bluuebunny/crossref_metadata_2025 huggingface dataset:
Perceived outcomes and SWOT analysis of a virtual community of practice in Burkina Faso
Authors: Lapierre J , Goyer-Pétrin G , Philibert L , Gagnon M-P , Dupéré S , Guillaumie L , Ouellet M , Bationo F , Ouedraogo C , Rouamba S
Published: October 2020

Background

In Burkina Faso, maternity is a risk. Global Affairs Canada funded the initiative PASME-2 with World University Service of Canada, Laval University and Farm Radio International to improve maternal outcomes. A preventative program was co-developed in phases. Phase 3 received funding from Social Sciences and Humanities Research Council in partnership with the Centre for International Cooperation in Health and Development (CCISD) and TIESS, a liaison and transfer expert in Québec, to support local teams towards sustainable practice changes. This research aimed at documenting the partnership experience, digital literacy, perceived direct and indirect outcomes.

Methods

A participative co-design approach, allowed the engagement of several stakeholders in the process. Two active phases where 16 health professionals engaged actively in the VCoP, according to the final agreed-upon Constitutional Chart, are presented. The phases pilot-tested two different technology tools.

Results

16 interviews post-phase 1 and 16 interviews post-phase 2 were conducted. Implementation issues as perceived by users are discussed and include: feasibility, challenges, needs, animation, relevance to care, communication and sharing, use and perspectives. Perceived outcomes focus on professional preventative practice changes, skills, family outcomes, challenges to practice integration, knowledge and practice exchanges.

Conclusions

The phases of experimentation demonstrate that strategies can be put in place to counter the digital literacy challenges and to engage users in new ways of communicating, sharing on the platform about health practices and taking valuable time to do it. Overcoming technology constraints is essential especially in lower resource settings. The most practical life experiences and cases lead to more engagement and innovations. Support from management and upper directorate is significant.

Key messages

Partnership from several stakeholders is key to implementing a VCoP. Experimenting and sharing solutions is influenced by the capacitating environment that the VCoP can provide with recognition from administration and as a professional development activity.
The Functioning of Outreach Programs Of/On the Street and the Work Processes of the Nurse
Authors: Schettino R , Ornelas C , Antônio M , Oliveira T , Soares S , Almeida S
Published: October 2020

Problem

Homeless people (PSR) are a heterogeneous and fragile group. They are among the most excluded ones from health service access because they cannot present a regular home. They are also a population who have great difficulty of accessing the entrance and mostly search only for emergency and urgency services when their lives are at stake. This intervention is important because it aims at decreasing the inequalities to health access and, moreover, it decreases the difficulties to health access.

Description of the problem

A field visit to an outreach program on the street (CR) in Belo Horizonte was made on April, 22nd and on May, 6th in 2019. This program is linked to a Health Center. The objectives were knowing the functioning of outreach programs on the street and understanding the assignments and participation of the team nurse on working with PSR.

Results

By acting with and approaching PSR, the nurse can create contact and humanized listening. This is an attempt to establish user / professional bonds. During this contact, the professional struggles to encourage the user to search the health attention net. This professional also approaches the rupture with home, with the family, with the work, and with others. He/She tries to support users to face the challenges and to stimulate social reinsertion as well. Tests on the street to detect HIV/AIDS and syphilis are made, guaranteeing the individual privacy right. By approaching PSR, it is crucial that the nurse, who is part of the multi-professional team, be free of any prejudice and stigmas which can make the attendance success difficult. The application of health expanded concept was also present because it considers the complexity of health, mainly to those who inhabit the streets.

Lessons

The nurse can succeed in facing inequity. This decreases not only the barriers established by social inequalities but also the organizational barriers PSR are exposed all the time.

Key messages

Attendance prioritizes local care. It not only tries to attend social and health problems but also shared actions with Health Centers. At last, it should be an example to other countries. It is important for health professionals to reinvent their practices, searching partnerships and the acquisition of new knowledge to succeed in decreasing individuals’ demands.
Dietary polyphenol intake, risk of hypertension and age status in adult Russian/Siberian population
Authors: Berezovikova I , Denisova D , Batluk T , Shcherbakova L , Malyutina S
Published: October 2020

Background

Consumption of polyphenolic compounds from various food sources is associated with a reduction in cardiovascular risk factors. The region of residence, the food habits of the population, and age have a significant impact on consumption.

Methods

Participants: the Siberian urban population (Novosibirsk, HAPIEE study, 9324 (4,249 men and 5,075 women) aged 45-69. Dietary data collected using a 141-item food frequency questionnaire. Data on the polyphenols were taken from the Phenol-Explorer database (3.6). Total polyphenols (TPH) were considered as a sum of all individual classes: flavonoids, phenolic acids, stilbenes, lignans and other polyphenols and their food sources. The consumption of polyphenolic compounds in the age groups of 45-49, 50-54, 55-59, 60-64 and more than 65 years was analyzed. To assess the relationship between CVD risk factors and the consumption of TPH, the odds ratio was calculated in quartiles of TPH consumption (OR).

