bluuebunny/crossref_metadata_2025 huggingface dataset:
Is parental socioeconomic status associated with irregularity of energy intake among children?
Authors: Roos E , Pajulahti R , Lehto R , Nissinen K , Erkkola M , Ray C , Korkalo L
Published: October 2022

Background

The timing of eating, chrono-nutrition, is a relatively new research area, where the focus is not on only what we eat but also when we eat and of irregularity between days. Chrono-nutrition have been associated with cardiovascular risk factors among adults. Societal factors influence the chrono-nutrition, but there is limited research on how different socioeconomic factors are associated with chrono-nutrition, especially among children. The aim of this study is to examine the association between parental socioeconomic status and irregularity of children’s energy intake.

Methods

We used data from the DAGIS (Increased Health and Wellbeing in Preschools) study in years 2015-2016, in which 864 preschool children participated (age 3-6 years old). Childreńs dietary intake was measured by a 3-day food record. We included only children that had complete data from all three days and the child was at day care on two of those days and one day was a weekend day (n = 568). To calculate the irregularity score, the absolute difference between the daily energy intake and 3-day mean intake for each three days was divided by the 3-day mean energy intake, multiplied by 100 and then averaged over the 3 days; this served as a measure of irregularity of energy intake, with a low score indicating a more regular energy intake and a higher more irregular energy intake. The parents reported highest parental educational level and household income on a questionnaire. The associations were tested by general linear models on SPSS.

Results

No association was found between parental educational level or household income with irregularity of children’s energy intake.

Conclusions

There was no association between parental socioeconomic status and children’s irregularity of energy intake. Other aspects of children’s chrono-nutrition should also be tested to be able to conclude that children’s chrono-nutrition is not influenced by parental socioeconomic status.

Key messages

• We found no association between parental socioeconomic status and irregularity in children’s energy intake.

• Chrono-nutrition among children is under-examined.
How healthy is it to consume soft and energy drinks? – primary school pupils’ opinions from Hungary
Authors: Girán J , Girán K , Ormándlaky D , Kollányi Z , Kiss I
Published: October 2022

Background

The consumption of soft drinks and energy drinks (SaED) in EU27 has hardly changed over the past decade. In contrast, it grows massively in Hungary, mainly among youths. In 2021, our research group studied the causes of the growing SaED consumption of primary school pupils. Now, we deliver our key findings on how pupils consider the health impacts of SaED consumption.

Methods

The study took place in a primary school in Komló, Hungary, in a mixed methods design: 157 pupils aged 10 to 15 filled out a survey, which we analyzed using descriptive statistical methods and independency tests. Besides, focus groups were conducted involving three stakeholder groups: a) school pupils; b) pupils’ parents; c) school teachers (39 respondents in total).

Results

Every fifth pupil consumes soft drinks daily and every third more than once a week. 28.1% of pupils consume energy drinks with some regularity, the majority more than once a week. Of those who think that soft drinks are rather unhealthy, 37.2% consume them daily or several times a week. Of those who believe that energy drinks are rather unhealthy, 24.6% consume them with some regularity. The focus groups confirmed that pupils perceive SaED consumption as accepted and “normal” behavior, and for the majority, the health consequences of the consumption are not a point.

Conclusions

Although many pupils are aware of the health risk of SaED, they still drink them regularly. The general social acceptance of SaED consumption and the influential marketing of these products both support this attitude. To affect consumers’ behavior, messages on how “unhealthy” SaED are does not seem adequate: a change in community acceptance is needed.

Key messages

• The knowledge of adverse health effects of soft and energy drinks itself won’t reduce consumption as long as its social acceptance is high.

• Preventive interventions should apply similar tools that have made soft and energy drink consumption popular and accepted to reverse recent trends.
Ginger Constituents and its Effects on Gastrointestinal malignancies: A Review of clinical trials
Authors: Aregawi L , Csiki Z , Shokralahi M , Teame H
Published: October 2022

The gastrointestinal tract (GI tract) is the tract of the digestive system that contains all the major organs of the digestive system. Disorder in any part of the GI tract results in various disease forms such as malignancies. The occurrence of GI cancer is very high in developed countries including Europe. A wide variety of natural products containing anticancer properties showed significant effects. Ginger, the rhizome of Zingiber officinale, is among one of the natural herbal remedies widely used for its spice and medicinal properties. It is fair sources of vitamins like, β-carotene, vitamin C and minerals. Recently ginger has shown significant attention in clinical studies due to its anti-cancer effects that possesses promising potential for inhibiting the proliferation of multiple cancer cells. The aim of this review is to provide a summarized report of clinical trials on ginger constituents and its effects on gastrointestinal malignancies. A systematic search was conducted by two independent authors on the databases of Scopus, Clinical Trials, PubMed and Science with the search term of the key words. This review article supported that ginger is an important plant with several constituents and gastrointestinal medicinal effects. Ginger constituents suppress the growth and induce apoptosis of variety of cancer types including colon, gastric, pancreatic and other GI cancers. It is mainly the 6-gingerol and 6-shogaol, of the major compounds in ginger rhizomes, among hundreds of molecules. It is reported that antioxidant and anti-inflammatory properties of ginger support its preventive role against the gastrointestinal malignancies.

