bluuebunny/crossref_metadata_2025 huggingface dataset:
A mobile device to reduce airborne particulate and prevent surgical site infections
Authors: Messina G , Spataro G , Catarsi L , De Marco M F , Grasso A , Carta G A , Cevenini G
Published: November 2019

Background

Surgical Site Infections (SSI) are the second main cause of Hospital Acquired Infections (HAI) in Europe and in the United States (US). In US and Europe hospitals the overall annual medical costs of HAI is about $40 billion and the SSI represent a relevant part of this spending. It is known that air particulate is a carrier of pathogen bacteria. The aim of this study is to verify if a mobile unit for air particle filtering can improve the environmental airborne conditions of an operating room (OR).

Methods

We carried out a cross sectional study in March 2018 in an Italian University Hospital. A novel mobile device to purify air was tested during surgical procedures. It is provided with: an air decontamination-recirculation system unit; a patented crystalline ultraviolet C reactor; a highly efficient particulate air filtering. The environmental contamination has been monitored in the following phases: I) device off and OR at rest; II) device off and OR in operational; III) device on and OR in operational; IV) device off and OR in operational. We used a particle counter to measure airborne particles of different sizes: 0.3; 0.5; 1.0; 3.0; 5.0; 10 µm. Air samples were withdrawn in four spots of the OR periphery. Wilcoxon rank test was used for the statistical analysis setting the significance level to 95% (p < 0.05).

Results

From phase II (device off) to phase III (device on), there was a reduction of any particulate matter size, ranging from 50% to 73% (p < 0.05). When the device has been turned off again (phase IV), particle dimensions of 0.3, 0.5, 1.0 and 3.0 µm were lower in the percentage range of 51-62% (p < 0,05). Particle dimensions of 5 and 10 µm were also lower in the range of 56% and 76%, respectively.

Conclusions

During mobile device operation, the amount of particulate matter remains significantly lower, reducing the probability of SSI.

Key messages

Air particulate in surgical room may play a role in preventing Surgical Site Infections. The mobile device was able to significantly improve air quality during real operation conditions.
Association between heat waves and number of deaths for old-age in slovenia, from 2013 to 2017
Authors: Percic S , Cegnar T , Hojs A
Published: November 2019

Background

Heat waves are associated with incresed mortalitiy, especially in old-age population.

Methods

We estimated relative risks for number of deaths, for the observed diagnoses, sex, and area, as well as 95% confidence intervals and excess deaths associated with heat waves occurring in the years from 2013 to 2017, for population 75+ years old.

Results

Statistically significant were: in 2014: all causes of deaths (RR = 1.27, CI 1.12-1.44); male, all causes of deaths (RR = 1.27, CI 1.04-1.56); female, all causes of deaths (RR = 1.26, CI 1.08-1.48); all, circulatory system diseases (RR = 1.19, CI 1.01-1.43); female, circulatory system diseases (RR = 1.23, CI 1.01-1.51); rural area (RR = 1.28, CI 1.09-1.51); urban area (RR = 1.35, CI 1.11-1.64); and in 2015: all causes of deaths (RR = 1.28, CI 1.15-1.41); male, all causes of deaths (RR = 1.27, CI 1.08-1.5); female, all causes of deaths (RR = 1.27, CI 1.12-1.45); all, circulatory system diseases (RR = 1.27, CI 1.1-1.48); male, circulatory system diseases (RR = 1.38, CI 1.06-1.79); female, circulatory system diseases (RR = 1.23, CI 1.03-1.47); rural area (RR = 1.31, CI 1.16-1.47). No significant association in 2013, 2016 and 2017 appeared.

Conclusions

Despite increasing heat load in observed years, we did not notice a statistically significant association between heat waves and the number of deaths in the last observed years 2016 and 2017. The results indirectly show that we are on good way with our public health efforts concerning awareness of Slovenian people about the dangers heat waves bring.

