bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Review on Barriers to Sustainable Telemedicine Implementation in Ethiopia
Authors: Sagaro Getu Gamo Gamo , BATTINENI GOPI , AMENTA FRANCESCO 
Published: October 2019

Abstract
Background Different studies showed that the use of telemedicine is effective in reducing hospital burden, suffer from patients, need of transports, hospital fear, save the money and time, and increasing the quality of healthcare. However, the implementation of telemedicine countenances different challenges in developing countries generally and in Ethiopia, particular.Objective This review aims to evaluate barriers which affecting sustainable telemedicine implementation in Ethiopia through analyses of the published works since 2010.Methods We conducted this review by extracting data from different databases, including MEDLINE, PubMed Central, CINAHL, Google Scholar, Academic Search Ultimate, and Africa-Wide Information. We analyzed finally 12 articles from the above databases based on our eligibility criteria and identified different barriers found in studies. We followed the Preferred Reporting Items for systematic review and meta-analyses (PRSIMA 2009) checklist for this review.Results We identified 23 barriers through 11 articles and classified barriers into organizational, users, and staff and programmers’ barriers. Accordingly, organizational, users’, and staff and programmer barriers were 11 (48%), 7 (30%) and 5 (22%), respectively with the frequency of occurrence through 11 articles and the results organized into table and figureConclusions Infrastructure and cost were the most frequently reported barriers, and staff resistance to change was also the critical factor. Inadequate availability Infrastructure and resistance to change could be overcome through training, creating awareness, strengthening Medicare reimbursement regulations and health care insurance programs, allocating budget for new technology and purchase, strong support and follow up, change management techniques.
Building research capacity in musculoskeletal health: qualitative evaluation of a graduate Nurse and Allied Health Professional internship programme
Authors: Wright David , Fry Mary , Adams Jo , Bowen Catherine 
Published: October 2019

Abstract
Background: Evidence based practice enhances service planning and delivery, clinical decision making and patient care. However, health professionals often lack the time and opportunity to access or generate evidence. Research capacity building is thus an important mechanism for improving health service delivery. This study evaluates the effectiveness of a Nurse and Allied Health Professional musculoskeletal research internship programme and explores the experiences of interns and their mentors. Methods: Sixteen new graduates completed the internship programme (September 2015 – August 2018). Twelve interns and thirteen mentors participated in the evaluation. The evaluation used qualitative asynchronous email-based interviews to explore the experiences of interns and mentors. Interpretive phenomenological analysis of coded transcripts identified principal themes. Results: Early research outputs from the interns include three peer reviewed publications and 21 conference abstract presentations. Two interns were in full time research at the time of interview or had a research component in their clinical role. Nine interns in clinical posts disclosed plans to return to research in the near future. Seven themes were identified: the impact on interns’ careers (e.g. changing perceptions of research); personal impact (e.g. confidence); impact on clinical practice (e.g. supporting evidence based practice); drivers for applying (e.g. assisting career choices); intervention design (e.g. appropriate timing and duration); mentorship and networking (e.g. general support and advice on career pathways); challenges (e.g. continuing with research when in full time clinical practice). Conclusion: The internship programme is an effective model in building research capacity in MSK research for Nurses and Allied Health Professionals, influencing careers, building confidence and improving clinical practice. The internship programme has the potential to be replicable to other clinical contexts nationally and internationally.
Short hairpin RNA attenuates liver fibrosis by regulating the peroxisome proliferator-activated receptor-γ and nuclear factor-κB pathways in hepatitis B virus-induced liver fibrosis in mice
Authors: Ye Lei , Cao Jiaqi , Sun Liying , Chen Ting , Li Wuping , Zhang Chenghai 
Published: October 2019