Key messages

• This review article provided evidences supporting the effects of ginger on gastrointestinal malignancies and demonstrates the importance of future studies.

• Therefore, more extensive and well-controlled clinical trial studies of ginger are required to demonstrate its effect on gastrointestinal malignancies.
Self-assessed achievement of eating balanced meals – is it reliable for tailoring interventions?
Authors: Schneider M , Nössler C , Lührmann PM
Published: October 2022

Background

Recording the self-assessed achievement of eating balanced meals offers the possibility to tailor nutritional interventions to the stage of behaviour change. Beforehand of an intervention, the self-assessed achievement of eating balanced meals was recorded and verified against the actual consumption.

Methods

Self-assessed achievement of eating balanced meals was operationalised using the behavioral stages of the Health Action Process Approach (HAPA). The actual consumption was assessed by a validated 3-day dietary record and the Healthy Eating Index of the National Nutrition Survey (HEI-NVS) was calculated. A score of 100 points represents one hundred percent compliance with the recommendations of the German Nutrition Society. Ten additional points could be scored if vegetables and fruit were consumed above the recommendation. An HEI-NVS score of ≥ 80.0 points was considered a cut-off for ‘eating balanced meals'.

Results

In a sample of 130 participants (86.9 % female, 29.0 ± 11.3 years), 9.2 % rated themselves as Non-Intenders, 17.7 % as Intenders, and 73,1 % as Actors. Their HEI-NVS was 69.6 ± 10.6 points, 79.2 ± 9.5 points, and 79.7 ± 9,0 points, respectively (ANOVA, p < 0.01). In the post-hoc-Test (Scheffé) Non-Inteders differed from the other groups (p < 0.05), Intenders and Actors were not different (n.s.). The proportion of participants with an HEI-NVS score ≥ 80.0 points was 16.7% for Non-Intenders, 60.9% for Intenders, and 51.6% for Actors (Chi2-Test, p < 0.05).

Conclusions

Self-assessed achievement of eating balanced meals is characterised by self-underestimation (predominatly Intenders) and self-overestimation (predominatly Actors). Tailored interventions should take this into account.

Key messages

• Self-assessed achievement of eating balanced meals is characterised by self-overestimation.

• Self-assessed achievement of eating balanced meals is also characterised by self-underestimation.
An integrated hospital-district evaluation for communicable diseases in low/middle-income countries
Authors: Tavoschi L , Belardi P , Mazzilli S , Manenti F , Pellizer G , Abebe D , Azzimonti G , Nsubuga JB , Dall'Oglio G , Vainieri M
Published: October 2022

Background

The last two decades saw an extensive effort to design and implement integrated and multidimensional healthcare evaluation systems in high-income countries. However, in low/middle-income countries, few experiences of such systems implementation have been reported in the scientific literature. We developed and piloted an innovative tool to assess the performance of health services provision for communicable diseases in three African countries.

Methods

A total of 42 indicators, 14 per each communicable disease care pathway (Tuberculosis, Gastroenteritis, and HIV/AIDS), were developed. A sub-set of 23 indicators was included in the evaluation process. The indicators assessed four care phases: prevention, diagnosis, treatment, and outcome. All indicators were calculated for the period 2017-2019, while performance evaluation was performed for 2019. The analysis involved four health districts and their relative hospitals in Ethiopia, Tanzania, and Uganda.

Results

Substantial variability was observed over time and across the four different districts. In the TB pathway, the majority of indicators scored below the standards and below-average performance was mainly reported for prevention and diagnosis phases. Along the Gastroenteritis pathway, excellent performance was instead evaluated for most indicators and the highest scores were reported in prevention and treatment phases. The HIV/AIDS pathway indicators related to screening and outcome phases were below the average score, while good or excellent performance was registered within the treatment phase.

Conclusions

The bottom-up approach and stakeholders’ engagement increased local ownership of the process and the likelihood that findings will inform health services performance and quality of care. Despite the intrinsic limitations of data sources, this framework may contribute to promoting good governance, performance evaluation and accountability in settings characterised by multiple healthcare service providers.

Key messages

• A successful experience in developing and implementing a communicable diseases performance evaluation systems in three sub-Saharan African countries using a bottom-up approach.

