bluuebunny/crossref_metadata_2025 huggingface dataset:
Non-communicable diseases and use of medication among Syrian refugees: a prospective cohort study
Authors: Strømme E M , Haj-Younes J , Hasha W , Fadnes L T , Kumar B , Diaz E
Published: October 2020

Background

Conflict-driven disruption in continuity of care for non-communicable diseases (NCDs) is likely to have adverse public health impact. Yet, data on the prevalence and treatment coverage of NCDs among refugees is scarce. In this study we aim to assess the changes in prevalence of NCDs and use of relevant medication among Syrian refugees from a near-conflict phase in Lebanon to a resettlement phase in Norway.

Methods

This is a prospective cohort study. Survey data were collected during 2017-2018 among adult Syrian refugees in Lebanon selected for quota resettlement and at follow-up approximately one year after resettlement in Norway. Our primary outcomes were changes in NCDs as defined by the WHO and use of relevant medication. We calculated prevalence proportions with confidence intervals and assessed changes in prevalence over time using generalized estimating equations.

Results

Altogether 353 Syrians participated. The median age was 34 years and 51 percent were women. The overall prevalence of NCDs was 12 (9-16) percent at baseline and 9 (6-12) percent at follow-up. The odds ratio for reporting any NCD at follow-up compared to baseline was 0.68 (0.46, 1.00). Among those reporting NCDs, the prevalence of using either antithrombotic or cholesterol lowering medication, antihypertensives, antidiabetics, or drugs for asthma or chronic obstructive pulmonary disease was 55 (39-70) percent at baseline and 63 (44-80) percent at follow-up. The odds ratio for using relevant medication at follow-up compared to baseline was 1.01 (0.63, 2.05).

Conclusions

In our study around one tenth of the refugees reported at least one NCD. Nearly half of those reporting NCDs in a conflict-near setting did not seem to receive relevant medication, while the same was true for more than one third of respondents after resettlement. We call for innovative public health approaches and interventions to protect continuity of care for NCDs in settings of conflict-driven exodus.

Key messages

A high share of Syrian refugees reporting NCDs do not seem to receive relevant medication. The management of NCDs among refugees needs attention in order to avoid negative health effects.
Motivational Interviewing for the control of type 2 diabetes mellitus and arterial hypertension
Authors: Leites de Souza Steffen P , Demétrio Faustino da Silva D , Schilling Mendonça C , Meyer E
Published: October 2020

Background

Motivational Interviewing (MI) has been effective in promoting positive changes in various health-related behaviors, including chronic disease management. The main goal of this study was evaluating the effectiveness of this care technology in individual nursing consultations for the control of type 2 Diabetes Mellitus (2DM) and Arterial Hypertension (AH) in primary healthcare.

Methods

Double-blind, controlled, parallel randomized clinical trial conducted in Porto Alegre, Rio Grande do Sul - Brazil, from June 2018 to July 2019. The study subjects suffered from 2DM with associated diagnosis of AH and were randomized individually to the Test/MI Group and Control Group. The Test Group was subjected to an MI-based nursing consultation intervention with a professional who had been trained for 20 hours, while the Control Group received conventional nursing consultation. The variables were collected in order to measure the main glycated hemoglobin and blood pressure outcomes, and for the secondary adherence outcome.

Results

After an average follow-up of 6 months, 175 patients completed the study. There was a significant difference between the groups with improvement in the Test/MI group for the outcomes Systolic Blood Pressure - SBP (p < 0.01), Diastolic Blood Pressure - DBP (p < 0.01), Total Adherence Score in Martín-Bayarre-Grau Questionnaire (p = 0.011) and their dimensions 'Treatment compliance' and 'Personal implication' (p = 0.033; p = 0.031). The blood pressure levels of the patients who received the Motivational Interviewing Intervention showed a significant mean reduction of 15.2 mmHg in SBP and 6.4 mmHg in DBP, compared to the control group. The Test group also showed a significant average intragroup reduction of 0.5% in HbA1c at the completion of the study (p < 0.01).

Conclusions

It is concluded that the MI-based nursing consultation was effective in improving clinical control and adherence in diabetic and hypertensive patients in primary healthcare.

Key messages

MI-based nursing consultation is effective in reducing pressure and glycemic levels in primary healthcare. The MI improves adherence levels in diabetic and hypertensive patients.
Raised blood pressure in Italy: results of the CUORE Project-health examination survey 2018-2019
Authors: Donfrancesco C , Di Lonardo A , Minutoli D , Lo Noce C , Buttari B , Profumo E , Bellisario P , Giampaoli S , Galletti F , Palmieri L
Published: October 2020

Background

The WHO Global Action Plan for the Prevention of Non-Communicable Disease (WHO-NCD) recommends a 25% relative reduction in the prevalence of raised blood pressure (RBP) by 2025. Prevalence of RBP and mean blood pressure in the Italian general adult population measured in the 2018 CUORE Project-Health Examination Survey are presented to investigate if Italy can reach this target.

