bluuebunny/crossref_metadata_2025 huggingface dataset:
Regional differences in the attributable burden for Germany: Exploring YLL for selected risk factors
Authors: Porst M , Wengler A , Gruhl H , von der Lippe E , Plaß D
Published: October 2020

Background

Within the BURDEN 2020 project (Burden of disease in Germany at the national and sub-national level) we calculate burden of disease indicators on a small-scale level for Germany. In order to provide a comprehensive view over diseases and their impact on population health, Years of Life Lost due to premature death (YLL) and Years Lived with Disability (YLD) are summed up to the measure Disability Adjusted Live Years (DALY). YLL, YLD and DALY will be attributed to a set of risk factors.

Methods

Object of the analysis is the indicator YLL across spatial planning regions in Germany. It is calculated by multiplying the number of deaths with the remaining life expectancy at the age of deaths. A share of YLL can be attributed to specific risk factors. Smoking and ambient particulate matter pollution are used as examples. The distribution of risk factors is based on German health surveys and local air pollution measurements. The analysis follows the Comparative Risk Assessment approach, which quantifies the possible change in burden by assuming a different exposure level in the past.

Results

Based on the absolute YLL estimates, the overall leading causes of deaths are ischemic heart diseases, tracheal, bronchus, and lung cancer and stroke. In addition, for women breast cancer is a leading cause of death. Causes vary by age groups and by region. We expect the attributable fraction to vary across local areas as well.

Conclusions

When it comes to health care intervention, the method of attributing risk factors to burden of disease outcomes reveals necessary fields of action, especially across regions. In order to allocate financial resources within the health care, the CRA can provide additional arguments for political decision making.

Key messages

Causes of death and the related years of life lost are an integral part of health monitoring. Our analysis reveals how YLL and risk factor attributable burden vary across German regions.
HIA on affordable housing policies and its effect on health and services of vulnerable populations
Authors: Chahalis E , Daines C , Jensen M , Miller J
Published: October 2020

Issue

Lack of affordable housing in Utah for vulnerable populations such as immigrants/refugees, low-income families, single parents and individuals with disabilities. A health impact assessment is necessary to identify the negative health impacts that arise and to determine how a policy to provide more funding for affordable housing can benefit the population. This issue is not specific to Utah and is comparable to other housing situations and policies throughout the U.S.

Description

The six steps of an HIA were completed in 4 months to analyze the potential health effects of affordable housing policy changes among low-income families in Utah. The HIA team completed an extensive literature review and communicated with several stakeholders, policy makers, and community leaders. Public state and national data was gathered and analyzed using a logic model and characterization of effects table.

Results

The bill to increase funding will increase affordable housing units throughout Utah. The negative health impacts for the population will decrease such as respiratory illnesses, hospital visits, crime, mental health disorders, and stress. The bill would also help to increase family housing stability, economic development, educational opportunities for children, and access to transportation.

Lessons

The recommendations include the use of funding for new development or the renovation of existing units, the location of developments should be near public transit to allow residents to take advantage of services that previously would not have been accessible. Developments should be an integrated approach that includes social support and case management services to narrow the gap in Utah and other areas in the U.S.

Key messages

Policies to increase affordable housing produce positive health impacts for vulnerable populations. Overall efforts for affordable housing will give these vulnerable populations better access to basic human needs.
The correlation between the quality of primary healthcare attributes and different health outcomes
Authors: Martins A C F , Miraglia J L , Monteiro C N , Bonfim D , Pereira G A , Siqueri C A S , Sumida G T , Santos J M M , Borges L M , Mafra A C C N
Published: October 2020

Background

Measuring the structure and processes of healthcare services form the basis of improvement efforts and make it possible to hold organizations accountable for the services they provide. Besides having a positive impact in different health outcomes, primary health care (PHC) could also affect experiences in secondary and tertiary care through its coordinating role, therefore efforts to assess the quality of the delivery of its services are important. Hence, the study objectives were to evaluate the PHC attributes of PHC teams and the correlation of these attributes with different health outcomes.

Methods

This was a cross-sectional study conducted during 2019, which used the Adult Primary Care Assessment Tool (PCATool) to evaluate 28 PHC teams working on the public healthcare sector at the city of São Paulo, Brazil. The Spearman's correlation coefficient was used to evaluate the association between each PCATool dimension and referral rates, hypertension, diabetes, prenatal care and gestational outcomes. The study was approved by the local ethics committee.

Results

A statistically significant positive correlation was identified between controlled hypertension and care coordination (rho=0.396; 95% CI:0.012-0.678; p = 0.036), and between 6 or more prenatal care visits and comprehensive care (rho=0.441; 95% CI:0.063-0.708; p = 0.018). A statistically significant negative correlation was identified between low birth weight and care coordination (rho=-0.502; 95% CI:-0.748- -0.136; p = 0.006) and between referral rates and comprehensive care (rho=-0.499; 95%CI:-0.753- -0.114); p = 0.009).

