bluuebunny/crossref_metadata_2025_split huggingface dataset:
Barriers and facilitators to dissemination and adoption of precision medicine among Hispanics/Latinos
Authors: Canedo Juan R. , Wilkins Consuelo H. , Senft Nicole , Romero Araceli , Bonnet Kemberlee , Schlundt David 
Published: May 2020

Abstract
Background
With the rapid advances in gene technologies in recent years, the potential benefits of precision medicine (PM) may spread unevenly to disadvantaged populations, such as Hispanics/Latinos.
The objective of this study was to explore patient-level barriers and facilitators to dissemination and adoption of PM among Hispanics/Latinos, including knowledge and awareness.

Methods
Self-identified Hispanics/Latinos from diverse countries in Latin America (N = 41) participated in the study. Using a cross-sectional observational qualitative research design, six focus groups and a demographic questionnaire were collected in English and Spanish. Qualitative content analysis was utilized to code the transcripts and identify emerging themes.

Results
Hispanics/Latinos never heard of and had no knowledge about PM. Barriers to dissemination and adoption of PM included lack of health insurance, financial burden, participants’ immigration status, distrust of government, limited English proficiency, low literacy levels, cultural norms, fear about genetic testing results, lack of transportation, newness of PM, and lack of information about PM. Facilitators included family support; information provided in Spanish; use of plain language and graphics; assistance programs for uninsured; trust in physicians, healthcare staff, well-known hospitals, academic institutions, and health care providers and community organization as sources of reliable information; personal motivation, and altruism or societal benefit.

Conclusions
Culturally-and linguistically-tailored, low-literacy educational material about PM should be created in English and Spanish. Future research should examine provider-level and system-level barriers and facilitators to implementation and adoption of PM among Hispanic/Latino patients.
Correlates of appropriate disposal of children’s stools in Malawi: a multilevel analysis
Authors: Nkoka Owen 
Published: May 2020

Abstract
Background
Management of children’s stools is an important aspect of achieving open defecation free communities and reduction of diarrhea. However, information regarding individual- and community- level factors associated with safe child stool disposal in Malawi is limited. The current study aimed to assess the prevalence of safe child stool disposal and the associated individual- and community- level factors in Malawi.

Methods
The cross-sectional study used data from the 2015–16 Malawi Demographic Health Survey in which 6326 children aged under 2 years, nested within 850 communities, were analyzed. Individual- and community- level factors were tested for association with safe child stool disposal practice using multilevel logistic regression models.

Results
Results revealed that 85.6% of the women reported to have safely disposed of their children’s stools. Women from households with improved sanitation had 36.0% greater odds of safely disposing of their children’s stools compared with those from households with unimproved sanitation [(adjusted odds ratio (aOR): 1.36; 95% confidence interval (CI): 1.12–1.65). Further, women from communities with a middle (aOR: 1.62; 95% CI: 1.18–2.21) and high (aOR: 1.45; 95% CI: 1.14–1.84) percentage of educated women were more likely to have their children’s stools safely disposed of than those from communities with a low percentage of educated women. Children’s age, media exposure, and region were significantly associated with safe stool disposal.

Conclusion
Both Individual- and community-level factors were revealed to be important factors for child stool disposal. Public health strategies designed to promote sanitation/safe child stools disposal need to conduct thorough community assessments to identify community-specific needs/barriers. Additionally, public health practitioners should take into consideration the geographical and wealth inequalities when designing programs aimed to improve safe child stood disposal.
Epidemic of chronic diseases and the related healthy lifestyle interventions in rural areas of Shandong Province, China
Authors: Lyu Juncheng , Zhang Wen , Li Wei , Wang Suzhen , Zhang Jie 
Published: May 2020

Abstract
Background
There were amounts of previous studies on chronic diseases, but few studies on the prevalence of chronic disease and the healthy lifestyle intervention in recent years, China. This study aimed to investigate the prevalence of chronic disease and the implementation of healthy lifestyle intervention in rural areas of China, so as to put forward health promotion measures to control the chronic diseases effectively.

Method
A large cross-sectional study (N = 2168) on community diagnosis and chronic disease was carried out in Shandong province, China. The chronic disease questionnaire and the healthy lifestyle intervention questionnaires were recruited to survey the chronic diseases and the implementation of healthy lifestyle intervention. Physical examination and biochemical indicators examination were carried out by the medical staffs and clinical laboratory.

Results
The current diagnosed prevalence of hypertension, diabetes, hyperlipidemia for total sample, female, male were 24.97, 24.6, 25.5, 7.60, 8.9, 6.0 and 40.27%, 45.9, 33.3% respectively in rural China. The one-year prevalence of myocardial infarction (MI) and stroke of the total sample, female, male were 1.06, 1.0, 1.1 and 2.09%, 2.2, 2.0% respectively.
Healthy lifestyles interventions were not effective in rural China. The current active smoking rate and passive smoking rate were 25.68 and 42.65%. 27.86% of the population drunk alcohol within a month and 47.01% of them participated in the actions to control salt daily intake. Only 1.07 and 7.89% of the population participated in medium to high intensity physical exercises.