Methods

Within the health examination survey conducted in 2018-2019, representative random samples of resident population, aged 35-74 years, stratified by age and sex (822 men and 869 women) were examined in 8 Italian Regions from the Northern, Central and Southern Italy. Blood pressure was measured by automated oscillometric device using standardized procedures and methods; mean level of two measurements are here considered. RBP is defined as systolic and/or diastolic blood pressure equal or greater than 140/90 mmHg or being under specific drug treatment. The survey is funded by the Italian Ministry of Health-CCM.

Results

Preliminary analysis shows that prevalence of RBP is 43% (95% C.I. 40-47) in men and 32% (29-36) in women. Prevalence of persons with raised blood pressure and not receiving pharmacological treatment is 19% (15-22) in men and 9% (5-12) in women. In men and women prevalence of raised blood pressure is significantly higher in the Southern Regions. Mean value of systolic blood pressure is 131 mmHg (130-132) in men and 122 mmHg (121-123) in women. Mean value of diastolic blood pressure is 77 mmHg (76-78) in men and 73 mmHg (72-74) in women.

Conclusions

Preliminary data underline that RBP is commonly observed in the Italian adult population. However, in comparison to data measured within the CUORE Project 10 years earlier, prevalence of RBP and mean blood pressure are declining, facilitating the meeting of WHO-NCDs target.

Key messages

Raised blood pressure is commonly observed in the Italian general adult population. If confirmed, in the last ten years prevalence of raised blood pressure and mean blood pressure are declining in the Italian general adult population.
From 'to cure' to 'to care' in Oncology Toward shared Evidence based practice
Authors: Rubba F , Paparo E , Capuano F , Montella E , Continisio I G , Iervolino A , Magri P , De Angelis C , De Placido S , Triassi M
Published: October 2020

Aims

Oncological disease need a system of care involving hospital staff and informal caregivers. Care-givers are subjected to stressful factors (burden) with repercussions on psycho-physical balance. The project, carried out together with the ONLUS Travel Companions Association and the Multidisciplinary Oncological Groups (GOM) of Brain and Breast Cancers, intends to offer supportive training experiences for care-givers and health workers, offering emotional and practical preparation for the treatments that they will find themselves providing the cancer relative by helping to improve the quality of care and the relationship between the subjects. The professionals participating in the project (doctors, nurses) take part in a training held by professionals from the Association. The care givers, divided into groups, carry out a CBI test (Caregiver Burden Inventory) and training meetings on medical, psychological and social assistance issues. After 3 months from the end of the course, the care-giver carries out the interview with the psychologist and recompiles the CBI. Furthermore, on 30 selected patients of Breast Cancers, GOM, an emotional evaluation questionnaire of their life experience was administered with respect to the stages of the disease pathway.

Results

The answers were then analyzed by the word cloud method and summarized in a synthetic map for each question. The most used words to describe the mood during the illness are 'anger, pain, anguish and worry'; while waiting before the visit they are 'long, exhausting, anxious'; towards the doctor 'availability, humanity, kindness, friendliness, professionalism'; with regard to 'excellent, availability' assistance; about social life during the 'unchanged, serene' illness; towards the return home 'joy'.

Conclusions

The project is a starting point towards a continuous and progressive humanization of the integrated pathways from 'to cure' to 'to care' in oncology.

Key messages

Patients are positively affected from shared initiatives. Word cloud may resume patients moods and thei main issues concerninthe path.
Health and Gender Medicine Clinic: 2 years of multidisclipinary team experience
Authors: Pasqualini P , Rizzo L , Facchi E , Culicchi V , Lenzi L , Mucci D , Erba F , Moscatelli C , Pagliara C , Doretti V
Published: October 2020

Background

Cardiovascular disease (CVD) is the leading cause of mortality in western countries and the first cause of mortality in women.

Purpose

Women generally do not concern about CVD and that represents the main risk for them.

Methods

Misericordia Hospital, Grosseto, started a Clinic of Health and Gender Medicine on 2017. On the first and third Monday of every month, we evaluate < 60 years patients who are at risk for traditional CVD, depression, early menopause, polycystic ovary, autoimmune and rheumatic disease. On the first visit, medical history, arterial pressure, electrocardiogram, body mass index, waist circumference and lipid profile, were collected. We also supply questionnaires to evaluate diabetes and depression risk by Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-9) and food diary. Two weeks later, a multidisciplinary team (cardiologist-diabetologist-nutritionist-gynecologist-psychiatrist and a nurse) evaluates the patients defining the personal risk profile.

Results

From 2017 to December 2019, 74 females and 7 males belonging to the target population were examined. Age group: <45(61%), 46-50(26%), 51-60(48%), >60(19%). Clinical characteristics: Hypertension: 64%; Obesity 5%; Unknown dyslipidemia 44%; Risk of diabetes: 39%; Gestational diabetes: 5%; Gestational hypertension: 5% CVD risk: 42%; Depression: 33% Autoimmune disease: 30%. From them 60.5% have needed further investigation. Follow-up is going on.

