bluuebunny/crossref_metadata_2025_split huggingface dataset:
Delayed diagnosis of tuberculosis in patients with diabetes mellitus co-morbidity and its associated factors in Zhejiang Province, China
Authors: Xiao Wenhui , Huang Dajiang , Li Saiqiong , Zhou Shangcheng , Wei Xiaolin , Chen Bin , Zou Guanyang 
Published: March 2021

AbstractBackgroundTuberculosis (TB) remains a significant global public health problem. China has the second highest TB burden in the world. With a growing TB population with diabetes mellitus (DM), the TB control system faces mounting challenges. To date, evidence remains inconclusive regarding the association between TB-DM co-morbidity and delayed diagnosis of TB patients. This study aims to assess the diagnostic delay of TB patients with known DM and identify the factors associated with this delay.MethodsData was collected from China’s Tuberculosis information management system in two counties of Zhejiang province, China. Patient delay, health system delay and total diagnostic delay are defined as follows: 1) the interval between the onset of TB symptoms and first visit to any health facility; 2) from the first visit to the health facility to the confirmed TB diagnosis in the designated hospital; 3) the sum of patient and health system’s respective delays. Comparison of these delays was made between TB patients with and without DM using Mann-Whitney U test and Chi-square test. Univariate and multivariate regression analysis was used to identify factors influencing delays among TB patients with DM.ResultsOf 969 TB patients, 67 (7%) TB patients had DM co-morbidity. Compared with TB patients without DM, TB patients with DM experienced significantly shorter health system delays (p < 0.05), and there was a significantly lower proportion of patients whose health system delayed> 14 days (7.0% vs. 18%,p < 0.05). However, no significant difference was observed between both patient categories regarding patient delay and total diagnostic delay. The multivariate regression analysis suggested that TB patients with DM who were aged < 60 years (AOR = 3.424, 95%CI: 1.008–11.627,p < 0.05) and non-severe cases (AOR = 9.725, 95%CI: 2.582–36.626,p < 0.05) were more likely to have a total diagnostic delay of> 14 days.ConclusionsOur study suggests that DM does not contribute to further diagnostic delay as expected. Instead, we observed significantly improved health system delay among TB patients with DM. The findings indicate the importance of early screening and diagnosis for TB among diabetic patients and of strengthening the integrated control and management of TB and diabetic programs.
Close contact infection dynamics over time: insights from a second large-scale social contact survey in Flanders, Belgium, in 2010-2011
Authors: Hoang Thang Van , Coletti Pietro , Kifle Yimer Wasihun , Kerckhove Kim Van , Vercruysse Sarah , Willem Lander , Beutels Philippe , Hens Niel 
Published: March 2021

Abstract
Background
In 2010-2011, we conducted a social contact survey in Flanders, Belgium, aimed at improving and extending the design of the first social contact survey conducted in Belgium in 2006. This second social contact survey aimed to enable, for the first time, the estimation of social mixing patterns for an age range of 0 to 99 years and the investigation of whether contact rates remain stable over this 5-year time period.

Methods
Different data mining techniques are used to explore the data, and the age-specific number of social contacts and the age-specific contact rates are modelled using a generalized additive models for location, scale and shape (GAMLSS) model. We compare different matrices using assortativeness measures. The relative change in the basic reproduction number (R0) and the ratio of relative incidences with 95% bootstrap confidence intervals (BCI) are employed to investigate and quantify the impact on epidemic spread due to differences in sex, day of the week, holiday vs. regular periods and changes in mixing patterns over the 5-year time gap between the 2006 and 2010-2011 surveys. Finally, we compare the fit of the contact matrices in 2006 and 2010-2011 to Varicella serological data.

Results
All estimated contact patterns featured strong homophily in age and sex, especially for small children and adolescents. A 30% (95% BCI [17%; 37%]) and 29% (95% BCI [14%; 40%]) reduction in R0 was observed for weekend versus weekdays and for holiday versus regular periods, respectively. Significantly more interactions between people aged 60+ years and their grandchildren were observed on holiday and weekend days than on regular weekdays. Comparing contact patterns using different methods did not show any substantial differences over the 5-year time period under study.

