bluuebunny/crossref_metadata_2025_split huggingface dataset:
A study on the perception of hand washing and health status in Korean adults
Authors: Park Soohee 
Published: January 2021

Abstract
This study aimed to investigate the perception about hand washing and health status among Koreans using the data from the Community Health Survey.
We examined the differences in the perceptions about hand washing and health statuses of 220,440 participants of the 2017 community health survey. The sample was divided into groups based on demographic variables, perceptions about hand washing, and prevalence of metabolic diseases. Participants’ demographic characteristics were analyzed using frequency, and perceptions about hand washing and subjective health status-related parameters were analyzed using t tests. The prevalence of metabolic disorder was analyzed with χ2 tests.
There were significant differences in subjective health status, subjective oral health status, and perceived obesity in the positive and negative hand washing perception groups (P < .01). The prevalence rate of hypertension and diabetes mellitus significantly differed in the positive and negative hand washing perception groups (P < .01), but no differences were observed for hyperlipidemia (P < .01).
This study showed that positive hand washing perception is associated with good health care practices. The perceptions of hand washing, which are formed during early childhood, were closely associated with health status. This finding could be useful evidence for developing programs focusing on major health behaviors and levels of health.
The Effect of Supervision Waivers on Practice
Authors: O’Reilly-Jacob Monica , Perloff Jennifer 
Published: January 2021

Background:
While optimal utilization of the nurse practitioner (NP) workforce is an increasingly popular proposal to alleviate the growing primary care shortage, federal, state, and organizational scope of practice policies inhibit NPs from practicing to the full extent of their license and training. In March of 2020, NP state-specific supervisory requirements were temporarily waived to meet the demands of the coronavirus disease 2019 (COVID-19) pandemic in Massachusetts.

Objective:
The objective of this study was to examine the impact of temporarily waived state practice restrictions on NP perception of care delivery during the initial surge of the COVID-19 pandemic in Massachusetts.

Research Design:
Mixed methods descriptive analysis of a web-based survey of Massachusetts NPs (N=391), conducted in May and June 2020.

Results:
The vast majority (75%) of NPs believed the temporary removal of practice restriction did not perceptibly improve clinical work. Psychiatric mental health NPs were significantly more likely than other NP specialties to believe the waiver improved clinical work (odds ratio=6.68, P=0.001). NPs that experienced an increase in working hours during the pandemic surge were also more likely to report a positive effect of the waiver (odds ratio=2.56, P=0.000).

Conclusions:
Temporary removal of state-level practice barriers alone is not sufficient to achieve immediate full scope of practice for NPs. The successful implementation of modernized scope of practice laws may require a collective effort to revise organizational and payer policies accordingly.
Family Caregiver Training Needs and Medicare Home Health Visit Utilization
Authors: Burgdorf Julia G. , Stuart Elizabeth A. , Arbaje Alicia I. , Wolff Jennifer L. 
Published: January 2021

Background:
Medicare home health providers are now required to deliver family caregiver training, but potential consequences for service intensity are unknown.

Objective:
The objective of this study was to assess how family caregiver training needs affect the number and type of home health visits received.

Design:
Observational study using linked National Health and Aging Trends Study (NHATS), Outcomes and Assessment Information Set (OASIS), and Medicare claims data. Propensity score adjusted, multivariable logistic, and negative binomial regressions model the relationship between caregivers’ training needs and number/type of home health visits.

Subjects:
A total of 1217 (weighted n=5,870,905) National Health and Aging Trends Study participants receiving Medicare-funded home health between 2011 and 2016.

Measures:
Number and type of home health visits, from Medicare claims. Family caregivers’ training needs, from home health clinician reports.

Results:
Receipt of nursing visits was more likely when family caregivers had medication management [adjusted odds ratio (aOR): 3.03; 95% confidence interval (CI): 1.06, 8.68] or household chore training needs (aOR: 3.38; 95% CI: 1.33, 8.59). Receipt of therapy visits was more likely when caregivers had self-care training needs (aOR: 1.70; 95% CI: 1.01, 2.86). Receipt of aide visits was more likely when caregivers had household chore (aOR: 3.54; 95% CI: 1.82, 6.92) or self-care training needs (aOR: 2.12; 95% CI: 1.11, 4.05). Medication management training needs were associated with receiving an additional 1.06 (95% CI: 0.11, 2.01) nursing visits, and household chores training needs were associated with an additional 3.24 total (95% CI: 0.21, 6.28) and 1.32 aide visits (95% CI: 0.36, 2.27).