Conclusions

This study reinforces the importance of the PHC attributes for different relevant health outcomes and of their continuous evaluation for services improvement.

Key messages

The quality of PHC attributes has a direct impact on different relevant health outcomes. Ways to improve the PHC performance must be considered based on its attributes.
Nurses' production of meaning about National Program for Access and Quality Improvement Primary Care
Authors: Santos R , Lima M , Santos L , Sousa R , Silva F , Silva R , Cardoso T , Cardoso O
Published: October 2020

Introduction

The Brazil's Family Health Strategy (ESF) is one of the initiatives for the strengthening of primary health care (PHC) in Brazil. The ESF is composed of a team of professionals, with the nurse usually adding care and administrative functions. In regard to the National Program for Improving Access and Quality in Primary Care (PMAQ-AB), the nurses have played a prominent role, especially in the external evaluation phase.

Aim

Analyze the meanings produced by nurses about the PMAQ-AB in a state in the northeastern of Brazil.

Methods

A qualitative research was carried out with twenty-five nurses from the health macro-regions of the State of Piauí. Data were collected from four focus groups, with one group in each macro-region, containing at least six and at most seven participants. The meetings were held from September to October 2018, in which semi-structured interview script was used. For the analysis of information, the maps of association of ideas proposed by Spink and Gimenes (1994) were used.

Conclusions

Despite the difficulties and conflicts felt by nurses with the implementation of PMAQ-AB, the program was understood as an agent for transforming in the work process of family health teams. In addition, the realization of this study allowed another space for reflection to the nurses about the program, qualification and financing of PHC, which can contribute to the institutionalization of the culture of monitoring and evaluation and also the consequent strengthening of these services.

Key messages

Based on the expected impacts, we seek collaborate with reflection on the experience and generate consistent and useful information to contribute to the decision-making processes of health policies. The PMAQ-AB was considered a program that was able to induce substantial changes in work processes because it was a way to finance the workforce.
Psychosocial factors associated with a healthy lifestyle in Brazilian adult women
Authors: Patrão A L , Aquino E M L , Almeida M C , Matos S M A
Published: October 2020

Background

It has been estimated that over 50% of the premature deaths occurring in Western countries can be attributed to causes rooted in lifestyle. In turn, leading a healthy lifestyle has also been associated with a wide range of psychosocial factors. Today, it is known that these differ among men and women. The present article aimed to identify the psychosocial factors associated with healthy lifestyles in women from the ELSA-Brazil cohort, the largest study concerning adult health conducted in Brazil.

Methods

This cross-sectional study was conducted using ELSA-Brasil baseline data, collected between 2008-2010. All included individuals were aged between 35 and 74 years at the time of voluntary recruitment. The ELSA-Brasil cohort has 8,218 women, both currently working and retired, from six public higher education and research institutions. Data were collected using the ELSA-Brasil questionnaire, a multidimensional instrument encompassing a range of topics. The lifestyle indicator was constructed by summing the scores attributed to four different behaviors (smoking, excessive alcohol consumption, inadequate nutrition and insufficient physical activity).

Results

Among women of the ELSA-Brasil, the following factors are associated with a healthier lifestyle: an age of 50-59 years (OR = 1.41; IC95% 1.24-1.61); age 60 years or older (OR = 2.21; IC95% 1.79-2.72); race/skin color Asian (OR = 2.29; IC95% 1.57-3.36), white/Caucasian (OR = 1.57; IC95% 1.36-1.81) or mixed-race (OR = 1.24; IC95% 1.07-1.44); a high-school equivalent (secondary) level of education (OR = 1.31; IC95% 1.09-1.57) or university degree (tertiary) (OR = 1.89; IC95% 1.55-2.29); being retired (OR = 1.33; IC95% 1.12-1.59); the self-perception of health status as good/very good (OR = 1.27; IC95% 1.12-1.45).

Conclusions

These findings should contribute towards preventing chronic non-communicable in adult women in Brazil and in other similar settings.

Key messages

Socio-demografic factors, such as age, race, education and retirement, influence the lifestyle of Brazilian women. Psychological factors, such as self-perception of health status, influence the lifestyle of Brazilian women.
Addictive behavior in adolescents in Kairouan (Tunisia)
Authors: Ghali H , El Ghardallou M , Mannai J , Marzougui L , Chemkhi O , Atallah M R
Published: October 2020

Background and aims

The levels of use of some psychoactive substances, especially alcohol, tobacco and cannabis, remain high among adolescents, despite progress in regulatory efforts to limit access to these products. Our objective is to determine the prevalence of addictive behavior among middle school students in the Kairouan region and to specify the risk factors.

Methods

We conducted a cross-sectional study in public schools of Kairouan (Tunisia) during one month (May 2016). Students aged 13 to 16 were included in the study. The statistical analysis was performed using the SPSS software version 18.