Conclusions
The second social contact survey in Flanders, Belgium, endorses the findings of its 2006 predecessor and adds important information on the social mixing patterns of people older than 60 years of age. Based on this analysis, the mixing patterns of people older than 60 years exhibit considerable heterogeneity, and overall, the comparison of the two surveys shows that social contact rates can be assumed stable in Flanders over a time span of 5 years.
Home-based exercise and bone mineral density in peritoneal dialysis patients: a randomized pilot study
Authors: Watanabe Kumi , Kamijo Yuka , Yanagi Mai , Ishibashi Yoshitaka , Harada Taku , Kohzuki Masahiro 
Published: March 2021

Abstract
Background
The prevalence of osteopenia and osteoporosis is higher in patients with chronic kidney disease than that in the general population. Although physical exercise prevents bone loss in hemodialysis (HD) patients, previous studies have not focused on peritoneal dialysis (PD) patients. Therefore, we aimed to evaluate the effects of home-based exercise on bone mineral density (BMD) in patients with PD.

Methods
Stable outpatients undergoing PD were randomly assigned to the intervention group (n = 26; male, 20; median age, 66 years) or usual-care group (n = 27; male, 21; median age, 64 years). Patients in the intervention group performed home-based exercises (resistance exercise, stretching, and aerobic exercise such as walking) for 6 months, whereas those in the usual-care group performed stretching and their usual physical activity. Based on dual X-ray absorptiometry, the primary outcomes were the BMD data of the lumbar spine and proximal femoral neck. Secondary outcomes included physical function and physical activity. Pre- and post-intervention values were compared.

Results
There was no significant within-group change in the BMD of the lumbar spine, femoral neck, and hip after 6 months of the exercise program. The intervention group had significantly improved 30-s chair-stand test, 6-min walk test, and physical activity results.

Conclusions
Home-based exercises in patients with PD did not improve BMD at any of the sites evaluated. Improvement in physical function and physical activity may reduce the risk of falls in patients with PD.

Trial registration
UMIN Clinical Trials Registry, UMIN000041678. Registered September 4, 2020; retrospectively registered.
Psychometric properties of a Persian version of respectful maternity care questionnaire
Authors: Esmkhani Mina , Namadian Masoumeh , Nooroozy Ali , Korte Jeffrey E. 
Published: March 2021

Abstract
Background
Providing high quality and respectful care during pregnancy and birth is one of the ways to reduce complications in women. Respectful care is a type of care that requires a valid instrument to measure. This study was conducted to determine the validity and reliability of the Persian version of the Respectful Maternity Care (RMC) questionnaire in 2018.

Methods
This study was performed with 150 women (in the first 48 h after birth), who were admitted in the postpartum wards of public hospitals from 1st January until 6th April 2018 in Zanjan city in Iran. Participants were selected randomly using the Poisson distribution (Time) sampling method. After receiving permission from the questionnaire’s author, the internal consistency of the tool was measured by Cronbach’s alpha coefficient after the Forward translation of the Persian version of the tool under expert supervision. The reliability of the modified questionnaire was assessed using a test-retest method in 10 eligible postpartum women, who completed the same questionnaire again after 72 h. The validity of the tool was confirmed by exploratory and confirmatory factor analysis using LISREL and SPSS software.

Results
The original RMC tool achieved an overall high internal reliability (α = 0.839). Confirmatory factor analysis of original RMC scores demonstrated poor fit indices. In LISREL proposed paths for the model, one item was excluded and a re-exploratory factor analysis was performed with the remaining 14 items. Four new subscales were defined for the revised tool including Abusive Care, Effective Care, Friendly Care, and Respectful Communication, which explained 60% of the variance.