Results

The consumption of TPH in men was 1273 (647) and 1203 (626) mg/day in women (P < 0,05). The main class for both men and women were flavonoids, as well as phenolic acids. For men, respectively, 68 and 21% of the total consumption of TPH, for women 70 and 20%. Chances of developing hypertension in quartiles of high and low consumption of TPH showed a risk reduction in whole population by 58%, in quartiles of high and low consumption of total flavonoids - by 56% and phenolic acids - by 21%. The main sources of TPH were tea, coffee, fruits, vegetables and rye bread. With increasing age, both men and women experience a decrease in TPH consumption by 9.5 and 11%, respectively, of flavonoids - by 10.6 and 15%. This is due to a decrease in fruit consumption with increasing age.

Conclusions

The consumption of polyphenol compounds in the Siberian urban population associated with reduction of hypertension and determined by age.

The study was carried out in the framework of budget theme No. AAAA-A17-117112850280-2.

Key messages

Consumption of polyphenolic compounds in the Siberian population is associated with a reduced risk of hypertension. In recommendations for the prevention of hypertension in the older age group, it is necessary to consider the increase in the consumption of fruits and berries from local sources.
Experiences with specialist clinics health care: a cross-sectional study among adult patients
Authors: Murko E , Poldrugovac M , Kralj M , Ropret N
Published: October 2020

Background

The measurement of patient experiences is gaining importance in many healthcare systems, including the Slovenian one. The need for a national survey on patient experiences in the specialist outpatient settings emerged recently, leading to the establishment of a new questionnaire in Slovenia. The aim of the study was to measure patients' experiences in the outpatient specialist medical settings in the fields of surgery, gastroenterology, otorhinolaryngology, diabetology, endocrinology and metabolic diseases, dermatovenerology and pulmonology.

Methods

The survey takes into account various aspects of healthcare such as waiting period to the visit, admission, waiting time in the waiting room, physician work, nurse work, privacy, patient rights information, and familiarity with continuation of treatment. As part of the study, patients evaluated treatment at a specialist outpatient clinic on a scale of 0 to 10, and were able to give praise and suggestions for improvements. The questionnaire used was a newly developed one, based on a review of the literature and focus groups with patients. The questionnaire was also cognitively tested and piloted before national rollout.

Results

The national survey was conducted in March 2019 and included adult patients who attended a specialist outpatient clinic in certain clinical fields. The survey included 149 specialist outpatient medical offices. 8,616 questionnaires were received. The response rate was estimated to be 32%. 79.0% of patients stated that waiting period to the visit did not pose any problem for them. 80.3% of the surveyed patients rated the medical treatment with a score of 9 or 10.

Conclusions

The surveyed patients in our study rate highly the treatment in selected outpatient specialist clinics. The strength of the findings is limited by suboptimal sampling. Possible changes to the sampling methods to be used in future iterations of the survey are currently being evaluated.

Key messages

In March 2019, the first national survey on patients' experience in selected public outpatient specialist clinics in Slovenia was conducted. 80.3 percent of the surveyed patients rate the medical treatment highly with a score of 9 or 10.
PROMs as an intervention – a randomised controlled study
Authors: Oschmann L , Kuklinski D , Geissler A , Pross C , Vogel J
Published: October 2020

Issue

Patient-Reported Outcome Measures (PROMs) are becoming part of the patient journey and are increasingly used as a mechanism to reward quality and to indicate the 'value' of the health care provided. However, only in rare cases, PROMs are not only applied to measure quality but used as a basis for medical intervention.

Description of the problem

Digitisation and patient-centred care are of major importance to highlight quality deficiencies and to promote transparency of patient pathways. However, there is little evidence on how to use the patient's feedback to transform the patient journey and to improve health outcomes. Additionally, there is rare information on scientifically tested or elaborated threshold values that could be applied to trigger an intervention in case of critical recovery. The patient's reaction to such interventions or alerts is unknown, although it promotes health literacy and could support cross-sectoral care and better health outcomes.

Results

In our two-arm RCT, we examine the effects of PROMs as an intervention and related health care costs by digitally collecting PROMs of around 10,000 patients in the field of endoprosthetics in 9 German clinics. The magnitude of the study and its digital approach suggest that the procedure can be easily transferred to other indications and countries. For the after-care period, PROM threshold alert values were defined with the support of an expert consortium of physicians, to signal critical recovery of patients in the intervention group. Study nurses are automatically alerted and post-treatment physicians informed to intervene in case of critical PROM values.

Lessons

Preliminary results suggest that patients respond positively to their contact with the study nurse and that they agree with informing their physicians about critical results. We expect an intervention of every 10th patient of the study and so far, the threshold definition seems robust in the way that it is neither too specific nor sensitive.