Conclusions
The prevalence of common chronic diseases were still high and the implementation of healthy lifestyle intervention were not optimal in rural area, China. Challenges to prevent chronic diseases were still severe, so medical institutes, government and individuals would put forward effective strategies to reduce the prevalence and public health promotion project should be effectively strengthened.
A systematic literature review of existing conceptualisation and measurement of mental health literacy in adolescent research: current challenges and inconsistencies
Authors: Mansfield Rosie , Patalay Praveetha , Humphrey Neil 
Published: May 2020

Abstract
Background
With an increased political interest in school-based mental health education, the dominant understanding and measurement of mental health literacy (MHL) in adolescent research should be critically appraised. This systematic literature review aimed to investigate the conceptualisation and measurement of MHL in adolescent research and the extent of methodological homogeneity in the field for meta-analyses.

Methods
Databases (PsycINFO, EMBASE, MEDLINE, ASSIA and ERIC) and grey literature were searched (1997–2017). Included articles used the term ‘mental health literacy’ and presented self-report data for at least one MHL domain with an adolescent sample (10–19 years). Definitions, methodological and contextual data were extracted and synthesised.

Results
Ninety-one articles were identified. There was evidence of conceptual confusion, methodological inconsistency and a lack of measures developed and psychometrically tested with adolescents. The most commonly assessed domains were mental illness stigma and help-seeking beliefs; however, frequency of assessment varied by definition usage and study design. Recognition and knowledge of mental illnesses were assessed more frequently than help-seeking knowledge. A mental-ill health approach continues to dominate the field, with few articles assessing knowledge of mental health promotion.

Conclusions
MHL research with adolescent samples is increasing. Results suggest that a better understanding of what MHL means for this population is needed in order to develop reliable, valid and feasible adolescent measures, and explore mechanisms for change in improving adolescent mental health. We recommend a move away from ‘mental disorder literacy’ and towards critical ‘mental health literacy’. Future MHL research should apply integrated, culturally sensitive models of health literacy that account for life stage and acknowledge the interaction between individuals’ ability and social and contextual demands.
Smoking is associated with pneumonia development in lung cancer patients
Authors: Heo Jung Won , Yeo Chang Dong , Park Chan Kwon , Kim Sung Kyoung , Kim Ju Sang , Kim Jin Woo , Kim Seung Joon , Lee Sang Haak , Kang Hye Seon 
Published: May 2020

Abstract
Background
Various host factors can promote pneumonia susceptibility of lung cancer patients. However, data about risk factors for pneumonia in lung cancer patients receiving active treatments such as chemotherapy, radiotherapy, and surgical intervention are limited. Thus, the purpose of this study was to identify risk factors for pneumonia development in lung cancer patients.

Methods
The present study used a lung cancer cohort of the Catholic Medical Center at the Catholic University of Korea from January 2015 to December 2018. Pneumonia was defined by the presence of a new or progressive infiltration on chest imaging together with any of the following: new onset purulent sputum, change in character of chronic sputum, and fever. We ruled out noninfectious infiltration such as drug or radiation toxicity and hydrostatic pulmonary edema. We especially excluded those if computed tomography revealed sharp demarcation consolidation or ground glass opacity limited radiation field.

Results
A total of 413 patients were enrolled in this study. Pneumonia occurred in 118 (28.6%) patients. The pneumonia group had significantly worse overall survival (OS) than the non-pneumonia group (456.7 ± 35.0 days vs. 813.4 ± 36.1 days, log rank p < 0.001). In patients with pneumonia, OS was shorter in ex-smokers and current smokers than in never smokers (592.0 ± 101.0 days vs. 737.0 ± 102.8 days vs. 1357.0 days, log rank p < 0.001). Age (hazard ratio [HR]: 1.046; 95% confidence interval [CI]: 1.019–1.074; p = 0.001), clinical stage IV (HR: 1.759; 95% CI: 1.004–3.083; p = 0.048), neutropenia (HR: 2.620; 95% CI: 1.562–4.396; p < 0.001], and smoking (HR: 2.040; 95% CI: 1.100–3.784; p = 0.024) were independent risk factors of pneumonia development in lung cancer patients in multivariate analysis. In subgroup analysis for patients treated with chemotherapy, age (HR: 1.043; 95% CI: 1.012–1.074; p = 0.006), neutropenia (HR: 3.199; 95% CI: 1.826–5.605; p < 0.001), and smoking (HR: 2.125; 95% CI: 1.071–4.216; p = 0.031) were independent risk factors of pneumonia development.

