bluuebunny/crossref_metadata_2025 huggingface dataset:
Cancer Prevention in People Experiencing Mental Ill-Health: A co-designed Patient Navigation Concept
Authors: Schäfer K , Mües H M , Dalma A , Papaioannou A , Mancebo Salas N , Wrzesińska M , Wieczorkowska M , Sanna L , Grabovac I
Published: October 2024

Introduction

People experiencing mental ill-health have greater disparities in cancer specific morbidity and mortality. Factors influencing cancer prevention include increased risk behaviours and frequent encounters with barriers to health care utilization. The Patient Navigation Model (PNM) has been proven to reduce barriers in accessing cancer preventive care in vulnerable populations. To facilitate successful implementation, the conceptual features of the PNM were co-designed with patients and other relevant stakeholders.

Methods

Twelve focus groups were conducted in January 2024 at four pilot sites in Austria, Greece, Poland, and Spain. Iterative focus group discussions were carried out following key considerations for the PNM as outlined by DeGroff et al., audio recorded and transcribed verbatim. Transcripts were analysed deductively using a directed content analysis while allowing for potential inductive emergence of codes and topics. A total of 50 participants attended, representing five groups (individuals with mental ill-health, care givers, care team members, representatives of mental health organizations, and representatives of service managers).

Results

The co-design focus groups allowed for the PNM to be contextually adapted to each pilot site, but similarities in the approach emerged within the following four themes: 1) the requirement for a person-centred approach, 2) consideration of both person-specific and context-specific needs, 3) flexibility and competencies of navigators and 4) variation of navigation services (e.g., improving health literacy, promoting a healthy lifestyle, and providing practical support).

Conclusions

Participatory approaches in co-designing interventions allow for context specific development of interventions to meet the requirements of people with complex needs. Co-designing the PNM is part of activities of the CO-CAPTAIN project funded by the European Union’s Horizon Europe Programme (GA 101104784).

Key messages

• The Patient Navigation Model for Primary Cancer Prevention is a tailored intervention aiming to meet the needs of individuals experiencing mental ill-health.

• The conceptual features of the Patient Navigation Model for Primary Cancer Prevention were co-designed with patients and other relevant stakeholders.
Co-producing evidence to inform universal health coverage implementation in Ireland: 2019-2024
Authors: Burke S , Parker S , Bruen C , Schulmann K , Siersbaek R , Mac Conghail L
Published: October 2024

Background

In 2017, Ireland’s parliamentary health committee published a ten-year health reform plan, entitled Sláintecare, with the aim of delivering universal healthcare. Endorsed by government in 2018, progressing Sláintecare remains government policy in 2024. In 2019, Prof Burke was awarded public funding to co-produce knowledge for the design and implementation of the regions, a key aspect of Sláintecare. In 2020, with the arrival of COVID-19, regional reform was paused and the research pivoted to capture the learning from the COVID-19 health system response to inform Sláintecare. In 2022/3, the research returned to focus on the regions.

Methods

Foundations’ research resulted in 14 peer-reviewed publications between 2019 and 2023. These were mixed-methods using qualitative and quantitative data and analysis. Coproduction with health system leaders that were devising and implementing the regions and the COVID-19 health system response underpinned the research.

Results

There are 14 academic publications from the Foundations Research (2019-2023). At the core of co-production is trust and good working relationships. Co-producing research with senior policy makers and implementers has benefits and drawbacks. The benefits include access to resources and data and that the data and knowledge generated are more likely to be adopted. Drawbacks include control over areas researched, denial of access to data and lack of openness to research findings. Producing controversial findings, unpopular with government, minister or health system leaders can also lead to difficulties for the research team.

Discussion/conclusions

Details of the coproduction process with senior health system and policy leaders will be presented. It will detail specific examples of the research which were initiated by the health system and those that came from the academic research team. It will give examples of how the research influenced the policy making and implementation processes.

Key messages

• Co-producing research between academics and health system and policy leaders leads to better use of evidence.

• Trust and good workign relationships are key to co-producing research that is used in policy making and implementation processes.
Working on new topics: Estimation of the burden of zoonotic diseases
Authors: di Bari C , Devleesschauwer B
Published: October 2024

