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High performance implementation of the hierarchical likelihood for generalized linear mixed models: an application to estimate the potassium reference range in massive electronic health records datasets.

BMC Med Res Methodol 2021 Jul 24;21(1):151. Epub 2021 Jul 24.

Department of Internal Medicine, University of New Mexico School of Medicine, MSC10 5550 1 University of New Mexico Albuquerque, Albuquerque, NM, 87131, USA.

Background: Converting electronic health record (EHR) entries to useful clinical inferences requires one to address the poor scalability of existing implementations of Generalized Linear Mixed Models (GLMM) for repeated measures. The major computational bottleneck concerns the numerical evaluation of multivariable integrals, which even for the simplest EHR analyses may involve millions of dimensions (one for each patient). The hierarchical likelihood (h-lik) approach to GLMMs is a methodologically rigorous framework for the estimation of GLMMs that is based on the Laplace Approximation (LA), which replaces integration with numerical optimization, and thus scales very well with dimensionality. Read More

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The influential factors for achieving universal health coverage in Iran: a multimethod study.

BMC Health Serv Res 2021 Jul 22;21(1):724. Epub 2021 Jul 22.

Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.

Background: The initial purpose of healthcare systems around the world is to promote and maintain the health of the population. Universal Health Coverage (UHC) is a new approach by which a healthcare system can reach its goals. World Health Organization (WHO) emphasized maximum population coverage, health service coverage, and financial protection, as three dimensions of UHC. Read More

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Recruiting 'hard to reach' parents for health promotion research: experiences from a qualitative study.

BMC Res Notes 2021 Jul 21;14(1):276. Epub 2021 Jul 21.

Health Promotion Research Centre, National University of Ireland, Galway, Ireland.

Objective: Marginalised populations are less likely to take part in health research, and are sometimes considered 'easy to ignore'. We aimed to describe our approach and results of recruiting parents who experience disadvantage, for focus groups exploring infant feeding on the island of Ireland. Upon receiving ethical approval, we implemented recruitment strategies that included building rapport with community organisations through existing networks, targeting specific organisations with information about our aims, and utilising social media groups for parents. Read More

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A randomised feasibility trial of an employer-based intervention for enhancing successful return to work of cancer survivors (MiLES intervention).

BMC Public Health 2021 Jul 21;21(1):1433. Epub 2021 Jul 21.

Department Public and Occupational Health/ Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.

Background: Employers express a need for support during sickness absence and return to work (RTW) of cancer survivors. Therefore, a web-based intervention (MiLES) targeted at employers with the objective of enhancing cancer survivors' successful RTW has been developed. This study aimed to assess feasibility of a future definitive randomised controlled trial (RCT) on the effectiveness of the MiLES intervention. Read More

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Continuous quality improvement (CQI) Institutionalization to reach 95:95:95 HIV targets: a multicountry experience from the Global South.

BMC Health Serv Res 2021 Jul 20;21(1):711. Epub 2021 Jul 20.

Institute of Human Virology, Center for International Health, Education, and Biosecurity (CIHEB), University of Maryland School of Medicine in Kenya, Baltimore, Kenya.

Background: Scaling up continuous quality improvement (CQI) processes could be key in achieving the 95:95:95 cascade and global HIV targets. This paper describes the experiences and outcomes related to implementing CQI processes to help reach these targets, with particular focus on clinical and programmatic settings in 6 countries from the global south.

Methods: The HIV program at the University of Maryland, Baltimore (UMB) implemented an adapted CQI model in Kenya, Tanzania, Botswana, Zambia, Nigeria and Rwanda that included the following steps: (1) analysing the problem to identify goals and objectives for improvement; (2) developing individual changes or 'change packages', (3) developing a monitoring system to measure improvements; and (4) implementing and measuring changes through continuous 'plan-do-study-act' (PDSA) cycles. Read More

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Innovative cardiovascular primary prevention population-based strategies: a 2-year hybrid type 1 implementation randomised control trial (RCT) which evaluates behavioural change conducted by community champions compared with brief advice only from the SPICES project (scaling-up packages of interventions for cardiovascular disease prevention in selected sites in Europe and sub-Saharan Africa).

BMC Public Health 2021 Jul 19;21(1):1422. Epub 2021 Jul 19.