Conclusions
The revised tool included four subscales of Abusive Care, Effective Care, Friendly Care, and Respectful Communication in 14 items which explained 60% of the variance. Given the importance of providing high quality maternity care, and the variety of cultures and birth services across different countries, further research is needed on this RMC tool to evaluate its use in other countries and regions.
What explains the inequalities in health care utilization between immigrants and non-migrants in Switzerland?
Authors: Tzogiou Christina , Boes Stefan , Brunner Beatrice 
Published: March 2021

Abstract
Background
Inequalities in health care use between immigrants and non-migrants are an important issue in many countries, with potentially negative effects on population health and welfare. The aim of this study is to understand the factors that explain these inequalities in Switzerland, a country with one of the highest percentages of foreign-born population.

Methods
Using health survey data, we compare non-migrants to four immigrant groups, differentiating between first- and second-generation immigrants, and culturally different and similar immigrants. To retrieve the relative contribution of each inequality-associated factor, we apply a non-linear decomposition method and categorize the factors into demographic, socio-economic, health insurance and health status factors.

Results
We find that non-migrants are more likely to visit a doctor compared to first-generation and culturally different immigrants and are less likely to visit the emergency department. Inequalities in doctor visits are mainly attributed to the explained component, namely to socio-economic factors (such as occupation and income), while inequalities in emergency visits are mainly attributed to the unexplained component. We also find that despite the universal health care coverage in Switzerland systemic barriers might exist.

Conclusions
Our results indicate that immigrant-specific policies should be developed in order to improve access to care and efficiently manage patients in the health system.
Accuracy of radiographic measurement techniques for the Taylor spatial frame mounting parameters
Authors: Gessmann Jan , Frieler Sven , Königshausen Matthias , Schildhauer Thomas A. , Hanusrichter Yannik , Seybold Dominik , Baecker Hinnerk 
Published: March 2021

Abstract
Aim
The correction accuracy of the Taylor Spatial Frame (TSF) fixator depends considerably on the precise determination of the mounting parameters (MP). Incorrect parameters result in secondary deformities that require subsequent corrections. Different techniques have been described to improve the precision of MP measurement, although exact calculation is reportedly impossible radiologically. The aim of this study was to investigate the accuracy of intraoperative and postoperative radiographic measurement methods compared to direct MP measurement from TSF bone mounting.

Methods
A tibial Sawbone® model was established with different origins and reference ring positions. First, reference MPs for each origin were measured directly on the frame and bone using a calibrated, digital vernier calliper. In total 150 MPs measured with three different radiographic measurement techniques were compared to the reference MPs: digital radiographic measurements were performed using soft-copy PACS images without (method A) and with (method B) calibration and calibrated image intensifier images (method C).

Results
MPs measured from a non-calibrated X-ray image (method A) showed the highest variance compared to the reference MPs. A greater distance between the origin and the reference ring corresponded to less accurate MP measurements with method A. However, the MPs measured from calibrated X-ray images (method B) and calibrated image intensifier images (method C) were intercomparable (p = 0.226) and showed only minor differences compared to the reference values but significant differences to method A (p < 0,001).

Conclusion
The results demonstrate that MPs can be accurately measured with radiographic techniques when using calibration markers and a software calibration tool, thus minimizing the source of error and improving the quality of correction.
Cervical cancer in women under 30 years of age in Norway: a population-based cohort study
Authors: Gravdal Brit Helene , Lönnberg Stefan , Skare Gry Baadstrand , Sulo Gerhard , Bjørge Tone 
Published: March 2021

Abstract
Background
We compared women with incident cervical cancer under the age of 30 with older women with regard to stage, morphology, screening history and cervical cancer mortality in a population-based cohort study.

Methods
We included data from the Cancer Registry of Norway. Incidence rates (per 100,000 women-years) were calculated and joinpoint regression was used to analyse trends. The Nelson-Aalen cumulative hazard function for risk of cervical cancer death during a 15-year follow-up was displayed. The hazard ratios (HRs) of cervical cancer mortality with 95% confidence intervals (CIs) were derived from Cox regression models.