Conclusion:
Family caregivers’ activity-specific training needs may affect home health visit utilization.
Achieving Population Health Impacts Through Health Promotion Programs Offered by Community-based Organizations
Authors: Brewster Amanda L. , Wilson Traci L. , Curry Leslie A. , Kunkel Suzanne R. 
Published: January 2021

Background:
Evidence-based health promotion programs can help older adults manage chronic conditions and address behavioral risk factors, and translating these interventions to population-scale impact depends on reaching people outside of clinical settings. Area Agencies on Aging (AAAs) have emerged as important delivery sites for health promotion programs, but the impacts of their expanded role in delivering these interventions remain unknown.

Objective:
The objective of this study was to test whether evidence-based health promotion programs implemented by AAAs from 2008 to 2016 influenced health care use and spending by older adults and to examine how agencies’ organizational capacity for implementation influenced these population-level impacts.

Research Design:
We used panel regression models to examine how the expansion of health promotion programs offered by AAAs over the course of 2008–2016 was associated with a change in health care use and spending by older adults in counties served by the AAAs. We examined impact separately for high capacity and low capacity agencies.

Results:
Across the full sample of AAAs, beginning to offer any health promotion program in the AAA was associated a with 0.94% percentage point reduction in potentially avoidable nursing home use in counties covered by the AAA (95% confidence interval=−1.58, −0.29), equivalent to a 6.5% change. Expanding the breadth of programs offered by the AAA was also associated with a significant reduction in potentially avoidable nursing home use. Stratified analysis showed that reductions in potentially avoidable nursing home use were evident only in places where the AAA had high implementation capacity. Expansion of health promotion programs offered by AAAs was not associated with the change in county-level hospital readmission rates, ambulatory care sensitive hospitalizations, or Medicare spending per beneficiary.

Conclusions:
AAAs are an example of community-based organizations that can contribute to health care policy goals such as cost containment. Organizational development support may be needed to extend their ability to effect change in more regions of the country.
Mandated Copayment Reductions in Medicare Advantage
Authors: Keohane Laura M. , Thomas Kali S. , Rahman Momotazur , Trivedi Amal N. 
Published: January 2021

Objectives:
To address concerns that postacute cost-sharing may deter high-need beneficiaries from participating in Medicare Advantage (MA) plans, the Centers for Medicare and Medicaid Services have capped cost-sharing for skilled nursing facility (SNF) services in MA plans since 2011. This study examines whether SNF use, inpatient use, and plan disenrollment changed following stricter regulations in 2015 that required most MA plans to eliminate or substantially reduce cost-sharing for SNF care.

Design:
Difference-in-differences retrospective analysis from 2013 to 2016.

Setting:
MA plans.

Participants:
Thirty-one million MA members in 320 plans with mandatory cost-sharing reductions and 261 plans without such reductions.

Measurements:
Mean monthly number of SNF admissions, SNF days, hospitalizations, and plan disenrollees per 1000 members.

Results:
Mean total cost-sharing for the first 20 days of SNF services decreased from $911 to $104 in affected plans. Relative to concurrent changes in plans without mandated cost-sharing reductions, plans with mandatory cost-sharing reductions experienced no significant differences in the number of SNF days per 1000 members (adjusted between-group difference: 0.4 days per 1000 members [95% confidence interval (95% CI), −5.2 to 6.0, P=0.89], small decreases in the number of hospitalizations per 1000 members [adjusted between-group difference: 0.6 admissions per 1000 members (95% CI, −1.0 to −0.1; P=0.03)], and small decreases in the number of SNF users who disenrolled at year-end [adjusted between-group difference: −16.8 disenrollees per 1000 members (95% CI, −31.9 to −1.8; P=0.03)].