Zoonoses, diseases naturally transmitted between vertebrates and humans, represent significant global health threats. These diseases not only affect human health but also impose a considerable burden on animal populations, emphasizing the need for a One Health approach that integrates strategies across human, animal, and environmental health sectors. The socioeconomic impacts of zoonoses are profound in low- and middle-income countries, disrupting production systems, impacting livelihoods, and compromising food security. Populations in these regions are excessively affected, highlighting the urgent need for a comprehensive approach. The disability-adjusted life year (DALY) quantifies disease burden in terms of morbidity and mortality. The zoonotic DALY (zDALY) expands this metric by incorporating the burden on animals through the ‘animal loss equivalents’, accounting for both fatal and non-fatal outcomes in livestock. However, zDALYs do not encompass broader economic impacts associated with prevention and treatment. Cost of illness (COI) studies further quantify the financial costs due to health issues; ad hoc approaches can be used to quantify other costs related to animal disease control and eradication, trade and movement Implications, or loss of consumer confidence. While few zoonoses, such as cystic echinococcosis and brucellosis, have comprehensive data across these metrics, most do not. While these metrics provide complementary insights, no holistic metric currently encompasses all necessary aspects to fully assess the burden of zoonoses within a One Health framework. This presentation aims to offer state-of-the-art estimates of the disease burdens of zoonoses, employing DALY, zDALY, and COI studies. It will explore how to integrate these metrics from a One Health perspective. Indeed, only by integrating health and economic metrics that consider the well-being of humans and animals, can the One Health approach effectively be developed for zoonotic diseases.
Assessment of a Therapeutic Education Program for Coronary Patients: Quasi-Experimental Study
Authors: Ghali H , ElHraiech A , Ben Cheikh A , Ben Souda H , Karray M , Bruno P , Zedini C
Published: October 2024

Introduction

Therapeutic education is a patient-centered, approach aimed at addressing the patient’s needs and resources. It is intended not only to help the patient understand their illness and treatment but also to empower them to become autonomous. So far, in Tunisia, we lack structures for therapeutic education specifically tailored for coronary patients. In this context, we implemented a Therapeutic Education Program (TEP) for coronary patients visiting the cardiology department at Sahloul University Hospital with the aim of assessing the impact of this program in the short, medium (3 months), and long term (12 months).

Methods

We conducted a quasi-experimental study on TEP for patients with coronary artery disease over one year at Sahloul University Hospital. Patients were divided into two groups, intervention, and control. Outcome measures included major cardiovascular events, improvement in knowledge, and biological indicators, with statistical analysis performed using SPSS in accordance with ethical considerations.

Results

The study included 129 patients, of whom 38 underwent a therapeutic education program. TEP demonstrated a significant improvement in knowledge about coronary artery disease, with program satisfaction rated ≥8 on a scale of 0 to 10.Our program also showed improvement in biological parameters, particularly lipid profiles, within the educated group before and after 3 months, such as LDL cholesterol levels (2.53 vs 1.88, P < 0.001), and compared to the control group (1.88 vs 2.9, P = 0.001).Moreover, it led to a significant reduction in long-term cardiovascular events compared to the control group (21.1% vs 59.3%, p < 0.001).

Conclusions

this study underscores the crucial importance of therapeutic education in enhancing the care and quality of life of coronary patients, highlighting its central role in a proactive, personalized approach to medical management.

Key messages

• The significance of therapeutic education in empowering patients to understand their condition and become self-reliant.

• Need for Structured Programs specifically for coronary patients in Tunisia.
Prediction of subsequent CKD according to eGFR decline slope varies by the presence of hypertension
Authors: Miyamatsu N , Shima A , Matsuno F , Segawa H , Tatsumi Y , Morino A , Kiyohara M , Yamaguchi A , Kawatsu Y
Published: October 2024

Background

We reported that a declining slope in eGFR evaluated from 3-year observation could predict subsequent CKD among the relatively healthy population, even adjusted for baseline eGFR. However, its certainty may vary depending on the presence of comorbidities such as diabetes and hypertension, which are also recognized as the risk factors of CKD.

Methods

Annual health check-up data from a Japanese company spanning from 2009 to 2022 was used. The analyses included participants having 4 times continuous eGFR measurements for 3 years, undergoing health checkups at least once during a follow-up period, with negative for urinary protein (UP), and non-diabetic. Individual ‘eGFR slopes’ were calculated by the regression line with 4 times eGFR measurements. Participants with slopes of < -5 per year were categorized as the “decreased” group and -5 or more were categorized as the “stable” group. The cases of positive UP or less than 45mL/min/1.73m2 in eGFR during a follow-up period were defined as CKD. Cox regression analyses adjusted for sex, age, and eGFR at baseline were performed to calculate the hazard ratios and 95% CIs for CKD in the decreased group (reference; stable), stratified by hypertension.

Results

Out of 5598 study participants(men 36%, mean age 48.2±10.1years, mean follow-up period 4.3 years), 260 CKD cases (4.6%) were observed. CKD cases accounted for 4.5% (235/5218) in the stable group and 6.6% (25/380) in the decreased group. Multivariate-adjusted hazard ratios [95%CIs] of CKD by eGFR decline was 1.50[0.99-2.27]. The eGFR decline increased the risk of CKD only in participants with hypertension (2.09[1.09-4.04]), but not in those without hypertension (1.25[0.73-2.13]). After excluding individuals with eGFR slopes exceeding 10 per year to consider for hyperfiltration of eGFR, the results were consistent.

