Publications by authors named "Huong Lan Thi Nguyen"

49 Publications

Predicting the environmental suitability for onchocerciasis in Africa as an aid to elimination planning.

PLoS Negl Trop Dis 2021 Jul 28;15(7):e0008824. Epub 2021 Jul 28.

Department of Health Policy Planning and Management, University of Health and Allied Sciences, Ho, Ghana.

Recent evidence suggests that, in some foci, elimination of onchocerciasis from Africa may be feasible with mass drug administration (MDA) of ivermectin. To achieve continental elimination of transmission, mapping surveys will need to be conducted across all implementation units (IUs) for which endemicity status is currently unknown. Using boosted regression tree models with optimised hyperparameter selection, we estimated environmental suitability for onchocerciasis at the 5 × 5-km resolution across Africa. In order to classify IUs that include locations that are environmentally suitable, we used receiver operating characteristic (ROC) analysis to identify an optimal threshold for suitability concordant with locations where onchocerciasis has been previously detected. This threshold value was then used to classify IUs (more suitable or less suitable) based on the location within the IU with the largest mean prediction. Mean estimates of environmental suitability suggest large areas across West and Central Africa, as well as focal areas of East Africa, are suitable for onchocerciasis transmission, consistent with the presence of current control and elimination of transmission efforts. The ROC analysis identified a mean environmental suitability index of 0·71 as a threshold to classify based on the location with the largest mean prediction within the IU. Of the IUs considered for mapping surveys, 50·2% exceed this threshold for suitability in at least one 5 × 5-km location. The formidable scale of data collection required to map onchocerciasis endemicity across the African continent presents an opportunity to use spatial data to identify areas likely to be suitable for onchocerciasis transmission. National onchocerciasis elimination programmes may wish to consider prioritising these IUs for mapping surveys as human resources, laboratory capacity, and programmatic schedules may constrain survey implementation, and possibly delaying MDA initiation in areas that would ultimately qualify.
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http://dx.doi.org/10.1371/journal.pntd.0008824DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8318275PMC
July 2021

A qualitative assessment in acceptability and barriers to use pre-exposure prophylaxis (PrEP) among men who have sex with men: implications for service delivery in Vietnam.

BMC Infect Dis 2021 May 25;21(1):472. Epub 2021 May 25.

Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.

Background: HIV Pre-exposure prophylaxis (PrEP) is being considered for implementation among MSM nationwide in Vietnam. However, there may be concerns about potential obstacles for PrEP adherence among Vietnamese MSM. This study aims to assess the acceptability to use PrEP, potential barriers and facilitators, and the preferences for PrEP service accessibility and delivery among Vietnamese MSM.

Methods: Four focus group discussions (FGDs) were conducted with 30 HIV-negative MSM in January 2018 in Hanoi, Vietnam. FGDs explored MSM's awareness regarding PrEP, perceived benefits and barriers of PrEP use, and willingness to use PrEP. FGDs were audio-recorded and transcribed verbatim. Content analysis was used.

Results: The mean age of participants was 23.9 years old. Most participants realized the advantages of PrEP given its efficacy in HIV risk reduction and expressed high motivation and interest to use PrEP in the future. PrEP was considered as a supplement alongside condoms. Common concerns about PrEP included side-effects, forgetting to take the pill daily, stigmatization due to using PrEP, negative attitudes toward PrEP from other MSM and accessibility of PrEP. Participants would prefer an injectable PrEP regime if available as it was seen as easier to adhere to. Concerns were also raised that PrEP usage could be interpreted as an indication of engaging in sexual risk behavior for HIV, potentially causing suspicion in love relationships or by family and friends. Participants preferred to receive PrEP in civil business organizations and MSM-friendly clinics, and recommended that pharmacy stores would not be suitable for PrEP implementation due to lack of trust and fear of fake drugs.

Conclusion: This study indicated a high level of willingness to use PrEP among MSM in Vietnam in combination with condom. Strategies to raise awareness of PrEP, reduce stigma towards PrEP, and improve the accessibility among MSM in Vietnam is needed. Existing MSM-friendly clinics were recommended to implement PrEP programs in Vietnam.
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http://dx.doi.org/10.1186/s12879-021-06178-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8147440PMC
May 2021

Survival Outcomes of Vietnamese People with HIV after Initiating Antiretroviral Treatment: Role of Clinic-Related Factors.

AIDS Behav 2021 May 26;25(5):1626-1635. Epub 2020 Nov 26.

Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

Given the rapid development of HIV clinics in Vietnam, this study evaluates the infrastructure surrounding this expansion, identifying clinic-related factors that impact survival outcomes. A retrospective longitudinal study was conducted among people living with HIV (PLWH) who initiated antiretroviral therapy (ART) between 2011 and 2015 among 62 ART clinics in 15 provinces. The mortality rate during the 717674.1 person-years of observation (PYO) was 0.29/100 PYO. Location in rural areas (versus urban) and in Central Vietnam (versus Northern Vietnam) were associated with higher risk of mortality. The risk was lower among clinics that had peer-educators. As Vietnam's HIV/AIDS program continues to expand, this data supports increasing resource allocation for rural clinics, incorporation of ART with the community's existing healthcare infrastructure in its efforts to decentralize, and integration of services to reflect patients' anticipated needs.
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http://dx.doi.org/10.1007/s10461-020-03079-7DOI Listing
May 2021

An exploratory assessment of the preference for eHealth interventions to prevent HIV and sexually transmitted infections among men who have sex with men in Hanoi, Vietnam.

BMC Public Health 2020 Sep 11;20(1):1387. Epub 2020 Sep 11.

Department of Global Public Health Sciences, Karolinska Institutet, SE-171 77, Stockholm, Sweden.