Conclusions:
Mandated reductions in SNF cost-sharing may have curbed selective disenrollment from MA plans without significantly increasing use of SNF services.
Model Homes
Authors: Saynisch Philip A. , David Guy , Ukert Benjamin , Agiro Abiy , Scholle Sarah H. , Oberlander Tyler 
Published: January 2021

Background:
The patient-centered medical home (PCMH) model has been widely adopted, but the evidence on its effectiveness remains mixed. One potential explanation for these mixed findings is variation in how the model is implemented by practices.

Objective:
To identify the impact of different approaches to PCMH adoption on health care utilization in a long-term, geographically diverse sample of patients.

Design:
Difference-in-differences evaluation of PCMH impact on cost and utilization.

Subjects:
A total of 5,314,284 patient-year observations from the HealthCore Integrated Research Database, and 5943 practices which adopted the PCMH model in 14 states between 2011 and 2015.

Intervention:
PCMH adoption, as defined by the National Committee for Quality Assurance.

Measurements:
Six claims-based utilization measures, plus total health care expenditures. We employ hierarchical clustering to organize practices into groups based on their PCMH capabilities, then use generalized difference-in-differences models with practice or patient fixed effects to estimate the effect of PCMH recognition (overall and separately by the groups identified by the clustering algorithm) on utilization.

Results:
PCMH adoption was associated with a >8% reduction in total expenditures. We find significant reductions in emergency department utilization and outpatient care, and both lab and imaging services. In our by-group results we find that while the reduction in outpatient care is significant across all 3 groups, the reduction in emergency department utilization is driven entirely by 1 group with enhanced electronic communications.

Conclusion:
The PCMH model has significant impact on patterns of health care utilization, especially when heterogeneity in implementation is accounted for in program evaluation.
The J-IDEA Pandemic Planner
Authors: Christen Paula , D’Aeth Josh C. , Løchen Alessandra , McCabe Ruth , Rizmie Dheeya , Schmit Nora , Nayagam Shevanthi , Miraldo Marisa , Aylin Paul , Bottle Alex , Perez-Guzman Pablo N. , Donnelly Christl A. , Ghani Azra C. , Ferguson Neil M. , White Peter J. , Hauck Katharina 
Published: January 2021

Background:
Planning for extreme surges in demand for hospital care of patients requiring urgent life-saving treatment for coronavirus disease 2019 (COVID-19), while retaining capacity for other emergency conditions, is one of the most challenging tasks faced by health care providers and policymakers during the pandemic. Health systems must be well-prepared to cope with large and sudden changes in demand by implementing interventions to ensure adequate access to care. We developed the first planning tool for the COVID-19 pandemic to account for how hospital provision interventions (such as cancelling elective surgery, setting up field hospitals, or hiring retired staff) will affect the capacity of hospitals to provide life-saving care.

Methods:
We conducted a review of interventions implemented or considered in 12 European countries in March to April 2020, an evaluation of their impact on capacity, and a review of key parameters in the care of COVID-19 patients. This information was used to develop a planner capable of estimating the impact of specific interventions on doctors, nurses, beds, and respiratory support equipment. We applied this to a scenario-based case study of 1 intervention, the set-up of field hospitals in England, under varying levels of COVID-19 patients.

Results:
The Abdul Latif Jameel Institute for Disease and Emergency Analytics pandemic planner is a hospital planning tool that allows hospital administrators, policymakers, and other decision-makers to calculate the amount of capacity in terms of beds, staff, and crucial medical equipment obtained by implementing the interventions. Flexible assumptions on baseline capacity, the number of hospitalizations, staff-to-beds ratios, and staff absences due to COVID-19 make the planner adaptable to multiple settings. The results of the case study show that while field hospitals alleviate the burden on the number of beds available, this intervention is futile unless the deficit of critical care nurses is addressed first.

Discussion:
The tool supports decision-makers in delivering a fast and effective response to the pandemic. The unique contribution of the planner is that it allows users to compare the impact of interventions that change some or all inputs.
Membranous nephropathy: current understanding of various causes in light of new target antigens
Authors: Ronco Pierre , Debiec Hanna 
Published: January 2021

Purpose of review
Membranous nephropathy is an autoimmune disease caused by antibodies mostly directed to podocyte antigens. PLA2R and THSD7A antigens were described in 2009 and 2014 using classical immunochemical techniques. In the last 2 years, thanks to the combination of laser microdissection of glomeruli and mass spectrometry of solubilized digested proteins, several antigens associated with various causes have been described in patients with membranous nephropathy. The purpose of this review is to report on those “new” antigens and to analyse the clinicopathological correlations that make each of this antigen unique.