Abstract
Background: Progressive liver fibrosis, caused by chronic viral infection and metabolic disorders, results in the development of cirrhosis and hepatocellular carcinoma. However, no antifibrotic therapies have been approved to date. In our previous study, adeno-associated virus (AAV) short hairpin RNAs (shRNAs) targeting hepatitis B virus (HBV) and transforming growth factor (TGF)-β administration could persistently inhibit HBV replication and concomitantly prevent liver fibrosis. However, the differentially expressed proteins and critical regulatory networks of AAVshRNA treatment remain unclear. Accordingly, in this study, our major goal was we aimed to analyze differentially expressed proteins in the liver of AAV-shRNAs-treated mice with HBV infection and liver fibrosis using isobaric tags for relative and absolute quantitation (iTRAQ)-based quantitative proteomics and to elucidate the underlying antifibrotic mechanisms.
Results: In total 2743 proteins were recognized by iTRAQ-based quantitative proteomics analysis. Gene ontology analysis suggested that the differentially expressed proteins were mostly participated in peptide metabolism in the biological process category, cytosolic ribosomes in the cell component category, and structural constituents of ribosomes in the molecular function category. Kyoto Encyclopedia of Genes and Genomespathway analysis indicated that oxidative stress and the peroxisome proliferator-activated receptor (PPAR) signaling pathway were actived after treatment. Verification studies showed that AAVshRNAs inhibited hepatic stellate cell activation and inflammation by suppressing nuclear factor-κB p65 phosphorylation and α-smooth muscle actin expression via upregulation of PPAR-γ. Hepatocytes steatosis was also decreased by activating PPAR signaling pathway and improving lipid metabolism. TGF-β level was decreased owning to increase PPAR-γ expression and directly inhibition using AAVshRNAs targeting TGF-β. TGF-β-induced oxidative stress was suppressed by increasing glutathione S-transferase Pi 1 and reducing peroxiredoxin 1.
Conclusions: Our results indicated that AAV-shRNAs were effective for modulating liver fibrosis by reducing oxidative stress, inflammation and activating PPAR signaling pathway.
Self-management practice, associated factors and its relationship with Health Literacy and Patient Activation among multi-morbid COPD patients from rural Nepal
Authors: Yadav Uday Narayan , Lloyd Jane , Hosseinzadeh Hassan , Baral Kedar Prasad , Bhatta Narendra , Harris Mark Fort 
Published: October 2019

Abstract
Background Chronic Obstructive Pulmonary Disease (COPD) is a progressive and debilitating condition that affects individuals' quality of life . COPD self-management and supports provided by carers is key to the quality of life people living with COPD. Health literacy (HL) and Patient Activation (PA) are main drivers of self-management practices (SMPs). However, their contribution remains to be fully explored. This study aimed to examine the level of self-management practices, and the relationship with socio-demographic factors, HL and PA among multi-morbid COPD patients from rural Nepal. Methods This is a cross-sectional study conducted between July 2018 and January 2019. Patients completed a survey, including Self-management Practices questionnaire (SMPQ), five domains of the Health Literacy Questionnaire (HLQ), and Patient Activation Measure (PAM). The relationship between HL, PAM, and self-management practice was examined using univariate statistics. Multivariable analysis was conducted to identify the factors associated with self-management practice. Results A total of 238 patients responded to the study. The mean score of SMPQ was 45.31(SD=9.00). The HLQ and PAM scores were positively correlated with the total score of SMPQ. Low level of SMPs were found to be positively associated with being uneducated (β=-0.43, p=.001), having a low family income (β=-5.22, p=.002), and, negatively associated with the presence of more than one co-morbidity (β=3.58, p=0.007) after controlling for other socio-demographic variables in the multivariable analysis. Conclusions The overall SMPs among this sample of Nepalese with COPD were low. Our findings highlight the need of implementation of self-management intervention program involving health literacy-focused activities for COPD, creating a support system for patients from low-income family and having low activation level.
Anemia among HIV Infected Children on Highly Active Anti Retroviral Therapy in Wolaita Zone, South Ethiopia: a facility based cross sectional study
Authors: Geleta Mesay Lema , Solomon Fithamlak Bisetegn , Tufa Efrata Girma , Sadamo Fekadu Elias , Kastro Samson 
Published: October 2019

