bluuebunny/crossref_metadata_2025_split huggingface dataset:
Large-scale screening of thalassemia in Ji’an, P.R. China
Authors: Qiu Yu , Mao Liangwei , Chen Shiping , Li Hao , Wang Hairong , Guan Liping , Huang Jin , Wu Xuan , Liu Yu , Xiao Jie , Fang Yuan 
Published: April 2020

Abstract
Background: To evaluate the prevalence of alpha- and beta-thalassemia in Ji'an City, Jiangxi Province, 28,941 people in the region were genetically screened to identify various thalassemia genotypes.

Methods: High-throughput amplicon sequencing and gap-PCR was used to screen 301 thalassemia alleles in 28,941 people in the region. Pregnant women were the focus of this screening, and if a pregnant woman harbored mutations in a thalassemia-inducing gene, her spouse was also genetically tested.

Results: Of the participants, 2,380 people were carriers of thalassemia, with at least one thalassemia allele, including 1,742 alpha-thalassemia carriers, 686 beta-thalassemia carriers and 48 composite alpha- and beta-thalassemia carriers. The total carrying rate of thalassemia in Ji'an was 8.22%, and the carrying rates of alpha- and beta-thalassemia were 6% and 2.37%, respectively. In addition, the first measured carrier rate of composite alpha- and beta-thalassemia in Ji'an was 0.17%. According to the geographical distribution of the 1,742 alpha -thalassemia carriers, the city with the highest carrier rate was Suichuan, followed by Wan’an and Taihe. According to the geographical distribution of the 686 beta-thalassemia carriers, the top three cities with high carrier rates were Suichuan, Wan'an and Xiajiang, sequentially.

Conclusions: This research emphasizes the importance of large-scale population screening and that comprehensive molecular epidemiology data are necessary for the proper prevention and treatment of thalassemia. The epidemiological data updated in this research may enable the local government to focus on the severity of this disease and determine a method for effective resource allocation under limited resource conditions.
Effectiveness of SMS messaging for diarrhoea measurement: a factorial cross-over randomised controlled trial
Authors: Rego Ryan Trevor Titus , Watson Samuel , Ishengoma Philbert , Langat Philemon , Otieno Hezekiah Pireh , Lilford Richard 
Published: April 2020

Abstract
BackgroundText messaging systems are used to collect data on symptom prevalence. Using a text messaging system, we evaluated the effects of question load, question frequency, and financial incentive on response rates and reported infant diarrhoea rates in an infant diarrhoea survey.MethodsWe performed a factorial cross-over randomised controlled trial of an SMS surveying system for infant diarrhoea surveillance with treatments: financial incentive (yes/no), question load (1-question/3-question), and questioning frequency (daily/fortnightly). Participants progressed through all treatment combinations over eight two-week rounds. Data were analysed using multivariable logistic regressions to determine the impacts of the treatments on the response rates and reported diarrhoea rates. Attitudes were explored through qualitative interviews.ResultsFor the 141 participants, the mean response rate was 47%. In terms of percentage point differences (ppd), daily questioning was associated with a lower response rate than fortnightly (-1·2[95%CI:-4·9,2·5]); high (3-question) question loads were associated with a lower response rate than low (1-question) question loads (-7·0[95%CI:-10·8,-3·1]); and financial incentivisation was associated with a higher response rate than no financial incentivisation (6·4[95%CI:2·6,10·2]).The mean two-week diarrhoea rate was 36·4%. Daily questioning was associated with a higher reported diarrhoea rate than fortnightly (29·9[95%CI:22·8,36·9]); with little evidence for impact by incentivisation or question load.ConclusionsClose to half of all participants responded to the SMS survey. Daily questioning evoked a statistically higher rate of reported diarrhoea, while financial incentivisation and low (1-question) question loads evoked higher response rates than no incentive and high (3-question) question loads respectively.Trial RegistrationThe protocol was registered on ISRCTN on the 20th of March 2019 under number ISRCTN11410773.
Motivation Factors Affecting the Job Attitude of Medical Doctors and the Organizational Performance of Public Hospitals in Warsaw, Poland
Authors: Chmielewska Malgorzata , Stokwiszewski Jakub , Filip Justyna , Hermanowski Tomasz 
Published: April 2020