Results

A total of 2020 students participated in this study with mean age of 13.9 ± 1.2 years. A male predominance was noted (44.1%, n = 890). The prevalence of addictive behavior was 7.1% (95% CI = [6% - 8.2%]). Multivariate analysis showed that the probability of addictive behavior decreased in young women (OR = 0.05, 95% CI = [0.02 - 0.09]) from rural origin (OR = 0.51, 95% CI = [0.32 - 0.83]). Independent risk factors associated with addictive behavior were: Age (OR = 1.39, 95% CI = [1.16 - 1.66]), family history of suicide (OR = 4.42, 95% CI = [ 2.56 - 7.62]), repeating the school year (OR = 2.91, 95% CI = [1.84 - 4.60]), physical aggression (OR = 1.78; 95% CI = [1.06 - 2.98]) and depression (OR = 1.56, 95% CI = [1 - 2.43]).

Conclusions

The entourage and caregivers are important actors to help adolescent to verbalize his suffering and find other ways to fight against the depressive affects.

Key messages

Prevalence of psychoactive substance use is very high in middle school students. Identification of risk factors is important for prevention program planning at an early stage.
Men's health promotion in waiting rooms: an observational study
Authors: Whitehead M , Ng Chok H , Whitehead C , Luck L
Published: October 2020

Thesis Statement

Men experience poorer health outcomes than females and gender specific targeted health promotion needs to adequately address this gender bias.

Methodology

This prospective observational study audited all printed health promotional materials in all health facility waiting rooms within a defined geographic region. A total of 24 sites were surveyed which included general practice centres, community health centres and hospitals. The surveyed health literature included posters, brochures, and booklets.

Results

There were 1143 health materials audited across the sites. Of these, 3.15% (n = 36) were male-specific literature, 15.31% (n = 175) were female specific health literature and 81.54% (n = 932) were gender neutral. Literature which had a gendered focus was overwhelmingly female to male with a ratio of approximately 5:1.

Conclusions and Implications

This research highlighted that despite the known outcomes of lower male life expectancy and higher burden of disease, male specific literature is significantly under-represented within health facility waiting spaces. There remains potential for health clinicians to provide targeted male health education and thereby improve male health literacy.

Key messages

Men's health both within Australia and globally remains under-represented despite lower health expectancy and higher burden of disease. Health facilities ought to actively control the health promotion messaging to vulnerable population groups.
It’s all about trust: Women's compliance with influenza and pertussis vaccinations during pregnancy
Authors: Satran C , Bord S , Schor A , Offer M , Ohana N , Sagi S
Published: October 2020

Background

Although vaccination against pertussis and seasonal influenza during pregnancy is the safest and most efficient strategy to protect mothers and infants from related morbidity and mortality, maternal vaccination is unfortunately suboptimal. The aim of the current study is to assess vaccination compliance during pregnancy and the factors associated with adherence with the relevant Ministry of Health recommendations.

Methods

The study included 344 women in a maternity ward of a hospital in northern Israel. After receiving approval from the Helsinki Commission and with the mothers' consent, data was collected through a self-administrated questionnaire from June to September 2019.

Results

Eighty-three percent of participants reported having been vaccinated against pertussis during pregnancy, and 44% reported having been vaccinated against influenza. The main reasons for not being vaccinated were distrust in vaccine efficiency, fear of vaccination during pregnancy, and lack of recommendations from health professionals. Multivariate logistic regressions analysis showed that compliance with influenza and pertussis vaccinations were significantly explained by women's attitudes (influenza: OR 2.88; 99% CI: 2.05, 4.05; pertussis: OR 4.77; 99% CI: 3.04, 7.47) and norms (influenza: OR 1.55; 95% CI: 1.15, 2.08; pertussis: OR 2.09; 99% CI: 1.46, 2.99). Process procedure for mediation reveals that the greater the level of trust in the healthcare system, the more positive the attitudes and subjective norms toward vaccination during pregnancy, and the greater the likelihood of complying with both vaccination requirements during pregnancy.

Conclusions

Efforts should focus on raising women's trust in the healthcare system as an important part of shaping attitudes and creating a supportive environment for vaccination.

Key messages

Trust in the healthcare system is associated with positive attitudes and norms, which in turn contribute to vaccination compliance. Explicit recommendations for vaccinations among pregnant women made by health professionals are needed, including reassurance of vaccine safety and effectiveness.
An intervention of physical activity promotion in an university hospital. A prospective cohort study
Authors: Ladner J , Mihailescu S D , Cerasuolo D
Published: October 2020

Background

Rouen University Hospital implements a policy of health promotion hospital since 2016. The objective of this study was to evaluate prospectively the impact of physical activity promotion in hospital health workers (HW), using pedometers over a period of six months.

Methods

Physical activity was measured by electronic pedometers distributed to HW, with the aim to improve their physical activity and to measure it during six months. Online questionnaires collected at different points of follow-up, from inclusion to sixth month (a total of seven points of follow-up). Socio-demographic and characteristics on type of health work were collected as well as the number of steps and the behavior regarding their routine physical activity.