Key messages

Heat waves will become more intense, will last longer and will appear more frequent. We must take care after old age population. Chronic noncommucating diseaes increase and life expectancy also increases, so the burden of deaths during heat waves is expected to increase too.
Evaluation of Norovirus contamination in bivalve molluscs harvested from Northern Adriatic Sea, Italy
Authors: Rubini S , Barbieri S , Losio M N , Taddei R , Bertasi B , Pavoni E , Bolognesi E , Berardelli C , Govoni G , Suffredini E
Published: November 2019

Background

Norovirus (NoV) is the leading cause of acute gastroenteritis in developed countries. Transmission is through direct contact, unsanitary food handling or ingestion of contaminated water or food. Shellfish bioaccumulate NoV and current post-harvest depuration is not effective for its removal.

Materials and

Methods

A monitoring programme for NoV in bivalve shellfish harvested from Northern Adriatic Sea was initiated in 2016. From January 2016 to March 2019, 418 samples including 257 Manila clams, 73 mussels, 46 striped clams, and 42 oysters, were examined. Mollusc samples were tested for NoV genogroups I (NoV GI) and II (NoV GII) contamination by RealTime RT-PCR according to ISO 15216-2.

Results

Ninety-three out of 418 tested samples (22.2%) were contaminated by at least one NoV genogroup, the simultaneous presence of the two genogroups was detected in 19/418 of the cases. Positive samples were distributed among the tested species as follow: 29/73 (39.7%) mussels, 51/257 (19.5%) Manila clams, 8/42 (19.0%) oysters, 5/46 (10.9%) striped clam. In 2016 (n = 135), 2017 (n = 122), 2018 (n = 132) and in the first trimester of 2019 (n = 12), prevalence of NoV was 6.7%, 24.6%, 31.8% and 41.4%, respectively. NoV GII was largely predominant being detected, alone or in association with GI, in 98.9% of the contaminated samples. On the other hand, GI prevalence increased from 1.5% (2016) to 12.1% in 2018, maybe reflecting a higher circulation of this genogroup in production environments.

The vast majority of positive samples (91.4%) were detected during the cold season (November to March).

Conclusions

Overall positive samples have increased over the years (from 6.7% in 2016 to 31.8% in 2018). NoV GII was the most frequently detected genogroup, but NoV GI prevalence significantly raised in 2018. The routine application of quantitative RT-PCR (ISO 15216-1) to determine the viral load in bivalve molluscs would expand knowledge on potential for foodborne transmission.

Key messages

Overall positive samples have increased over the years. The routine application of quantitative PCR to determine the viral load in bivalve molluscs would expand knowledge on potential for foodborne transmission.
A set of pedagogical recommendations for improving the integrated approach to childhood obesity
Authors: Ruiter E L M , Molleman G R M , Fransen G A J , Wagenaar M , van der Velden K , Engels R C M E
Published: November 2019

Background

Studies increasingly emphasize the importance of the parents’ role in interventions designed to prevent overweight in children. The aim of this study was to develop a unified set of recommendations for healthy parenting practices that can be applied by all professionals who work with children age 4-13 years and can contribute to strengthening the integrated approach to childhood overweight.

Methods

A modified Delphi procedure was used to reach consensus regarding what these pedagogical recommendations should encompass. The 30 panelists were professionals and researchers who work with children in the domains of health care, overweight, parenting, education, nutrition, and/or sports. The procedure consisted of: i) extracting existing pedagogical recommendations from national guidelines and professional protocols, ii) appraising and prioritizing these recommendations in terms of relevance through two rounds of questionnaires, and iii) meeting to discuss and approve the set of recommendations.

Results

Consensus was reached for one set of eleven pedagogical theme-based recommendations designed to support and instruct parents how to stimulate healthy energy balance-related behaviors in their child. Each recommendation contained information regarding: i) which behaviors are important, ii) why this is important, and iii) how parents can stimulate this behavior by applying parenting skills. The eleven themes were: modeling, positive parenting, breakfast, varied diet, sugar-sweetened beverages, snacks, physical activity, playing sports, quantity of screen time, screen time during meals, and sleep.

Conclusions

We developed a set of recommendations for healthy parenting that can be used by various professionals working with children age 4-13 and can contribute to creating an integrated approach to childhood overweight. We also developed a web-based app called “Recommendations for Healthy Parenting” as a convenient tool for following these recommendations.