Abstract
Background: This paper explores the relationship between organizational performance of hospitals and selected motivation factors that affect the attitude to work among medical doctors at public hospitals.Methods: This study was based on World Health Organization questionnaires designed to estimate motivation factors and to measure the levels of organizational performance of hospitals in the social aspect. A survey was conducted among physicians (N=249) with either surgical or non-surgical specialty, in 22 departments/units of general public hospitals in Warsaw (Poland).Results: The survey revealed that motivation factors related to “quality and style of supervision” have the greatest impact on the hospital’s organizational performance (Spearman's rank correlation coefficient = 0.490; p<0.001), whereas “performance feedback” was rated the lowest among the surveyed healthcare professionals (54% of physicians). Conclusion: The principles of Individual Performance Review should be incorporated into strategies designed to improve the organizational performance of hospitals (with NHS serving as a role model) in order to establish specific rules on how to share performance feedback among individual physicians. This study makes a research contribution to literature on human resource management in the healthcare sector, highlighting the importance of social aspects in improving organizational performance in a hospital setting.
Measuring Healthcare Services Productivity with Environmental Constraints in China
Authors: Yu Jinna , liu zhen , Zhang Tingting , Hatab Assem Abu , Lan Jing 
Published: April 2020

Abstract
Objectives: A growing literature the efficiency and productivity of health system, however, environmental pollution factors have not been used as undesirable outputs in Chinese research. Considering the amount of medical waste from healthcare services, this paper analyzes the growth and decomposition of Total Factor Productivity (TFP) change in the provision of healthcare services across 31 provinces in China.Methods: We employed the Meta-frontier undesirable super-efficiency slack-based measure (SBM) model and the Global Malmquist-Luenberger (GML) Index to analysis the growth and decomposition of TFP. We used balanced panel data for 2005-2016 covering 31 Provinces in China. The data came from 2006-2017 China Health and Family Planning Statistical Yearbook (which is also called the China Health Statistics Yearbook, depending on the year).Results: The first valley of TFP change appeared in 2009, the second valley of TFP change occurred in 2015. The rate of technological change (TC) shows a slow decline. The rate of efficiency change (EC) is slowly increasing. The average annual growth rate of TFP, EC, TC, and technology gap change (TGC) in eastern China is 1.8%, 2.08%, -0.03%, and -0.77%, respectively. These indicators in the central region are -2.48%, 2.2%, -4%, and -0.01%, respectively. These indicators in western China are 0.72%, 1.73%, -0.45%, and 0.12%, respectively. With the national average being the benchmark, there are 17 provinces and cities whose TFP exceed the average, 16 provinces and cities whose efficiency changes are above average, 9 provinces and cities whose technology change rates exceed the average, and 13 provinces and cities whose changes in the Technology Gap Ratio (TGR) are above average. Conclusions: (1) Considering the entire country, healthcare services’ TFP shows a slow decline, which is due to insufficient technical innovation. However, an increase in technical catch-up can alleviate this trend. (2) The effect of technical catch-up in the eastern, middle, and western regions of China is significant across all three, while the effect of technical innovation was negative. (3) There are differences between province-level TFPs. These findings suggest that, under existing environmental constraints, relevant government departments should improve technical innovation in the supply of healthcare services and medical waste treatment, increase technical efficiency in the factor of healthcare production, strengthen regional health planning, and balance the development of regional healthcare.
Patient feedback to improve quality of care in public hospitals: a systematic review of the evidence
Authors: Wong Eunice , Mavondo Felix , Fisher Jane 
Published: April 2020