Key messages

PROMs used as an intervention can promote health literacy and outcomes. Development and testing of thresholds is needed.
What drives absenteeism among doctors in rural primary healthcare setting in Bangladesh? A qualitative exploration
Authors: Nahar N
Published: October 2020

Absenteeism', among physicians, has been a long-standing issue in Bangladesh, but little is known about the intersection between political structures, health system policy and shortages that drives provider behaviour. Using an in-depth interview guideline 30 interviews were conducted with physicians working in rural and urban facilities through purposive sampling. Data were analysed in Atlas ti and synthesized following Gales framework method. Senior doctors were usually absent due to the lack of opportunities to specialise/dual/private practice in rural facilities. Absence of career progression (especially among junior physicians), inadequate and unsafe living and workplace arrangements, absence of transport facilities, lack of community understanding and ownership, non-cooperation from colleagues and absence of incentives or recognition de-motivated physicians to stay at their posts in rural facilities. Incidences of abuse (verbal/physical) by local community were common with female physicians particularly vulnerable. Disciplinary actions against absenteeism were unclear, and many respondents were unaware of these. Almost all of the doctors wished to move out of rural areas. Those who were successful, used their social and political networks and the payments of bribes to facilitate movement into urban settings. Doctors who did not have access to financial resources or to these networks failed to move out of rural areas and one left the profession.
Addressing the challenge of bringing evidence in decision-making for public health emergencies: can HTA reach out to preparedness?
Authors: de Waure C , Miglietta A , Favaretti C
Published: October 2020

Background

Preparedness is one of the fundamental public health activities as it allows health systems to effectively manage threats. It can be considered a continuous quality improvement process, therefore requiring an assessment both in planning and checking phase. The assessment should consider several aspects spanning contextual factors but also health technologies being used. In order to manage threats, epidemics in particular, several health technologies are generally deployed. Among them, vaccines, antimicrobials, medical devices (i.e. masks), procedures (i.e. quarantine). Indeed, an early and as much as comprehensive evaluation of their value in the mitigation of epidemics' impact is needed. Health Technology Assessment (HTA) could help doing that. It could be also useful to predict the magnitude of the problem and to shed light on alternatives and needs for organizational reengineering. Anyway, what are the actions required to make HTA reaching out preparedness?

Results

In order to do it, several conditions should be brought about. The first one is the recognition of the importance of HTA in projecting health technologies impacts by health authorities and institutions. The second one is the timeliness of the assessment. In fact, HTA is generally a time and resource consuming approach as it is based on the collection of available evidence and data. Nevertheless, an early interaction with all stakeholders, the availability of flexible computer infrastructures for data collection and the preventive development of impact models might allow developing the assessment in a limited time. Furthermore, having dedicated working teams at supranational/national level could help keep down time and efforts to conduct the assessment.

Conclusions

Based on available experiences, advances and barriers in the use of HTA for preparedness might be highlighted and actions to strengthen the role of HTA in this field can be recognized.
Estimating burden of foodborne diseases where public health impact is higher and data scarcer: a study in four African countries
Authors: Desta B
Published: October 2020

Low and middle-income countries, in particular from Africa, bear the highest burden of foodborne disease (FBD). However, because research and disease surveillance data from Africa are limited, previous burden estimates are subject to uncertainty. The main challenge to estimating burden of FBD in Africa is lack of data, where factors ranging from lack of capacity to lack of political commitment, and a focus on priority diseases, limit existing surveillance systems. To address this, we are working with Ethiopia, Mozambique, Nigeria, and Tanzania, to estimate the burden of, and strengthen surveillance systems for, FBD in Africa. We are conducting a population survey (to estimate incidence and distribution of diarrhea in the community), a systematic literature review (to estimate proportions of diarrheal disease caused by different agents), and an active review of available FBD reports (to estimate the extent of under-reporting in existing surveillance). Together, these findings will provide more accurate estimates of the burden of FBD for African countries. Lessons from this large-scale project can be extrapolated to other countries and regions where the burden is high but data are scarce. We highlight applying leadership attributes, including delegation of duties, setting milestones, regular meetings, transparency, and risk mitigation plans. The leading role of experts in this project helps to reduce hurdles. We have also adapted existing data collection tools for use across our diverse African study populations. We are engaging stakeholders who will use our research outputs, by involving them at all stages of the project. This integrated Knowledge Translation approach is translatable to other settings. These studies are part of FOCAL (Foodborne Disease Epidemiology, Surveillance, and Control in African LMIC), a multi-partner, multi-study project co-funded by the Bill and Melinda Gates Foundation and the United Kingdom's Department for International Development.
Association between marital status and mental health among cohabitating same-sex couples in the UK
Authors: Hagen D , Goldmann E
Published: October 2020

Background

A large body of research suggests that the formalisation of opposite-sex relationships is associated with favourable mental health outcomes, particularly among males. Despite the recent introduction of same-sex civil partnership and/or marriage in many countries, there is little evidence as to whether this salutary effect of formalised partnership extends to same-sex couples.