• The communicable diseases performance evaluation tool helped the data sharing between local healthcare providers and the development of competencies in data collection, analysis and interpretation.
Evaluation of a universal early intervention for parents and children from birth to age five
Authors: Sampaio F , Häggström J , Ssegonja R , Eurenius E , Ivarsson A , Pulkki-Brännström AM , Feldman I
Published: October 2022

Background

This study aimed to investigate the health and economic outcomes of a universal early intervention for parents and children, the Salut Programme, from birth to when the child completed five years of age.

Methods

This study adopted a retrospective observational design using routinely collected register data with respect to both exposures and outcomes from a county in northern Sweden. Areas that received care-as-usual (non-Salut area) were compared to areas where the Programme was implemented after 2006 (Salut area) in terms of: i) health outcomes, healthcare resource use and related costs around pregnancy, delivery and birth, and ii) healthcare resource use and related costs, as well as costs related to care of sick child. Costs were estimated for inpatient care and specialised outpatient care for mothers and children. Two analyses were conducted: a matched difference-in difference analysis using the total sample and an analysis including a longitudinal subsample.

Results

The longitudinal analysis on mothers who had given birth in both the pre- and post-measure periods showed that those that had been exposed to the Salut Programme, had on average 6% (95% CI 3-9%) more full-term pregnancies and 2% (95% CI 0.03-3%) more babies born within normal weight range, compared to mothers who had only care-as-usual. Savings were incurred in terms of outpatient care related costs for children of mothers in the Salut area ($826). The difference-in-difference analysis using the total sample did not result in any significant differences in health outcomes or cumulative resource use over time.

Conclusions

The Salut Programme achieved health gains at a reasonable cost for children and parents, and may lead to lower usage of outpatient care. Other indicators point towards positive effects but the small sample size may have led to underestimation of true differences. The current findings support the continuous investment in this early childhood programme.

Key messages

• The Salut Programme improves the health of children and parents at a low cost.

• The Salut Programme as a health promotion early intervention is value for money and should be included in the local policy investment agenda.
Does Portuguese pharmaceutical market follow an innovative trend? The INFOMED database analysis
Authors: Avelar FG , Raposo B , Torres A , Pedro AR
Published: October 2022

Background

Product innovation in the pharmaceutical market is, although not exclusively, a new product with the capacity to generate value. Thus, it must represent an invention through investment in research and development, and not a commercial monopoly. The aim is to identify innovation trends by Marketing Authorization (MA) granted in Portugal.

Methods

Quantitative descriptive study based on data (years 2017 to 2021) from Human Medicinal Products Database (INFOMED), managed by the National Authority of Medicines and Health Products, I.P. The parameters identified and used were MA and medical product subject to medical prescription. List was filtered by Product Group - New Active Substance. To identify innovation, findings were compared with the Anatomical Therapeutic Chemical (ATC) database and scientific literature to find other therapeutic options available.

Results

A total of 2695 records were identified. 1804 (67%) were generic drugs. Regarding new substances, 46 registrations (1.7%) were obtained, with the highest number recorded in 2017 (n = 13 - 2.03%) and the lowest in 2019 (n = 3 - 0.76%). After exclusion of different concentrations with the same therapeutic indication, a total of 26 medicines were observed: 54% had a listed ATC code and those, 64% had more than two linked ATC codes; 12 medicines had no related ATC code and 5 were classified as vaccine and therefore were not considered, thus 7 medicines were classified as major innovation.

Conclusions

Most of the innovation seen in the pharmaceutical market is not major innovation, but rather due to structural changes to chemical compositions. The Portuguese scenario is no different. Generic drugs, although not innovative, are important in the pharmaceutical market from a public health perspective. The identified innovations, although not major innovations, are important from a clinical and market availability perspective, however they should not represent a large portion of the pharmaceutical market.

Key messages

• In Portugal, the innovation trend in the pharmaceutical industry is based essentially on modifications in chemical composition and related therapeutic class.

• The development of major innovation in medicines should be stimulated and new models of financing and sustainability should be improved.
Factors associated with gender-based violence in couples during confinement by COVID-19 in Veracruz
Authors: Cruz Garduza AJ , Rodriguez Barranco AR , Vazquez Garate R , Uscanga Alcantara S , Martinez Torralba A , Perez Santamaria M , Juarez de la Huerta H , Pavan Gallardo JJ , Villegas Dominguez JE
Published: October 2022

Background

In the world, about a third of women who have had a relationship have suffered some type of violence and Veracruz city in Mexico presented 83 femicides, 519 assaults and 686 disappearances, occupying the 2nd place national in this field.

Objetives

To determinate the factors associated with gender violence during confinement by covid-19

Methods

A cross-sectional, prospective, analytical and observational study was conducted between August - December 2021. Women residents of Veracruz who have or have had a relationship in the last year were included. Violence was quantified by applying to through Google Forms® assessment inventory of mistreatment of women by their couple (APCM) with cronbach’s alpha of 0.94; this instrument takes into account physical and psychological violence. SPSS v22 software was used for data analysis, X2 test with Odds Ratio (OR) and 95% confidence interval (95%CI) and MannWhitney U test.