Conclusions
Smoking and neutropenia were risk factors affecting pneumonia development in the total group and subgroup of patients with lung cancer.
The effect of antimicrobial activity of Teucrium Polium on Oral Streptococcus Mutans: a randomized cross-over clinical trial study
Authors: Khoramian Tusi Somayeh , Jafari Ahmad , Marashi Seyed Mahmoud Amin , Faramarzi Niknam Salomeh , Farid Malihe , Ansari Mehdi 
Published: May 2020

AbstractBackgroundThe purpose of this study is to determine the effect of a mouthwash containingTeucriumpoliumherb onStreptococcus mutansin mouth.MethodsThis study was a randomized, crossover, double-blind clinical trial, where we selected 22 volunteers (dental students) randomly and we divided them into two groups. The study had two phases. In each phase, one group acted as the intervention group, while the other one was the control group. Both the intervention and control groups were given the mouthwash with and withoutTeucriumpolium, respectively.S. mutansof saliva were measured before and after each phase to compare the effects of the mouthwashes. A three-week washout period was considered between the two phases. An independent two-sample t-test was utilized to compare the mean ofS. mutanscolonies. Additionally, we used a standard AB/BA crossover model to find the results of the treatment and the impact of carryover on the residual’s biological effects. The significance level was considered 0.05 in this experiment.ResultsThere is no significant difference observed between the two groups in the number ofS. mutansbefore using the mouthwashes. When the mouthwash containingTeucriumpoliumwas used, there was a significant decrease in the number ofS. mutanscolonies in both phases’ extract (P = 0.002).Conclusion: The results of this study indicate the mouthwash containing aqueous extract ofTeucrium poliumcan majorly reduce the colonization ofS. mutansin human saliva.Trial registrationEthical issues approved by the Ethics Committee of the Rafsanjan University of Medical Sciences with the approval number of 937/9/31, IRCT code Number ofIRCT2013121815842N1and it was approved on 06/16/2014. The study was conducted in the period of September to November 2014.
Clitoral leiomyoma in a premenopausal woman: a case report
Authors: Taraschi Gianmarco , Aguiar Diego , Tille Jean Christophe , Petignat Patrick , Abdulcadir Jasmine 
Published: May 2020

Abstract
Background
Extrauterine leiomyomata is an uncommon lesion that can lead to several problems of differential diagnosis, especially when localized in the external genitalia. There are few reports in the English literature and a novel association with Alport’s syndrome has been investigated since the 1980s.

Case presentation
Here, we describe the case of a premenopausal woman who presented with an indolent swelling of the right interlabial fossa that resulted in a Bartholin cyst. In addition to this cyst, a benign leiomyoma of the right side of the clitoris was also found and removed. Our patient refused any further examination, although she was informed that genetic counselling could be organized to rule out an association with Alport’s syndrome.

Conclusions
Extrauterine leiomyomata localized in the external genitalia is an uncommon lesion arising from smooth muscle cells around vascular epithelium or erectile tissue. Since an association between extrauterine leiomyomata and Alport’s syndrome has been described, genetic testing can be proposed to these patients. Upper intestinal tract symptoms such as dysphagia should prompt a gastroenterological evaluation as an association with an esophageal leiomyomatosis has been described.
Developing a digital training tool to support oncologists in the skill of information-provision: a user centred approach
Authors:   on behalf of the INSTRUCT project group, Stuij Sebastiaan M. , Drossaert Constance H. C. , Labrie Nanon H. M. , Hulsman Robert L. , Kersten Marie José , van Dulmen Sandra , Smets Ellen M. A. 
Published: May 2020

Abstract
Background
For patients with cancer, being well informed by their oncologist about treatment options and the implications thereof is highly relevant. Communication skills training (CST) programs have shown to be effective in improving clinicians’ communication skills, yet CSTs are time-consuming, inconvenient to schedule, and costly. Online education enables new ways of accessible learning in a safe and personalised environment.

Aim and methods
We describe the design of a digital CST-tool for information provision skills that meets oncologists’ learning needs. We used the CeHRes Roadmap for user-centred design as a guiding framework. Phase 1 (Contextual Inquiry) involved consultation of the literature and a focus group interview study to uncover the learning needs and training preferences of clinicians’ regarding a digital training for the skill of information-provision. In phase 2 (Value Specification), two multidisciplinary expert panels specified the learning content and format of a digital training. Phase 3 (Design) encompassed an iterative development process, including two user group assessment sessions and 5 individual user sessions in which prototypes were tested. All sessions were recorded and independently analyzed by two researchers.