Results

A total of 680 HW were included in the cohort. The sex ratio M:W was 0.16. The mean age was 41.6 years (SD = 10.7). 44.0% were non-medical caregivers, 32.1% were in administrative section, 14.3% were technical workers and 9.7% were physicians or pharmacists; 53.7% of HW reported doing sport regularly. At inclusion the mean number of daily steps was 8662. The mean progression for all professional profiles between first week and sixth month was of 1082 steps daily, with difference according to position: 1319 in physicians, 1234 in non-medical caregivers, 1106 in administrative workers and 314 in technical workers. In linear regression model, the mean number of progression of daily steps was 964 in physicians, 752 in non-medical caregivers.

Conclusions

The study shows a significant increase in the number of daily steps measured objectively using an incentive tool, as pedometer during six months of intervention. Further researches are needed to determine if these changes are sustainable over a long period of time

Key messages

Despite high level of daily steps at baseline, the longitudinal study shows an increase of daily steps over a 6-month period. Such public health intervention is a relevant method to engage people in self-monitoring their physical activity.
Trends in tobacco use among children and adolescents in Israel, 1998–2015
Authors: Tesler R , Kolobov T , Korn L , Shuval K , Levin Zemer D , Marques A , Harel Fisch Y
Published: October 2020

Objectives

This study aims to measure trends in cigarette smoking among children and adolescents in Israel, focusing on school grade, sex, and ethnicity. We hypothesized that smoking would be higher among boys and Arab-Israelis, rates would grow with age, and there would be a decline over time.

Methods

Data were derived from the Health Behavior in School-aged Children study between 1998-2015 in Israel. The total sample included 56,513 students in grades 6, 8, and 10, with 29,411 girls and 27,102 boys. Descriptive analysis described trends of smoking behavior according to grade, sex, ethnicity, family affluence, and year of study. Multivariate logistic regression analysis examined predicting variables.

Results

Smoking was higher among boys in all grades, ethnic groups, and years of study, with the highest frequencies among Arab-Israelis. Trends over the years show a decline from 1998-2004, followed by an increase for both sexes. The increase was more prominent among girls. Logistic regression analysis revealed strong associations between smoking and grade, sex, ethnicity, and year of study.

Conclusions

The results of this study can significantly enhance the development and implementation of smoking prevention and control programs among students in Israel.

Key messages

Our calibrated results engender important policy implications for the development of cigarette smoking prevention programs for Israeli youth, specifically in the school environment. health inequities needs to be a key part of a comprehensive strategy when discussing health promotion and development.
Work health promotion (WHP) and salutogenesis: application of soc-13 in a company
Authors: Serratore C , Caricato M , Abbafati E , Masanotti G
Published: October 2020

Background

Workplace Health Promotion (WHP) is the combined efforts of employers, employees and society to improve the health and well-being of people at work. Sense of Coherence (SOC) is the ability to perceive and manage stressful events. The aims of this study are: to prove the SOC-13 scale sensitivity and, using this tool, to investigate employers' welfare in a company promoting ENWHP model.

Methods

We selected an Italian company, that, since 2017, is carrying out a WHP project. We sent to all the workers (n = 358) the SOC scale-13 items, which investigates three dimensions: comprehensibility (C), manageability (Ma) and meaningfulness (Me), at T0 (October 2018) and T1 (April 2019). Each item is scored on a 7-point Likert scale, ranging 13-91, with higher score corresponding to a more developed SOC. Total score for C, Ma and Me subscales were calculated. The scores were compared using paired “T” tests.

Results

The response rate was 29% (n = 104) and 25% (n = 89) at T0 and at T1, respectively. At T1 SOC score and its three dimensions were higher (mean SOC ± SD: T0 =57,23 ± 11,00 vs T1= 61,90 ± 12,03 p = 0,005; mean C ± SD: T0=21,97±4,46 vs T1=23,02±5,16 p = 0,124; mean Ma ± SD: T0=16,64± 4,27 vs T1=17,96±4,36 p = 0,033; mean Me ± SD: T0=18,62 ±5,01 vs T1=20,92±4,89 p = 0,002).

Conclusions

Our findings suggest that a WHP project can promote healthy workplace environments, enhance workers quality of life and improve the individual capacity to cope successfully with stress. We showed that SOC-13 scale is an easy and appropriate tool to evaluate the employers' wellbeing, thanks to its high sensitivity.

Key messages

SOC scale-13 can record the quality of workplace health promotion measures and continually improve them. WHP good practices enhance workers’ welfare.
How much general practitioners empathize with patients?
Authors: Fineschi D , Acciai S , Scarafuggi G , Napolitani M , Bedogni C , Messina G , Nante N
Published: October 2020

Introduction

Thanks to the privileged relationship that the general practitioner establishes with patients, he well knows their personal background and assesses the disorders as a whole, without focusing only on unique pathology. The aim of the work were: I) to assess the level of concordance between the health profile (HP) of the patient measured by the doctor and that measured by the patient, and II) to and assess which variables influence the perception.