Results

A total of 740 women participated, with a mean age of 28.1±12.07, 87.8% heterosexual. Gender, sexual preference, educational level, witnessing violence in the family or in relationships with friends obtained values of p > 0.05 to suffer violence, while age was higher for those who suffered gender-based violence (28.8 vs 24.2) and the associated factors (OR/CI95%) were being a housewife (3.1/1.4-6.9), being a student (0.5/0.3-0.8), being married (1.8/1.05-3.3), having a boyfriend (0.3/0.2-0.5), having suffered violence in a previous relationship (1.6/1.06-2.5), identifying gender-based violence correctly or perceived (0.2/0.1-0.4), having suffered gender-based violence at some time by their partner in their last relationship (15.9/5.0-50.9) (p < 0.05)

Conclusions

Being a housewife, being married, having suffered violence in previous relationships and in the last relationship increase the risk of gender violence, while being a student, having a boyfriend and knowing the concept of gender violence decrease the probability of suffering it.

Key messages

• We must work on a deconstruction of ideas that allows women with risk factors for violence with their couples to identify it without fear of not meeting the socio-cultural expectations assigned to it.

• Including a woman’s partner within the structure of prevention of violence against women must be fundamental to promote an environment free of violence.
Health protection among own account and platform workers during COVID19 in Chile. The PWR project
Authors: Ruiz M , Vives A , Alvarez V , Diaz I , Zaupa A
Published: October 2022

Background

In the last decades, non-standard employment has grown globally. Especially for own account workers (OAW), this implies the self-management of economic, health and other work-related risks. In the context of COVID19, this management was stressed by lockdowns and the novel health risks imposed by an unknown and highly contagious virus, demanding the incorporation of new knowledge and preventive actions. As part of a six-country multiple case qualitative study on non-standard workers (NSW), we explore their experiences and strategies deployed to protect their health while continuing to work.

Methods

We performed 40 in-depth interviews to NSWs between October 2020 and February 2021, identified through the PWR online-survey and selected through an intentional sampling strategy according to levels of precarity (high-low), gender (male/female) and age (18-39/40-55). Interviews were analysed through abductive thematic analysis.

Results

We observed a significant transfer to platform, Uber-like jobs in the delivery of goods during lockdown (n = 7). In the absence of institutional prevention programs and provision of protective equipment, OAWs (n = 13) refer the self-provision of COVID19 prevention to protect themselves and their families while continuing to work, deploying a series of strategies amidst limited understanding of both mode of transmission of the virus and actual effective preventive measures. This had serious consequences for them and their families, expressed in anguish, sense of lack of control, fear, and fragility in the face of a major health risk given their constant potential exposure to the virus, leading to both physical and mental health problems, as well as COVID19 infection.

Conclusions

The substantial growth worldwide of gig delivery work during lockdowns magnified a pressing public health problem, critically requiring social security for gig and OAWs and the development of more equitable and accessible occupational health for all.

Key messages

• Substantial growth worldwide of gig delivery work during lockdowns magnified a pressing public health problem.

• Social security for gig and OAWs are critically required as well as the development of more equitable and accessible occupational health for all.
Health workers labor market before and during the Covid-19 pandemic: Health sector capacity of Serbia
Authors: Šantrić Milićević M , Mandić-Rajčević S , Stevanovic A
Published: October 2022

Background

During the COVID-19 pandemic surges, healthcare stakeholders were concerned with the sufficiency of available health workforce capacity. In this study we examined the changes in the supply and demand of physicians, nurses and care workers in Serbia over the period 2011-2021.

Methods

The National Employment Service (NES) data on total number of unemployed physicians, nurses and care workers, and vacancy data in health sector were described using the annualized % change for the period 2011-2021. The long-term duration of unemployed female physicians and nurses was further analyzed.

Results

In 2021, NES has registered total of 13,332 unemployed physicians, nurses and care workers, out of which the majority were females (79%), and nurses and care workers (88%). 2021 data on vacancies showed that only 16% of unemployed workers were needed. The peak of health workers unemployment was in 2016, highlighting the period of unemployment rise (2011-2016) at an annualized rate of 3.7% for medical doctors’ specialists, 6.4% for medical doctors without specialization, and 3.2% for nurses and care workers, and the period of unemployment decline (2017-2021) at an annualized rate of -7.9% for medical doctors’ specialists, -10.9% for medical doctors without specialization, and -5.9% for nurses and care workers. The annualized rate of decline was the lowest for female nurses and care workers. On average 53% of all long term unemployed medical doctors, nurses and care workers were women. In comparison to 2019, during the COVID-19 epidemic in 2020 and 2021 the number of vacancies for specialists and nurses and care workers has increased by one-third.