Conclusions

The eGFR decline over a 3-year observation may predict subsequent CKD only in individuals with hypertension.

Key messages

• With a relatively short-term evaluation period of three years, eGFR decline can predict subsequent CKD only in hypertensive individuals.

• In middle-aged hypertensive patients, it would be important for the prevention of CKD to pay attention not only to low eGFR but also to the progression of eGFR decline.
The Effect of Text messages and Education on Cancer Screening in Women Aged 30-65
Authors: Kutman H , Kadıoğlu H
Published: October 2024

Background

Despite it is known that cancer screenings reduce cancer-related deaths, screening rates are still inadequate. The aim of this study is to examine the effect of text messaging and training on cancer screening in women aged 30-65.

Methods

This non-randomized controlled trial was conducted with 120 women aged 30-65 between November 2023 and April 2024 in Tekirdağ, Türkiye. Participants were divided into the text message group (TMG) (n = 60), the training group (TG) (n = 60), and the control group (CG) (n = 60). In the text message group, every participant received text messages about cancer and importance of screening procedures, one a day for ten days. The training group was educated for a session that lasted 45 min. Data was collected both before and 3 months after the intervention, using a questionnaire that included two parts (sociodemographic characteristics and stages of change for cancer screening practices). Data was analyzed using the Marginal Homogeneity test.

Results

The rates of those who had a pap smear test, breast self-examination (BSE), mammography, and stool occult blood screening were found to be significantly higher in both the text message group and the training group in the post-test than the pre-test. (p<.001). In the text message group, there was an increased rate of 43.4% for pap smear test, 25% for BSE, 17.3% for mammography, and 10% for stool occult blood screening. In the training group, there was an increased rate of 31,7 % for pap smear test, 26,7% for BSE, 13,3% for mammography, and 23,4 % for stool occult blood screening. There was no change in the control group.

Conclusions

The results showed that both text messages and training about cancer screening are effective in increasing the rate of cervix, breast, and colorectal cancer screening.

Key messages

• Text messaging about cancer screening is as effective as training in increasing the rate of cervix, breast, and colorectal cancer screening.

• Text messaging interventions may be an effective and practical way to increase cancer screening rates in populations most affected by health disparities.
Assessment of Integrated Care Pathways for dementia in Italy according to the National Guidance
Authors: Marconi D , Pani S M , Salemme S , Lazzeri G , Sardu C , Bacigalupo I , Lorenzini P , Vanacore N , Bellomo G
Published: October 2024

Background

Italy counts 1 million people with dementia and 3 million caregivers. An integrated management system provides comprehensive care for people with non-communicable diseases, including dementia, through integrated care pathways (ICPs). Our study identified available dementia ICPs and assessed their compliance with the National Guidance on ICPs for People with Dementia (NGICPD). The project is carried out with the technical and financial support of the Ministry of Health (Chapter 2302).

Methods

We located ICPs by browsing all the websites of regions and Local Health Authorities (LHAs), contacting by email all LHAs, collecting ICPs from a survey carried out by the Dementia Observatory of the Italian National Institute of Health, and communicating with regional contacts. We included the ICPs produced after the NGICPD by the end of 2023. We applied a checklist developed on NGICPD consisting of 3 domains: Reference framework (0-15), Elements of the ICP (0-14), Construction of the ICP (0-14). ICPs were assessed by two researchers; a third solved the conflict points. The concordance was expressed by the intra-class correlation coefficient.

Results

We analysed 39 ICPs (11 regional, 28 LHAs) out of 87 collected. 15/21 regions and 30/110 LHAs developed an ICP. The observed mean total score was 23.5±7.9 for the regional ICPs and 23.1±5 for the LHAs ICPs. We observed low compliance with NGICPD, particularly in domain 3. The development of a health information system was included in 5/11 of regional and 12/28 of ICPs of LHAs; a monitoring system was present in 8/11 of regional and 25/28 LHAs ICPs. Concordance analysis showed an excellent correlation for regional ICPs and good for LHAs ICPs.

Conclusions

Our analysis highlighted low compliance of ICPs with the NGICPD and critical issues in monitoring. Our analysis stresses the need for all regions and LHAs to develop or update ICPs in line with NGICPD and the Italian Guidance on diagnosis and treatment of dementia.

Key messages

• Developing a pathway of efficient and coordinated care is essential to guarantee the quality of care for people with dementia and their families. All regions and LHAs must develop or update ICPs.

• Monitoring ICP with indicators is crucial to planning cost-effective healthcare services.
Association between the education level and heatwaves mortality in Slovenia, 2015-2022
Authors: Percic S , Pohar M , Bitenc K , Medved A , Krosel M , Hrzenjak V V , Hojs A
Published: October 2024

Background

So far only a few studies have addressed the heat related mortality risks associated with socioeconomic factors. The study aimed to determine whether low education is associated with more deaths during heat waves, which in turn leads to health inequalities linked to climate change.