EA 7479 SPURBO, Department of general practice, University of Western Brittany, Brest, France.

Background: Cardiovascular diseases (CVD) caused 17.9 million deaths worldwide in 2016, being the world's leading cause of death. Prevention of CVD in high-income countries is expensive and fails to reach the population at risk. Read More

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An observed, prospective field study to evaluate the performance and acceptance of a blood-based HIV self-test in Canada.

BMC Public Health 2021 07 18;21(1):1421. Epub 2021 Jul 18.

MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, Ontario, Canada.

Background: Self testing for HIV is a targeted intervention with the potential to increase the access, uptake and frequency of HIV testing and more effectively reach the undiagnosed, especially in priority populations. The objectives of this study were to (1) evaluate the INSTI HIV self-test performance compared with laboratory reference testing, (2) document if intended users can perform the steps to use the HIV self-test device, and (3) document if intended users can successfully interpret contrived positive, negative, and invalid results. Study was intended to be submitted to Health Canada for review for regulatory approval purposes. Read More

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Using path analysis to test theory of change: a quantitative process evaluation of the MapSan trial.

BMC Public Health 2021 Jul 16;21(1):1411. Epub 2021 Jul 16.

Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK.

Background: Although theory-driven evaluations should have empirical components, few evaluations of public health interventions quantitatively test the causal model made explicit in the theory of change (ToC). In the context of a shared sanitation trial (MapSan) in Maputo, Mozambique, we report findings of a quantitative process evaluation assessing intervention implementation, participant response and impacts on hypothesised intermediary outcomes on the pathway to trial health outcomes. We examine the utility of path analysis in testing intervention theory using process indicators from the intervention's ToC. Read More

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Trends in socioeconomic inequality of periodontal health status among Dutch adults: a repeated cross-sectional analysis over two decades.

BMC Oral Health 2021 Jul 15;21(1):346. Epub 2021 Jul 15.

Department of Periodontology, Center for Dentistry and Oral Hygiene, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands.

Background: Studies exclusively focusing on trends in socioeconomic inequality of oral health status in industrialized countries are relatively sparse. This study aimed to assess possible differences in oral hygiene and periodontal status among people of different socioeconomic status (SES) in the Netherlands over two decades.

Methods: A repeated cross-sectional analysis of 3083 participants aged 25-54 years was conducted on the Dutch National Oral Health Surveys of 1995, 2002, 2007, and 2013. Read More

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Bridging the research to practice gap: a systematic scoping review of implementation of interventions for cancer-related fatigue management.

BMC Cancer 2021 Jul 14;21(1):809. Epub 2021 Jul 14.

Cancer and Palliative Care Outcomes Centre, School of Nursing, N Block, Kelvin Grove Campus,, Queensland University of Technology (QUT), Kelvin Grove, Queensland, 4059, Australia.

Background: Cancer-related fatigue (CRF) is one of the most common and distressing symptoms in people with cancer. Although efficacy of interventions for CRF have been extensively investigated, less has been done to ensure successful translation into routine clinical practice. The aim of this systematic scoping review was to synthesise knowledge surrounding the implementation of CRF interventions, summarise the processes and outcomes of implementation strategies used, and identify opportunities for further research. Read More

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The impact of physical exercises with elements of dance movement therapy on the upper limb grip strength and functional performance of elderly wheelchair users living in nursing homes - a randomized control trial.

BMC Geriatr 2021 Jul 12;21(1):423. Epub 2021 Jul 12.

Institute of Health Sciences, Medical College of Rzeszow University, Warzywna 1A Street, 35-310, Rzeszów, Poland.

Introduction: Over the last few decades, the quality of care and the quality of life of nursing home (NH) residents have significantly improved, but insufficient physical activity and social involvement still represent substantial challenges in modern nursing facilities. The main aim of this research was to assess the influence of physical exercises with dance movement therapy (DMT) elements on strength and other fitness components of the upper limbs and the overall functional performance of NH residents in wheelchairs compared to standard exercise programmes and usual care.

Method: The study participants were persons aged 68-85 who lived in NH and used manual wheelchairs as a primary means of mobility. Read More

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Factors influencing paramedics' and emergency medical technicians' level of knowledge about the 2015 basic life support guidelines.

BMC Emerg Med 2021 Jul 12;21(1):82. Epub 2021 Jul 12.