Results
The incidence of cervical cancer in women under the age of 30 has almost tripled since the 1950s, with the steepest increase during 1955–80 (with an annual percentage change (APC) of 7.1% (95%CI 4.4–9.8)) and also an increase after 2004 (3.8% (95%CI -1.3–9.2)). Out of 21,160 women with cervical cancer (1953–2013), 5.3% were younger than 30 years. A lower proportion of younger women were diagnosed at more advanced stages and a slightly higher proportion were diagnosed with adenocarcinoma and adenosquamous carcinoma comparing women above 30 years. The cumulative risk of cervical cancer death was lower for patients under the age of 30. However, the difference between the age groups decreased over time. The overall adjusted HR of cervical cancer mortality was 0.69 (95% CI 0.58–0.82) in women diagnosed under the age of 30 compared to older women.

Conclusion
There has been an increase in cervical cancer incidence in women under the age of 30. Cervical cancer in younger women was not more advanced at diagnosis compared to older women, and the cervical cancer mortality was lower.
Group meta-cognitive therapy and depression in women with breast cancer: a randomized controlled trial
Authors: Zahedian Elham , Bahreini Masoud , Ghasemi Nezamaddin , Mirzaei Kamran 
Published: March 2021

AbstractBackgroundBreast cancer is one of the most common cancers in Iranian women. They will experience a mental health problem like depression before, during or after treatment. This study aimed to determine the effectiveness of group metacognitive therapy on depression, cognitive-emotional regulation, and meta-cognitive beliefs in women with breast cancer.MethodsIn this randomized controlled clinical trial, a total of 24 depressed patients with breast cancer were randomly allocated to experimental and control groups. The experimental group received meta-cognitive therapy in 8 weekly sessions, but the control group received treatment as usual. Beck Depressive Inventory, cognitive emotion regulation questionnaire, and meta-cognitions questionnaire were completed before, after and one month after the intervention. Data were analyzed using Wilcoxon and Chi-square tests.ResultsThe mean score of depression in the experimental group was reduced from 21.6 ± 4.83 in the pre-test to 13.83 ± 8.12 in one-month follow-up (p = 0.16); however, there was no significant difference in the control group. The mean score of cognitive emotion regulation did not show a significant change in the two groups during the study and follow-up period. The mean score of meta-cognitive beliefs reached 68.75 ± 15.74 from 79.51 ± 10.72 in the experimental group during the follow-up period (p = 0.006); however, there was no significant difference in the control group in the score of metacognitive beliefs.ConclusionThese findings support the efficacy of meta-cognitive therapy as a viable psychosocial intervention in depressed patients with breast cancer.Trial registrationIRCT201606288473N5. Registered on: 05/09/2016https://www.irct.ir/trial/8946.
Complementary and alternative medicine use by pediatric oncology patients before, during, and after treatment
Authors: Lüthi Emmanuelle , Diezi Manuel , Danon Nadia , Dubois Julie , Pasquier Jérôme , Burnand Bernard , Rodondi Pierre-Yves 
Published: March 2021

AbstractBackgroundThe prevalence of complementary and alternative medicine (CAM) use and the modalities used by pediatric oncology patients vary widely across studies. In addition, the changes in the use of CAM over the course of treatment are understudied. Thus, this study aimed to explore (1) CAM use by pediatric oncology patients in relation to specific time intervals and (2) communication about CAM use between parents and oncologists.MethodsThis retrospective cross-sectional study was conducted among parents of children diagnosed with cancer at a Swiss pediatric hematology-oncology center by means of an online questionnaire. Questions were related to their child’s CAM use over different time intervals, sources of information about CAM use, and communication with the oncologists.ResultsAmong 140 respondents, CAM was used by 54.3% of patients before diagnosis and 69.3% of patients after diagnosis. During each defined time interval, between 50 and 58.8% of the patients used at least one CAM. Homeopathy was the most popular CAM modality used during oncology treatment, during the first year after treatment, and between 1 and 5 years after the end of treatment. Osteopathy was the most popular CAM ≥5 years after the end of oncology treatment. Forty percent of respondents did not discuss CAM with their oncologist.ConclusionsThe high prevalence of CAM use and the different trends of use during the oncology care pathway and afterward underline the need to increase communication about CAM in the pediatric oncology setting, notably regarding benefits and risks of interaction with oncology treatment.
The effectiveness of implementation strategies for promoting evidence informed interventions in allied healthcare: a systematic review
Authors: Goorts Kaat , Dizon Janine , Milanese Steve 
Published: March 2021