Methods

Using data from wave 8 (2016-18) of Understanding Society: the UK Household Longitudinal Study (UKHLS), respondents living with a same-sex partner were included in the analytical sample (n = 225). Respondents from Northern Ireland were excluded, as same-sex marriage did not exist there at the time of data collection. Mental health status was assessed using the General Health Questionnaire (GHQ)-12 (range: 0-36) and the established cut-off point of 11/12 to identify psychiatric caseness. The association between marital status (marriage, civil partnership, and cohabitation only) and psychiatric caseness was examined in logistic regression models in the overall sample and stratified by sex.

Results

A total of 112 respondents (40%) were cohabitating, 81 (40%) were living in civil partnership, and 32 (19%) were married. In bivariable analyses, respondents living in civil partnership had a lower prevalence of psychiatric caseness (30%) than those who were married (50%) or cohabitating only (51%) (p = 0.041). In models adjusted for age, sex, and education, civil partnership was associated with 84% reduced odds of psychiatric caseness (95% CI: 0.39-0.66) compared to cohabitation among females; no statistically significant effect was found for marriage or among males.

Conclusions

This study provided evidence of a inverse association between civil partnership and psychiatric caseness among females in same-sex couples. Given that same-sex marriage was only introduced in England, Wales, and Scotland in 2014, further research will be needed as more same-sex couples formalise their relationships.
Associations between workplace characteristics and “outness” in LGBTIQ workers in Austria
Authors: Markovic L , Grabovac I
Published: October 2020

Introduction

Lesbian, gay, bisexual, transgender, intersex, and queer (LGBTIQ) individuals are often subjected to negative attitudes at the workplace, which may lead to non-disclosure of their sexual and/or gender identities. We aimed to determine the prevalence of workplace disclosure of sexual or gender identity (i.e. “outness”; being “out”) and to examine its associations with workplace characteristics in LGBTIQ workers in Austria.

Methods

Sociodemographic, work- and wellbeing-related data were gathered using an online questionnaire between February and June 2017. From the initial 1268 respondents, 1054 (83%) provided complete data and were included in the analysis.

Results

Participants were mostly 26-35 years old (39.1%), educated (43.9% tertiary level), urban (53.8%), cisgender gay men (40.0%) with a full-time employment (63.9%). Overall, 51.7% were “out” at the workplace. Being bisexual (OR = 0.46, 95%CI 0.27-0.81), having anti-discrimination guidelines (OR = 0.53, 95%CI 0.32-0.90), living alone (OR = 0.50, 95%CI 0.32-0.79 and in shared households (OR = 0.49, 95%CI 0.25-0.96) were associated with lesser likelihood of being “out” at work. Furthermore, being “out” at work was associated with middle age (36-45-year-olds; OR = 1.74, 95%CI 1.07-2.85), duration of employment >10 years (OR = 2.03, 95%CI 1.08-3.81), LGBT friendly work environment (OR 1.61, 95%CI 1.36-1.91), anti-discrimination policies enacted (OR = 2.02, 95%CI 1.23-3.32), and work council protections (OR = 1.56, 95%CI 1.04-2.36).

Conclusions

Approximately half of participants reported being “out” at work. An LGBTIQ-friendly work environment, presence of work council protections and of enacted anti-discrimination policies were linked with higher workplace outness. Instating discrimination protections might facilitate “outness” and therefore visibility of LGBTIQ workers, leading to better health outcomes and productivity.
20.A. Round table: COVID-19, infectious diseases, and human rights and risks in public health
Authors:   Organised by: GHLG (Netherlands),   Chair persons: David Patterson - Netherlands
Published: October 2020

The 21st century has been marked by trans-national epidemics of SARs, MERS, Ebola and most recently COVID-19. In spite of WHO advice to the contrary, some States have responded by closing their borders to persons travelling from certain countries. International human rights law permits restrictions of movement to protect public health, subject to strict tests of necessity and proportionality. To a potentially unprecedented degree, however, the spread of COVID-19 has brought to the fore the use of social distancing measures, and a surge in demand for health care, both of which raise significant questions of equity given disparities in wealth and income within and across populations. This panel discussion will explore how a human rights-based approach supports evidence-based responses to epidemics of infectious diseases, and why a human rights-based response may be more effective than other measures in addressing these global threats. Issues covered will include: Advantages and possible limitations of a human rights-based approach to infectious epidemics.Emerging questions of human rights, distributive justice, regulatory authority and efficacy associated with sustained social distancing measures and the management of health care access in a time of surging demand.Early evidence of the health and social impact of legal responses to COVID-19.