Medicalpark Gaziantep Hospital, Gaziantep, Turkey.

Background: This study aimed to determine the cardiopulmonary resuscitation (CPR) knowledge level and factors affecting the current CPR knowledge level among EMTs and paramedics working in the Kayseri 112 emergency health system.

Methods: This survey aimed to reach all paramedics and emergency medical technicians working in the 112 emergency health system in Kayseri province. The data collection consists of sociodemographic/occupational characteristics, CPR training and practice characteristics and 20 four-choice CPR knowledge questions. Read More

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Effectiveness of a community-level social mobilization intervention in achieving the outcomes of polio vaccination campaigns during the post-polio-endemic period: Evidence from CORE Group polio project in Uttar Pradesh, India.

BMC Public Health 2021 Jul 10;21(1):1371. Epub 2021 Jul 10.

Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

Background: A social mobilization (SM) initiative contributed to India's success in polio elimination. This was the CORE Group Polio Project (CGPP) India, a partner of the Uttar Pradesh (UP) SM Network and which continued its SM activities, even during the polio-free period through a network of multi-level social mobilizers. This paper assesses the effects of this community-level SM (CLSM) intervention on the extent of community engagement and performance of polio Supplementary Immunization Activity campaigns (SIAs) during the post-polio-endemic period (i. Read More

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Disability trajectories prior to death for ten leading causes of death among middle-aged and older adults in Taiwan.

BMC Geriatr 2021 Jul 10;21(1):420. Epub 2021 Jul 10.

Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

Background: Prolonged life expectancy is associated with increased prevalence of chronic diseases. The aim of this study was to determine the different disability trajectories for the top ten leading causes of death in Taiwan .

Methods: A total of 2,431 participants aged 50-96 in 1996 from the Taiwan longitudinal study on aging (TLSA) who died from 1996 to 2016 were analyzed. Read More

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Symptoms and signs of colorectal cancer, with differences between proximal and distal colon cancer: a prospective cohort study of diagnostic accuracy in primary care.

BMC Fam Pract 2021 Jul 8;22(1):148. Epub 2021 Jul 8.

Faculty of Nursing and Health Sciences, Nord University, P.O.Box 1490, 8049, Bodø, Norway.

Background: In an abdominal symptom study in primary care in six European countries, 511 cases of cancer were recorded prospectively among 61,802 patients 16 years and older in Norway, Denmark, Sweden, Netherlands, Belgium and Scotland. Colorectal cancer is one of the main types of cancer associated with abdominal symptoms; hence, an in-depth subgroup analysis of the 94 colorectal cancers was carried out in order to study variation in symptom presentation among cancers in different anatomical locations.

Method: Initial data capture was by completion of standardised forms containing closed questions about symptoms recorded during the consultation. Read More

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Predicting synchronized gene coexpression patterns from fibration symmetries in gene regulatory networks in bacteria.

BMC Bioinformatics 2021 Jul 8;22(1):363. Epub 2021 Jul 8.

Levich Institute,Physics Department, City College of New York, New York, NY, 10031, USA.

Background: Gene regulatory networks coordinate the expression of genes across physiological states and ensure a synchronized expression of genes in cellular subsystems, critical for the coherent functioning of cells. Here we address the question whether it is possible to predict gene synchronization from network structure alone. We have recently shown that synchronized gene expression can be predicted from symmetries in the gene regulatory networks described by the concept of symmetry fibrations. Read More

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Reach, engagement and effectiveness of in-person and online lifestyle change programs to prevent diabetes.

BMC Public Health 2021 07 5;21(1):1314. Epub 2021 Jul 5.

Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.

Background: COVID-19 has accelerated interest in and need for online delivery of healthcare. We examined the reach, engagement and effectiveness of online delivery of lifestyle change programs (LCP) modelled after the Diabetes Prevention Program (DPP) in a multistate, real-world setting.

Methods: Longitudinal, non-randomized study comparing online and in-person LCP in a large multistate sample delivered over 1 year. Read More

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Community health volunteers challenges and preferred income generating activities for sustainability: a qualitative case study of rural Kilifi, Kenya.

BMC Health Serv Res 2021 Jul 3;21(1):642. Epub 2021 Jul 3.

Department of Population Health (DPH), Aga Khan University, Nairobi, Kenya.