Conclusions

according with the literature, more than 50% of the cohort was unconsciously at high risk of CVD. So a multidisciplinary approach is needed in order to frame a complex health status. Thus we established collaboration with patients to improve lifestyles as CVD-prevention's tool.

Key messages

Cardiovascular disease represent often an hidden health problem, especially in women. Multidisciplinary approach is needed to face CVD.
The prognostic role of micro-RNAs in Head and Neck Cancers: an umbrella review
Authors: Mariani M , Castagna C , Pastorino R , Boccia S
Published: October 2020

Head and neck cancer (HNC) represents the sixth most common cancer and the seventh cause of cancer-related deaths worldwide. Because of HNC high mortality and morbidity a support from the development of new biomarkers and personalized care for patients is needed. The role of micro-RNAs (miRs), as new epigenetic biomarkers, aimed at improving early diagnosis, predicting prognosis and establishing effective cancer therapies, has recently received considerable attention. The aim of this study was to conduct an umbrella review that synthetizes all the findings of systematic reviews already available in literature that investigate the prognostic role of miRs as potential biomarkers in the field of tertiary prevention of HNC.

We selected systematic reviews, published in English until December 2019, related to human HNC with meta-analysis of observational studies that reported quantitative prognostic measures, Hazard Ratios (HRs), of Overall Survival (OS) or Disease-Free Survival (DFS). The methodological quality of the included reviews was assessed using the Assessment of Multiple Systematic Reviews AMSTAR 2 tool.

Six systematic reviews were included in the umbrella review. The most reported miRNAs were: miR21; the Let7 family (c,d,g), miR17, 18 family, 20a, 29 family, 125b, 375. A total of 4 reviews assessed miR-21 expression in HNC patients, all showing its upregulation.

The most frequently studied miR was miR21 which was reported either in the OS and DFS statistical analyses. The OS analysis showed a significant lower prognosis when miR21 was upregulated.

It is involved in oncogenic and oncosuppressive cell signals pathways: the overexpression of miR21 was shown to be associated with cell proliferation, migration, invasion and survival. Recently the cumulative effects of sets of miRs has been increasingly studied and they might be stronger predictor of survival than single. The role of miRNAs as a prognostic biomarker specifically in HNC still need to be investigated.

Key messages

Some miRs were demonstrated to have as tumor-suppressing and oncogenic roles according to their level of regulation (up/down-regulation) in Head and Neck cancer patients. The role of miRs as prognostic biomarkers in HNC patients still need to be addressed by performing large scale to verify and enhance the power of evidence and clinical utility of these.
Return to work guidance within cardiac rehabilitation: content and costs of two settings compared
Authors: Drost R , Noben C , Paulus A , Smeets R , Kuijpers P , Evers S , de Rijk A
Published: October 2020

Background

Of those who survived a cardiac event and participated in cardiac rehabilitation (CR), many experience labor participation restrictions. The Dutch CR guideline includes return to work (RTW) guidance but no directives on where CR has to be offered. The aim was to compare rehabilitation centre and hospital based CR regarding 1) how RTW guidance was organised, 2) changes after CR in sickness absence and quality of life, 3) costs.

Methods

The study was designed as an exploratory cost-outcome description with naturalistic design. Care was assessed at the level of CR in a specialised rehabilitation centre and a hospital. The study population consisted of 116 employed cardiovascular patients (19-63 years of age) of one hospital referred to out-patient level II CR (for complex pathology), either at a rehabilitation centre (n = 53) or at the hospital (n = 63). Information on RTW guidance was obtained by interviews with the CR coordinators. Survey data from patients were collected at baseline, six and twelve months.

Results

At baseline, patient groups did not differ apart from sickness absence being higher in the rehabilitation centre group (76 versus 19 days in previous half year). RTW guidance within CR consisted of individual-based therapy including occupational therapy in the rehabilitation centre, and group-based therapy in the hospital. Costs of RTW guidance in the rehabilitation centre were estimated at €1,892.30, versus €296.82 in the hospital (net difference of €1,595.48). Sickness absence increased during CR for the hospital group, and decreased for both groups after twelve months (with 55 and 7 days, respectively); Quality of Life did not change.

Conclusions

Costs of CR at the rehabilitation centre were more than six times higher than in the hospital. Patients in the rehabilitation centre might have needed the more intensive RTW guidance. Cost-effectiveness research is needed to confirm if the guideline should include stricter targeting.

Key messages

Costs of return to work guidance within cardiac rehabilitation are higher at a rehabilitation centre than in a hospital. Further research on whether costs outweigh effects of return to work guidance at rehabilitation centres and hospitals is needed.
HBPM to refine the diagnosis of hypertension in a Family Health Care Unit in RJ, Brazil - LapARC
Authors: Mello T S , Botelho B G , Hollanda J V G , Antequera L A , Mourão M A O , Azevedo R B , Aragão L F , Botelho E G , Velasco P J P , Muxfeldt E S
Published: October 2020

Background

The new hypertension (HT) guidelines recommend the use of out-of-office blood pressure (BP) measures for its diagnosis however, in the scope of public health in Brazil, it is still based on office BP (OBP) for logistical and financial reasons. Furthermore, in our country, it is not yet clear whether the use of out-of-office BP would really be more reliable for the diagnosis.