Conclusions

The study indicated a continuous mismatch between the supply and demand of physicians and nurses in Serbia (a surplus of some categories of nurse-specialists versus a shortage of some doctor specialists). The Serbian stakeholders need to urgently intervene regarding the long-term unemployment of female health workers.

Key messages

• NES data imply a low capacity of the Serbian health sector to absorb the huge numbers of (long-term) unemployed health workers.

• It is necessary to thoroughly examine and counteract the causes of the dramatic number of unemployed health workers on the NES records in Serbia.
Function, coping and health as predictors of sick leave after rehabilitation
Authors: Berget AM , Moen VP , Hustoft M , Assmus J , Strand LI , Skouen JS , Hetlevik Ø
Published: October 2022

Background

Function, coping and health are central factors in rehabilitation after injury or sickness. To investigate how these factors are associated with sick leave during 12 months after rehabilitation is the aim of this study.

Methods

A sample of 412 rehabilitation patients ≤ 67years were included. They were all employed, and referred to inter-professional rehabilitation in western Norway. Rehabilitation consisted of physical activity/exercise, cognitive approaches and pain management. In two surveys patients reported mental (MCS) and physical (PCS) function (SF-36), self-perceived health (EQ-VAS) and coping (SOC-13). Register data on sick leave during 12 months in the calendar year after rehabilitation was retrieved from Statistics Norway and categorised to; non, (n = 168), ≤ 364 days (n = 152) and 365 days (n = 92). Ordinal regression was used to analyse association between sick leave and MCS, PCS, EQ-VAS and SOC-13, adjusted for age, sex and diagnoses.

Results

The levels of MCS and PCS (SF-36) were found to be associated with sick leave; OR 0.96, 95% CI 0.92-0.99, p = 0.004 and OR 0.93, 95% CI 0.90-0.97, p < 0.001, respectively (Pseudo R2 = 0.1133). EQ-VAS and SOC-13 were significant predictors of sick leave in crude analysis (EQ-VAS: OR 0.97, 95% CI 0.96-0.98, p < 0.001. SOC-13: OR 0.98, 95% CI 0.95-0.98, p < 0.001), but not in the fully adjusted model (EQ-VAS: OR 0.98, 95% CI 0.96-1.01, p = 0.178. SOC-13: OR 0.99, 95% CI 0.99-1.03, p = 0.479).

Conclusions

Patientś self-reported mental and physical function were associated with sick leave 12 months after inter-professional rehabilitation. Higher level of function was associated with no sick leave. In our study, patient’s self-reported health and coping were not associated with sick leave. This suggest that interventions for functional improvement are beneficial in health care strategies to help patients return to work after injury or sickness.

Key messages

• Achieved higher physical and mental function after rehabilitation seems to contribute to reduced sick leave after injury or sickness.

• Improving function should remain a central factor in rehabilitation.
The effect of vocational rehabilitation on the use of health care services in Finland
Authors: Rinne H
Published: October 2022

Background

Because vocational rehabilitation is a separate service from other health services, there may be interruptions at their interface. We examined whether the use of health services changes before and after rehabilitation.

Methods

Longitudinal individual-level register-based data was utilized on all individuals aged 15-60 living in the city of Oulu, Finland and starting vocational rehabilitation in 2014-2015 (N = 792). We compared their use of outpatient health care services in 3-month periods from 1.5 years before to 1.5 after the rehabilitation period to the total population of the same age and to the propensity score matched controls. Several socio-demographic factors and sickness and employment histories were used for matching.

Results

According to the preliminary results, rehabilitees had on average 1.5 visits to outpatient health care services in the 6th quarter before the start of rehabilitation, twice that of the total population. In the 4th quarter before the start of rehabilitation, the number increased to 1.8. After the rehabilitation period, the quarterly number of visits were at the same level as in the beginning of the follow-up. The biggest changes took place in the use of occupational health services. Changes were modest in public health care services. In other services changes were minimal. Compared to the propensity score matched controls, vocational rehabilitation did not appear to have an effect on the use of health care services.

Conclusions

The use of health care services is more common before vocational rehabilitation than after it. The effect of rehabilitation on the use of health care needs further analysis.

Key messages

• The pattern of the use of health care services changes in the course of vocational rehabilitation. The changes are mainly due to visits in occupational health care services.

• The use of health care services is most common before rehabilitation. However, vocational rehabilitation does not appear to have an effect on the use of outpatient and inpatient health care services.
Patient-Reported Outcome Measures for care quality assessment of a breast cancer Care Pathway
Authors: Angioletti C , de Mattia E , Perilli A , de Belvis AG
Published: October 2022

Background

Breast Cancer (BC) is the most common type of cancer among women in Europe, accounting for around 28% of newly diagnosed female cancers. A clinical Pathway (CP) is an effective tool able to deliver high quality care especially if linked to a Monitoring System. Still, it is essential to integrate them with the patient’s perspective according to Value-Based Care. This paper aims to define and test a tool for care quality assessment in patients with breast cancer, in a value-based perspective.