Methods

A cross-sectional study was conducted between Aug 2019-Jan 2020 in a primary care setting. To assess health-related quality of life we administered the EuroQol 5d-5L to patients (EQ-p). Simultaneously, we asked the doctors to fill in the questionnaire 'from the patient's point of view' (EQ-d), also based on data collected in the computerized clinical diary. Data was collected anonymously and the statistical analysis was carried out using Stata 14 (Cohen's kappa; Fisher test).

Results

The sample consisted of 223 patients (46% men). The mean age was 56.5±19.6 (min 18-max95). The mean BMI was 25.5±5 (28% overweight; 18% obese). Significant differences by gender were found in Pain and Anxiety/Depression dimensions (44% of men had not pain vs 33% of women (p = 0.03) and 56% of men had no Anxiety/Depression vs 36% of women (p < 0.01)). These differences were not detected by doctors; As regards the concordance between EQ-p and EQ-d, it was moderate for Mobility (k = 0.45; p < 0.01) and Self-Care (k = 0.46; p < 0.01). The agreement was fair for usual activities (k = 0.39; p < 0.01) and it was poor for Pain/Discomfort (k = 0.14; p < 0.01), Anxiety/Depression (K = 0.19; p < 0.01) and EQ Index (k = 0.11 p < 0.01).

Conclusions

Our analysis shows a greater concordance especially for the dimensions that appear more objective (Mobility and self-care) than the subjective ones (Pain, Anxiety). The physicians do not seem to take into account the differences in perception between men and women when they empathize with patients.

Key messages

The general practitioner knows the personal history of his patients and assesses the disorders as a whole, without focusing only on the specific pathology. In the exercise of the identification, he seems to understand mainly dimensions that appear more objective without grasping the differences in perception between men and women.
Prevention of dental caries by eating vegetables at the beginning of a meal in Japanese children
Authors: Ito K , Isumi A , Doi S , Ochi M , Fujiwara T
Published: October 2020

Backgrounds

Dental caries is still a worldwide serious problem among children. Previous studies showed that higher consumption of vegetables prevents dental caries. Eating order habits, such as eating vegetables at the beginning of a meal, called “Vege-first”, may increase the amount of vegetable consumption, and in turn, prevent dental caries. We used cross-sectional data in our previous study to show the association between “Vege-first” and dental caries. However, the causal relationship of “Vege-first” on dental caries is not clear. The aim of this study to investigate the effect of “Vege-first” on dental caries, using cohort data of Japanese elementary students.

Methods

We used cohort data from 2015 to 2016 by the Adachi Child Health Impact of Living Difficulty (A-CHILD) study, a population-based study of all first- and Second- grade students in Adachi City, Tokyo, Japan. The number of DMFT (decayed, missed due to decay, and filled teeth) in 2016 was used as an outcome. Poisson regression analyses were applied to determine the independent association between keeping the “Vege-first” habit over one year and the number of DMFT in 2016 after controlling for the effects of a child's sex, parental marital status, socioeconomic status, and child's dental caries status in 2015.

Results

Of 3,164 valid participants, 45.0% had dental caries and 6.3% kept the “Vege-first” habit. Children who kept the “Vege-first” habit had fewer DMFTs in 2016 than children who did not (p < 0.001). After controlled for covariates, children with having a continuous “Vege-first” habit were still significantly and independently decreased the number of DMFT in 2016 (Incidence-rate ratios=0.87 (95% confidential interval [0.75-0.98])).

Conclusions

This study showed that having the continuous “Vege-first” habit was associated with preventive dental caries even after accounting for socioeconomic status. Health policy introducing the “Vege-first” habit may be effective to prevent pediatric dental caries.

Key messages

The practice of eating vegetables at the beginning of a meal, called “Vege-first” may increase vegetable consumption and reduce dental caries. The continuous habit of 'Vege-first' was effective in preventing a child’s dental caries even if after accounting for socioeconomic status.
Towards an impactful intervention in a food retail setting - insights from transition management
Authors: Mackenbach J , Middel C , Beulens J , Lakerveld J , Broerse J , Schuitmaker-Warnaar T J
Published: October 2020

Issue

Socioeconomic inequalities in diet and health form a persistent public health problem. Environmental, non-agentic interventions are most likely to be equitable, but have to be implemented in a wider system with interests other than health promotion.

Description of the Problem

The Supreme Nudge project (2017-2022) implements a health promotion intervention (niche experiment) in a supermarket setting (regime context). As a sufficiently impactful intervention is likely to conflict with interests of the setting, the Transition Management (TM) framework is used to guide design and implementation. Following the four steps in this cyclical model, we explore the context of the food retail system and identify key players; develop coalitions, shared visions and transition agendas; mobilize actors and implement the intervention; and evaluate, monitor and learn from the intervention. Interviews and focus groups were held to address these steps.