Objective

To evaluate the importance of using Home Blood Pressure Monitoring (HBPM) in diagnosing HT in a young adult population in primary care in Brazil.

Methods

A cross-sectional population study enrolled adults between 20 and 50 years in a primary healthcare unit in Rio de Janeiro. Office BP was the mean value of 2 measures, while the HBPM followed a 7-day protocol. It was considered normal a Home BP < 135x85 mmHg and OBP <140x90 mmHg. Patients were classified into 4 phenotypes: normotension (controlled OBP and HBPM); white coat HT (uncontrolled OBP and controlled HBPM); masked HT (controlled OBP and uncontrolled HBPM) and sustained HT (uncontrolled OBP and HBPM).

Results

A total of 462 individuals were enrolled [38% males; mean age 36±9 years]. Sedentary lifestyle (43%), dyslipidemia (38%) and obesity (28%) were the main CV risk factors. OBP, the prevalence of HT was 13%, HBPM it was 19%, with low concordance between them (kappa=0.472). After HBPM, 17% changed the diagnosis, being 6% of them white-coat HT and 11% masked HT. The variables that were independently associated with HT diagnosed by OBP were male gender (OR 1.83,CI95%:1.01-3.33,p=0.04) and increased neck circumference (OR 3.77,CI95%:1.59-8.93,p=0.003), whilst by HBPM they were obesity (OR 2.18,CI95%:1.27-3.76,p=0.005) and increased neck circumference (OR 2.37,CI95%:1.05-5.33,p=0.04).

Conclusions

If the diagnosis was based only in the office BP values, 17% of the subjects would've had an erroneous diagnosis of hypertension, suggesting the importance of implementing out-of-office BP measurements in primary care.

Key messages

Home monitoring blood pressure corrected the diagnosis of hypertension of 17% of patients, allocating them correctly into white-coat HT and masked HT. Increased neck circumference was independently associated with the diagnosis of hypertension by both methods.
High-risk lifestyle and all-cause mortality in older Australians with stroke: A data linkage study
Authors: Peng W , Hayen Andrew , Maguire J a n e , Adams J o n , Sibbritt David
Published: October 2020

Background

Stroke prevention via lifestyle modification is a public health priority in developed countries. Few studies have examined the association of high-risk lifestyle factors with long-term mortality of stroke survivors. Therefore, this study aims to explore the effect of key lifestyle factors on all-cause mortality after stroke.

Methods

Sample is derived from the 45 and Up Study, the largest ongoing study in the Southern Hemisphere focusing on the health of people aged 45 years and older living in NSW, Australia. The lifestyle data in the 45 and Up Study between 2006 to 2015 were linked with data from the NSW Registry of Births, Deaths and Marriages, NSW Cause of Death Unit Record File, and NSW Admitted Patient Data Collection by the Centre for Health Record Linkage. We defined a high-risk lifestyle as no vigorous exercise, smokers, or > 10 alcoholic drinks/week. Multivariate Cox regression model is used to examine the effect of high-risk lifestyle on survival using 10-year all-cause mortality as the main outcome, adjusted for key confounders.

Results

We analysed information on 8410 adults with a stroke event occurring prior to the baseline 45 and Up Study, and 31% of them died in 10 years. 6219 participants were identified as having a high-risk lifestyle at baseline. Being a current smoker and without vigorous exercise were associated with 41% (95% CI: 16%, 73%) and 52% (95% CI: 30%, 78%) increase in the likelihood of death in 10 years, respectively. However, high-risk alcohol drinking was not significantly associated with survival. Of note, having cardiovascular-related comorbidities showed greater risks of mortality (HR range, 3.6-7.2).

Conclusions

High-risk lifestyle factors were associated with an increased risk of long-term all-cause mortality, suggesting that enhancing public health initiatives to promote 'healthy' lifestyle behaviours can be of great benefit to stroke survivors.

Key messages

It is essential for stroke survivors to maintain a healthy lifestyle to delay all-cause mortality. Stroke survivors with high-risk lifestyle may be associated with increased likelihood of death if they have comorbidities such as diabetes and hypertension.
Non-communicable diseases in Latin America: a case study of Latin American tobacco control diplomacy
Authors: Carballo M
Published: October 2020

Background

This research emphasizes on better understanding what is leading Latin America to collaborate on tackling Non-communicable diseases (NCDs). The uniqueness of this research lays on analysing the case of tobacco control diplomacy in the region, from a multi-actor and multi-level diplomacy approach in global health. By doing so, it addresses the existent research gap on academic literature focusing on NCDs in Latin America and global health diplomacy.

Methods

The research is framed within a qualitative approach to global health. It includes both primary and secondary sources, with a geographical focus in Latin America. Semi-structured interviews were conducted with representatives of key global health actors.