Methods

A scoping search of the main databases (PubMed, Scopus, Web of Science) and official websites of institutions and organizations (AIOM, CIPOMO, EORTC, ICHOM, Istat) was carried out. A Delphi survey was conducted to assess the tool, according to four criteria (general relevance, evidence-based, measurability, actionability). We only included indicators that achieved strong agreement. Time-points for data collection were defined and validated in relation to the different steps of the CP.

Results

The final tool consists of 21 questions coming from the following sources: BREAST-Q and EORT QLQ-BR23 questionnaire. BREAST-Q’s questions, have to be administered at T0 (first medical contact) and T12 (follow-up), while the EORT QLQ-BR23’s questions have to be administered at T0 (first medical contact) T Surgery, T6 (follow-up) and T12 (follow-up). The survey will be administered to a sample of 152 BC patients (MOE 5%; CL 95%) undergoing surgery in the period June-September 2021.

Conclusions

The present tool will give a quick view of Value provided by the CP to these patients. In light of the high volume of patients treated at our center (1008 breast cancer surgery hospitalisations in 2020), this study acquires further public health relevance. Additionally, this approach can be extended for further evaluation of other CPs.

Key messages

• We assess care quality for Breast Cancer patients in a large hospital in Italy through Patient-Reported Outcome Measures, based on an evidence-based, Value-based, Delphi-validated tool.

• Assessing Value brought to patients with Breast Cancer gives a unique perspective on care quality assessment and paves the way for further quality improvements and extension to other health issues.
Use of healthcare services and hospitalisation among elderly people in Latvia
Authors: Dātava S , Reine I
Published: October 2022

Background

Demographic changes have occurred worldwide during the recent decades, with an increasing proportion of the elderly in the society, leading to higher average age of the population. Older people are more likely to suffer from different chronic diseases, and higher consumption of healthcare services and, thus, posing additional burden and challenges to the healthcare system.

Methods

The descriptive analysis relied on the longitudinal study of Health, Ageing and Retirement (SHARE). The target population included people aged 50 years or older, a total of 782 residents living in Latvia. We used the data from wave 8, collected from 2019-2020.

Results

The mean age in the study population was 69 years, and 62.5 % of the respondents were women. Results show that 14.7 % of all respondents were hospitalised in the last 12 months. The average length of stay at hospital was 10.9 days (range 1 - 71, SD 10.5). In 36.7 % of the cases hospitalisation was planned, but in 42.9 % it was due to an emergency. More than a half had visited hospital only once, but 19.1 % four times or more. The most common diseases among the hospitalised patients were high blood pressure/hypertension (60 %), heart attack (27.8 %), high cholesterol (26.1 %), osteoarthritis (21.7 %), stroke (18.3 %), diabetes (12.2 %) and different fractures (11.3 %).

Conclusions

We found that the main ailments for hospitalised patients were both chronic diseases like cardiovascular diseases, rheumatism, diabetes and acute conditions like fractures. The average hospital stay was 11 days.

Key messages

• Understanding how causes of hospitalisation among elderly interact with the use of healthcare services might help to reduce risk factors associated with hospitalisation and improve the health systems.

• Further studies on hospital admissions among older persons with particular characteristics health conditions could help to reduce the burden of disease and improve the well - being of the elderly.
Use of diabetic healthcare according to the accessibility of diabetology services
Authors: Maláková K , Šídlo L
Published: October 2022

Background

Diabetologists, as other specialists, are more likely concentrated in towns and cities rather than in the countryside so the people who live in these municipalities have a wider supply of health services. Our aim is to determine whether there are significant differences in the use of diabetology services between patients who live in the municipality with these services or not in Czechia.

Methods

The sorted anonymized data obtained from the General Health Insurance Company of the Czech Republic (GHIC CR) were used. The studied patients were people with a diagnosis of type 2 diabetes mellitus (E11) who were insured by GHIC CR and used health services in 2019 in Czechia.

Results

The distribution of providers of diabetology services (PDS) is relatively even throughout the country, and PDS are mainly concentrated in the municipality with a large population. In total, 52% of patients have the diabetologist in their municipality of residence. Patients living in the municipality with PDS have greater odds of using their services (OR 1.63, Cl 1.61-1.65). Specifically, 67% of the patients who have the diabetologist in their municipality of residence use diabetology services compared to 55% of the patients living in the municipality without PDS commute for diabetology services to the other municipality.