Results

The Dutch supermarket context consists of multiple chains that, after several price wars, are shifting competition from price to corporate social responsibility goals, including health promotion. Together with key supermarket players, a shared vision was defined: making healthy dietary choices easier while striving for neutral business outcomes. Transition paths towards this vision, including their barriers and facilitators, were explored. Additional actors were mobilized to adapt and refine intervention components, and the intervention will be implemented mid-2020. The intervention will be monitored and evaluated to facilitate upscaling.

Lessons

Applying the TM framework facilitated the development of coalitions and a shared vision, the co-creation of intervention components and identification of transition paths. This is likely to also benefit implementation and upscaling of the intervention. Applying the TM framework will also be useful for transferring successful interventions to other contexts.

Key messages

Implementing a health promotion in a food retail setting is challenging because of the conflicting interests. The Transition Management framework can facilitate successful implementation through creating a shared vision and foreseen transition paths.
Teachers' opinion about the need for health promotion information
Authors: Maceinaitė R , Šurkienė G , Sketerskienė R
Published: October 2020

Background

School is the most appropriate place for health promotion of pupils, which enables them to increase control over their health and improve it. Health promotion gives the best results when not only pupils but also their teachers are involved in the process, it is obvious that the success of health promotion depends on the teacher's attitude towards this process and his knowledge in this field. Aim of the study - to assess teachers' perceptions of the need for information on health promotion for themselves and their pupils.

Methods

1247 teachers from 110 different schools in Lithuania were surveyed. Estimate of prevalence were calculated at 95% CI, logistic regression models were concluded, 95% CIs of adjusted odds ratio were calculated.

Results

44.3% of teachers received sufficient amount of information on health promotion and 43.3% of them wanted more information on this subject. The odds of getting enough information on pupils health promotion were significantly related to teachers education, schools membership in Health Promoting Schools Network (HPSN) and location of school, the odds of wishing to get more information - with age and the subject teacher teaches. The most necessary information for teachers was information about healthy diet. They indicated that this information is most relevant to their pupils. In the opinion of the teachers, their pupils lack information on mental health. 71.6% of teachers were interested in information about health promotion. Interest in this subject was significantly related to gender, the subject teacher teaches and schools membership in HPSN.

Conclusions

Less than half of the respondents have received a sufficient amount of health promotion information and most of them are interested in this information, so it is important to provide teachers with health information that meets their needs. Providing teachers with health information it is important to take into consideration individual and school characteristics.

Key messages

Only less than half of teachers received sufficient amount of health promotion information. The majority of teachers were interested in information about health promotion.
Education for health promotion: the challenges of centrality and decentralization in southern Brazil
Authors: Lopes Gomide P , Frantz Krug S B
Published: October 2020

Background

The research starts at the possible invisibility of the theme of Health Promotion (PS) in Health education, its curricular propositions as well as its teaching strategies, and when visible, questions arise: What is the concept of Promotion in Health underpinning the training actions implemented? The concealment of the theme makes it impossible to produce the Health Promotion within the scope of a Residency Program?

Methods

To analyze the dynamics of the conduct of the Health Promotion Policy, present in the relationship between the centrality of the guidelines formulated at national and global level and the decentralization of Health Education strategies. This proposal presents a qualitative and systemic approach, which intends to analyze four in-service training programs (three national and one international), with regard to the conceptual conceptions of Health Promotion and Health System users. the subjects of the research, conduct semi-structured interviews and documentary analysis when necessary.

Results

This proposal presents as a reference the expanded concept of health and its social determinants, the responsibility of the State in sanitary regulation, universality, population participation and integrality, accessibility to information as a right and territorialization.

Conclusions

This study will feed the elaboration, in two Brazilian municipalities, through the School of Public Health of the state of Rio Grande do Sul, of a training proposal for health workers, guided by the conceptual and political framework of Health Promotion.

Key messages

The dynamics of the Health Promotion Policy, present in the relationship between the centrality of the guidelines formulated at global level and the decentralization of Health Education strategies. The importance of Health Promotion in interprofessional training in health services.
Future orientation in context of school support, and the Unplugged program among Slovak children
Authors: Orosova O , Benka J , Gajdosova B
Published: October 2020

Background

Recent literature has highlighted the crucial role of schools in creating a psychologically healthy environment. The aim of this study was to explore the changes in schoolchildren's positive future orientation (PFO) following their participation in the school-based Unplugged program (PU).

Methods

This study was carried out as a cluster randomized controlled trial (1292 participating schoolchildren, Mean age=11.52; 46.8% boys) with data collection conducted immediately before PU implementation(T1), immediately after implementation(T2) and then 3 months(T3), 12 months(T4) and 18 months after the implementation(T5). The schools were randomly assigned to either an experimental (EG, n = 639) or control group (CG, n = 653). The EG was exposed to PU (http://www.eudap.net/). The effect of PU, gender, and school social support (SSS/T1) was explored through the changes in PFO. GLM Repeated Measures were used for the data analyses.