Key messages

States have both obligations and limitations under international human rights law in preventing and responding to infectious epidemics. The large-scale application of social distancing approaches can create acute pressure on poorer people and poses legal, moral and practical questions about the social burdens of disease control.
Early evidence of the impact of legal responses to COVID-19
Authors: Burris S
Published: October 2020

This short presentation will consider how rights and equity challenges may be addressed in responding to epidemic diseases.
Which are the opportunities and current challenges for the use of polygenic risk scores in risk prediction and the prevention of common adult onset conditions?
Authors: Bottà G
Published: October 2020

The panellist Giordano Bottà will discuss about: Which are the opportunities and current challenges for the use of polygenic risk scores in risk prediction and the prevention of common adult onset conditions? Coronary artery disease (CAD) is a complex multifactorial disease leading cause of morbidity and mortality worldwide. Identifying individuals at high risk is crucial to guide life-style and therapeutics interventions. Notably, individuals at high genetic risk who adhere to a healthy lifestyle displayed between two and three-fold relative risk reduction, compared to individuals with a poor lifestyle. Despite such evidences, a systematic assessment of the interplay between PRS and CAD risk factors such as blood lipid levels in contributing to the overall CAD risk is still lacking. Panelists will present and disuss a study on 130,0000 individuals of the UK Biobank on the association of incident CAD with PRS and blood lipids (LDL, TC, HDL, TC:HDL, LDL:HDL). Using the largest prospective genotyped cohort available to date, researchers identified for the first time a significant interaction between LDL and genetics in determining CAD incidence. This result has deep implications in a CAD primary prevention perspective.
20.D. Skills building seminar: Design for mental health integration through built environment interventions
Authors:   Organised by: EUPHA Urban public health section, EUPHA Public mental health section, EUPHA Environment and health section, University of Crete (Greece),   Chair persons: Jutta Lindert - EUPHA-PMH, Stefano Capolongo – EUPHA-URB
Published: October 2020

Mental illness is associated with social exclusion and stigma more than most other health issues. This affects psychiatric facility provision (Chrysikou et al 2017), prevention and early treatment interventions. The planning and design of services both conceptually (service procedures, experience designs, campaigns and physically (e.g. buildings, products, interiors) could help change that. New approaches could build resilience by increasing access to and acceptance of mental health services and enable recovery as a constant process (Slade et al 2008). This intense skill- building workshop will use a role-game approach with cross-disciplinary methods from experience design and design thinking to foster innovative spatial concepts in a co-creative manner. This helps to build capacity and knowledge on exploring and developing innovative and disruptive concepts for public urban mental health. Focus is on spatial configuration, architectural and design aspects for services and mental health systems. The highly interactive seminar-workshop starts with two 5' presentations to set the theoretical multi-disciplinary stage. A third 5' presentation addresses issues addressed to the participants and presents the locus of the role play, i.e. Crete, chosen for its unique socio-spatial and systemic characteristics. A 5' presentation explains the scenario and stakeholder roles. The group session comprises a 50' long structured series of ideation and analysis methods based on a role-play-like schedule in which delegates act as service provider for a municipal client (Crete) that request an innovative mental health care solution for a specific urban context. Then 10' will be the closing session on the process by mapping the reflections of the process on a collective SWOT diagram.

Chrysikou, E., Kostopoulou, E., Savvopoulou, E., Fatah gen. Schieck, A., 2017. Medical Architecture on the Social Valorisation of Psychiatric Patients: Employing transdisciplinary approaches between architecture, physical and mental well-being disciplines. Proceedings of the AAE 2017 Conference, Architecture Connects, 6th -9th September 2017. Oxford Brookes University, UK

Slade, Mike; Amering, Michaela; Oades, Lindsay (2008): Recovery: an international perspective. In: Epidemiologia e psichiatria sociale 17 (2), S. 128-137.

Key messages

Participants will explore participatory design methodologies to help them consider and use building infrastructure as resource for public health and healthcare actions in relation to mental health. Participants will cross disciplinary boundaries exposed to eco- and psychosocial frameworks, i.e, build and social infrastructure, to co-create healthy, vibrant, resilient and equitable communities.
Patient engagement, autonomy, access to mental care services – the case for integrated care in Crete
Authors: Petelos E , Papadakaki M , Lionis C
Published: October 2020

Access to comprehensive primary care (PC) services is imperative to address the complex biopsychosocial needs of patients with mental illness and their families, while it holds the potential to safeguard mental health and enhance resilience in communities. Integration of mental health and social care services in primary care has not yet been achieved, while access to such services for the mentally ill is still hindered by patient-, provider- and system-oriented barriers. Improving service integration, quality and access requires active engagement of patients and families in the design and planning of services.