Recent findings
This article covers the literature of the last 2 years devoted to the description of those new antigens and biomarkers including NELL-1 and Semaphorin 3B in primary membranous nephropathy, and exostosins 1 and 2 and NCAM in lupus class V membranous nephropathy, which will be compared with the previously described antigens. These findings will lead to propose a new classification of membranous nephropathy based on serology and tissue antigen identification that could/should substitute for the classical distinction between primary and secondary membranous nephropathy.

Summary
The discovery of the latest antigens has major implications for the care of patients with membranous nephropathy as they drive the etiologic investigations and provide invaluable markers for treatment monitoring.
Mindfulness-Based Intervention Effects on Substance Use and Relapse Among Women in Residential Treatment: A Randomized Controlled Trial With 8.5-Month Follow-Up Period From the Moment-by-Moment in Women’s Recovery Project
Authors: Amaro Hortensia , Black David S. 
Published: January 2021

ABSTRACT

Objective
We tested the efficacy of Moment-by-Moment in Women’s Recovery (MMWR), a mindfulness training program adapted for ethnoculturally diverse women with complex social and clinical histories in residential treatment for substance use disorder, on substance use and relapse outcomes.

Methods
Participants were randomized to MMWR (n = 100; 60% Hispanic/Latina, 18% non-Hispanic Black) or the attention control condition, Neurobiology of Addiction (n = 100; 56% Hispanic/Latina, 21% non-Hispanic Black). Substance use outcomes (days until first use, days of use, and relapse status: abstained, lapsed, relapsed) were obtained from interviewer-assisted timeline followback for an 8.5-month follow-up period spanning the intervention start through the 6-week intervention period and 7 months after the intervention ended.

Results
An intent-to-treat survival analyses showed that time delay to first marijuana use favored MMWR (hazard ratio = 0.44, 95% confidence interval = 0.20–0.98, p = .049) with a medium-to-large effect size. In negative binomial hurdle models, the MMWR group showed fewer days of marijuana use at 3.5 months (B = −1.71, SE = 0.79, incidence rate ratio = 0.18, p = .030) and a trend at 7 months after the intervention (B = −0.90, standard error = 0.55, incidence rate ratio = 0.41, p = .10). For marijuana, mindfulness practice time during the intervention predicted time delay to first use (B = 0.28, p = .006) and total abstinence days (B = 0.34, p = .002) across the 7 months after MMWR. No other substance use outcomes showed differential response to MMWR relative to controls. Only in MMWR, number of study intervention sessions attended (dose) correlated with a greater length of time to alcohol intoxication (r = .48, p < .001), fewer days of alcohol intoxication (r = −.24, p = .020), and greater improvement in mindfulness skills (r = .61, p < .01).

Conclusions
MMWR added to an ongoing intensive residential treatment program serving vulnerable women is protective against marijuana use but no other substance use outcomes. Mindfulness practice time predicted a delay in time to first marijuana use. MMWR class attendance, an indicator of intervention dose, appears protective of alcohol intoxication at follow-up; thus, extended MMWR exposure might be useful.
Dispositional Mindfulness and Acute Heat Pain: Comparing Stimulus-Evoked Pain With Summary Pain Assessment
Authors: Mischkowski Dominik , Stavish Caitlin M. , Palacios-Barrios Esther E. , Banker Lauren A. , Dildine Troy C. , Atlas Lauren Y. 
Published: January 2021

ABSTRACT

Objective
Dispositional mindfulness is associated with reduced pain in clinical and experimental settings. However, researchers have neglected the type of pain assessment, as dispositional mindfulness may have unique benefits for reduced pain sensitivity when relying on summary pain assessments, in contrast to assessing the pain of each noxious stimulus. Here, we test the association between dispositional mindfulness and pain using both trial-by-trial pain assessments and overall summary ratings after acute pain tasks.

Methods
One hundred thirty-one healthy adult volunteers (mean age = 29.09 [8.00] years, 55.7% female) underwent two experimental thermal pain paradigms. We tested whether dispositional mindfulness measured with the Mindful Attention Awareness Scale was related to a) heat-evoked pain sensitivity, as measured by pain threshold, pain tolerance, average pain, trial-by-trial ratings, and heat-evoked skin conductance response, and b) summary judgments of sensory and affective pain assessed using the McGill Pain Questionnaire (MPQ).