Results

The process of addressing NCDs in Latin America has highlighted several challenges including: the difficulty to achieve awareness of the urgency of NCDs, while countering the tobacco industry interference in public health.the limited funding for the initiatives seeking to tackle NCDs in the region vs the financial and political power of the industry.the limited comprehensive approach to NCDs, that goes beyond risk factors to address NCDs as a whole issue.

Conclusions

The analysis shows that tobacco control has been a pioneer in global health diplomacy on NCDs in Latin America. Furthermore, it has portrayed a leadership role of Latin America and an increasing tendency to collaborate at regional level. The recommendations that arise are: There is a need to regulate products as alcohol and ultra-processed food in Latin America following the examples set by the successful regional tobacco control efforts.There is a need to expose tobacco industry interference in public health, since it undermines regional efforts to tackle NCDs.There is a need for regional NCDs efforts to focus on the diversity of global health actors involved.It is imperative to collaborate on NCDs at regional level, given the escalating economic burden of NCDs

Key messages

The focus is analysing the challenges that Latin America faces when addressing NCDs, from a global health diplomacy perspective. The case study of tobacco control diplomacy contributes to better understand the factors that have been leading up to regionally collaborate on NCDs.
Diabetes mellitus and associated factors, determined by glycated hemoglobin
Authors: Carvalho Malta D , Duncan B B , Schmidt M I , Eloah Machado I , Gomes da Silva A , Tomie Ivata Berna R , Moehlecke Iser B P , Felisbino Mendes M S , Rizato Stopa S , Landman Szwarcwald S
Published: October 2020

Objective

To analyze the prevalence of diabetes mellitus (DM) according to different diagnostic criteria, in the Brazilian adult population, according to laboratory results from the Brazilian National Health Survey.

Methods

Analysis of laboratory data from the National Health Survey, collected between 2014 and 2015. The prevalence of diabetes was calculated according to different diagnostic criteria. The prevalence of diabetes was calculated according to the criterion of glycosylated hemoglobin ≥ 6.5% or using medication, using Poisson regression and calculating crude and adjusted PR and 95%CI.

Results

The prevalence of diabetes according to different criteria varies from 6.6 to 9.4%. Intermediate or pre-diabetes hyperglycemia ranged from 6.8 to 16.9%. Considering laboratory criteria or medication use, the prevalence of DM was 8.4 (95%CI 7.65-9.11). The adjusted PR for gender, age, educational level and region was lower for males (PR 0.75; 95%CI 0.63 - 0.89), increased with age: 30 to 34 years (PR 2.32; 95% CI 1.33 - 4.07), 40 to 59 years PR 8.1; 95%CI 4.86 - 13.46), 60 years old or older (PR 12.6; 95%CI 7.1 - 21.0), and higher educational levels was protective (PR 0.8; 95%CI 0.6 - 0.9). Therewas a higher PR in the Central West Region (PR 1.3; 95%CI 1.04 - 1.7), in overweight people (PR 1.8; 95%CI 1.4 - 2.1), and in obese people (PR 3.3; 95%CI 2.6 - 4.1).

Conclusions

The prevalence of diabetes was higher in females, people over 30 years of age, in populations with low educational levels, and people who were overweight and obese. The study advances in determining the diabetes situation in the country through laboratory criteria. These data demonstrate the importance of controlling hyperglycemia in order to avoid the vascular and systemic effects of DM.

Key messages

This is the first study to analyze the prevalence of DM using laboratory data from a representative sample of the Brazilian population. The study pointed to a strong association between overweight and obesity and diabetes, showing the importance of public health measures to encourage healthy eating and physical activity.
Characteristics of patients with gastric cancer, treated at the National Cancer Institute-Bogotá
Authors: Manrique-López M , Puerto-Jimenez D
Published: October 2020

Background

Gastric cancer has the highest mortality rates for both sexes in the country, is one of the five most prevalent in both Colombia and the world and in the country most cases are detected late.

Methods

Participants: Gastric cancer patients selected according to inclusion criteria; observational, cross-sectional and descriptive study.

Results

39 participants: 21 men (54%) and 18 women (46%); with a mean age at diagnosis (± standard deviation) of 56 ± 12 years; Primary studies (43%), low socioeconomic status: 74%; no access to sewage aqueduct in childhood (61.5%); cigarette consumption (41%), consumption of alcoholic beverages: 84.6%; Overweight: 49%. Helicobacter Pilory infection was only documented in 20 of the 39 patients (yes: 23%, no: 28%), in the remaining 19 patients no data were evidenced. 36% of patients were diagnosed in stage II; and 77% cases received a late diagnosis. These are preliminary results.

Conclusions

The results show that the majority of patients belong to a low social class and almost half have only primary studies - which has an impact on exposure to various risk factors, lack of knowledge about risk factors, or access to health services. Likewise, a late diagnosis or the detection of cancer in advanced stages (II; III; IV) represents a social, economic impact for both the patient, the family and society. A posteriori, the investigation will allow to recognize differences / association patterns in the different characteristics between the early and late stages in this group of patients, which will allow to generate recommendations for the early detection and prevention of gastric cancer in the country.

