both positive attitude and good practice. But mothers who were knowledgeable placed below 50%. Therefore, community awareness about parasitic infestation would be created.