Results
Mindful Attention Awareness Scale ratings were associated with decreased pain on the MPQ sensory (B = −0.18, SE = 0.05, 95% confidence interval = −0.29 to −0.07, t = −3.28, p = .001) and affective (B = −0.11, SE = 0.03, 95% confidence interval = −0.18 to −0.05, t = −3.32, p = .001) dimensions but not with experimental thermal pain assessments, including threshold, tolerance, heat-evoked pain, or skin conductance response (p values ≥ .29).

Conclusions
In this study, dispositional mindfulness mitigated acute thermal pain only when pain was assessed using the MPQ. These findings may reflect differences in immediate versus retrospective judgments or the type of pain assessed by each measure. Future research should examine regulation processes that may explain these differential analgesic benefits, such as attention, rumination, or reappraisal.
The Daily Dose-Response Hypothesis of Mindfulness Meditation Practice: An Experience Sampling Study
Authors: Levi Karin , Shoham Adi , Amir Iftach , Bernstein Amit 
Published: January 2021

ABSTRACT

Objective
Because of fast-growing interest in the applications of mindfulness to promote well-being and mental health, there are field-wide efforts to better understand how mindfulness training works and thereby to optimize its delivery. Key to these efforts is the role of home practice in mindfulness-based intervention (MBI) outcomes. Despite its centrality in MBIs, recent reviews have documented limited and mixed effects of home practice on MBI outcomes. However, methodological issues regarding monitoring and quantifying home practice and focus on cumulative or additive effects may limit our understanding of it. Temporally proximate, more transient, and contextually circumscribed effects of mindfulness mediation practice have not been examined.

Methods
We applied intensive experience sampling to measure daily practice and levels of targeted proximal outcomes (state mindfulness, decentering, emotional valance, and arousal) of training over the course of a 21-day MBI among a community-based sample of 82 meditation-naive adults.

Results
Despite intensive experience sampling, we found no evidence of cumulative or additive effects of total mindfulness meditation practice on outcomes at postintervention for mindfulness, decentering, emotional valence, or emotional arousal. However, we found that that daily dose of mindfulness meditation home practice significantly predicted same-day levels of state mindfulness (B = 0.004, SE = 0.001, t = 3.17, p = .000, f
2 = 0.24), decentering (B = 0.004, SE = 0.001, t = 2.757, p = .006, f
2 = 0.05), and emotional valence (B = 0.006, SE = 0.003, t = 2.015, p = .044, f
2 = 0.01) but not daily levels of emotional arousal. Daily dose-response practice effects did not carry over to next-day levels of monitored outcomes.

Conclusions
Findings show that effects of daily home mindfulness meditation practice dose on state mindfulness, decentering, and positive emotion are reliable but transient and time-limited. Findings are discussed with respect to the proposed daily dose-response hypothesis of mindfulness meditation practice.
Selecting Health Care Improvement Projects: A Methodology Integrating Cause-and-Effect Diagram and Analytical Hierarchy Process
Authors: Testik Özlem Müge , Shaygan Amir , Dasdemir Erdi , Soydan Guray 
Published: January 2021

Objectives:
It is often vital to identify, prioritize, and select quality improvement projects in a hospital. Yet, a methodology, which utilizes experts' opinions with different points of view, is needed for better decision making.

Methods:
The proposed methodology utilizes the cause-and-effect diagram to identify improvement projects and construct a project hierarchy for a problem. The right improvement projects are then prioritized and selected using a weighting scheme of analytical hierarchy process by aggregating experts' opinions. An approach for collecting data from experts and a graphical display for summarizing the obtained information are also provided.

Results:
The methodology is implemented for improving a hospital appointment system. The top-ranked 2 major project categories for improvements were identified to be system- and accessibility-related causes (45%) and capacity-related causes (28%), respectively. For each of the major project category, subprojects were then ranked for selecting the improvement needs.

Conclusion:
The methodology is useful in cases where an aggregate decision based on experts' opinions is expected. Some suggestions for practical implementations are provided.