Results

There was a significant main effect of time on PFO, F(4, 968)=8.38, p < 0.001. Pairwise comparisons revealed that PFO was significantly lower at every follow-up when compared to PFO/T1. There were significant interaction effects TimexGender, F(4, 968)=2.65, p < 0.05, TimexSSS/T1, F(4, 968)=3.73, p < 0.01, Timex GenderxSSS/T1, F(4, 968)=2.73, p < 0.05. This effect indicates that the level of PFO was higher among schoolchildren with a higher level of SSS/T1 across the five measurement points. However, the decrease of PFO was stronger among the boys than among the girls from T1 to T5. The contrast analysis revealed a higher level of PFO only among schoolchildren in the EG with a lower level of SSS/T1 at T5 when compared to CG, F(1, 242)=3.93, p < 0.05.

Conclusions

The findings suggest a main effect of time measures on PFO and a moderation effect of gender and SSS/T1.

Key messages

Schoolchildren’s positive future orientation (PFO) was found to generally decrease over time during the 22-month period. However, Unplugged was able to encourage schoolchildren with a lower level of SSS/T1 and to increase their PFO within the 18 months following the implementation of the program.
Association between non-adequate health literacy and cancer screening adherence: a meta-analysis
Authors: Isonne C , Baccolini V , Salerno C , Giffi M , Migliara G , Mazzalai E , Turatto F , Marzuillo C , De Vito C , Villari P
Published: October 2020

Objective

Individuals with non-adequate health literacy (NAHL) are more likely to have poor health outcomes and behaviors, including a limited use of preventive services. This study aimed at summarizing the evidence on the association between NAHL and adherence to cancer screening programs.

Methods

PubMed, Scopus, and Web of Science were searched. Cross-sectional studies conducted in any country, published through January 2020 and quantifying the association between NAHL and cancer screening adherence, were included. An adapted Newcastle-Ottawa Scale was used to assess quality. Inverse-variance random-effects methods were used to produce pooled estimates: overall, by cancer and by HL tool.

Results

Seventeen articles of heterogeneous quality were included in the systematic review and 45 analyses were combined. NAHL was found to negatively influence screening adherence in both the crude (n = 26) and adjusted (n = 19) pooled analyses, and the association was slightly stronger in the latter (OR = 0.70, 95%CI: 0.62-0.79 and aOR=0.66, 95%CI: 0.57-0.76, respectively). Moreover, NAHL was significantly associated with lower adherence in all the types of cancer screening investigated: breast cancer (n = 7), aOR=0.55, 95%CI: 0.38-0.78; cervical cancer (n = 4), aOR=0.63, 95%CI: 0.53-0.75; prostate cancer (n = 1), aOR=0.60, 95%CI: 0.36-0.99, and colorectal cancer (n = 7), aOR=0.85, 95%CI: 0.74-0.97. Lastly, tools measuring NAHL with reading comprehension/numeracy items yielded the strongest association with the outcome (n = 5, aOR= 0.53, 95%CI: 0.35-0.80), that was attenuated in tools with either self-reported comprehension items (n = 7, aOR=0.72, 95%CI: 0.65-0.80) or medical term recognition items (n = 7, aOR=0.74, 95%CI: 0.57-0.95).

Conclusions

This study shows that NAHL may have a significant impact on adherence in all types of screening programs analysed, independently of the tools applied to measure it. Hence, it should be a useful focus for interventions to improve screening participation rates.

Key messages

Non-adequate health literacy negatively influences cancer screening adherence. Efforts to promote the uptake of cancer screening programs should consider and address NAHL.
The phase angle as a marker of health and body composition in soccer players in Bogotá – Colombia
Authors: Argüello P , Gálvez A , Castro L , Sánchez I , Melo P
Published: October 2020

Background

Body composition is a parameter that is evaluated to predict the nutritional status of the population. This is assessed by bioelectric impedance analysis, which reports BMI, fat percentage, skeletal muscle mass, phase angle (AP), among others. The latter, in recent years has become important because it is a direct electrical measurement in the body, used for the clinical prognosis of diseases such as cancer, anorexy nervous, sarcopenia and chronic liver disease. AP is an index of vitality and integrality of the cell membrane and an indicator of muscle strength and endurance; likewise, it is inversely related to BMI, age and gender, normal values in healthy populations range between 5.5° to 9°, it is believed that physical activity and sport can also modify AP values. Therefore, the purpose of the study was to determine the relationship between body composition and AP in soccer players in Bogotá, Colombia.

Methods

Quantitative, cross-sectional, correlational approach. The sample was 84 soccer players (age: 18.67 + 2.9 years; height: 1.73 + 0.07 m; weight: 66.58 + 9.94 Kg), who were assessed using the Bioimpedance method through InBody 770®.