Methods

In this time series study, we assessed the association between the level of education in three Slovenian climate regions and mortality during the heatwaves from 2015 to 2022. We estimated the relative risks (RR) with 95 % confidence interval for the number of deaths due to all causes among persons with three different levels of education associated with heatwaves in three Slovenian climate regions independently, comparing the number of deaths during heat waves with the reference days.

Results

Continental and Littoral Climate: We found no statistically significant association in the number of deaths due to all causes during heatwaves according to the three levels of education. When comparing these three levels to each other (Relative Risk Ratio), we found no statistically significant differences between them. Transitional Climate: For the second education level (middle education) we found statistically significant increase in number of deaths due to all causes (12%; 95% CI: 2%, 23%). When comparing the three education levels to each other, we found statistically significant decreased number of deaths in the first education level (low education) compared to second (-13%; 95% CI: -24%, -1%).

Conclusions

When assessing the effects of climate change on health and planning preventive measures, it is necessary to consider both socioeconomic factors and the characteristics of different climate regions in Slovenia. Further studies are needed.

Key messages

• Heatwaves will contiue to be more intense, longer and more frequent also in Europe.

• Not many studies assessed association between social status and mortality durin heatwaves. WE found statistically significant more deaths in middle class education group. Further studies are needed.
Greening the mind: exploring the link between vertical gardens, urban forests, and mental health
Authors: Urbano T , Akkawi S , Brînzac M G , Savoia C , Cadeddu C
Published: October 2024

Background

Mental disorders impose a significant global burden, affecting millions of individuals, contributing to disability, reduced quality of life, and economic costs worldwide. Between 1990 and 2019, the global number of disability-adjusted life-years due to mental disorders increased from 80.8 million to 125.3 million. The economic costs are projected to rise to 6,000 billion euros by 2030. Urbanization has been associated with a worsening of mental disorders over the years due to various factors, such as increased stress, social isolation, reduced access to green spaces, and higher levels of pollution. Decades of research have instead shown that exposure to green space may promote psychological well-being, regulate stress, and endorse social health across the lifespan. In this systematic review, we aim to investigate how proximity to vertical gardens or urban forests, specifically, may affect mental health.

Methods

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were followed. The study protocol was registered in PROSPERO (CRD42024517969) with the following PECOS question: Is there an association between vertical gardens or urban forests and mental health?

Results

After performing searches on PubMed, Scopus, and Web of Science, and duplicate removal, we retrieved 556 articles. The main reasons for exclusion after title/abstract screening were mainly wrong outcome (not mental health) and wrong study type (not observational/intervention/cross-sectional studies). The selection of full texts is expected to end shortly and results will be available for November 2024. Preliminary findings support the role of green environmental assets in facilitating physical activity, social contact, and stress reduction.

Conclusions

In summary, mental disorders are exacerbated by urbanization’s stressors. Our review will further elucidate the potential benefits of urban green spaces like vertical gardens and urban forests on mental health.

Key messages

• Urbanization exacerbates the issue of mental disorders global burden.

• Exposure to urban forests and vertical gardens may promote physiological well-being and mental health.
Public health effectiveness of cooling centres in adverse hot weather events: a systematic review
Authors: Dearman C , Adams N , Sousa A , Pearce-Smith N , Petrokofsky C
Published: October 2024

Background

The 2022 heatwave in England highlighted the need for effective public health interventions like cooling centres in temperate climates where built-in air conditioning is uncommon.

Aim

To determine the impacts of cooling centres on heat-related health outcomes for users in temperate climates, assessing their effectiveness and identifying barriers to usage.

Methods

This systematic review analysed literature sourced from MEDLINE, Embase, Web of Science, CENTRAL, and Google Scholar from January 2010 to February 2023. Criteria for inclusion focused on studies evaluating health outcomes related to cooling centre use. Screening and quality assessments were independently conducted using the Mixed Methods Appraisal Tool.

Results

The review included six studies: three quantitative, three qualitative. Two were evidence synthesis of prior studies. No studies conclusively measured health and wellbeing outcomes directly after cooling centre use; instead, research emphasised user demographics, barriers, and facilitators. Common barriers included accessibility, operational hours, and public perceptions, which often misalign with user needs. Successful implementations were noted in centres integrated within community facilities like libraries or community centres. One modelling study suggested a number needed to treat to avoid one heat-related death of 1 million. The relevance of this is unclear as it was in a hotter climate with greater prevalence of air conditioning than in England.

Conclusions

While direct health benefits in cooler climates like England are poorly documented, cooling centres play an essential role in comprehensive heat response strategies. They offer potential social benefits and provide a cost-effective alternative to urban redesign. Future studies should aim to directly measure health outcomes and refine operational strategies to maximise benefits.

Key messages

• Cooling centres are crucial in comprehensive heat response strategies, yet direct evidence in cooler climates like England remains limited.