Background: Electronic health (eHealth) interventions are promising in HIV and sexually transmitted infections (STIs) prevention among men who have sex with men (MSM), given a high rate of the Internet use in this population. This study determined the preferences for eHealth interventions to prevent HIV and STIs among MSM in Hanoi, Vietnam to guide the development of future eHealth interventions.

Methods: Five focus group discussions (FGD) were conducted with 35 MSM recruited by purposive sampling in January 2018 in Hanoi, Vietnam. The FGDs addressed attitudes towards the feasibility and uptake of HIV/STI interventions via online modalities such as smartphone applications (apps, social network sites, or emails); preferences and concerns regarding an online HIV/STI intervention. FGDs were audio-recorded and transcribed verbatim. Content analysis was used to determine themes.

Results: MSM reported that they commonly searched for information regarding HIV/STI and sexual health on Facebook and a variety of mobile apps. They perceived a lack of reliable online sources, a high need, and interest for an online intervention. Most of them preferred short and concise messages without perceived sensitive words such as "HIV" or "STI". Diversity of online modalities were preferred with information from credible sources about HIV/STI symptoms, testing and treatment, safe sex practices and testing locations with a focus on safe MSM-friendly clinics. Concerns about the need to trust the organization behind the online information and interventions, and the importance of confidentiality when participating in online interventions were raised.

Conclusion: High acceptance and perceived need for an online HIV/STI intervention were reported. The importance of establishing trust within the MSM community as a reliable source of information was emphasized, as well as the importance of confidentiality.
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http://dx.doi.org/10.1186/s12889-020-09449-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7488431PMC
September 2020

Estimating global injuries morbidity and mortality: methods and data used in the Global Burden of Disease 2017 study.

Inj Prev 2020 10 24;26(Supp 1):i125-i153. Epub 2020 Aug 24.

Department of Pharmacy, Adigrat University, Adigrat, Ethiopia.

Background: While there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria.

Methods: In this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation. In summary, these methods included estimating cause-specific mortality for every cause of injury, and then estimating incidence for every cause of injury. Non-fatal disability for each cause is then calculated based on the probabilities of suffering from different types of bodily injury experienced.

Results: GBD 2017 produced morbidity and mortality estimates for 38 causes of injury. Estimates were produced in terms of incidence, prevalence, years lived with disability, cause-specific mortality, years of life lost and disability-adjusted life-years for a 28-year period for 22 age groups, 195 countries and both sexes.

Conclusions: GBD 2017 demonstrated a complex and sophisticated series of analytical steps using the largest known database of morbidity and mortality data on injuries. GBD 2017 results should be used to help inform injury prevention policy making and resource allocation. We also identify important avenues for improving injury burden estimation in the future.
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http://dx.doi.org/10.1136/injuryprev-2019-043531DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7571362PMC
October 2020

Investigation on the Epoxidation of Piperitenone, and Structure-activity Relationships of Piperitenone Oxide for Differentiation-inducing Activity.

J Oleo Sci 2020 Aug 9;69(8):951-958. Epub 2020 Jul 9.

Department of Applied Biological Science, Tokyo University of Science.

Piperitenone oxide, a major chemical constituent of the essential oil of spearmint, Mentha spicata, induces differentiation in human colon cancer RCM-1 cells. In this study, piperitenone oxide and trans-piperitenone dioxide were prepared as racemic forms by epoxidation of piperitenone. The relative configuration between two epoxides in piperitenone dioxide was determined to be trans by H NMR analysis and nuclear Overhauser effect spectroscopy (NOESY) in conjunction with density functional theory (DFT) calculations. Optical resolution of (±)-piperitenone oxide by high-performance liquid chromatography (HPLC) using a chiral stationary phase (CSP) afforded both enantiomers with over 98% enantiomeric excess (ee). Evaluation of the differentiation-inducing activity of the synthetic compounds revealed that the epoxide at C-1 and C-6 in piperitenone oxide is important for the activity, and (+)-piperitenone oxide has stronger activity than (-)-piperitenone oxide. The results obtained in this study provide new information on the application of piperitenone oxide and spearmint for differentiation-inducing therapy. Furthermore, natural piperitenone oxide was isolated from M. spicata. The enantiomeric excess of the isolated natural piperitenone oxide was 66% ee. Epoxidation of piperitenone with hydrogen peroxide proceeded in a phosphate buffer under weak basic conditions to give (±)-piperitenone oxide. These results suggest that the nonenzymatic epoxidation of piperitenone, which causes a decrease in the enantiomeric excess of natural piperitenone oxide, is accompanied by an enzymatic epoxidation in the biosynthesis of piperitenone oxide.
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http://dx.doi.org/10.5650/jos.ess19278DOI Listing
August 2020

The Status of First Aid and Its Associations with Health Outcomes among Patients with Traffic Accidents in Urban Areas of Vietnam.

Int J Environ Res Public Health 2020 06 26;17(12). Epub 2020 Jun 26.

Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.

While it is well-evident that proper first aid would significantly promote survival and later treatment outcomes, little attention has been paid to improving its capacity in Vietnam. Thus, we conducted this study to assess the status of first aid and its associations with health outcomes among patients in traffic accidents in urban areas of Vietnam. We conducted a cross-sectional study on 413 patients in traffic accidents from October to December 2018 at six hospitals in Thai Binh province. Socio-demographics, first aid characteristics, and health outcomes were collected via face-to-face interviews using a structured questionnaire. We used a chi-square test to determine the differences in health outcomes among those who received first aid and those without. In addition, a multivariable regression was performed to determine the factors associated with first aid. The results indicated that less than half of the patients received first aid (48.1%), and only one fourth received first aid within 10 min after an accident. The proportions of having problems with mobility, self-care, usual activities, and pain/discomfort were significantly lower among those who received first aid compared to those without it. The regression model showed that those with multiple injuries were less likely to receive first aid.
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http://dx.doi.org/10.3390/ijerph17124600DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7344911PMC
June 2020

Measuring satisfaction with health care services for Vietnamese patients with cardiovascular diseases.