Results

The averages obtained were: AP 6.46°+0.58; muscle mass 32.25 + 5.06 Kg, percentage of fat mass 15.90 + 3.97. There was a direct relationship between AP, skeletal muscle mass and lean mass in the right, left arm, trunk and right leg (p < 0.01), while with the percentage of body fat mass of the right and left arm the relationship was inverse.

Conclusions

Body composition with high values of musculoskeletal mass and AP favor the functionality and development of strength, which in turn are protective factors for the presence of diseases such as sarcopenia.

Key messages

The Phase Angle is constituted as an easily accessible marker of nutritional health and morphofunctional profile in athletes. The Phase Angle and body composition as determinants of the profile in athletes.
Comparison between health-related quality of life in normal-weight and overweight-obese children
Authors: Scrimaglia S , Esposito F , Masini A , Marini S , Gori D , Toselli S , Campa F , Grigoletto A , Messina R , Dallolio L
Published: October 2020

Background

In Italy 32% of 6-10 aged children were overweight in 2017-2018. Measures of Health-Related Quality of Life (HRQoL) assess important aspects of health daily activities, physical symptoms, social interactions and emotional well-being. It is suggested that HRQoL is influenced by children's weight status. The aim of the study is to compare HRQoL among normal-underweight and overweight-obese children in an Italian sample.

Methods

A cross-sectional study was conducted in 2019 among 144 children, aged 6-10, recruited in a primary school in Bologna (Italy). Children were divided in Group1 (G1: normal-underweight) and Group2 (G2: overweight-obese) using the International Obesity Task Force cut points. HRQoL was assessed using 4.0 Italian version of PedsQL questionnaire. We obtained summary scores for children's total HRQoL and two subscales: one for physical health and one for emotional, social and school functioning.

Results

Of 144 children, 98 (68%) and 46 (32%) were respectively in G1 and G2. HRQoL total scores were 73.10±1.30 in G1 and 69.28±1.96 in G2 (p = 0.051). We analysed separately children in Grade 1 and Grade 3-4. In Grade 1, there were 68 children: 48 (71%) in G1 and 20 (29%) in G2. In grade 3-4 there were 76 children: 50 (66%) in G1 and 26 (34%) in G2. HRQoL total scores in grade 3-4 were: 73.28±1.63 in G1 and 72.66±2.32 in G2 (p = 0.41). In Grade 1, HRQoL total scores were 72.92±2.05 in G1 and 64.89±3.15 in G2 (p = 0.02); at subscale levels, means for physical health were 77.73±1.92 in G1 and 72.5±3.58 in G2 (p = 0.08) and means for emotional, social and school functioning were 70.35±2.48 in G1 and 60.83±4.04 in G2 (p = 0.02).

Conclusions

The effects of child overweight and obesity on health-related QOL was more evident in children aged 6-7, especially regarding emotional, social and school functioning. Prevention of childhood overweight and obesity is important not only to avoid health consequences of weight but also to improve children' quality of life.

Key messages

Overweight is a public health problem in Italy not only among adults, but even among children. Overweight has a negative impact on quality of life, therefore a healthy lifestyle should be promoted.
The effects of physical activity on human gut microbiota composition: a systematic review
Authors: Dorelli B , Iachini M , Zaccarin M , Preziosi Standoli J , Galle F , Valeriani F , Liguori G , Romano Spica V , Cattaruzza M S , De Vito C
Published: October 2020

Background

Gut microbiota development and composition can be influenced by an existing dynamic balance between host physiology and lifestyle. This systematic review aims to assess the impact of physical activity on human gut microbiota.

Methods

PubMed, Scopus and Web of Science were searched until May 2019. Full-text in English were recruited if focused on gut microbiota in healthy athletes or active people, without age or gender restrictions, collected on faecal samples and analysed with genome sequencing of rRNA 16S. All types of study design were included as long as they performed a comparison with a sedentary control group. No specific time frame for the publication date was applied. Quality assessment was performed using the JBI Critical Appraisal Checklist for Analytical Cross Sectional Studies (2017) and Cochrane Risk of Bias Tool for Randomized Controlled Trials.

Results

The analysis yielded 7/985 articles: five cross-sectional studies and two clinical trials, published from 2014 to 2019. The overall methodological assessment was of fair quality. Types of exercise included in the studies were: rugby, running, aerobic exercise, bodybuilding. More in detail, regarding the exercise load, some studies were conducted on elite professional athletes, such as rugby players, marathon runners or bodybuilders, with rigorous training, while other studies included a few weeks of aerobic and resistance training at a moderate intensity. Shannon diversity index increased in three studies. Concerning phyla, Firmicutes were increased in five studies and three studies described a significant decrease in Bacteroides.

Conclusions

This systematic review confirms the direct correlation between microbiota composition and physical activity, but further studies are needed to establish the possible presence of a causal link between the two factors.

Key messages

Exercise can play an important role as an environmental factor in determining gut microbiota composition. Further studies are needed to gain robust evidence of physical activity influence on gut microbiota variability.