Interprofessional collaboration, interdisciplinary approaches and sound deliberative processes are only the start of initiating discussions to establish the needs of local communities. Mapping care paths, involving stakeholders and engaging in practice-based research are impeded by the organisation and design of care provision, including siloed processes and semantic ambiguity in establishing common ground. Academic centres ought to act as hubs for bringing together all actors, creating living labs and addressing the needs of people in urban and rural areas. The case study from Crete will focus on the following questions: What actions are needed to improve access of people with mental health disorders to PC services and how could PC mediate effective communication with mental health services?To what extent people with mental health disorders experience violence, abuse or discriminatory behaviour in PC?To what extent PC services recognize and facilitate autonomy, self-determination and inclusion of people with mental health disorders?To what extent stakeholders and PC services engage people with mental health disorders in decision making process and local governance?To what extent educational interventions for PC practitioners could result in the reduction of discriminatory behaviour and safeguard the dignity among people with mental health disorders?
Developing concepts for early mental health prevention and treatment using the built environment
Authors: Rehn J , Chrysikou E
Published: October 2020

After the brief initial input presentations outlining relevant aspects such as the eco-psychosocial approach as well as facts regarding the context of the case study Crete, a co-creative multidisciplinary workshop is being facilitated that aims at developing concepts for early mental health prevention and treatment focusing on innovations in the built environment.

Touchpoint inventory for urban public mental health offerings

The key methodology of the workshop follows principles from experience design (Risbon et al., 2018) and service design (Stickdom et al., 2018) using the touchpoint inventory. The overall workshop is divided into two main phases. In the first phase participants will be divided into two groups. One of them will outline a chronological journey for early mental health interventions for stereotypical mentally ill person (e.g. preventive information, low threshold support groups, and so on). The second group will collect places and elements of the built environment that surf as a basis for interaction (”channels”) by which services for mental healthcare and prevention can be submitted (e.g. Shops, public places, coffee shops, libraries etc.).

In the second phase, results of both groups will be collected using a spreadsheet. All participants are then asked to ideate concepts for “touchpoints” at the intersection of both groups of elements. These concepts can serve as a conceptual starting point for more comprehensive developments on design for early mental health interventions.

References

Risdon, C., Quattlebaum, P., Rettig, M. (2018) Orchestrating experiences. Collaborative design for complexity. Brooklyn, New York: Rosenfeld Media

Stickdorn, M., Hormess, M., Lawrence, A., Schneider, J. (Hg.) (2018) This is service design doing. Applying service design thinking in the real world; a practitioners` handbook. First edition. Sebastapol, CA: O'Reilly
Conceptual framework on health and tourism – an interregional point of view of the Silver Economy
Authors: Maritati A , Leonardini L
Published: October 2020

Background

It is essential that both sectors of health and tourism, share experiences and integrate each other's excellence maintaining focus on citizens wellbeing. The demographic evolution mandates the development of a common planning that takes into account the needs and characteristics of each sector. The health care system should no longer be regarded as a cost-generating sector, but rather as a driving force of the economy. Quality health benefits and services can attract citizens who are concerned about maintaining or improving health and well-being as well as patients in search of high-quality services, thus contributing to the development of the tourism market. We aim to discuss with participants active and healthy ageing (Silver Economy), share a workable definition of health tourism, map tourist flow at national and international level, outline trajectories with a specific focus on recommendations.

Methods

Document and stakeholder analysis will be used to define health services 'attractiveness'.

Results

Health tourism can be considered an opportunity for the Silver Economy. Actions are necessary to profile customers/clients, countries/regions to seek for scalable best practices. Creating age-friendly tourism contexts while enhancing culture and tourism to support active ageing policies can be used to focus/prioritize and strengthen digital solutions.

Conclusions

Further actions are essential from the systems point of view like administrative simplification, emphasis in a collaborative and non-competitive approach; The creation of new business models (access and reimbursement paths, investment mergers, reinvestment of avoided costs for effective health promotion / prevention interventions); Communication campaigns (e.g. on the health benefits of thermal waters, derogation for the protection of specific labels); New training and education curricula for administrative, tourism, health and socio-health personnel are a new focus to be procured
Factors associated with suboptimal blood pressure control in a multi-ethnic population in Amsterdam
Authors: van der Linden E L , Collard D , Beune E J A J , Nieuwkerk P T , Galenkamp H , Haafkens J A , Moll van Charante E P , van den Born B J H , Agyemang C
Published: October 2020

Background

Among patients using antihypertensives, blood pressure (BP) control is generally low and appears to vary between ethnicities. We aimed to identify factors associated with suboptimal BP control in a multi-ethnic population.

Methods

Cross-sectional data of the Healthy Life in an Urban Setting (HELIUS) study were used, including participants aged 18-70 years, with Dutch, African Surinamese (AS), South-Asian Surinamese (SAS), Ghanaian, Turkish or Moroccan ethnicity living in Amsterdam, the Netherlands. Suboptimal BP control was defined as BP ≥ 140/90 mmHg among participants using antihypertensives. Logistic regression analysis was performed to identify sociodemographic, lifestyle, health and psychosocial factors associated with suboptimal BP control for the total population and for each ethnic group.