PLoS One 2020 25;15(6):e0235333. Epub 2020 Jun 25.

Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

Patient satisfaction is a useful predictor of adherence and outcomes of cardiovascular diseases (CVDs) treatment. This study explored the satisfaction of Vietnamese CVDs inpatients and outpatients using a scale specifically designed for CVDs patients and examined the factors associated with satisfaction towards CVDs treatment services. Interviews of 600 patients at the Hanoi Heart Hospital were conducted. We developed a measurement scale for both inpatient and outpatient services. Multivariate Tobit regression was used to determine the associated factors with patient satisfaction. For inpatients, Cronbach's alpha reported for the domains were in the range of 0.72-0.97, while for outpatients, Cronbach's alpha was within 0.61-0.97. Overall, patients were more satisfied with inpatient services (Mean = 81.8, SD = 5.8) than outpatient services (Mean = 79.7, SD = 5.2, p<0.05). In inpatients, the highest complete satisfaction was in "Attitude of Nurse" item (42.0%), the highest satisfaction score was in "Care and treatment" domain (Mean = 85.6, SD = 9.7) and the lowest in "Hospital facilities" domain (Mean = 78.3; SD = 9.2). Among outpatients, the highest complete satisfaction was in "Attitude of physicians when examining, guiding and explaining to the patient" item (19.7%), the highest satisfaction score was in "Attitude of medical staff" domain (Mean = 82.8; SD = 7.9) and the lowest in "Waiting time" domain (Mean = 76.6; SD = 8.2). People not having health insurances had significantly higher scores in "Waiting time", "Hospital facilities" and "Attitude of staff" domains (for outpatients) and in "Health service accessibility", "Hospital facilities" domains (for inpatients) as well as higher total satisfaction score than those having health insurance. Findings discovered through the application of the newly developed instrument showed low satisfaction regarding hospital facilities for inpatients and waiting time for outpatients, suggesting renovation efforts, while inferiority regarding patient satisfaction of health insurance covered patients compared to those without implied policy reform possibility. Further enhancement and validation of the developed instrument was required.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0235333PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7316281PMC
September 2020

Inadequate Knowledge, Attitude and Practices about Second-Hand Smoke among Non-Smoking Pregnant Women in Urban Vietnam: The Need for Health Literacy Reinforcement.

Int J Environ Res Public Health 2020 05 25;17(10). Epub 2020 May 25.

Department of Psychological Medicine, National University Hospital, Singapore 119074, Singapore.

The rate of exposure to second-hand smoke (SHS) is relatively high in several countries, including Vietnam, and health issues related to SHS have worsened in recent years, especially for pregnant women and their infants. Enhancement of knowledge, attitude, and practice (KAP) scores of pregnant women in Vietnam could raise practical interventions to protect their health and reduce complications of SHS. A cross-sectional study of 432 pregnant women who came to the Obstetrics Department of Bach Mai Hospital, Hanoi, Vietnam for antenatal care was conducted in 2016 to collect information about their KAP related to SHS. Composite mean scores from survey questions assessing their KAP were calculated on a 10-point scale, finding mean scores of 4.19, 7.45, and 4.30, respectively. Higher scores indicated better knowledge, attitude, and practice. Generalized linear models identified that age, occupation, living place, and sources of information were associated with SHS-related KAP. Findings from this study indicate that suitable programs related to SHS should be implemented to improve and reinforce health literacy to both mothers and smokers to reduce the harmfulness of smoking on women and their infants' health.
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http://dx.doi.org/10.3390/ijerph17103744DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7277525PMC
May 2020

Psychological Distress of Patients Experiencing Different Types of Road Traffic Injuries in Vietnam.

Int J Environ Res Public Health 2020 05 14;17(10). Epub 2020 May 14.

Department of Psychological Medicine, National University Hospital, Singapore 119074, Singapore.

Road-related injuries are often catastrophic, and the eighth leading cause of all-aged mortality. While psychological problems, including anxiety, driving phobia, and post-traumatic stress have been found to be common among injured survivors, the literature in this area is still limited. This study aimed to evaluate the prevalence of distress between different types of road injuries among 413 patients in Thai Binh hospitals from October to December 2018. The Kessler Psychological Distress Scale (K6) was used to assess mental health status. Sociodemographic and clinical characteristics were also collected. The results of Multiple Logistic and Tobit regression models were utilized. Psychological issues were found in 13.8% of the participants. In terms of K6 profile, nervous, restless/fidgety, and "everything was an effort" were the three most frequently endorsed aspects. Having soft-tissue injuries had a 0.32-time lower likelihood of psychological distress compared to those having other injuries. Additionally, patients who were diagnosed with fractures were 4.5-times more likely to report psychological distress. Our finding highlights the need for psychological screening to reduce disabilities associated with non-fatal injury related to road traffic crashes.
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http://dx.doi.org/10.3390/ijerph17103429DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7277653PMC
May 2020

Global injury morbidity and mortality from 1990 to 2017: results from the Global Burden of Disease Study 2017.

Inj Prev 2020 10 24;26(Supp 1):i96-i114. Epub 2020 Apr 24.

Faculty of Health Sciences - Health Management and Policy, American University of Beirut, Beirut, Lebanon.

Background: Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries.

Methods: We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs).

Findings: In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505).

Interpretation: Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.
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http://dx.doi.org/10.1136/injuryprev-2019-043494DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7571366PMC
October 2020

Individual and Environmental Factors Associated with Recurrent Falls in Elderly Patients Hospitalized after Falls.

Int J Environ Res Public Health 2020 04 3;17(7). Epub 2020 Apr 3.

Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam.