Abstract
Objective: To review systematically the published literature relating to interventions informed by patient feedback for improvement to quality of care in hospital settings. Methods: A systematic search was performed in the CINAHL, EMBASE, PsyINFO, MEDLINE, Cochrane Libraries, SCOPUS and Web of Science databases for English-language publications from January 2008 till October 2018 using a combination of MeSH-terms and keywords related to patient feedback, quality of health care, program evaluation and public hospitals. The quality appraisal of the studies was conducted with the MMAT and the review protocol was published on PROSPERO. Narrative synthesis was used for evaluation of the effectiveness of the interventions on patient-centred quality of care. Results: Twenty papers reporting 20 studies met the inclusion criteria, of these, there was one cluster RCT, three before and after studies, four cross-sectional studies and 12 organisational case studies. In the quality appraisal, 11 studies were rated low, five medium and only two of high methodological quality. Two studies could not be appraised because insufficient information was provided. The papers reported on interventions to improve communication with patients, professional practices in continuity of care and care transitions, responsiveness to patients, patient education, the physical hospital environment, use of patient feedback by staff and on quality improvement projects. However, quantitative outcomes were only provided for interventions in the areas of communication, professional practices in continuity of care and care transitions and responsiveness to patients. Multi-component interventions which targeted both individual and organisational levels were more effective than single interventions. Outcome measures reported in the studies were patient experiences across various diverse dimensions including, communication, responsiveness, coordination of and access to care, or patient satisfaction with waiting times, physical environment and staff courtesy. Conclusion: Overall, it was found that there is limited evidence on the effectiveness of interventions, because few have been tested in well-designed trials, very few papers described the theoretical basis on which the intervention had been developed. Further research is needed to understand the choice and mechanism of action of the interventions used to improve patient experience.
Determinants of Customer Satisfaction in the United Arab Emirates Health Care Industry
Authors: Sayani Hameedah , Moonesar Immanuel Azaad , Zakzak Lama , Elsholkamy Mona Mostafa 
Published: April 2020

Abstract
Background: The United Arab Emirates is aiming to provide ‘world-class healthcare’ to its citizens. This study aims to study the association between overall satisfaction and various aspects of health care services in the United Arab Emirates on a country level. Methods: The data was collected from 5,855 respondents on affordability, quality, accessibility, and responsiveness dimensions of health care. Besides frequency tables and descriptive statistics, statistical methods, such as Principal Component Analysis and Multiple Regression were used for dimension reduction and model the association between dependent (overall satisfaction) and independent (affordability, quality, accessibility, and responsiveness) variables. Results: The findings indicated higher levels of satisfaction with quality and accessibility and lower levels of satisfaction with affordability and responsiveness. Recommendations are provided to address the latter two factors. Conclusions: The study identifies issues in health care service provision in the United Arab Emirates and offers recommendations about enhancing affordability and responsiveness.
The Subjective Wellbeing of Healthcare Staff and their Patients
Authors: Vlaev Ivo , Lee Henry A , Dolan Paul , Darzi Ara 
Published: April 2020

Abstract
Subjective wellbeing (SWB) is a broad category of phenomena that includes people’s emotional responses, domain satisfactions (e.g., health or work), and global judgements of life satisfaction. Measures of SWB offer a means to gauge the impact of events in the lives of individuals. This article examines for the first time the ways in which measures of SWB can be used within a healthcare setting, which brings a new perspective to the way that SWB is considered and applied in determining health policy. The research uses methods for SWB data collection developed through innovative empirical work. The study is a cross sectional survey of the adult inpatient population of an NHS hospital and the nurses caring for the patients, which was undertaken at two time points: summer and winter. This work on the SWB of the staff and inpatients of an acute NHS hospital generated new data sets in clinical populations. The SWB of patients was shown to be significantly affected by severe levels of EQ5D states. When considering the data on a ward-by-ward basis, it was shown that nurses health and job satisfaction were important determinants of patient SWB. We discuss the implications of this research and explain how, when and where SWB measures, when used in healthcare, can be used in health policy. We offer a novel perspective that ensures a greater focus is placed on the way that patients experience health interventions when developing health policy.
Systematic Review on the Effect of Training Interventions to Improve the Skills of Health Professionals in Promoting Health Behaviour Change, with Meta-Analysis of Behavioural Outcomes.
Authors: Hatfield Tom G , Withers Thomas Michael , Greaves Colin J 
Published: April 2020