Abstract
Background Anemia is a global public health problem and most of the HIV positive people become anemic at some point in the course of the disease. We lack adequate evidence on the magnitude of anemia among children on highly active anti retroviral therapy in Ethiopia and particularly in South Ethiopia. Thus, this study aimed at determining the proportion and associated factors of anemia among children on highly active anti retroviral therapy in Wolaita zone, South Ethiopia.Method a facility based cross-sectional study has been conducted from November to December 2018 on 256 children 6 months to 14 years of age who were on Anti retroviral therapy. Data were collected through an interview with caregivers and review of medical records. CD4+ cell count was analyzed using FACS caliber and Hemoglobin level was measured with Hem cue 301 analyzer. Stool sample was examined for presence of intestinal parasites by direct wet mount technique. Data analyzed with Stata version 14.0 were conveyed in mean and standard deviation of the mean, median and inter-quartile range. Multivariate analysis was carried out to identify independent predictors of the outcome variable. Adjusted Odds Ratio with 95% confidence interval was reported.Results The magnitude of anemia was found to be 38.8%. Taking Co-trimoxazole antibiotic prophylaxis (AOR=.45; 95% CI: .21, .95), caregivers’ not receiving nutritional counseling (AOR=09; 95% CI: .01, .98) and presence of intestinal parasites (AOR=3.10; 95% CI: 1.39, 6.88) were associated with anemia.Conclusion The magnitude of anemia obtained in this study is a moderate public health problem. Health education programs in Anti Retroviral Therapy clinics should be targeted at appropriate dietary practice, and appropriate hand washing and other hygienic practices to prevent intestinal parasitic infections. Co-trimoxazole prophylaxis should give given to all eligible children based on the recommendation.
Recombinant Human Thrombomodulin for Pneumonia-Induced Severe Acute Respiratory Distress Syndrome Complicated by Disseminated Intravascular Coagulation in Children: A feasibility study
Authors: Hirata Naoyuki , Ngo Dong Tien , Phan Phuc Huu , Ainai Akira , Phung Thuy Thi Bich , Tuan Ta Anh , Dien Tran Minh , Takasaki Jin , Kawachi Shoji , Nakajima Noriko , Hai Le Thanh 
Published: October 2019

Abstract
Background
Recombinant human soluble thrombomodulin (rTM) has been used to treat disseminated intravascular coagulation (DIC). Recent studies have shown the efficacy of rTM through its anti-inflammatory effects for treatment of adults with acute respiratory distress syndrome (ARDS). However, the safety and efficacy of rTM in children with severe ARDS complicated by DIC have not been reported. In this study, we investigated the feasibility of using rTM for the treatment of pneumonia-induced severe ARDS complicated by DIC in children.

Methods
Six children (age: median 10 month-old) with pneumonia-induced severe ARDS complicated by DIC were enrolled in this feasibility study. rTM (380 U/kg) was administered for a maximum of 6 days, in addition to conventional therapies including cardiopulmonary support, antibiotics and/or antivirus drugs administration, steroid administration and intravenous immunoglobulin after diagnosis of severe ARDS complicated by DIC. After administration of rTM, we measured changes in the plasma TM concentration and evaluated the clinical course, status of DIC and ARDS, and other laboratory findings, including levels of cytokines, chemokines, and biomarkers.

Results
In all six children, the plasma concentration of TM increased and DIC scores decreased after administration of rTM. Four of the six children recovered from the severe ARDS complicated by DIC after treatment in the pediatric intensive care unit, and were discharged from the hospital with no complications. In surviving children, levels of soluble receptors for advanced glycation end products, interleukin-6, interleukin-8 and monocyte chemotactic protein-1 decreased after administration of rTM.

Conclusions
The rTM administration is feasible as a therapeutic strategy for children over 2 months with pneumonia-induced severe ARDS complicated by DIC.
Epidemiological analysis of the Kaohsiung city strategy for dengue fever quarantine and epidemic prevention
Authors: CHEN Chun-Hong , Pan Chao Ying , Liu Wei-Liang , Su Matthew P. , Chang Te Pin , Ho Hui-Pin , Huang Joh-Jong , Lin Li Jen 
Published: October 2019