Results

A total of 3,571 participants (500 Dutch, 1052 AS, 656 SAS, 637 Ghanaian, 433 Turkish, 293 Moroccan) were included in the analysis, of whom 53.3% had suboptimal BP control. Female sex (OR 0.50, 95%CI 0.43-0.59), being married (0.83, 0.72-0.96), current smoking (0.78, 0.65-0.94), obesity (1.67, 1.35-2.06), cardiovascular disease (CVD) history (0.56, 0.46-0.68), non-adherence to antihypertensives (1.26, 1.00-1.58), and family history of hypertension (1.19, 1.02-1.38) were associated with suboptimal BP control. Among ethnic subgroups, female sex was associated with lower odds of suboptimal BP control in all ethnic groups, as was current smoking (Turkish) and CVD history (Dutch, SAS, AS), whereas obesity (Dutch, AS, Turkish), older age (Turkish) and non-adherence to antihypertensives (Dutch) were associated with higher odds of suboptimal BP control.

Conclusions

Our analysis identifies several factors that are independently associated with suboptimal BP control, with only small variation between ethnic groups, suggesting that focussing on well-known determinants of suboptimal BP control is worthwhile to improve BP control rates in a multi-ethnic population.

Key messages

Several factors are associated with suboptimal blood pressure control in a multi-ethnic population, with only small variation between ethnic groups. These findings suggest that focussing on well-known determinants of suboptimal BP control is worthwhile to improve BP control rates in a multi-ethnic population.
The HIV paradox: perinatal mortality is lower in HIV+ mothers. A case-control study in Ethiopia
Authors: Fonzo M , Dalla Zuanna T , Sperotto M , Resti C , Tsegaye A , Azzimonti G , Manenti F , Putoto G , Bertoncello C
Published: October 2020

Background

In Ethiopia, HIV prevalence is 1.2% in 15-49-year-old women, peaking at 3% in aged 40-44. Nationally, efforts have made to provide HIV testing and treatment to all HIV+ subjects, and prevention of mother-to-child transmission. This may imply a closer monitor of health conditions for HIV+ pregnant women. Moreover, antenatal care (ANC) in the third trimester of pregnancy is associated with lower perinatal mortality (PNM). Considering this, we aimed at comparing PNM between HIV+ and HIV- mothers.

Methods

The study was conducted in Wolisso Hospital, Oromiya Region, Ethiopia, a second level hospital with a 1,000,000-catchment area. Cases were all mothers who experienced a perinatal death before hospital discharge. For each case, two mothers who gave birth to a baby alive until discharge were selected as controls. A regression model was built, considering maternal age, rural-urban residence, grand multiparity, twin pregnancy, maternal ongoing chronic/infectious disease and provision of ANC as potential confounders.

Results

Overall, 1175 cases and 2350 controls were included. HIV+ women (n = 71; 2,0%) showed a crude OR = 0.44 (95%CI: 0.24-0.81) for PNM and an adjusted aOR=0.50 (95%CI: 0.25-0.98) when controlling for the aforementioned confounders, including provision of ANC. While 69,0% of HIV+ women received specific ANC, only 24,2% of HIV- women did (p(χ2)<0.001).

Conclusions

Our findings show how the risk of PNM is 50% less in HIV+ mothers. Because of their HIV-positive-status, they are more likely to be in contact with healthcare providers and, thus, to have higher chances to be addressed to ANC services. A large part of the contribution seems to reside in activities directly related to HIV control. This evidence supports national policies against HIV and suggests a considerable improvement of PNM by extending high quality ANC to all pregnant Ethiopian women. Paradoxically, HIV stands out for being a health threat that reduces PNM.

Key messages

In Wolisso hospital, a second level general hospital in Ethiopia, babies born to HIV+ women have a -50% risk of perinatal death. Extending high quality ANC is worth the effort: removing barriers to access and reaching all pregnant women would lead to a massive reduction in perinatal mortality.
The National Collaborating Centre for Methods and Tools: Supporting evidence-informed decision making
Authors: Howarth C , Neil-Sztramko S , Dobbins M
Published: October 2020

Background

Public health continuously evolves to address an uncertain future, and public health professionals must effectively and efficiently adapt to changes. Evidence-informed decision making (EIDM) is one way to adapt to change. The National Collaborating Centre for Methods and Tools (NCCMT) provides high quality resources, training and mentorship to support the EIDM process through both in-person and distance-based formats. Freely accessible resources including online training opportunities can help public health professionals globally put evidence into practice and be ready to respond to change.