Abstract
Background We aimed to identify, synthesise and evaluate randomised control trial evidence on the effects of healthcare professional training on the delivery quality of health behaviour change interventions and, subsequently, on patient health behaviours.Methods Systematic review with narrative synthesis of effects on delivery quality and meta-analysis of health behaviour outcomes. We searched: Medline, EMBASE, PsychInfo, AMED, CINAHL Plus and the Cochrane Central Register of Control Trials up to March 2019. Studies were included if they were in English and included intervention delivery quality as an outcome. The systematic review was registered on PROSPERO (registration: CRD42019124502).Results Twelve-studies were identified as suitable for inclusion. All studies were judged as being high risk of bias with respect to training quality outcomes. However with respect to behavioural outcomes, only two of the six studies included in the meta-analysis had a high risk and four had some concerns. Educational elements (e.g. presentations) were used in all studies and nine included additional practical learning tasks. In eight studies reporting delivery quality, 54% of healthcare professional communication outcomes and 55% of content delivery outcomes improved in the intervention arm compared to controls. Training that included both educational and practical elements tended to be more effective. Meta-analysis of patient health behavioural outcomes in six-studies found significant improvements (Standardised mean difference (SMD): 0.20, 95% confidence interval: 0.11 to 0.28, P<0.0001, I 2 = 0%). No significant difference was found between short (≤6-months) and long-term (>6-months) outcomes (SMD: 0.25 vs 0.15; P=0.31).Conclusions Delivery quality of health behaviour change interventions appears to improve following training and consequently to improve health behaviours. Future studies should develop more concise /integrated measures of delivery quality and develop optimal methods of training delivery.
Influence of Participation in a Quality Improvement Collaborative on Staff Perceptions of Organizational Sustainability
Authors: II James H Ford , Gilson Aaron 
Published: April 2020

Abstract
Background: Organizational sustainability capacity (SC) – the ability to implement and maintain change – is influenced by internal attributes, environmental contextual influencers, and intervention attributes. Dissemination and implementation research has generally not explored temporal changes in staff SC perceptions, and how quality improvement collaborative (QIC) participation influences those changes. This project addresses the gap, using the British National Health Services sustainability index, to measure staff SC perceptions at four time points (baseline and every 9 months) for participating clinics in the NIATx200 QIC initiative.Methods: Respondent demographic information (Organization ID, Job Function, First Initial, Day of Birth, Employment Status) allowed matching individual survey responses, so all analyses comprise responses from the same staff members (n=908, representing 2,329 total cases) across the evaluation timeframe. A mixed linear model repeated measures analysis fit three separate statistical models to assess potential predictors of SC perceptions: Time (Models I-III); NIATx200 intervention, staff job function, and tenure (Models II &III); and NIATx200 participation hours (Model III).Findings: Model I yielded strong overall predictive significance for Time (F=7.270, p<.0001), with staff perceptions of overall SC increasing throughout most of the study (t 1,4 =-6.74, p<.0001; t 2,4 =-3.100, p<.036; t 3,4 =-0.23, p=ns). Model II did not change the overall Time effect from Model I, but the assigned NIATx200 intervention – combined services, (t=-3.28, p=.026), staff job function and organizational administrators, (t=-3.50, p=.001) became significantly associated with greater perceptions of SC. The addition of participation levels in Model III demonstrated the importance of a higher participation dose (t=-3.73, p<.0001) on staff perceptions about overall SC.Implications for D&I Research: Although there was minimal staff exposure to sustainability principals within NIATx200, staff perceptions about their organization’s SC significantly differed over time. However, an organization’s participation level in a QIC became the principal predictor of staff SC perceptions, regardless of other factors. Given these findings, it is possible to develop and introduce specific sustainability content within the structure of a QIC to assess the impact on staff SC perceptions over time and the sustainment of organizational change.Trial Registration: ClinicalTrials.gov, NCT00934141 Registered July 6, 2009. Retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT00934141
Implementing oncology clinical trials in Nigeria: A model for Capacity building.
Authors: Ntekim Atara , Ibraheem Abiola , Sofoluwe Adenike , Adepoju Toyosi , Oluwasanu Mojisola , Aniagwu Toyin , Awolude Olutosin , Balogun Williams , Kotila Olayinka , Adejumo Prisca , Babalola Chinedum Peace , Arinola Ganiyu , Ojengbede Oladosu , Olopade Christopher O , Olopade Olufunmilayo I 
Published: April 2020