Key messages

It is necessary to establish prevention programs, timely detection and improve access to health services according to the social, economic contexts of the different regions of the country. A timely and early diagnosis can generate greater chances of recovery and survival not only in gastric cancer, but in other types of cancer.
The status of integrated care on the chronic abuse of alcohol response - A cross-sectional study
Authors: Moreira de Sousa A , Lopes L , Costa P , Martins-Coelho G , Capucho R
Published: October 2020

Background

In 2017, the risk-weighted prevalence of alcohol consumption was the health indicator with a more negative impact on the Institute for Health Metrics and Evaluation Sustainable Development Goals Health Index Value in Portugal. According to data from 2012-14, the Alto Tâmega and Barroso (ATB) had the highest value of Years of potential life lost (YPLL) in North Portugal - 4570,1/10.000 people. Liver chronic disease was the specific cause of death that contributed to the value of YPLL - 465,4/10.000 people.

Methods

A cross-sectional study was conducted with data from the Northern Health Administration and the General Directorate for Intervention on Addictive Behaviours and Dependencies. We compared the number of patients with chronic alcohol consumption (CAC) in 2018, the leading causes of death between 2012-14, the main morbidity causes according to data from primary healthcare (PHC) physicians in 2018 and the number of patients in specialized treatment team (STT) for alcohol abuse treatment in 2018 in ATB.

Results

In 2018, 2643 patients of ATB had a diagnosis of CAC; only 178 were followed by an STT. Although CAC had a massive influence on YPLL, this was only the 11º cause of morbidity in ATB according to the data from PHC. The number of women with CAC was stable between 2012 (n = 284) and 2018 (n = 291). In the same period, there was an increase of 52,86% of CAC on men (n = 1523 to n = 2348).

Even though 18,4% of YPLL due to chronic liver disease happen in women, only 11,2%of the patients with CAC in the PHC are women.

Conclusions

There is a need for the improvement of CAC diagnosis in PHC, and the improvement of referral of patients to STT and hospital care. Besides, to reach the SDG3, there is the need to work intensely on SDG 17 (partnership for the goals). The Public Health Unit of ATB is organizing Operation PROMETEU to improve communication, institutional collaboration, and monitoring of the existing health activities that are tackling CAC.

Key messages

The need to integrate data from different healthcare sources for a better analysis on health problems. The urgent need to tackle the alcohol abuse problem in ATB.
Gastric cancer incidence and predictions: Observational Study (Monastir, Tunisia: 2002-2030)
Authors: Bannour R , Zemni I , Ben Nasrallah C , Aroua N , Abroug H , Ben Fradj M , Kacem M , Sriha A
Published: October 2020

Introduction

Gastric cancer is a major health burden worldwide. Based on GLOBOCAN 2018 data, stomach cancer is the fifth most common neoplasm and the third most deadly cancer, with an estimated 783,000 deaths in 2018. Unfortunately, only a few countries have set up extensive programs of early screening. In Tunisia the gastric cancer ranks among the ten most frequent cancers with more than 637 new cases per year. The aim of this study was to we report trends in the gastric cancer incidence during the span of time between 2002 and 2013 from the population-based cancer registry of the centre of Tunisia, and to predict the future number of cancer cases by 2030.

Methods

The cancer incidence data were collected from the cancer register of the Tunisian Center from 2003 to 2012.The data were stratified by cancer site, sex and age. We used SPSS software in order to calculate the crude incidence rates and standardized incidence rates. SPSS software was used in order to estimate the future number of cancer cases by 2030.

Results

During our study period, 326 cases of gastric cancer were observed. 53.1% of our patients were male with a sex ratio male to female 1.13.The crude incidence rates were 5.71 for male patients and 5.43 for females. The standardized incidence rates were 7.22 and 6.3 respectively for male and female patients. A stable trend was observed. Only 28 cases of gastric cancer are predicted by 2030.

Conclusions

Over the recent, there has been a slight decrease in gastric cancer rates. Many preventive steps should be encouraged in order to maintain this decreasing trend such as changing dietary habits by encouraging the consumption of fresh fruit and vegetables, as well as decreasing the use of tobacco and salt.

Key messages

Gastric cancer is a major health burden worldwide, only a few countries have set up extensive programs of early screening. Changingdietary habits by encouraging the consumption of fresh fruit and vegetables, as well as decreasing the use of tobacco and salt.
Oncoepidemiological situation of sarcomas in Kazakhstan
Authors: Pyssanova Z h U , Serikbaev G A , Kaydarova D R , Tuleuova D A , Shinbolatova A S , Kurmanaliev A K
Published: October 2020

Background

Sarcoma is a malignant tumor of soft tissues and bones. They make up 1% of all malignant tumors in adults and 15% in children. More common in men 1.1: 1. By age: 20.7% - up to 40 years old, 27.6% - 40-60 years old and 51.7% over 60 years old. In 2018, in the Kazakhstan, malignant tumor of connective and soft tissues of 444 (1.4%) cases was registered and ranks 19th in the structure of cancer, bones and articular cartilage 188 (0.6%), takes 22nd place. Of these, with sore cases, bone sarcomas were recorded - 12.7%, soft tissues - 9.5%. The mortality rate from soft tissue sarcoma is -177 (1.2%) people, bone sarcoma - 85 (0.6%) people. Five-year survival of patients from soft tissue sarcomas is 53.8%, from bone sarcomas - 67.3%.