• Integration with existing community services may significantly enhance cooling centre utilisation and effectiveness.
Extreme Heat and Specific-Cause Mortality during Summer 2018 in Mainland Portugal
Authors: Subtil I , Silva S P , Leite A
Published: October 2024

Climate change has led to increased frequency and duration of extreme heat periods, impacting human health and mortality. During the 2003 heatwave, it was estimated that there were between 25,000 and 70,000 excess deaths in Western Europe. Specific-cause mortality analysis was conducted in Portugal that year and has not been assessed since. The goal of this study is to estimate the impact of an extreme heat period in 2018 on specific-cause mortality in mainland Portugal. An ecological study was conducted comparing observed and expected deaths, from August 2 to 9, 2018, in Portugal. Two comparison periods were chosen: from July 19 to 26, 2018 (C1) and the average deaths from August 2 to 9 in 2017 and 2019 (C2). Excesses, ratios, and respective 95% confidence intervals were calculated in R. Analyses were stratified by sex, age group, and district. Consistent excess deaths were observed between comparators, showing a greater impact in circulatory diseases (C1: 283, 95% CI: 210; 356 and C2: 239, 95% CI: 164; 314) and respiratory diseases (C1: 98, 95% CI: 55; 141 and C2: 95, 95% CI: 52; 138). Regarding death ratios, with C1, the highest death ratios were observed for exposure to excessive natural heat (50.00, 95% CI: 37.11; 65.92) and ischemic stroke (4.00, 95% CI: 2.07; 6.99). With C2, the highest death ratios were observed for exposure to excessive natural heat (50.00, 95% CI 37.11; 65.92) and atherosclerosis (2.71, 95% CI 1.63; 4.24). The excesses and ratios of deaths were higher in more urbanized districts, females, and age groups above 75 years. The results suggest that the extreme heat in 2018 had an impact on mortality. Elevated death ratios and excesses were observed for various causes of death with considerable statistical magnitude and significance. These findings align with other national and international studies. Public health action is increasingly critical to mitigate the observed rise in mortality during periods of extreme heat.

Key messages

• Specific-cause mortality analysis during extreme heat suggests a greater impact in circulatory and respiratory diseases, in residents of urbanized districts, females, and individuals of 75+ years.

• Understanding these specific causes can better inform public health actions and planning, thereby mitigating the adverse effects of extreme heat.
Why greenhouse agricultural workers do not use pesticide protection methods? A case study
Authors: Ilgaz A , Karabiyik I H
Published: October 2024

Background

Exposure to pesticides in individuals working in greenhouse agriculture is an important public health problem that threatens their health more than individuals working in other agricultural jobs for the same period of time, causing an increase in mortality and morbidity rates. Applying protection methods plays an important role in reducing/preventing exposure-related health risks. It is aimed to explore the reasons why greenhouse agricultural workers do not use pesticide protection methods.

Methods

This case study was adopted the descriptive qualitative approach between February-March 2024. Individual in-depth face-to-face interviews were conducted with semi-structured interviews, resulting in 20 participants. The inclusion criteria for participants include being a greenhouse agricultural worker (at least 1 year), being 18 years of age or older, using pesticides, not using any personal protective equipment, and not engaging in protective behavior. Braun and Clark’s (2021) reflexive thematic analysis methodology was used to analyze the data.

Results

In this study generated three main themes and fourteen subthemes. The main themes identified were a) personal attitudes/ characteristics b) negative features of the physical environment, c) negative features of personal protective equipment.

Conclusions

The reasons why greenhouse agricultural workers do not use pesticide protection methods are individual attitudes/characteristics such as laziness and not to care about, negative characteristics of the environment such as temperature, humidity and wetness, and negative characteristics of personal protective equipment such as being heavy and inflexibility. Health institutions and health professionals serving in regions where agricultural workers should develop interventional studies, intervention programs and strategies to protect and improve the health of these individuals.

Key messages

• Greenhouse agriculture workers do not use any of the pesticide protection methods due to individual attitudes/characteristics, negative characteristics of environment and personal protective equipment.

• Health professionals can ensure that greenhouse agricultural workers use pesticide protection methods by increasing their awareness of health risks and planning interventional studies.
Antibiotic resistant Pseudomonas aeruginosa in dental unit waterline: a case study in Milan (Italy)
Authors: Tesauro M , Consonni M , Lodi G , Mattina R , Bergna A , Zehender G , Lai A
Published: October 2024