Abstract
Background: There is both higher mortality and morbidity from cancer in low and medium income countries (LMICs) compared with high income countries (HICs). Clinical trial activities and development of more effective and less toxic therapies have led to significant improvements in morbidity and mortality from cancer in HICs. Unfortunately, clinical trials remain low in LMICs due to poor infrastructure and paucity of experienced personnel to execute clinical trials. There is an urgent need to build local capacity for evidence based treatment for cancer patients in LMICs. Methods: We conducted a survey at facilities in four Teaching Hospitals in South West Nigeria using a checklist of information on various aspects of clinical trial activities. The gaps identified were addressed using resources sourced in partnership with investigators at HIC institutions. Results: Deficits in infrastructure were in areas of patient care such as availability of oncology pharmacists, standard laboratories and diagnostic facilities, clinical equipment maintenance and regular calibrations, trained personnel for clinical trial activities, investigational products handling and disposals and lack of standard operating procedures for clinical activities. Interventions were instituted to address the observed deficits in all four sites which are now well positioned to undertake clinical trials in oncology. Training on all aspects of clinical trial was also provided.Conclusions: Partnerships with institutions in HICs can successfully identify, address and improve deficits in infrastructure for clinical trial in LMICs. The HICs should lead in providing funds, mentorship and training for LMIC institutions to improve and expand clinical trials in LMIC countries.
Elevated vitreous Lipocalin-2 levels of patients with proliferative diabetic retinopathy
Authors: Wang Hui , Lou Hui , Li Yongrong , Ji Fengtao , Chen Wei , Lu Qianyi , Xu Guoxu 
Published: April 2020

Abstract
Background Lipocalin-2 (LCN2) is a novel adipokine with potential roles in obesity, insulin resistance, and inflammation. This study aims to assess the concentrations of LCN2 and vascular endothelial growth factor (VEGF) expressed in the vitreous humors of patients with proliferative diabetic retinopathy (PDR). Methods The concentrations of LCN2 and VEGF were measured from the vitreous of 67 patients undergoing vitrectomy (20 controls and 47PDR) via enzyme-linked immunosorbent assay (ELISA). Results The vitreous concentration of LCN2 was statistically significantly higher in the PDR group compared to the control group (63,522 ± 30,009 pg/ml versus 1663 ± 1191 pg/ml, respectively; P<0.001). VEGF level was also significantly higher in the PDR group than in the control group (1038 ± 1326 pg/ml versus 9 pg/ml, respectively; P<0.001). The mean vitreous LCN2 and VEGF levels in active PDR patients were significantly higher than that of the inactive PDR patients. The mean LCN2 concentration in vitreous humor was significantly lower in the 28 PDR patients with a history of complete PRP (37,304 ± 16,651 pg/mL) in comparison with 19 PDR patients without preperformed panretinal photocoagulation or with preperformed incomplete panretinal photocoagulation (79,796 ± 24,391 pg/mL). A significant correlation between the vitreous LCN2 level and VEGF level was found in patients with PDR (R=0.34; P=0.019). Conclusions This report shows a significant increase of LCN2 in the vitreous fluid of patients with PDR and present a significant correlation between LCN2 and VEGF, suggesting LCN2 might be involved in the pathogenesis of PDR.