Methods

from 2015 to 2019, 1,068 patients with malignant tumor of bones and articular cartilage, 963 patients with malignant tumor of connective and soft tissues addmited to KazNIIOiR. Of these, 225 patients underwent organ-sparing surgeries - endoprosthesis replacement of limbs.

Results

In Kazakhstan over the past 5 years there has been an increase in the incidence of sarcomas of bones and soft tissues.

Conclusions

in comparison with previous years, there is an increase in the incidence of malignant tumor of bones and articular cartilage, connective and soft tissues, and an increase in mortality from tumor of bones and articular cartilage in men by 16.7%, in women by 50%. Late reversal of patients at the IV stage and a high proportion posthumously recorded in patients with maliganan tumors.

Key messages

Purpose: Assessment of the epidemiological situation and incidence of sarcomas of the bones and soft tissues in Kazakhstan. Out of 25 localizations of cancer, detection is worsened during professional examinations in 10 localizations, of which bones and articular cartilage, connective and other soft tissues.
Ferraz de Vasconcelos syphilis: epidemiological profile, investigation and evolution of cases
Authors: Vieira C
Published: October 2020

The increased incidence of syphilis in Brazil can be explained by multiple reasons: increased reports of acquired syphilis, increased coverage of rapid tests in pregnant women provided by the Brazilian Ministry of Health, reduced condom use, inadequate treatment of patients and partners. In Ferraz de Vasconcelos, a city in the metropolitan region of São Paulo, an increasing elevation in syphilis cases in healthcare services and in the epidemiological surveillance system. In 2017, the city reported 148 cases from which 27 cases were congenital syphilis, with one death. The purpose of the survey was to evaluate the cases reported and describe the main sociodemographic, epidemiological, clinical, and syphilis investigation. A high incidence of syphilis in adults, pregnant women, and congenital syphilis was recorded with a detection rate of 45.0 per 100,000 in habitants and 12.4 and 9.3 per 1,000 live births, respectively. These rates reflect failures in the diagnosis, treatment, and follow-up of cases. Syphilis in adults was obtained in this study in a higher incidence in men 54.1%.Being 49.4% between brown and black people. It is noteworthy that more than 97% of the pregnant women reported with syphilis underwent prenatal care; however, 36.1% of them started from the second trimester, only 88.9% were given treatment, and 66.7% with record of healing. In addition, only in 27.8% pregnant women, the sexual partner underwent the specific treatment. Regarding congenital syphilis, only 81.5% newborns were given proper treatment and only 55.6% underwent laboratory investigation of cerebrospinal fluid. It is evident that these results expose the weaknesses of the municipal healthcare system. Greater coordination among services can contribute to early diagnosis and active search of cases. The epidemiological bulletin containing data from this study may enhance the organization of syphilis prevention, planning, and surveillance actions in the city.

Key messages

The increased incidence of syphilis in Brazil can be explained by multiple reasons: increased coverage of rapid tests on people, reduced condom use, inadequate treatment of patients and partners. Greater coordination among services can contribute to early diagnosis and active search of cases.
Using theory of change to assess impact of knowledge translation initiatives
Authors: Howarth C , Neil-Sztramko S
Published: October 2020

Issue

The National Collaborating Centre for Methods and Tools (NCCMT) offers high quality supports to public health professionals on evidence-informed decision making (EIDM). We developed a theory of change evaluation framework to guide evaluations of our programs and services to ensure that the NCCMT's resources and training continue to be high quality and meet the needs of public health professionals globally.

Description of the Problem

Our objective was to develop an evaluation framework that illustrates our reach, quality, and impact. The NCCMT contracted an external program evaluation expert to assist in developing a revised framework to better capture these aspects. An inductive approach was used to identify evaluation themes through internal document review, and a review of applicable program evaluation literature.

Results

A revised evaluation framework, influenced by theory of change, was developed and is being implemented at the NCCMT. The theory of change visualizes how the NCCMT influences EIDM and public health practice through four stages that progress from creation of products and services, to knowledge and awareness, to engagement and capacity development, and finally to policy and practice changes embedded within organizational structures. Specific outcome indicators include: public health professionals' confidence, knowledge, and skills; improved public health programs; organizational support for evidence-informed decision making; and workforce engagement and competence.

Lessons

This innovative evaluation framework informed by a theory of change resulted in significant streamlining of the centre's evaluation activities, and has provided clearer direction with respect to the purpose of evaluation, as well as enhanced ability to capture the centre's reach, quality and impact. The lessons of the importance of using theory of change to underpin evaluation activities can be applied to other public health organizations globally.