Conclusions

The results show that diabetology services are concentrated mainly in towns and cities and patients living in the municipality with the diabetologist use more diabetology services compared to patients living in the municipality without them. At the same time, it seems that more than half of the patients in the municipality where is not PDS are willing and able to commute for diabetology services.

Key messages

• Although patients living in the municipality without the diabetologist use diabetology services less often than with them, due to the commuting for healthcare, the differences are blurred.
Development of cancer policies between Europe Against Cancer Programme and Europe’s Beating Cancer
Authors: Albreht T , Jelenc M
Published: October 2022

Issue/problem

European Union has legally certain limitations in developing joint policies for services, activities and interventions that belong to the national competencies. Cancer control and cancer policy occupy a special place as they have received special attention throughout the last 40 years.

Description of the problem

European Union launched its first important disease policy with the start of the Europe Against Cancer Programme in 1984/85. It was a step, supported by a few interventions and activities, which facilitated the development of several important policy tools. After its closure in 2003, there was some unease, especially in view of the forthcoming biggest enlargement of the EU in 2004. Several activities revived the EU cancer policy and these processes culminated in the adoption of the Europe’s Beating Cancer Plan. There were some doubts whether the latter would be feasible but a careful development process at different levels resulted in success.

Results

A policy analysis will be presented that will introduce key steps and documents that mark the period between the two milestones - Europe Against Cancer Programme (EACP) and Europe’s Beating Cancer Plan (EBCP). We will present the development of various tools as well as the important outcomes of the different policies and interventions triggered by the two documents. The period between 2003 and 2019 will be elaborated in view of the adoption of EBCP. Three Joint Actions and their various outputs with a strong impact on the cancer policy development, contributing also to the development of flagships and actions of EBCP will be presented as well.

Lessons

EU top level decisions and policies can be developed harmoniously and to the benefit of both - the EU and the Member States - when launched in a joint process and with the involvement of all the relevant stakeholders.

Key messages

• EU policy documents are important drivers for the development of health policy tools at both the EU level as well as at the Member State level.

• A combination of top-level documents with carefully developed policy tools enables the development of cancer policies acting at both EU and Member State level.
Health promotion among unemployed people – meta-analytic evidence
Authors: Hollederer A , Paul K
Published: October 2022

Background

It is well known that unemployment impairs health. However, less is known about health promotion among unemployed people and healthy coping strategies to deal with unemployment.

Methods

A random-effect meta-analysis was applied to statistically integrate quantitative controlled intervention studies among unemployed people.

Results

The meta-analysis included 34 eligible primary studies with 36 independent intervention samples. For mental health, the average meta-analytic effect sizes for the comparison of intervention group and comparison group was significant and of small size after the intervention d = 0.25; 95% CI [0.10, 0.39], and at follow-up, d = 0.13; 95% CI [0.04, 0.22]. For health behavior (measured as physical activity), the effects were also significant after the intervention, d = 0.30; 95% CI [0.12, 0.47] (no data available at follow-up). Effects on self-assessed physical health status were very small and not significant. However, when health improvement was the only goal of the respective intervention (in contrast to studies with multiple goals, e.g., health improvement plus re-employment), the effect on physical health was significant, too, d = 0.15; 95% CI [0.04, 0.25]. Moderator tests showed that intervention effects on mental health were significantly stronger when cognitive-behavioral methods were used (p < .05), while the use other kinds of stress-management techniques (p < .05), of methods to increase social support (p < .05), or of relaxation techniques (p < .07) did not improve the effectiveness of the intervention.

Conclusions

The present meta-analyses provided evidence that, on average, interventions aiming at improving unemployed people’s health do indeed improve participants’ health.

Key messages

• The present meta-analysis confirms that it is possible to promote unemployed people’ health. The moderator effects for type of intervention that were found here might be helpful for health promotion.

• The inclusion of cognitive-behavioral methods, appears to be a successful approach for health-oriented interventions with unemployed people.
Changes in university student health behaviors since the beginning of the COVID-19 pandemic
Authors: Patin A , Ladner J , Tavolacci MP
Published: October 2022

Background

The COVID-19 pandemic lead many upheavals in the life habit whith lockdowns and curfews since March 2020 and possibly in the health behaviours of university students could be impacted. The objective of the study was to assess the evolution of the health behaviors of university students between before the COVID-19 period and May 2021.

Methods

Two retrospectives online studies of a university students in France were in May 2020 and May 2021 were conducted. Socio demographics and academics environment data, tobacco smoking, binge drinking, cannabis use, and vigorous physical activity were collected in a declarative way.