Falls and recurrent falls cause great health and social consequences in older people. However, these problems are poorly understood in Vietnam. A cross-sectional study was performed at seven hospitals in Thai Binh province, Vietnam, to investigate the individual and environmental factors associated with recurrent falls among elderly patients hospitalized due to fall injuries in Vietnam. A history of recurrent falls within the last 12 months, sociodemographic, health, and clinical characteristics, as well as environmental conditions, were obtained via self-reported interviews. Multivariate logistic and Poisson regression models were used to identify associated factors. Overall, the mean fall episodes in the last 12 months were 1.8 (Standard deviation-SD = 1.2) episodes, and the 12-month prevalence of recurrent falls was 40.5%. The individual risk factors included not receiving fall prevention guidelines, walking with devices, loss of sensation in hand or foot, and using pain relief medications. The environmental risk factors comprised having too-high stairs and not having dry, clean, and nonslippery bathrooms. This study highlights a significantly high 12-month prevalence of recurrent falls in older patients hospitalized after falls in Vietnam. Moreover, regular assessments of functional disabilities and hazardous environmental conditions, as well as the provision of prevention programs, have potential to prevent falls and recurrent falls.
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http://dx.doi.org/10.3390/ijerph17072441DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7177702PMC
April 2020

Global, Regional, and National Burden of Calcific Aortic Valve and Degenerative Mitral Valve Diseases, 1990-2017.

Circulation 2020 05 29;141(21):1670-1680. Epub 2020 Mar 29.

Institute of Family Medicine and Public Health, University of Tartu, Tartumaa, Estonia (M.J.).

Background: Nonrheumatic valvular diseases are common; however, no studies have estimated their global or national burden. As part of the Global Burden of Disease Study 2017, mortality, prevalence, and disability-adjusted life-years (DALYs) for calcific aortic valve disease (CAVD), degenerative mitral valve disease, and other nonrheumatic valvular diseases were estimated for 195 countries and territories from 1990 to 2017.

Methods: Vital registration data, epidemiologic survey data, and administrative hospital data were used to estimate disease burden using the Global Burden of Disease Study modeling framework, which ensures comparability across locations. Geospatial statistical methods were used to estimate disease for all countries, because data on nonrheumatic valvular diseases are extremely limited for some regions of the world, such as Sub-Saharan Africa and South Asia. Results accounted for estimated level of disease severity as well as the estimated availability of valve repair or replacement procedures. DALYs and other measures of health-related burden were generated for both sexes and each 5-year age group, location, and year from 1990 to 2017.

Results: Globally, CAVD and degenerative mitral valve disease caused 102 700 (95% uncertainty interval [UI], 82 700-107 900) and 35 700 (95% UI, 30 500-42 500) deaths, and 12.6 million (95% UI, 11.4 million-13.8 million) and 18.1 million (95% UI, 17.6 million-18.6 million) prevalent cases existed in 2017, respectively. A total of 2.5 million (95% UI, 2.3 million-2.8 million) DALYs were estimated as caused by nonrheumatic valvular diseases globally, representing 0.10% (95% UI, 0.09%-0.11%) of total lost health from all diseases in 2017. The number of DALYs increased for CAVD and degenerative mitral valve disease between 1990 and 2017 by 101% (95% UI, 79%-117%) and 35% (95% UI, 23%-47%), respectively. There is significant geographic variation in the prevalence, mortality rate, and overall burden of these diseases, with highest age-standardized DALY rates of CAVD estimated for high-income countries.

Conclusions: These global and national estimates demonstrate that CAVD and degenerative mitral valve disease are important causes of disease burden among older adults. Efforts to clarify modifiable risk factors and improve access to valve interventions are necessary if progress is to be made toward reducing, and eventually eliminating, the burden of these highly treatable diseases.
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http://dx.doi.org/10.1161/CIRCULATIONAHA.119.043391DOI Listing
May 2020

Global trends of hand and wrist trauma: a systematic analysis of fracture and digit amputation using the Global Burden of Disease 2017 Study.

Inj Prev 2020 10 13;26(Supp 1):i115-i124. Epub 2020 Mar 13.

Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.

Background: As global rates of mortality decrease, rates of non-fatal injury have increased, particularly in low Socio-demographic Index (SDI) nations. We hypothesised this global pattern of non-fatal injury would be demonstrated in regard to bony hand and wrist trauma over the 27-year study period.

Methods: The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 was used to estimate prevalence, age-standardised incidence and years lived with disability for hand trauma in 195 countries from 1990 to 2017. Individual injuries included hand and wrist fractures, thumb amputations and non-thumb digit amputations.

Results: The global incidence of hand trauma has only modestly decreased since 1990. In 2017, the age-standardised incidence of hand and wrist fractures was 179 per 100 000 (95% uncertainty interval (UI) 146 to 217), whereas the less common injuries of thumb and non-thumb digit amputation were 24 (95% UI 17 to 34) and 56 (95% UI 43 to 74) per 100 000, respectively. Rates of injury vary greatly by region, and improvements have not been equally distributed. The highest burden of hand trauma is currently reported in high SDI countries. However, low-middle and middle SDI countries have increasing rates of hand trauma by as much at 25%.

Conclusions: Certain regions are noted to have high rates of hand trauma over the study period. Low-middle and middle SDI countries, however, have demonstrated increasing rates of fracture and amputation over the last 27 years. This trend is concerning as access to quality and subspecialised surgical hand care is often limiting in these resource-limited regions.
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http://dx.doi.org/10.1136/injuryprev-2019-043495DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7571361PMC
October 2020

The burden of unintentional drowning: global, regional and national estimates of mortality from the Global Burden of Disease 2017 Study.

Inj Prev 2020 10 20;26(Supp 1):i83-i95. Epub 2020 Feb 20.

The George Institute for Global Health, New Delhi, India.