Objectives

The NCCMT's work is driven by the belief that everyone deserves optimal health and well-being and this can be achieved by using the best available evidence in practice. Our training and education resources include thirteen online learning modules, an EIDM skills assessment, video series, a rapid review guidebook and regular webinars, amongst others. These resources are self-paced and they can be accessed when and where it is most convenient for public health professionals.

Results

The NCCMT's resources are highly accessed, with over 320, 000 visits to the NCCMT website from around the world from April 2018-March 2019. There were also over 42,000 downloads of knowledge products in the same time period. The NCCMT's resources have been integrated into public health organizations and curriculum in public health postsecondary programs in Canada. We are continuously evolving by engaging our users. We will be launching an updated version of our Learning Centre in April 2020.

Conclusions

The NCCMT houses useful resources for all public health professionals to learn about finding, understanding, and using evidence. Public health professionals from around the world have used the NCCMT's educational resources to put evidence into practice. The NCCMT is committed to working with global organizations to support them to achieve their EIDM goals.

Key messages

The NCCMT supports public health professionals to use the best available evidence in practice. The NCCMT offers high quality resources, training and mentorship to public health professionals.
Using Instagram to deliver a theory-based wellness intervention designed to promote behavior change
Authors: Blackstone S , Russie C
Published: October 2020

Background

With a high number of users, social networking sites (SNS), such as Instagram, have the potential to serve as a tool to dispense health information and promote health. This pilot study examined the effect of a four-week wellness intervention on Instagram users with targeted posts regarding fitness, nutritious eating, and self-care behaviors.

Methods

A review of best practices in Instagram posts was conducted to create daily posts relating to Theory of Planned Behavior constructs for the wellness areas of fitness (e.g., daily movement), nutritious eating (e.g., vegetable and fruit consumption, healthy recipes), and self-care (e.g., social time, journaling). The intervention group (N = 22) and control group (N = 11) were assessed pre and post test using a Theory of Planned Behavior survey.

Results

At post-test, self-care intention for the intervention group was significantly higher compared to the control. However, there was not a significant difference between the intervention group and control for engaging in actual self-care behaviors reported at post-test. There were no significant differences between the groups for other constructs pre to post-test. User engagement or lack of engagement with posts did not relate to any differences in constructs at post-test.

Conclusions

A wellness intervention delivered through Instagram did not impact health behaviors over a four-week period in the intervention group compared to the control group. Future research should continue examining if SNS interventions, specifically changing what users see and interact with, can influence health behavior outcomes. This pilot study also provides an example of a theory-based intervention that can be tailored to examine effects on behavior change in other populations.

Key messages

Though there is potential to use social networking sites as health promotion tools, there is a lack of understanding how to best use this technology, engage participants, and promote health. Using health behavior change theories in intervention research using social networking sites is considered the best approach to evoke and understand behavior change among populations.
What can you find online about Nursing-home? A website analysis on the Metropolitan City of Milan
Authors: Gasparri S , Facchetti I , Pietronigro A , Gandolfi C E , Boncinelli S , Colaianni A
Published: October 2020

Background

Websites are among the most important communication distribution tools in everyday life. Does this apply to assisted living facility too? Can website information be used to assess quality of care? Can Public Health Administration use information provided on nursing home websites to define whether accreditation standards are met? The aim of this study was to assess websites of all the assisted living facility of the Metropolitan City of Milan (MCM) Agency for Health Protection (ATS) territory according to five dimensions: Description, Utility tools, eHealth literacy, Accreditation Standard and Usability, to answer the questions above.

Methods

A total of 141 websites for MSM ATS nursing homes were identified. A tailored check-list approach was used to investigate each of the 5 dimensions for all websites. For the dimension Description we analyse 20 items, for the Utility tools 14 items, for the eHealth literacy 12 items, for the Accreditation Standard 5 item and for Usability 6 item. A score was assigned to each dimension based on completeness of check-list items.

Results

Of the 160 nursing homes in the MSM ATS, 141 had a website (88%). No website was complete of all items. The average score was 34% the higher was 65% the lower 12%. The five dimensions description, utility tools, eHealth literacy, accreditation standard and usability scored 44%, 16%, 25%, 18% and 29% respectively. The Item more founded was Mission, 137 sites (97%), the least was Customer Satisfaction in 5 Sites (4%). We evaluated the Social Media presence: 81 facility (57%) have at least one social media.

Conclusions

Notwithstanding the Internet and Social Media are a powerful tool to promote eHealth Literacy are underused. Health promotion is shared more with the social media rather than the webpages. The webpage could become a powerful instrument to use by Administration to define whether accreditation standards are met but the contents on the sites are few and non-consistent.

Key messages

11.500 people are assisted by our nursing homes, so part of the population can be reach through websites. We analyse them and discover that health promotion is spread by social media not by websites. We wanted to understand if Public Health Administration can evaluate accreditation standards through the website. We discover that standards can be evaluated on line rather than in-site assessment.