Background: There is a global emphasis on engaging community health volunteers (CHVs) in low- to middle-income countries (LMICs) to reach to the vast underserved populations that live in rural areas. Retention of CHVs in most countries has however been difficult and turnover in many settings has been reported to be high with profound negative effects on continuity of community health services. In rural Kenya, high attrition among CHVs remains a concern. Read More

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Estimating regional prevalence of chronic hepatitis C with a capture-recapture analysis.

BMC Infect Dis 2021 Jul 3;21(1):640. Epub 2021 Jul 3.

Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.

Background: The hepatitis C virus (HCV) infection is a candidate disease for micro-elimination. Accurate baseline HCV prevalence estimation is essential to monitor progress to micro-elimination but can be methodologically challenging in low-endemic regions like the Netherlands due to lack of disaggregated data by age or risk-groups on the number of chronic HCV patients (i.e. Read More

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Increased symptoms of post-traumatic stress in school students soon after the start of the COVID-19 outbreak in China.

BMC Psychiatry 2021 07 3;21(1):330. Epub 2021 Jul 3.

Mental Health Center, West China Hospital of Sichuan University, No. 28 South Dianxin Street, Chengdu, 610041, Sichuan, China.

Background: The outbreak of Coronavirus Disease 2019(COVID-19) caused psychological stress in Chinese adults population. But we are unaware of whether the pandemic causes psychological stress on children.

Methods: We used the Children's Impact of Event Scale questionnaire (CRIES-13) to investigate the degree of Post-traumatic Stress (PTSD) symptoms caused by the pandemic in students selected from schools in Sichuan, Jiangsu, Henan, Yunnan, and Chongqing provinces of China. Read More

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A new strategy for quality evaluation and control of Chinese patent medicine based on chiral isomers ratio analysis: with Yuanhuzhitong tablet as an example.

Biomed Chromatogr 2021 Jul 3:e5211. Epub 2021 Jul 3.

College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China.

Chiral compounds commonly exist in traditional Chinese medicine (TCM) but little research on the quality control of TCM has been conducted. In this study, a new strategy is proposed, taking Yuanhuzhitong tablet (YHZT, consisting of Radix Angelicae Dahuricae and Rhizoma Corydalis, YHS) for example, which is based on Chiral isomers ratio analysis to monitor the production process of Chinese patent medicine (CPM) companies. In the process of content determination for tetrahydropalmatine (THP) in YHZT from different companies, noticeable differences were found in their chromatographic behaviors. Read More

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Mortality in homeless people enrolled in the French housing first randomized controlled trial: a secondary outcome analysis of predictors and causes of death.

BMC Public Health 2021 Jul 2;21(1):1294. Epub 2021 Jul 2.

Aix-Marseille University, School of medicine - La Timone Medical Campus, EA 3279: CEReSS - Health Service Research and Quality of Life Center, F-13005, Marseille, France.

Background: Homeless people face large excess mortality in comparison with the general population, but little is known about the effect of housing interventions like Housing First (HF) on their mortality.

Aims Of The Study: 1) to explore 2-years mortality among homeless people with severe mental illness (SMI) included in French HF randomized controlled trial (RCT). 2) To examine causes of death among homeless participants. Read More

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Professionals' views on working in the field of domestic violence and abuse during the first wave of COVID-19: a qualitative study in the Netherlands.

BMC Health Serv Res 2021 Jun 30;21(1):624. Epub 2021 Jun 30.

Gender Unit, Department of Primary and Transmural Care, Radboud University Medical Center, Postbus 9101, Nijmegen, Netherlands.

Background: The COVID-19 pandemic and lockdown evoked great worries among professionals in the field of domestic violence and abuse (DVA) as they expected a rise of the phenomenon. While many countries reported increased DVA, the Netherlands did not. To understand this discrepancy and the overall impact of the lockdown on DVA support services, we interviewed DVA professionals about their experiences with DVA during the rise of COVID-19, the impact of the lockdown on clients and working conditions, and views on eHealth and online tools. Read More

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The role of an educational vignette to teach dental students on issues of substance use and mental health disorders in patients at the University of British Columbia: an exploratory qualitative study.

BMC Med Educ 2021 Jun 29;21(1):360. Epub 2021 Jun 29.