Background: Drowning is a leading cause of injury-related mortality globally. Unintentional drowning (International Classification of Diseases (ICD) 10 codes W65-74 and ICD9 E910) is one of the 30 mutually exclusive and collectively exhaustive causes of injury-related mortality in the Global Burden of Disease (GBD) study. This study's objective is to describe unintentional drowning using GBD estimates from 1990 to 2017.

Methods: Unintentional drowning from GBD 2017 was estimated for cause-specific mortality and years of life lost (YLLs), age, sex, country, region, Socio-demographic Index (SDI) quintile, and trends from 1990 to 2017. GBD 2017 used standard GBD methods for estimating mortality from drowning.

Results: Globally, unintentional drowning mortality decreased by 44.5% between 1990 and 2017, from 531 956 (uncertainty interval (UI): 484 107 to 572 854) to 295 210 (284 493 to 306 187) deaths. Global age-standardised mortality rates decreased 57.4%, from 9.3 (8.5 to 10.0) in 1990 to 4.0 (3.8 to 4.1) per 100 000 per annum in 2017. Unintentional drowning-associated mortality was generally higher in children, males and in low-SDI to middle-SDI countries. China, India, Pakistan and Bangladesh accounted for 51.2% of all drowning deaths in 2017. Oceania was the region with the highest rate of age-standardised YLLs in 2017, with 45 434 (40 850 to 50 539) YLLs per 100 000 across both sexes.

Conclusions: There has been a decline in global drowning rates. This study shows that the decline was not consistent across countries. The results reinforce the need for continued and improved policy, prevention and research efforts, with a focus on low- and middle-income countries.
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http://dx.doi.org/10.1136/injuryprev-2019-043484DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7571364PMC
October 2020

Burden of injury along the development spectrum: associations between the Socio-demographic Index and disability-adjusted life year estimates from the Global Burden of Disease Study 2017.

Inj Prev 2020 10 8;26(Supp 1):i12-i26. Epub 2020 Jan 8.

School of Public Health, Auckland University of Technology, Auckland, New Zealand.

Background: The epidemiological transition of non-communicable diseases replacing infectious diseases as the main contributors to disease burden has been well documented in global health literature. Less focus, however, has been given to the relationship between sociodemographic changes and injury. The aim of this study was to examine the association between disability-adjusted life years (DALYs) from injury for 195 countries and territories at different levels along the development spectrum between 1990 and 2017 based on the Global Burden of Disease (GBD) 2017 estimates.

Methods: Injury mortality was estimated using the GBD mortality database, corrections for garbage coding and CODEm-the cause of death ensemble modelling tool. Morbidity estimation was based on surveys and inpatient and outpatient data sets for 30 cause-of-injury with 47 nature-of-injury categories each. The Socio-demographic Index (SDI) is a composite indicator that includes lagged income per capita, average educational attainment over age 15 years and total fertility rate.

Results: For many causes of injury, age-standardised DALY rates declined with increasing SDI, although road injury, interpersonal violence and self-harm did not follow this pattern. Particularly for self-harm opposing patterns were observed in regions with similar SDI levels. For road injuries, this effect was less pronounced.

Conclusions: The overall global pattern is that of declining injury burden with increasing SDI. However, not all injuries follow this pattern, which suggests multiple underlying mechanisms influencing injury DALYs. There is a need for a detailed understanding of these patterns to help to inform national and global efforts to address injury-related health outcomes across the development spectrum.
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http://dx.doi.org/10.1136/injuryprev-2019-043296DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7571356PMC
October 2020

Mapping 123 million neonatal, infant and child deaths between 2000 and 2017.

Nature 2019 10 16;574(7778):353-358. Epub 2019 Oct 16.

School of Health Sciences, Madda Walabu University, Bale Goba, Ethiopia.

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2-to end preventable child deaths by 2030-we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000-2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations.
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http://dx.doi.org/10.1038/s41586-019-1545-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6800389PMC
October 2019

Characterizing Artificial Intelligence Applications in Cancer Research: A Latent Dirichlet Allocation Analysis.

JMIR Med Inform 2019 Sep 15;7(4):e14401. Epub 2019 Sep 15.

Center of Excellence in Behavior Medicine, Nguyen Tat Thanh University, Ho Chi Minh, Vietnam.

Background: Artificial intelligence (AI)-based therapeutics, devices, and systems are vital innovations in cancer control; particularly, they allow for diagnosis, screening, precise estimation of survival, informing therapy selection, and scaling up treatment services in a timely manner.

Objective: The aim of this study was to analyze the global trends, patterns, and development of interdisciplinary landscapes in AI and cancer research.

Methods: An exploratory factor analysis was conducted to identify research domains emerging from abstract contents. The Jaccard similarity index was utilized to identify the most frequently co-occurring terms. Latent Dirichlet Allocation was used for classifying papers into corresponding topics.

Results: From 1991 to 2018, the number of studies examining the application of AI in cancer care has grown to 3555 papers covering therapeutics, capacities, and factors associated with outcomes. Topics with the highest volume of publications include (1) machine learning, (2) comparative effectiveness evaluation of AI-assisted medical therapies, and (3) AI-based prediction. Noticeably, this classification has revealed topics examining the incremental effectiveness of AI applications, the quality of life, and functioning of patients receiving these innovations. The growing research productivity and expansion of multidisciplinary approaches are largely driven by machine learning, artificial neural networks, and AI in various clinical practices.

Conclusions: The research landscapes show that the development of AI in cancer care is focused on not only improving prediction in cancer screening and AI-assisted therapeutics but also on improving other corresponding areas such as precision and personalized medicine and patient-reported outcomes.
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http://dx.doi.org/10.2196/14401DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6774235PMC
September 2019

A Systematic Review of eHealth Interventions Addressing HIV/STI Prevention Among Men Who Have Sex With Men.