Abstract
Abstract
Background. Dengue is endemic in over 100 countries and is an important public health problem worldwide. Dengue is not considered endemic in Taiwan however, with importation of dengue viruses from neighboring countries via close commercial links and air travel believed to be the cause of local outbreaks. Disease control efforts have therefore focused on preventing the importation of dengue into Taiwan. Here, we investigate the relationships between numbers of imported and indigenous dengue cases to test the validity of this strategy.
Methods. Dengue-fever case data from between 2013 and 2018 was obtained from the surveillance systems of the Taiwan Center for Disease Control and Kaohsiung City Health department. Standard epidemiological data, including the monthly numbers of indigenous and imported dengue cases, was calculated. Potential associations between the number of indigenous and imported cases were investigated using correlation analyses.
Results. We identified a possible relationship between the period of disease concealment and the number of reported imported dengue cases which resulted in indigenous dengue-fever epidemics within local communities. Further analysis of confirmed dengue cases during previous dengue-fever epidemics in Kaohsiung City found that the risk of indigenous dengue-fever may be related to the likelihood of patients suffering from imported cases of dengue-fever staying within local communities.
Conclusion. Given the correlations found between imported and indigenous dengue-fever cases, as well as the relationship between disease concealment period and risk of indigenous dengue-fever, the major priorities for disease control remain prevention of disease importation and efficient identification of dengue cases within high-risk communities.
Knowledge, attitudes and practices of faculty on mentorship: An exploratory interpretivist study at a Sub-Saharan African medical school
Authors: Mubuuke Aloysius , Mbalinda Scovia N. , Munabi Ian G. , Kateete David , Opoka Robert B. , Kiguli Sarah 
Published: October 2019

Abstract
Background Mentorship has become a routine part of undergraduate training in health professions education. Although many health professions training institutions have successfully incorporated faculty-student mentorship in their formal training, many others especially in Sub-Saharan Africa have not fully embraced this. Institutionalized mentorship programmes are an effective methods of enhancing student learning experiences. Faculty, who are the mentors have an active role to play in driving the mentorship agenda and ensure that students benefit from this important activity. The aim of this study was to explore the knowledge, attitudes and practices of faculty about student mentorship at Makerere University College of Health Sciences.Methods It was an exploratory qualitative study using interviewer-administered semi-structured questionnaires. The study participants included faculty at Makerere University College of Health Sciences. Thematic analysis was used to analyse the data using pre-determined themes.Results Four themes were identified: 1) Knowledge of mentorship, 2) Attitude towards mentorship, 3) Practice of mentorship and 4) Improving the mentorship process. Majority of the faculty reported being less knowledgeable on mentorship regardless of seniority. The level of knowledge seemed to influence the practice of mentorship. Despite the observed knowledge gap, all faculty demonstrated a positive attitude to participate in mentoring.Conclusion Faculty demonstrated a positive attitude towards mentorship despite the knowledge gap of mentorship identified. Continuous faculty development in mentorship as well as using peer mentorship were identified as key in sustaining the mentorship programme.
Nutritional intakes and associated factors among tuberculosis patients: A cross-sectional study in China
Authors: ren zhewen , Zhao Fei , Chen Hui , Hu Dongmei , Yu Wentao , Xu Xiaoli , Lin Dingwen , Luo Fuyi , Fan Yueling , Wang Haijun , Cheng Jun , Zhao Liyun 
Published: October 2019

Abstract
Abstract

Background: The objectives of this study were to examine nutrient intakes of tuberculosis (TB) patients and to identify their associated factors.

Methods: In this cross-sectional study, 300 adult TB patients were surveyed in two impoverished counties in China. Nutrient intakes were evaluated through two consecutive 24-h dietary recalls and compared with the Chinese Dietary Reference Intakes (DRIs) 2013. The potential socio-demographic and behavioral factors were analyzed using multivariate logistic model to identify strong influential factors.

Results: We found that mean daily energy intake was 1655.0 kcal (SD: 619.3 kcal) and 1360.3 kcal (SD: 552.1 kcal) for male and female patients, respectively. The mean daily energy intake was significantly lower than that has been recommended by DRI (i.e., 2250 and 1800 kcal for males and females, respectively), with 87.4% of the male patients and 59.9% of female patients failed to consume adequate energy. The protein intakes were 44.6 g (SD: 18.2 g) and 35.9 g (SD: 12.3 g) for male and female patients, respectively, which were lower than the recommended values by DRI (i.e., 65 and 55 g for males and females, respectively). Most male (90.8%) and female (58.4%) TB patients had insufficient daily protein intake. Further analyses suggested that mean daily intakes of many micronutrients, were insufficient, while for most of patients, intakes of vitamin E and sodium were sufficient. We identified that unemployment was a risk factor for low energy intake (p<0.05) and out-home-eating was a protective factor for low protein intake (p<0.01).

