[Experimental] List of manuscripts available for review volunteers
6 manuscripts available for review volunteers
November 19, 2017
Background. Satisfaction evaluation is widely used in healthcare systems around the world to improve healthcare service quality and levels, in order to obtain better health outcomes. In the evaluation of healthcare reform, patient and medical staff satisfaction with this reform is a key criterion. The aim of this study was to measure employee work satisfaction and patient satisfaction status in the Wuhan region, China; the unsatisfactory factors as discovered through the evaluation will be used as a reference by healthcare policy makers and management so that they can adopt reasonable and effective measures to decrease the risk of dissatisfaction in the future. Methods. A cross-sectional study was conducted in 14 medical institutions in Wuhan from October to November 2016. The medical institutions included public general hospitals (tertiary and secondary) and community healthcare service centers/stations (primary). Stratified sampling of target medical staff and patients was carried out and the final valid sample comprised a total of 696 medical staff and 668 patients. Results. In the Wuhan area, it was found that the reliability levels of medical staff work satisfaction scales and patient satisfaction scales comprised Cronbach's alpha=0.973 and Cronbach's alpha=0.949, respectively. The studies in Wuhan and Guangzhou showed that the psychometric characteristics of the scales were basically the same. The overall satisfaction levels of medical staff and patients were 58.28±14.60 and 65.82±14.66, respectively. The medical staff satisfaction ranking in sequence from most to least satisfied was: work itself, work environment and atmosphere, hospital management, practicing environment, and job rewards. The patient satisfaction ranking in sequence from most to least satisfied was: physician-patient relationship and communication, service organization and facilities, continuity and collaboration of medical care, access to relevant information and support, and healthcare and related services. There were differences in the overall satisfaction levels of medical staff based on gender, age, educational level, job title, nature of the job, employment status, and whether staff were at the standardized training stage (p<.05 or .01). There was no statistically significant difference in various demographic variables in terms of overall patient satisfaction (p>.05). Discussion. The overall satisfaction evaluation of medical staff was average. In the future, healthcare policy makers and management staff of medical institutions should focus on job rewards and practicing environment in order to decrease the risk of dissatisfaction amongst medical staff. This would allow them to increase their work happiness and sense of belonging, which in turn would allow them to provide better medical services to patients. The overall patient evaluation was satisfactory, with patients satisfied at all levels of the satisfaction evaluation.
November 17, 2017
Introduction: Using spatial-temporal analyses to understand coverage and trends in elimination of mother-to-child transmission of HIV (eMTCT) efforts may be helpful in ensuring timely services are delivered to the right place. We present spatial-temporal analysis of 7-years of HIV early infant diagnosis data collected from 12 districts in western Kenya from January 2007 to November 2013, during pre-Option B+ use. Methods: We included in the analysis infants up to one year old. We performed trend analysis using extended Cochran–Mantel–Haenszel stratified test and logistic regression models to examine trends and associations of infant HIV status at first diagnosis with: early diagnosis (<8 weeks after birth), age at specimen collection, infant ever having breastfed, use of single dose nevirapine (sdNVP), and maternal antiretroviral therapy (ART) status. We examined these covariates and fitted spatial and spatial-temporal semi-parametric Poisson regression models to explain HIV-infection rates using R-Integrated Nested Laplace Approximation (INLA) package. We calculated new infections per 100,000 live births and used Quantum GIS to map fitted MTCT estimates for each district in Nyanza region. Results: Median age was 2 months, interquartile range (IQR) 1.5 to 5.8 months. Unadjusted pooled positive rate was 11.8% in the 7-years period and declined from 19.7% in 2007 to 7.0% in 2013, p<0.01. Uptake of testing ≤8 weeks after birth was under 50% in 2007 and increased to 64.1% by 2013, p<0.01. By 2013, the overall case rate was 447 infections per 100,000 live births. Based on Bayesian deviance information criterion comparisons, the spatial-temporal model with maternal and infant covariates was best in explaining geographical variation in MTCT. Discussion: Improved EID uptake and reduced MTCT rates are indicators of progress towards e-MTCT. Co-joined analysis of time and covariates in a spatial context provides a robust approach for explaining differences in programmatic impact over time. Conclusions: During this pre-Option B+ period, the PMTCT program in this region has not achieved e-MTCT target of ≤50 case rates per 100,000 live births. Geographical disparities in program achievements may signify gaps in spatial distribution of e-MTCT efforts and could indicate areas needing further resources and interventions.
November 16, 2017
Although water and sanitation are considered as a human right, about three out of ten people (2.1 billion) do not have access to safe drinking water. In 2016, 5.6 million students were enrolled in the 33.9% of Brazilian schools located in rural areas. Only 72% of them have a public water supply network. Herein, we proposed to evaluate the efficacy of environmental intervention for water treatment in rural schools of the Western Amazonia. The study is characterized by an experimental design with environmental intervention for the treatment of water for human consumption, through the installation of a simplified chlorinator, in 20 public schools in the rural area of Rio Branco municipality, Acre state. Before the intervention, the results revealed 20% (n = 4), 100% (n = 20) and 70% (n = 14) of schools having water outside the potability standards for Turbidity, Faecal coliforms, and Escherichia coli, respectively. There was no significant difference in the turbidity results after the intervention (p = 0.71). On the other hand, there was a very significant difference in the results of Faecal coliforms and Escherichia coli after the intervention (p<0.001). The actions carried out in this intervention have considerably improved the water quality of the schools, thus decreasing children’s health vulnerability due to inadequate water provided to the school community in the rural area. The activities of training, educational lectures, installation of equipment, supply of materials and supplies (65% calcium hypochlorite, and reagents) were fundamental to the obtained results.
November 15, 2017