AIDS Behav 2019 Sep;23(9):2253-2272

Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.

A systematic review was conducted to summarize and appraise the eHealth interventions addressing HIV/STI prevention among men who have sex with men (MSM), and characterize features of successful eHealth interventions. Fifty-five articles (17 pilots and 38 full efficacy trials) were included with the predominance of web-based interventions in the United States-based settings. Intervention modalities include web-based, short message service (SMS)/text messges/email reminder, online video-based, computer-assisted, multimedia-based, social network, live chat and chat room, virtual simulation intervention, and smartphone applications. Forty-nine eHealth interventions achieved a short-term behaviour change among participants. Four studies were conducted with 12-month follow-ups; and only one of them could maintain the behaviour change over this longer time period which could be due to the lack of booster interventions. Our study suggests that eHealth interventions can achieve short term behaviour change among MSM, however limited interventions could maintain behaviour change over 12 months. Further eHealth intervention strategies to promote HIV prevention among MSM should be conducted and rigorously evaluated.
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http://dx.doi.org/10.1007/s10461-019-02626-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6766471PMC
September 2019

The Current Research Landscape of the Application of Artificial Intelligence in Managing Cerebrovascular and Heart Diseases: A Bibliometric and Content Analysis.

Int J Environ Res Public Health 2019 07 29;16(15). Epub 2019 Jul 29.

Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119074, Singapore.

The applications of artificial intelligence (AI) in aiding clinical decision-making and management of stroke and heart diseases have become increasingly common in recent years, thanks in part to technological advancements and the heightened interest of the research and medical community. This study aims to provide a comprehensive picture of global trends and developments of AI applications relating to stroke and heart diseases, identifying research gaps and suggesting future directions for research and policy-making. A novel analysis approach that combined bibliometrics analysis with a more complex analysis of abstract content using exploratory factor analysis and Latent Dirichlet allocation, which uncovered emerging research domains and topics, was adopted. Data were extracted from the Web of Science database. Results showed topics with the most compelling growth to be AI for big data analysis, robotic prosthesis, robotics-assisted stroke rehabilitation, and minimally invasive surgery. The study also found an emerging landscape of research that was centered on population-specific and early detection of stroke and heart disease. Application of AI in health behavior tracking and improvement as well as the use of robotics in medical diagnostics and prognostication have also been found to attract significant research attention. In light of these findings, it is suggested that the currently under-researched issues of data management, AI model reliability, as well as validation of its clinical utility, need to be further explored in future research and policy decisions to maximize the benefits of AI applications in stroke and heart diseases.
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http://dx.doi.org/10.3390/ijerph16152699DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6696240PMC
July 2019

Determining Risk for Depression among Older People Residing in Vietnamese Rural Settings.

Int J Environ Res Public Health 2019 07 25;16(15). Epub 2019 Jul 25.

Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam.

(1) Background: Major causes of the burden of disease in older persons include mental disorders and neurological diseases, such as depression. This study aims to explore the prevalence of older people at risk for depression and identify the factors associated with this risk in rural Vietnam. (2) Methods: A cross-sectional study was conducted in Soc Son, Hanoi with 523 community dwelling elders aged 60 and over. Face-to-face interviews were performed to collect data about socioeconomic status, risk for depression, health status, and health utilization. The Geriatric Depression Scale-4 items (GDS-4) was used to assess the risk for depression occurrence. Multivariable logistic regression was employed for determining the factors associated with the risk for depression. (3) Results: Among 523 participants, there were 26.4% of participants at risk for depression. The proportion of females at risk for depression (29.0%) was significantly higher than males (20.4%). Differences were found in economic status (near poor group had higher risk for depression compared to the poor group) ( < 0.01). Older adults living with spouse/partner, living in near-poor household, and suffering pain/discomfort were all more likely to be at risk for depression. (4) Conclusions: Being female, living in a near poor household, being in pain or experiencing discomfort are all factors strongly correlated to high risk for depression. These findings highlight the urgent need for additional research among Vietnamese community-dwelling older people.
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http://dx.doi.org/10.3390/ijerph16152654DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6696606PMC
July 2019

The Current Research Landscape on the Artificial Intelligence Application in the Management of Depressive Disorders: A Bibliometric Analysis.

Int J Environ Res Public Health 2019 06 18;16(12). Epub 2019 Jun 18.

Center of Excellence in Evidence-based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam.

Artificial intelligence (AI)-based techniques have been widely applied in depression research and treatment. Nonetheless, there is currently no systematic review or bibliometric analysis in the medical literature about the applications of AI in depression. We performed a bibliometric analysis of the current research landscape, which objectively evaluates the productivity of global researchers or institutions in this field, along with exploratory factor analysis (EFA) and latent dirichlet allocation (LDA). From 2010 onwards, the total number of papers and citations on using AI to manage depressive disorder have risen considerably. In terms of global AI research network, researchers from the United States were the major contributors to this field. Exploratory factor analysis showed that the most well-studied application of AI was the utilization of machine learning to identify clinical characteristics in depression, which accounted for more than 60% of all publications. Latent dirichlet allocation identified specific research themes, which include diagnosis accuracy, structural imaging techniques, gene testing, drug development, pattern recognition, and electroencephalography (EEG)-based diagnosis. Although the rapid development and widespread use of AI provide various benefits for both health providers and patients, interventions to enhance privacy and confidentiality issues are still limited and require further research.
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http://dx.doi.org/10.3390/ijerph16122150DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6617113PMC
June 2019

Understanding Global HIV Stigma and Discrimination: Are Contextual Factors Sufficiently Studied? (GAP).

Int J Environ Res Public Health 2019 05 29;16(11). Epub 2019 May 29.

Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam 700000, Vietnam.