P.aeruginosa (Pa) is one of the most serious cause of healthcare-associated bacteremia, well-known for its antibiotic resistance (AR). Pa has often been found in dental unit water representing a great risk in public health. Aims are to evaluate the presence of Pa in dental unit (DU) water and its phenotypic and genotypic properties. Pa isolates derive from a monitoring of DU water in an Italian hospital (Milan). Samples were collected on Monday and on Friday, before the beginning and after the end of activities. Resistant PA strains were characterized by phenotypic method using E-test for 6 different classes of antibiotics, and by genotypic method with Whole-genome sequencing (WGS). Resistance genes were annotated with ResFinder v. 4.5 and Sequence Type (ST) was determined using the PA MLST database. 70/272 strains were identified as Pa and 21 of them were AR to one or more antibiotics. They were detected in 10/44 (22.7%) DUs and 2/4 (50%) control sinks (1-2000UFC/100mL). WGS was obtained for 18 strains. 17 belonged to serogroup O11 and ST667 was prevalent (8/18) followed by ST395 (4/18). At the ground floor ST395 was the most prevalent, followed by ST667 and 260, while, at the first floor, ST309 and 667 were in the two controls and ST667, 3245 and 260 in the other DUs. Resistant genes blaPAO, aph(3’)-IIb, catB7 conferring resistance to β-lactams, aminoglycosides and amphenicol, respectively, were observed in all isolates. Only ST3245 strain did not show resistance to Fosfomycin. Genotypic and phenotypic analyses present some discrepancies with the presence of AR genes and no antibiotic resistance detection (4/18) or resistance to other different classes of antibiotics (6/18). The MLST analyses showed a high diversity, with the presence of strains sharing different antibiotic resistance mechanisms in DU water. Detection and analyses by WGS can help to track dissemination of genetic resistance determinants and potential emergence of high-risk clones.

Key messages

• Phenotypic and genotypic analyses in DU water are needed to evaluate risk for human health, in addition to routine microbial monitoring.

• WGS can help to track dissemination of genetic resistance determinants and potential emergence of high-risk clones.
Digital Health Literacy Enhancement Strategies Across Diverse Groups: A Scoping Review
Authors: Ahmed F , Bernal B , Cervera P , Brenner H , Saletti S , Krini M , Fonseca C , Yared W , Zeeb H , Brand T
Published: October 2024

Background

The COVID-19 pandemic has accelerated the use of digital health technologies. Digital health literacy (DHL) is essential for effectively understanding and applying electronic health information. However, unequal access and use of these technologies require interventions to improve DHL for fair healthcare access.

Objectives

This scoping review aimed to identify strategies to enhance DHL in patients and the general population.

Methods

The review used the Joanna Briggs Institute Scoping Review Methodology and PRISMA-ScR guidelines. Eligibility criteria included a wide population, interventions aimed at improving DHL, with no restrictions on outcomes. The search strategy included electronic databases (MEDLINE, PsycINFO, Web of Science), and AI-based software, AS Review, was used for screening.

Results

The review found 5149 articles, 44 met the eligibility criteria. Studies focused on different demographic groups and health conditions. Most interventions were in North America and Europe. The study designs varied. Interventions via mobile apps, online platforms, and in-person sessions aimed at various conditions yielded positive results, including increases in DHL, self-management skills, and health-related behaviors. These interventions involved either independent interventions that focused on DHL or integrated interventions that were part of another intervention that aimed at a health outcome and had an element of DHL enhancement.

Conclusions

The review highlights the importance of DHL in informed decision-making and navigating digital health environments. While many interventions had positive outcomes, methodological limitations challenge the findings, emphasizing the need for more rigorous study designs. Future research should address sustainability, scalability, and the impact of DHL on health disparities, considering cultural sensitivity when developing interventions.

Key messages

• Scoping review identifies strategies to enhance Digital Health Literacy (DHL), crucial for effective use of health technology.

• Despite positive outcomes, methodological limitations exist. Future research should focus on sustainability and scalability.
Facilitating the transfer and implementation of practices across health and care systems
Authors: Koivisto J , Muurinen H
Published: October 2024

The THCS partnership has developed the initial draft of a framework designed to facilitate the transfer and implementation of solutions across health and care systems. During the workshop, we will present this framework along with the preliminary results of its real-world testing in transfer and implementation activities. The goal of this presentation is to gather feedback on the framework and generate ideas for its further development. Choosing to transfer existing solutions rather than developing new ones can offer several advantages in terms of efficiency, reliability, and cost-effectiveness. Adopting existing solutions can save time and reduce development costs significantly. The THCS framework aims to support, promote, and accelerate the transfer and implementation of solutions across health and care systems. The THCS framework is primarily targeted at individuals involved in planning, coordinating, and executing development activities within health and care organizations. This framework includes: 1) Paradigmatic commitments that underpin its understanding of development activities, transferability, and implementation; 2) Principles for conducting the activities of transferring and adapting solutions developed elsewhere; 3) Guidelines for describing original solutions; and 4) Key development tasks that outline the necessary steps for transferring, adapting, and implementing solutions developed elsewhere.
Diets, ergogenic supplements, and microbiota in professional and non-professional athletes
Authors: Ghaffar T , Ubaldi F , Romano Spica V , Valeriani F
Published: October 2024