Objective: The analysis of ill-health related job loss may be a relevant indicator for the prioritization of actions in the workplaces or in the field of public health, and a target for health promotion. The aim of this study was to analyse the medical causes, the incidence, and the characteristics of employees medically unfit to their job.

Methods: This one-year prospective study included all workers followed by occupational physicians in an occupational health service in the South of the France. Our study design allowed two data frames to be merged (followed up workers and “unfit” patients who lost their jobs due to ill-health). We performed a multivariate analysis in order to adjust the Odds ratio for the age groups, sex, occupation and the activity sectors which are strongly associated with job loss.

Results: Seventeen occupational physicians followed 51,132 workers. The all-cause incidence of being unfit to return to one’s job was 0.778%. The two main causes of being unfit for one’s job were musculoskeletal disorders (47.2%) and psychopathology (38.4%). Being over 50 years old [Odds ratio (OR) 2.63, 95% confidence interval (95% CI) [2.13-3.25] and being a woman [OR 1.52, 95% CI 1.21-1.91] were associated with the all-cause unfitness, independent of occupations and activity sectors.

Conclusions: Identification of occupational and demographic determinants independently associated with ill-health related job loss may provide significant and cost-effective arguments for health promotion and job loss prevention.
November 14, 2017

Background. Participation rate is one of the main challenges medical researchers face. We examined how demographic background and trust in medical research affect the willingness of people to participate in medical research in Taiwan.

Methods. Data from the 2011 Taiwan Genomic Survey were used. A total of 3,159 people aged 18 to 70 years were sampled, and 1,538 of them completed the survey. Missing data were excluded. A total of 1,389 respondents were included in the final analysis.

Results. About 12 percent of the respondents answered that they would be willing to participate in medical research. Respondents who had a college degree or above and were married orlived with a significant other were less likely to participate in medical research. By contrast, respondents who were men and who or their close family members had a biomedicine-related degree were more likely to participate in medical research. After adjustment for demographic factors, respondents who expressed trust in doctors who conduct medical research, agreed that doctors would never ask them to join a medical research study that might harm them, thought that participating in a medical research study is safe, and agreed that medical researchers have no selfish reasons for doing research were more likely to participate in medical research.

Discussion. Some of our findings, such as the effect of education level and marital status on participation in medical research, are different from the findings of most previous studies conducted in other countries. This study is useful for the development of strategies for improving participant recruitment.

October 28, 2017
Background : Although, most of the research focus on the effect of birth methods on postpartum hemorrhage (PPH), there is, however, a lack of studies that examine whether the association between PPH and birth methods is different between nulliparous and multiparous women. We aims to compare the effects of birth methods on PPH between nulliparous and multiparous women. Methods: The data on 151,333 eligible women, who gave birth between January 2014 and May 2016, was obtained from the electronic health records in Shanxi province, China. The ordered logistic regression model was used to examine the association of birth methods and varying degrees of PPH between nulliparous and multiparous women. Results: In comparison with the odds for SVB, the odds of increased PPH for CS in multiparous women (aOR: 4.32; 95% CI: 3.03-6.14) was more than twice that in the nulliparous women (aOR: 2.04; 95% CI: 1.40-2.97). However, the PPH risk for episiotomy between multiparous (aOR: 1.24; 95% CI: 0.96-1.62) and nulliparous women (aOR: 1.55; 95% CI: 0.92-2.60) were nearly the same. The PPH risk of forceps-assisted birth was much higher in multiparous women (aOR: 9.32; 95% CI: 3.66-23.71) than in nulliparous women (aOR: 1.70; 95% CI: 0.91-3.18). Meanwhile, that for vacuum-assisted birth in multiparous women (aOR: 2.41; 95% CI: 0.36-16.29) was more than twice the PPH risk in the nulliparous women (aOR: 1.05; 95% CI: 0.40-2.73). However, the difference was insignificant. Uterine inertia was more prone to cause PPH in the multiparous women (aOR: 5.54; 95% CI: 1.76-17.50) than in the nulliparous women (aOR: 3.03; 95% CI: 1.48-6.21). In contrast to uterine inertia, vertex malposition presented a decreased effect to the development of PPH in the multiparous (aOR: 1.93; 95% CI: 1.25-3.00) and nulliparous women (aOR: 0.87; 95% CI: 0.63-1.22). Conclusion: The associations between birth methods and PPH are different between nulliparous and multiparous women. Therefore, the choice of birth methods should be tailored for nulliparous and multiparous women at labor to lower the severity of postpartum hemorrhage.

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