Stigma and discrimination are among the greatest challenges that people living with human immunodeficiency virus (HIV) face, and both are known to negatively affect quality of life as well as treatment outcomes. We analyzed the growing research and current understanding of HIV-related stigma and contextual factors in HIV/AIDS (human Immunodeficiency virus/ acquired immunodeficiency syndrome) bibliography. A total of 5984 publications published from 1991 to 2017 were retrieved from the Web of Science database. The number of papers and their impacts have been considerably grown in recent years. Research landscapes related to stigma and discrimination include clinical, physical and mental health outcomes, risk behaviors of most-at-risk populations, and HIV-related services. We found a lack of empirical studies not only on social, cultural and economic contexts, but also on specific interventions for particular settings and sub-populations. This study highlights certain gaps and provides a basis for future studies and interventions on this critical issue given the changing drivers of HIV epidemics.
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http://dx.doi.org/10.3390/ijerph16111899DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6603743PMC
May 2019

Rubella Vaccination Coverage Among Women of Childbearing Age in Vietnam.

Int J Environ Res Public Health 2019 05 16;16(10). Epub 2019 May 16.

Center of Excellence in Behavior Medicine, Nguyen Tat Thanh University, Ho Chi Minh 70000, Vietnam.

Despite the availability of effective and safe rubella vaccines for women of childbearing age, prevention and control of congenital rubella syndrome in children remains challenging in Vietnam. In order to examine this issue, we conducted a cross-sectional study, examining the current coverage of rubella vaccination before pregnancy among 807 pregnant women and women with children under 12 months of age in urban and rural districts, Dong Da and Ba Vi, in Hanoi, Vietnam. In this population, we observed an alarming non-compliance rate with rubella vaccination before pregnancy in both localities. Among the 82.0% of participants who remained unvaccinated against this contagious viral infection, 95.8% of them were in Ba Vi district, compared to 68.0% in Dong Da district ( < 0.001). Besides the differences in age, number of children, education levels, primary occupations and monthly incomes among the participants between the two districts, other reasons for noncompliance with rubella vaccination includeddisinterest in rubella vaccination, the high cost and long distance to vaccination sites as well as unawareness of vaccination locations. In addition to addressing the unique socio-economicchallenges behind one's accessibility to vaccination services in urban and rural areas, our study supports a continued effort in ensuring proper access to and education about pre-pregnancy vaccines and vaccination among women of childbearing age in order to achieve and sustain sufficient immunization coverage of rubella and other vaccine-preventable diseases in both settings.
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http://dx.doi.org/10.3390/ijerph16101741DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6572083PMC
May 2019

Health Inequality between Migrant and Non-Migrant Workers in an Industrial Zone of Vietnam.

Int J Environ Res Public Health 2019 04 28;16(9). Epub 2019 Apr 28.

Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam.

Vietnam has experienced massive internal migration waves from rural to industrialized zones. However, little efforts have been made to understand differences in health conditions and health-related quality of life (HRQOL) between local and migrant industrial workers. This study aimed to examine the inequality in health status and HRQOL between these workers. We conducted a cross-sectional study of 289 Vietnamese workers at three industrial areas in Hanoi and Bac Ninh. Self-reported health status and HRQOL were measured using the EuroQOL-5 dimensions-5 levels (EQ-5D-5L) instrument. Sociodemographic, working, and environmental factors were also investigated. Overall, the mean EQ-5D index was 0.74 (SD = 0.21) and the average number of health problems in the last 12 months in our sample was 1.91 (SD = 1.63) problems. Migrant people had a lower EQ-5D index (β = -0.08, < 0.01) and more health problems (β = 0.20, < 0.05) compared to local workers. Those being male, working in the same posture more than 60 min, and exposed to more hazards at work were correlated with a lower EQ-5D index and higher number of health problems. The results highlighted inequalities in health status and HRQOL between migrant and local workers. Reinforcing regular health check-ups, ensuring sufficient protective equipment and working conditions may help improve the health outcomes of the workers.
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http://dx.doi.org/10.3390/ijerph16091502DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6539052PMC
April 2019

Diseases, Injuries, and Risk Factors in Child and Adolescent Health, 1990 to 2017: Findings From the Global Burden of Diseases, Injuries, and Risk Factors 2017 Study.

JAMA Pediatr 2019 06 3;173(6):e190337. Epub 2019 Jun 3.

Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran.

Importance: Understanding causes and correlates of health loss among children and adolescents can identify areas of success, stagnation, and emerging threats and thereby facilitate effective improvement strategies.

Objective: To estimate mortality and morbidity in children and adolescents from 1990 to 2017 by age and sex in 195 countries and territories.

Design, Setting, And Participants: This study examined levels, trends, and spatiotemporal patterns of cause-specific mortality and nonfatal health outcomes using standardized approaches to data processing and statistical analysis. It also describes epidemiologic transitions by evaluating historical associations between disease indicators and the Socio-Demographic Index (SDI), a composite indicator of income, educational attainment, and fertility. Data collected from 1990 to 2017 on children and adolescents from birth through 19 years of age in 195 countries and territories were assessed. Data analysis occurred from January 2018 to August 2018.

Exposures: Being under the age of 20 years between 1990 and 2017.

Main Outcomes And Measures: Death and disability. All-cause and cause-specific deaths, disability-adjusted life years, years of life lost, and years of life lived with disability.

Results: Child and adolescent deaths decreased 51.7% from 13.77 million (95% uncertainty interval [UI], 13.60-13.93 million) in 1990 to 6.64 million (95% UI, 6.44-6.87 million) in 2017, but in 2017, aggregate disability increased 4.7% to a total of 145 million (95% UI, 107-190 million) years lived with disability globally. Progress was uneven, and inequity increased, with low-SDI and low-middle-SDI locations experiencing 82.2% (95% UI, 81.6%-82.9%) of deaths, up from 70.9% (95% UI, 70.4%-71.4%) in 1990. The leading disaggregated causes of disability-adjusted life years in 2017 in the low-SDI quintile were neonatal disorders, lower respiratory infections, diarrhea, malaria, and congenital birth defects, whereas neonatal disorders, congenital birth defects, headache, dermatitis, and anxiety were highest-ranked in the high-SDI quintile.