Abstract
Background
Evidence based practice in health care has become increasingly popular over the last decades. Many guidelines have been developed to improve evidence informed decision making in health care organisations, however it is often overlooked that the actual implementation strategies for these guidelines are as important as the guidelines themselves. The effectiveness of these strategies is rarely ever tested specifically for the allied health therapy group.

Methods
Cochrane, Medline, Embase and Scopus databases were searched from 2000 to October 2019. Level I and II studies were included if an evidence informed implementation strategy was tested in allied health personnel.
The SIGN method was used to evaluate risk of bias. The evidence was synthesised using a narrative synthesis. The National Health and Medical Research Council (NHMRC) model was applied to evaluate the grade for recommendation.

Results
A total of 490 unique articles were identified, with 6 primary studies meeting the inclusion criteria. Three different implementation strategies and three multi-faceted components strategies were described. We found moderate evidence for educational meetings, local opinion leaders and patient mediated interventions. We found stronger evidence for multi-faceted components strategies.

Conclusion
Few studies describe the effectiveness of implementation strategies for allied healthcare, but evidence was found for multi-faceted components for implementing research in an allied health therapy group population. When considering implementation of evidence informed interventions in allied health a multi-pronged approach appears to be more successful.
A feasibility study using time-driven activity-based costing as a management tool for provider cost estimation: lessons from the national TB control program in Zimbabwe in 2018
Authors: Chirenda J. , Nhlema Simwaka B. , Sandy C. , Bodnar K. , Corbin S. , Desai P. , Mapako T. , Shamu S. , Timire C. , Antonio E. , Makone A. , Birikorang A. , Mapuranga T. , Ngwenya M. , Masunda T. , Dube M. , Wandwalo E. , Morrison L. , Kaplan R. 
Published: March 2021

Abstract
Background
Insufficient cost data and limited capacity constrains the understanding of the actual resources required for effective TB control. This study used process maps and time-driven activity-based costing to document TB service delivery processes. The analysis identified the resources required to sustain TB services in Zimbabwe, as well as several opportunities for more effective and efficient use of available resources.

Methods
A multi-disciplinary team applied time-driven activity-based costing (TDABC) to develop process maps and measure the cost of clinical pathways used for Drug Susceptible TB (DS-TB) at urban polyclinics, rural district and provincial hospitals, and community based targeted screening for TB (Tas4TB). The team performed interviews and observations to collect data on the time taken by health care worker-patient pairs at every stage of the treatment pathway. The personnel’s practical capacity and capacity cost rates were calculated on five cost domains. An MS Excel model calculated diagnostic and treatment costs.

Findings
Twenty-five stages were identified in the TB care pathway across all health facilities except for community targeted screening for TB. Considerable variations were observed among the facilities in how health care professionals performed client registration, taking of vital signs, treatment follow-up, dispensing medicines and processing samples.
The average cost per patient for the entire DS-TB care was USD324 with diagnosis costing USD69 and treatment costing USD255. The average cost for diagnosis and treatment was higher in clinics than in hospitals (USD392 versus USD256). Nurses in clinics were 1.6 time more expensive than in hospitals. The main cost components were personnel (USD130) and laboratory (USD119). Diagnostic cost in Tas4TB was twice that of health facility setting (USD153 vs USD69), with major cost drivers being demand creation (USD89) and sputum specimen transportation (USD5 vs USD3).

Conclusion
TDABC is a feasible and effective costing and management tool in low-resource settings. The TDABC process maps and treatment costs revealed several opportunities for innovative improvements in the NTP under public health programme settings. Re-engineering laboratory testing processes and synchronising TB treatment follow-up with antiretroviral treatments could produce better and more uniform TB treatments at significantly lower cost in Zimbabwe.