Conclusions: In impoverished areas in China, intakes of macronutrients and most micronutrients in TB patients were inadequate compared with DRIs, especially for unemployed patients and patients eating at home. These findings suggested that public health actions are needed to promote education on TB patients about significance of nutritional support, and, further interventions in TB patients’ nutritional intakes are also required.

Keywords: Tuberculosis patients; Nutrient intakes; Socio-demographic factors; Behavioral factors
Prediction of reading and writing difficulties of first graders using dyslexia risk questionnaire (DRQ) in preschool age
Authors: Labanienė Katažyna , Gedutienė Reda , Gintilienė Gražina 
Published: October 2019

This article examines relationships between the scores of Dyslexia Risk Questionnaire (DRQ) in preschool age and the abilities, necessary for acquisition of reading and writing skills, as well as reading and writing skills in the 1st Grade. The results of the study showed that the scores of Dyslexia Risk Questionnaire (DRQ), completed by pre-primary teachers and parents of children attending pre-primary group, are related to prognostic indicators of reading and writing difficulties (phonological abilities: rapid naming, phonological awareness, short-term auditory memory; vocabulary; visual-motor skills), as well as to 1st graders’ reading skills and their reading and writing ratings provided by parents and teachers.
Examining the factors related to bacteriological testing of private wells in Southern Ontario
Authors: Ugas Mohamed , Pearl David L. , Zentner Shawn , Tschritter Dana , Briggs Wendy , Manser Donna , Trotz-Williams Lise A. 
Published: October 2019

Abstract
The incidence of infectious waterborne disease in Canada continues to be a public health issue and can be associated with the source of drinking water. Millions of Canadians relying on unregulated private well water are at increased risk of disease. This study examined relationships between well and owner characteristics and the frequency of microbial testing of private wells in two southern-Ontario counties. Using multi-level logistic regression models, testing frequency (i.e., at least once per year vs. less) was modeled, as both self-reported and laboratory-validated, for associations with owner and well characteristics. For the self-reported outcome, a previous adverse test result significantly increased the odds of being classified as a frequent tester, and owners with a well-head more than 16 inches (40.6 cm) above the ground were at significantly higher odds of being classified as frequent testers compared to those with well-heads less than 16 inches above the ground and those below ground level. For the model based on the laboratory-validated outcome, the odds of an owner being a frequent tester significantly varied with the length of occupancy and the occurrence of a previous adverse result. The absence of associations between other well characteristics and testing frequency suggests that well safety education could benefit these communities.
INOVAÇÃO E CIÊNCIA DA INFORMAÇÃO NO BRASIL: ANÁLISE DAS PUBLICAÇÕES DO ENANCIB E BRAPCI ENTRE 2006 E 2016
Authors: Fachin Juliana , Blattmann Ursula , Vianna William Barbosa 
Published: October 2019

Estudo exploratório e descritivo com objetivo conhecer o cenário das publicações científicas sobre inovação, disponíveis nos anais do ENANCIB entre 2006 e 2017 e publicações periódicas indexadas na BRAPCI, constituindo uma amostra de 121 documentos. A amostra documental aponta que a maior parte das pesquisas analisadas na informação como fonte para a tomada de decisões, na gestão da informação e do conhecimento para a inovação, e, mapeamento de estudos sobre inovação e suas derivações: aberta, incremental, social e radical. Para conhecer o cenário da publicação científica da área, obteve-se dados como: ano de publicação, título do periódico, quantidade de publicações e o indicativo de autoria e co-autoria. Conclui-se sobre a produção científica na área da Ciência da Informação que a inovação está direcionada ao objeto informação enquanto fonte no processo inovativo. Estudos de aplicação de inovação de produtos ou serviços ainda são incipientes