Conclusions And Relevance: Mortality reductions over this 27-year period mean that children are more likely than ever to reach their 20th birthdays. The concomitant expansion of nonfatal health loss and epidemiological transition in children and adolescents, especially in low-SDI and middle-SDI countries, has the potential to increase already overburdened health systems, will affect the human capital potential of societies, and may influence the trajectory of socioeconomic development. Continued monitoring of child and adolescent health loss is crucial to sustain the progress of the past 27 years.
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http://dx.doi.org/10.1001/jamapediatrics.2019.0337DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6547084PMC
June 2019

Knowledge, Attitude and Practice about Dengue Fever among Patients Experiencing the 2017 Outbreak in Vietnam.

Int J Environ Res Public Health 2019 03 18;16(6). Epub 2019 Mar 18.

Center of Excellence in Behavior Medicine, Nguyen Tat Thanh University, Ho Chi Minh 70000, Vietnam.

There is a gap in the literature on the understanding of the general Vietnamese population toward dengue fever (DF). This study aimed to explore knowledge, attitudes, practice (KAP) of dengue fever among Vietnamese participants and the potential associated factors. A cross-sectional study was conducted among 330 patients at the Bach Mai Hospital in Northern Vietnam. A Tobit regression model was utilized to investigate the associated factors. The average knowledge score was 4.6/19. Respondents perceived their risk of DF infection to be very low (39.5%) to low (20.7%) and had a neutral attitude about the necessity of hospitalization when being infected with DF (60.9%). A total of 17.6%, 9.8% and 6.6% of respondents reported frequently changing water, properly disposing of waste and covering water storage containers to eliminate larvae. Gender, education level, duration of illness and travel history were correlated with knowledge. Occupation, the presence of DF in the neighborhood, mosquito density at home and DF symptom severity were associated with attitudes. Occupation, mosquito density at home, type of patient, knowledge and attitudes were associated with practices. To enhance the KAP towards DF, further efforts should first be directed to improve knowledge through education, especially at the school level and people in less developed areas.
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http://dx.doi.org/10.3390/ijerph16060976DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6466316PMC
March 2019

Global Evolution of Research in Artificial Intelligence in Health and Medicine: A Bibliometric Study.

J Clin Med 2019 Mar 14;8(3). Epub 2019 Mar 14.

Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam.

The increasing application of Artificial Intelligence (AI) in health and medicine has attracted a great deal of research interest in recent decades. This study aims to provide a global and historical picture of research concerning AI in health and medicine. A total of 27,451 papers that were published between 1977 and 2018 (84.6% were dated 2008⁻2018) were retrieved from the Web of Science platform. The descriptive analysis examined the publication volume, and authors and countries collaboration. A global network of authors' keywords and content analysis of related scientific literature highlighted major techniques, including Robotic, Machine learning, Artificial neural network, Artificial intelligence, Natural language process, and their most frequent applications in Clinical Prediction and Treatment. The number of cancer-related publications was the highest, followed by Heart Diseases and Stroke, Vision impairment, Alzheimer's, and Depression. Moreover, the shortage in the research of AI application to some high burden diseases suggests future directions in AI research. This study offers a first and comprehensive picture of the global efforts directed towards this increasingly important and prolific field of research and suggests the development of global and national protocols and regulations on the justification and adaptation of medical AI products.
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http://dx.doi.org/10.3390/jcm8030360DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463262PMC
March 2019

Catastrophic health expenditure of Vietnamese patients with gallstone diseases - a case for health insurance policy revaluation.

Clinicoecon Outcomes Res 2019 11;11:151-158. Epub 2019 Feb 11.

Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam.

Purpose: Despite gallstone diseases (GSDs) being a major public health concern with both acute and chronic episodes, none of the studies in Vietnam has been conducted to investigate the household expenditure for the GSD treatment. The objective of this study was to estimate the costs of managing GSD and to explore the prevalence and determinants of catastrophic health expenditure (CHE) among Vietnamese patients.

Materials And Methods: A cross-sectional study was conducted from June 2016 to March 2017 in the Department of Hepatobiliary and Pancreatic Surgery, Viet Duc Hospital in Hanoi, Vietnam. A total of 206 patients were enrolled. Demographic and socioeconomic data, household income, and direct and indirect medical costs of patients seeking treatment for GSD were collected through face-to-face interview. Multivariate logistic regression was used to explore factors associated with CHE.

Results: The prevalence of CHE in patients suffering from GSD was 35%. The percentage of patients who were covered by health insurance and at risk for CHE was 41.2%, significantly higher than that of those noninsured (15.8%). Proportions of patients with and without health insurance who sought outpatient treatment were 30.6% and 81.6%, respectively. Patients who were divorced or widowed and had intrahepatic gallstones were significantly more likely to experience CHE. Those who were outpatients, were women, had history of pharmacological treatment to parasitic infection, and belong to middle and highest monthly household income quantile were significantly less likely to experience CHE.

Conclusion: The findings suggested that efforts to re-evaluate health insurance reimbursement capacity, especially for acute diseases and taking into account the varying preferences of people with different disease severity, should be conducted by health authority. Further studies concerning CHE of GSD in the context of ongoing health policy reform should consider utilizing WHO-recommended measures like the fairness in financial contribution index, as well as taking into consideration the behavioral aspects of health care spending.
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http://dx.doi.org/10.2147/CEOR.S191379DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6375106PMC
February 2019
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