Background

Regular physical activity has significant health benefits and can help prevent and manage non-communicable diseases. Intense exercise during training requires diet modulation to support health and performance. Anaerobic sports require high-protein diets, while aerobic sports prefer high-carbohydrate diets. Two-thirds of adult athletes take dietary supplements, and non-professional athletes also use supplements to enhance their appearance. However, dietary stress and imbalanced use of supplements leads the body to different diseases like gastrointestinal diseases and even multifactorial diseases e.g. cancer, cardiovascular diseases, and neurodegenerative diseases. Depending on the specific nutritional intake, supplementations, types of exercises the microbiota can be influenced positively or negatively. A systematic review meta-analysis and a pilot study were conducted to investigate the role of diet and supplementation about the microbial composition of the gut, under different types and intensities of physical activities.

Methods

The systematic review and meta-analysis were conducted according to the PRISMA guidelines, and the protocol was registered in PROSPERO (Number CRD42024500826). In a pilot study gut microbiota (16S amplicon sequencing), anthropometric data, and information on diet and supplementation, physical activity and sport habits were collected in a sample including professional and non-professional athletes.

Results

Out of 1318 studies, only 9 met the criteria for inclusion in the meta-analysis. The pilot study’s meta-regression analysis and microbiota analysis highlight the role of physical activity type in changing the Bacillota/Bacteroidota ratio (p = 0.001).

Conclusions

As gut training becomes more popular among athletes, it is necessary to map interactions between microbiota and different personalized diets, physical activities, and the most popular ergogenic supplements to enhance performance and athletic wellness

Key messages

• The microbiome can be inﬂuenced positively or negatively by the specific dietary intake, types of physical activities and ergogenic supplementations.

• To map interactions between microbiota and different diets, physical activities, and popular ergogenic supplements is needed to design new strategies to enhance performance and athletic wellness.
Developing a community engagement toolkit for health impact assessment in Ireland
Authors: Nash K , Kenny T , O’Mullane M , Harris-Roxas B
Published: October 2024

Background

Community involvement is a core principle of Health Impact Assessment (HIA). However, current guidance for HIA published by Ireland’s Institute for Public Health does not include guidelines on community engagement in HIA. As part of the project HIA-IM - ‘Development of a Health Impact Assessment Implementation Model: Enhancing Intersectoral Approaches in Tackling Health Inequalities,’ a Community Engagement Toolkit was created, with the aim of providing guidance for those carrying out HIAs and engaging with community in the process. The project will implement two HIAs, on the Cork City Development Plan (2022-2028) and the national Climate Action Plan (2024). Incorporating the learnings from the first HIA, the Toolkit will be employed in the second HIA of the project.

Methods

To develop the toolkit, a literature review of community engagement in HIA was conducted, with benefits and challenges, key approaches, and case studies of HIA’s gathered from grey literature and peer reviewed articles. In line with the participatory nature of HIA, a public consultation event was held, which was presented as a case study within the Toolkit.

Results

Findings from the literature review contend that engaging with community in HIA captures the lived experiences and local circumstances of the community, fostering empowerment and greater health awareness. However, many practitioners find community engagement to be practically challenging, citing factors such as time and resource constraints; with risks of consultation fatigue and raising expectations.

Conclusions

The review identified tools that have been used to mitigate these challenges and risks to facilitate meaningful community participation. These findings, along with learnings from conducting the first HIA, has informed the content of the Toolkit. Therefore, this Toolkit aims to complement national HIA guidance to centre the community voice in future HIA practice.

Key messages

• Developing a toolkit to strengthen participatory approaches and community engagement in health impact assessment in Ireland.

• Centering the community voice in health impact assessment: the inclusion of lived experiences and local circumstances in health impact assessment practice in Ireland.
Oncofertility in primary health care: the role of the Portuguese family doctor
Authors: Monteiro G P , Carvalhinho M , Amorim H
Published: October 2024

Background

The increasing number of cancer cases diagnosed at young ages and the impact of the disease and treatments on reproductive function have led to the development of Oncofertility. While oncologists typically lead these discussions, family doctors, as primary care providers, also play a crucial role. This study aims to assess family doctors’ knowledge, attitudes, and practices regarding fertility preservation in cancer patients.

Methods

This cross-sectional study, conducted between April 2023 and March 2024, surveyed 351 General and Family Medicine doctors from the Portuguese Northern Regional Health Administration. The questionnaire, consisting of 15 questions, assessed sociodemographic profiles, knowledge, attitudes, and practices. Data were analyzed using descriptive statistics and multivariate logistic regression.

Results

Most participants were female (80.5%) and under 40 years old. The majority (91.5%) had treated fewer than 10 cancer patients under 40 in the past two years. Key barriers included lack of knowledge (63.3%), time constraints (57.0%), and patient age (18.5%). Male physicians were more likely to address specific fertility concerns (OR 2.239) and less likely to view patient age as a barrier (OR 0.459). Physicians aged 31-35 were less likely to discuss fertility preservation (OR 0.553) but more likely to address it in the first consultation (OR 2.969). Urban-based physicians were less likely to discuss fertility preservation (OR 2.099). Only 9.1% always discussed fertility preservation before treatment, 27.6% did so sometimes, and 63.3% never discussed it.