Results

In 2020, 3483 (72.5% of women, mean age 20.9 (SD = 2.46)) and in 2021, 3504 (74.4 of women, mean age 20.73 (SD = 2.32)) university students were included. After logistic regression, in 2020 compared to the pre-COVID19 period, the regular vigorous physical activity didn't change significantly while there appears to be a study period effect with a decrease of the regular binge drinking (AOR=0.24 IC95% [0.20,0.29]). In 2021 compared to the pre-COVID19 period, the regular vigorous physical activity and the regular binge drinking decreased respectively, (AOR=0.53; IC95% [0.48,0.59]) and (AOR=0.60 IC95% [0.52,0.70]). Regular tobacco smoking and cannabis use didn't change significantly in 2020 and 2021 compared to the pre-COVID period.

Discussion: The decrease of binge drinking and physical activity between preCOVID-19 and 2021 could be attribute by the restricting mobility and social interactions. We did not observe an increase in risky health behaviors as smoking and cannabis use. These behaviors remain to be monitored in the future to assess the long-term effects of the pandemic COVID-19 on student health behaviors

Key messages

• Health-promotion strategies directed at adopting or maintaining positive mental health should be developed for university students to better manage future lockdown periods.

• Recommendations to maintain health during the ongoing COVID-19 pandemic specifically target university student populations are needed.
Digital Health Literacy in the Training of Informal Caregivers – Community Intervention
Authors: Águas D , Paço M , Henriques A , Arriaga M , Costa A
Published: October 2022

Background

Health Literacy allows optimizing healthy lifestyles and preventive and health protective behaviors (DGS, 2019). Low literacy can lead to a greater number of hospitalizations, a more frequent use of emergency services and a lower prevalence of preventive attitudes in the field of health. Internet-based interventions could have a positive impact on informal caregivers, reducing the geographical barrier, promoting self-efficacy in managing their own emotions, reducing burden.

Aim

Contribute to the training of informal caregivers of a primary health care unit in Lisbon, through the promotion of digital health literacy.

Methods

The Community Intervention project was carried out in the context of a home visit, focusing on 11 informal caregivers, through the presentation of an interactive digital manual. It was based on the methodology of health planning, through the elaboration of a diagnosis of the situation, definition of priorities, setting of objectives, selection of strategies, operational preparation and evaluation (Imperatori & Giraldes, 1993).

Results

It was found that not all informal caregivers have access to the internet or digital technologies, and it was necessary to deliver the printed manual. Caregivers who accessed the interactive digital manual rated its content as very important, having accessed the suggested links without difficulty. The possibility of forwarding the digital manual to other caregivers was valid for all.

Conclusions

Digital technologies promote communication in terms of health promotion, contributing to universal access and digital training in health, giving individuals the opportunity to increase care for their own health. The creation of digital health tools must be directed to the characteristics of the population. For individuals with low digital literacy, simple technologies must be created and for those who cannot or do not want to use digital tools, adequate alternatives must be created.

Key messages

• Primary care health professionals may use digital technologies to promote health literacy.

• Vulnerable groups with low digital health literacy need support to increase access to digital technology that can promote health literacy.
Addressing health literacy to reduce inequalities among migrants: which profiles need our attention?
Authors: Marques MJ , Gama A , Cheng C , Osborne R , Dias S
Published: October 2022

Health literacy, the ability to access, understand, appraise, remember and use health information and services, has great potential to reduce inequalities in access to and outcomes of care. People may have different patterns of health literacy needs and strengths. Yet, the design of interventions is frequently not responsive to the specificities of different segments of the population, including migrant groups. We aimed to identify profiles of migrants to inform the co-design of interventions targeting people at risk of poor outcomes. A cross-sectional survey was conducted with 1126 adult migrants living in Portugal. Data were collected using the 9-dimension HLQ (Health Literacy Questionnaire), and a sociodemographic questionnaire. A cluster analysis of data was performed. Semi-structured interviews were conducted with 15 migrants, stratified by the clusters. The optimal cluster solution yielded 16 profiles revealing diversity in combinations of strengths and needs across the HLQ domains. While 29.8% of migrants scored moderate to high on all 9 domains (profiles 2, 6, 8, 16), 63.4% of participants struggled with 1 or several aspects of health literacy, namely ‘Feeling understood and supported by healthcare providers'. Notably, 36.8% (6 profiles) exhibited difficulty across most of health literacy domains. The interviews provided a tangible description of the health literacy needs and resources with five main themes (access, understand, appraise, retrieve and use). Regarding ‘access', migrants expressed different preferred learning styles and needed to access different sorts of information at distinct times. The ‘use’ of information was rarely a one-time decision but a decision that people needed to make repeatedly. Health literacy is a highly diverse concept where subgroups exhibited diverse patterns. The cluster analysis can be used to inform the co-design, prioritisation and implementation of locally designed, fit-for-purpose solutions to improve health literacy.

Key messages

• Health literacy profiles can inform interventions to mitigate health inequalities among vulnerable migrant groups.

• The identification of distinct profiles can contribute to minimise the disconnect between what people/communities need and what is developed to improve health and equity.