Key messages

Applying an evaluation framework supports effective and efficient programming. The evaluation framework demonstrates the NCCMT’s impact and reach in public health.
Monitoring of contaminated areas: Environmental Health Surveillance actions in Diadema/SP Brazil
Authors: Garbin A , Corrallo F , Jesus J
Published: October 2020

Contaminated areas are a challenge for public health, since the most diverse chemicals can interfere with human health, making it necessary to adopt health promotion measures, prevention and control of diseases and diseases. That way this work aims to disseminate the actions carried out by the Environmental Health Surveillance of the city of Diadema to monitor the contaminated areas, aiming at reducing the risk to the population's health.

For this purpose, it was carried out the characterization of the environment of the contaminated areas using Mapinfo software and tools free of georeferencing, recording of information from research in information and dissemination systems for institutions, services and municipal authorities. As a result, it can be highlighted that 100% of the areas were characterized with definitive radius of surroundings based on the affected environmental compartment; 88,63% were registered in the Health Surveillance Information System for Populations exposed to contaminated soil (SISSOLO). In 27.3% of the areas deep wells were found and out of these, 83.30% they made the buffering/deactivation and 16.7% use the water for industrial purposes. Of the identified wells around 54,5% were buffered/deactivated and 18,2% are under monitoring.

It is concluded that it is essential to continuously monitor the territory through different strategies, seeking technical support, invest in intra- and intersectoral articulation and define work processes in order to detect changes in the determinants and constraints of the environment that interfere with human health and thus be able to act in the best possible way. Additionally, it was found that mapping prior to field work is essential to qualify the information and that including the investigation of the water compartment is important to identify and interrupt exposure routes so present in daily life.

Key messages

It is concluded that it is essential to continuously monitor the territory through different strategies, seeking technical support, invest in intra- and intersectoral articulation. It was found that mapping prior to field work is essential to qualify the information and that including the investigation of the water compartment is important to interrupt exposure routes.
How to facilitate long-term citizen participatory processes as part of local public health work
Authors: Lorentzen C , Stang I
Published: October 2020

Background

Letting the citizens` voices being heard is regarded crucial for successful local public health work. A national project aimed at developing health promoting neighbourhoods through citizen participatory processes was implemented in 42 municipalities in Norway between 2016 and 2018. This study aims to explore the variety of conditions facilitating broad and long-term citizen participation in this project.

Methods

Data were collected by open-ended questionnaires completed by project workers and participating citizens in the eight municipalities involved in this particular study. Data were analysed by qualitative content analysis.

Results

The results revealed that broad citizen participation presupposed the use of many different approaches that were adapted to different subgroups of the population. Personal invitations to join participatory processes in smaller groups in familiar settings, and seeking out citizens in their own arenas, appeared to be particularly useful recruiting approaches to reach those who usually are under-represented in traditional participatory processes. Long-term commitment to citizen participation processes seems to be facilitated by pre-process clarification of the frames, early post-process information about the results and anticipated future use of the results, and quick implementation of some efforts based on these results.

Conclusions

Broad and long-term commitment to citizen participatory processes as part of local public health work seems to presuppose a flexibility regarding different types of participatory and recruitment approaches and clear communication to the citizens on relevant issues at each particular stage of the processes.

Key messages

Broad and long-term commitment to citizen participatory processes requires flexibility regarding participatory and recruitment approaches. Broad and long-term commitment to citizen participatory processes requires clear communication to citizens pre- and post-process.
Brief assessment of (in)direct questions on domestic/partner violence in the Belgian HIS 2013-2018
Authors: Drieskens S , Demarest S , De Ridder K
Published: October 2020

Background

Domestic and partner violence have considerable physical and mental consequences for the victims. The Belgian Health Interview Survey (HIS) 2013 previously evaluated a combination of two (indirect) related questions as an appropriate tool to assess domestic and partner violence in the general population. A more direct approach in the HIS 2018 will be compared with the HIS 2013 deduction method.

Methods

The HIS is a cross-sectional survey in a representative population sample. The more sensitive subjects like domestic and partner violence are part of the self-administered questionnaire. In 2013 the indicator related to domestic violence was derived from the question whether the perpetrators was a member of the household; for the indicator on partner violence also the household composition was taken into account. For the HIS 2018, the question has been adapted. It was specifically asked who the perpetrator was (i.e. unknown, colleague, acquaintance, friend, (ex-)partner, parents, children) from where easily these two indicators could be defined. Proportions are compared.

Results

In 2018, 1.0% of the population aged 15+ indicated being victim of domestic violence in the past 12 months, which is in line with the proportion found in 2013 (1.1%). However, for partner violence there is a difference in the proportions. In 2018, 0.6% of the population 18-74 years indicated being victim of partner violence in the past 12 months, which is only half of the proportion found in 2013 (1.3%).

Conclusions

For assessing domestic violence, defining perpetrators as members of the household or detailed questioning about the relationship towards the perpetrator produce similar results. For distinguishing partner violence, the estimations benefit from directly defining the relationship towards the perpetrator.

Key messages

Even when investigating sensitive topics, straightforward questions produce more accurate results. The problem of domestic violence and partner violence remains underreported and so it needs to be explored more.