Department of Oral & Biomedical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada.

Background: Inverted classroom approaches and the use of vignettes have been suggested in health care education. The objective of this study was to use an educational vignette to discuss issues of stigma around substance use and mental disorders within undergraduate Doctor of Medicine in Dentistry (DMD) and Bachelor of Dental Science in Dental Hygiene (BDSc-DH) students at the University of British Columbia, Canada. Our research question was "how can an educational vignette, depicting a fictitious patient with a history of substance use and mental health disorders accessing dental care, promote an open dialogue about stigma?"

Methods: An educational vignette was developed based on individuals' lived-experiences with a variety of substance use and/or mental health disorders. Read More

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Disparate access to nutritional food; place, race and equity in the United States.

BMC Nutr 2021 Jun 29;7(1):29. Epub 2021 Jun 29.

Bush School of Government and Public Service, Texas A&M University, 4220 TAMU, College Station, TX, 77843, USA.

Background: Prior research has demonstrated minority communities have fewer options to access healthy foods when compared to their majority counterparts. While much focus has been placed upon community-level resources, little research has been placed on the efforts that minority groups need to undergo to reach well-stocked stores to purchase healthy food options.

Methods: As part of the Water, Energy, Food Nexus Research Group at Texas A&M University, a nationally representative survey (n = 1612) was conducted to acquire self-reported distance, time, and motives that certain populations must travel to purchase food for themselves and their families. Read More

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Patient education program for Brazilians living with diabetes and prediabetes: findings from a development study.

BMC Public Health 2021 06 26;21(1):1236. Epub 2021 Jun 26.

Faculty of Physical Therapy, Federal University of Juiz de Fora, Juiz de Fora, MG, 36038-330, Brazil.

Background: Globally, the incidence of diabetes is increasing and strategies to reach a comprehensive approach of care are needed, including education in self-management. This is particularly true in low and middle-income countries where the number of people living with diabetes is higher than in the high-income ones. This article describes the development of a structured patient education program for Brazilians living with diabetes or prediabetes. Read More

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Impacts of COVID-19 and social isolation on academic staff and students at universities: a cross-sectional study.

BMC Public Health 2021 06 24;21(1):1213. Epub 2021 Jun 24.

Geospatial Analysis and Modelling (GAM) Research Laboratory, Universiti Teknologi PETRONAS (UTP), 32610, Seri Iskandar, Perak, Malaysia.

Background: "The impacts of the Coronavirus Disease 2019 (COVID-19) pandemic and the shutdown it triggered at universities across the world, led to a great degree of social isolation among university staff and students. The aim of this study was to identify the perceived consequences of this on staff and their work and on students and their studies at universities.

Method: The study used a variety of methods, which involved an on-line survey on the influences of social isolation using a non-probability sampling. Read More

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Who should be tested in a pandemic? Ethical considerations.

BMC Med Ethics 2021 06 22;22(1):76. Epub 2021 Jun 22.

Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77, Stockholm, Sweden.

Background: In the initial phase of the Covid-19 pandemic, difficult decisions had to be made on the allocation of testing resources. Similar situations can arise in future pandemics. Therefore, careful consideration of who should be tested is an important part of pandemic preparedness. Read More

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Place4Carers: a multi-method participatory study to co-design, piloting, and transferring a novel psycho-social service for engaging family caregivers in remote rural settings.

BMC Health Serv Res 2021 Jun 21;21(1):591. Epub 2021 Jun 21.

Department of Management Engineering, Politecnico di Milano, Milan, Italy.

Background: Family caregivers are key actors in the ageing society. They are mediators between practitioners and patients and usually provide also essential daily services for the elders. However, till now, few services have been deployed to help caregivers in their care tasks as in improving their mental health which can experience sever burden due to caregiving duties. Read More

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Effects of task difficulty during practice on learning a dynamic balance task in healthy young adults: An intervention study.

BMC Res Notes 2021 Jun 16;14(1):235. Epub 2021 Jun 16.

Division of Movement and Training Sciences/Biomechanics of Sport, University of Duisburg-Essen, Gladbecker Str. 182, 45141, Essen, Germany.

Objective: Cross-sectional studies reported increased postural sway during balance tasks with a high (e.g., unipedal stance on foam ground) compared to a low (e. Read More

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