Conclusions

There are significant gaps in the knowledge and practices of family doctors regarding fertility preservation for cancer patients. Targeted training and resources are urgently needed to support family doctors in effectively discussing fertility preservation, crucial for improving the quality of life of young cancer patients wishing to preserve their fertility.

Key messages

• Empowering Portuguese family doctors to address fertility concerns in cancer patients contributes to comprehensive oncofertility care, improving patient outcomes and quality of life.

• Integrating oncofertility support with Portuguese family doctors strengthens primary care, ensuring discussion of fertility preservation is considered as part of cancer treatment planning.
Hospital policies as a tool to reduce gaps between ethnic groups of employees and patients
Authors: Gur A , Inchi L
Published: October 2024

Background

As diverse organizations, hospitals require an inclusive culture that respects and promotes ethnic diversity. Violence, a threat to this diversity, hampers effective organizational functioning. Our study delves into the positive influence of cultural diversity policies and communication about violence on the perception of the hospital’s atmosphere regarding ethnic differences among health employees. It enhances hospital labor relations and mitigates the risk of workplace violence.

Methods

372 hospital employees with an average tenure of 6.5 and an average age of 38 filled out an online close-ended questionnaire (83% are Israeli Jews, 68% are female). 91% report working closely with people from different ethnic origins. Respondents ranked the atmosphere in the hospital regarding ethnic differences between employees and patients, the hospital’s cultural diversity policy, and organizational communication about violence. Data were analyzed by SPSS 28.

Results

Positive correlations were found between variables. A positive atmosphere was significantly related to the hospital’s cultural diversity policy (r=.14, p=.002) and to organizational communication about violence (r=.22, p< .001). However, the regression analysis (with control variables age, sex, and managerial role) revealed that despite employees acknowledging the hospital’s efforts to address diversity and violence, these factors only predict 10% of the variance of the hospital atmosphere [F(5, 366) = 8.346, p < .001; R²=.10].

Conclusions

The hospital should increase actions that will improve the ethnic atmosphere in the hospital. Understanding how the encounter, where employees and patients from diverse ethnic backgrounds interact, influences the hospital’s atmosphere is crucial. These interactions can lead to tensions and offensive behaviors toward employees if not managed well. Hospitals can create an inclusive and harmonious work environment by addressing these tensions.

Key messages

• A cultural diversity policy and communication are necessary to maintain harmonious working relationships. It is essential, particularly in health organizations characterized by ethnic diversity.

• Reducing the perception of ethnic differences may increase well-being and decrease violence. While hospitals often don’t prioritize these issues, this study forefront their influence and importance.
Primary care utilization in Bulgaria: some effects of the COVID-19 pandemic
Authors: Rohova M , Koeva S
Published: October 2024

Background

Disruptions to primary care provision during the pandemic set back prior advancements in screening and chronic disease management. Delays in routine vaccination added to preexisting hesitancy and sustained the downward trend in vaccination rates. The study examines the magnitude and duration of primary care disruptions in Bulgaria between 2020 and 2022.

Methods

The impact of the pandemic on primary care is assessed using administrative data from the National Health Insurance Fund covering the annual number of primary care services. To evaluate the effect on healthcare utilization, the average number of check-ups per person during the pandemic is compared to a pre-pandemic period (2017-2019).

Results

After the onset of the pandemic, all visits declined significantly on an annual basis. In 2020, overall prophylactic check-ups dropped by 6-13% and remained lower than the baseline until 2022. Initial figures for 2023 suggest some recovery, while specific services are likely to experience an ongoing decrease. During the pandemic, the average number of prophylactic examinations for children fell between 6.9 and 9.3%. In 2022, there was a modest resumption, although these services did not reach the preceding levels. Adult prophylactic visits declined by approximately 10-12% between 2020 and 2021, but following a U-shaped pattern, they rebounded in 2022. Visits associated with chronic diseases experienced a drop of 7.8% in 2020 and continued to decrease in the next two years. Child vaccination was affected for a shorter period. In 2022, the coverage for most vaccine-preventable diseases was close to the pre-pandemic levels. However, the uptake of MMR and pneumococcal vaccines failed to demonstrate a clear path to recovery.

Conclusions

During the pandemic, a considerable drop in primary care utilization has been recorded. Effective recovery requires sustained service delivery and a rapid post-lockdown rebound to mitigate the negative impact on health outcomes.

Key messages

• Primary care needs additional recovery measures to prevent long-term harmful impacts on health outcomes.

• Investing in service delivery innovations can boost resilience during disruptive events.