Results
Based on literature and consultation of the users in the inquiry phase of the development process, and on expert opinion in the value specification phase, relevant (sub) skills and user requirements were defined to consider for the digital training format. It was decided to develop a conventional e-learning and a chatbot. Personalization and interactivity were integrated in the prototypes by including features that allow for e.g., choosing text, video or animation; to upload video-recorded consultations to receive peer-feedback; and to consult a communication expert. Results revealed that, overall, participants expressed a willingness to use a digital training tool to acquire information-provision skills. Individual user testing (including junior clinicians), indicated a preference for the chatbot over the e-learning.

Conclusion
We offer a description of extensive development work which was conducted in collaboration with multiple health care professionals to iteratively develop two innovative prototypes of digital tools that would appropriately engage oncologists in learning effective information giving skills. The resulting prototypes were well appreciated and thus provide a solid basis for further development and testing.
Implementation support practitioners – a proposal for consolidating a diverse evidence base
Authors: Albers Bianca , Metz Allison , Burke Katie 
Published: May 2020

AbstractBackgroundWorkforce development for implementation practice has been identified as a grand challenge in health services. This is due to the embryonic nature of the existing research in this area, few available training programs and a general shortage of frontline service staff trained and prepared for practicing implementation in the field. The interest in the role of “implementation support” as a way to effectively build the implementation capacities of the human service sector has therefore increased. However, while frequently used, little is known about the skills and competencies required to effectively provide such support.Main bodyTo progress the debate and the research agenda on implementation support competencies, we propose the role of the “implementation support practitioner” as a concept unifying the multiple streams of research focused on e.g. consultation, facilitation, or knowledge brokering. Implementation support practitioners are professionals supporting others in implementing evidence-informed practices, policies and programs, and in sustaining and scaling evidence for population impact. They are not involved in direct service delivery or management and work closely with the leadership and staff needed to effectively deliver direct clinical, therapeutic or educational services to individuals, families and communities. They may be specialists or generalists and be located within and/or outside the delivery system they serve. To effectively support the implementation practice of others, implementation support practitioners require an ability to activate implementation-relevant knowledge, skills and attitudes, and to operationalize and apply these in the context of their support activities. In doing so, they aim to trigger both relational and behavioral outcomes. This thinking is reflected in an overarching logic outlined in this article.ConclusionThe development of implementation support practitioners as a profession necessitates improved conceptual thinking about their role and work and how they enable the uptake and integration of evidence in real world settings. This article introduces a preliminary logic conceptualizing the role of implementation support practitioners informing research in progress aimed at increasing our knowledge about implementation support and the competencies needed to provide this support.
Eliciting patient views on the allocation of limited healthcare resources: a deliberation on hepatitis C treatment in the Veterans Health Administration
Authors: Waljee Akbar K. , Ryan Kerry A. , Krenz Chris D. , Ioannou George N. , Beste Lauren A. , Tincopa Monica A. , Saini Sameer D. , Su Grace L. , Arasim Maria E. , Roman Patti T. , Nallamothu Brahmajee K. , De Vries Raymond 
Published: May 2020

AbstractBackgroundIn response to the development of highly effective but expensive new medications, policymakers, payors, and health systems are considering novel and pragmatic ways to provide these medications to patients. One approach is to target these treatments to those most likely to benefit. However, to maximize the fairness of these policies, and the acceptance of their implementation, the values and beliefs of patients should be considered. The provision of treatments for chronic hepatitis C (CHC) in the resource-constrained context of the Veterans Health Administration (VHA) offered a real-world example of this situation, providing the opportunity to test the value of using Democratic Deliberation (DD) methods to solicit the informed opinions of laypeople on this complex issue.MethodsWe recruited Veterans (n = 30) from the VHA to attend a DD session. Following educational presentations from content experts, participants engaged in facilitated small group discussions to: 1) identify strategies to overcome CHC treatment barriers and 2) evaluate, vote on, and modify/improve two CHC treatment policies – “first come, first served” (FCFS) and “sickest first” (SF). We used transcripts and facilitators’ notes to identify key themes from the small group discussions. Additionally, participants completed pre- and post-DD surveys.ResultsMost participants endorsed the SF policy over the FCFS policy, emphasizing the ethical and medical appropriateness of treating the sickest first. Concerns about SF centered on the difficulty of implementation (e.g., how is “sickest” determined?) and unfairness to other Veterans. Proposed modifications focused on: 1) the need to consider additional health factors, 2) taking behavior and lifestyle into account, 3) offering education and support, 4) improving access, and 5) facilitating better decision-making.ConclusionsDD offered a robust and useful method for addressing the allocation of the scarce resource of CHC treatment. Participants were able to develop a modified version of the SF policy and offered diverse recommendations to promote fairness and improve quality of care for Veterans. DD is an effective approach for incorporating patient preferences and gaining valuable insights for critical healthcare policy decisions in resource-limited environments.