Key messages

Our set of recommendations for healthy parenting can be used by various professionals who work with school-aged children, thereby helping strengthen the integrated approach to childhood overweight. We developed and released a Dutch web app entitled “11 Recommendations for Healthy Parenting” to provide a convenient tool for easily communicating these recommendations to parents.
Impacts of post-Brexit agricultural policy on fruit and vegetable intake and cardiovascular disease
Authors: Seferidi P , Laverty A A , Pearson-Stuttard J , Collins B , Bandosz P , Capewell S , O’Flaherty M , Millett C
Published: November 2019

Background

The post-Brexit agricultural regime represents an opportunity to positively influence food systems and improve public health. Health-improving measures could include expanding the UK production of fruits and vegetables (F&V), thus increasing F&V availability. Currently, only 1.4% of total agricultural land in England is allocated to F&V. This study aims to estimate the potential impacts of allocating additional land to F&V production on cardiovascular disease (CVD) and inequalities in England between 2021 and 2030.

Methods

We used the previously validated IMPACT Food Policy model to translate changes in land allocated to F&V into changes in F&V intake and associated CVD mortality, expressed in number of deaths prevented or postponed (DPPs) by age, sex, and Index of Multiple Deprivation (IMD) quintile. We modelled two scenarios that assumed a linear increase in agricultural land allocated to F&V until it covers a) 10% and b) 20% of all land suitable for production of horticultural crops in England. We assumed that F&V prices would drop to a new equilibrium. We used Monte Carlo simulations to produce uncertainty intervals.

Results

Our model suggested that by 2030, F&V intake might increase by approximately 4% (95% Uncertainty Interval: 2%-7%) and 8% (4%-13%) respectively, under the first scenario. Under the second scenario, F&V intake could increase by approximately 17% (10%-29%) and 37% (26%-51%) respectively. These increases in F&V intake were associated with 3360 (1760-5920) CVD DPPs under the first scenario and 15700 (9000-24310) under the second scenario in 2021-2030. Our modelled scenarios could also reduce inequalities, with some 16% of DPPs occurring in the least deprived group compared with 22% in the most deprived.

Conclusions

Policymakers should consider the public health impacts of the post-Brexit agricultural regime in England. Increasing the land allocated to F&V production could substantially reduce the burden of CVD and associated inequalities.

Key messages

The post-Brexit agricultural policy can be an opportunity to improve diet and public health in the UK. Increasing the agricultural land allocated to fruit and vegetable production in England could reduce the burden of cardiovascular disease and associated inequalities.
Visual food diary - peer support and better diet quality
Authors: Puranen T , Salokekkila P , Ahlblad-Makinen N , Haggman-Laitila A
Published: November 2019

Background

Healthy Life -groups are targeted to patients with symptoms of metabolic syndrome, problems with coping or overweight at public health centers in Helsinki. The aim of one-year Healthy Life -group is to give support for self-care and empowerment. The groups are generic, and each participant sets her own goal such as smoking cessation, alcohol or weight management.

Methods

To create opportunities for positive and empowering diet intervention for working aged population, we have started a pilot study with visual food diary (MealLogger). The nutritionist are coaching the three-month-intervention aiming at improving the diet quality. Participants share photos of their meals with each other and receive peer support.

Results

During years 2016 - 2018, 445 completed the one-year intervention in Healthy Life -groups. The mean decrease of weight loss was 4 kg (n = 222) and decrease of waist circumference 5 cm (n = 57).

Conclusions

Since the goal for most participants was weight loss, we decided to offer a modern intervention with MealLogger-application. During year 2019 we will complete six groups (about 100 participants) and we will measure participants food quality, weight, waist circumference, quality of life. The results we report in the autumn.

Key messages

To manage overweight epidemic, new prevention strategies are needed in the primary health care. Visual food diary enables positive and empowering approach to improve died quality and weight management.
Early feeding profiles based on breastfeeding, infant formula and introduction of solid foods
Authors: Amazouz H , Bougas N , de Lauzon-Guillain B , Momas I , Rancière F
Published: November 2019

Background

As early feeding practices may be related with allergy at older age, we aimed to investigate infant-feeding profiles in the first year of life and their determinants in the PARIS (Pollution and Asthma Risk: an Infant Study) cohort.

Methods

This study included 3446 infants. Feeding data was collected using standardized questionnaires at 1, 3, 6, 9 and 12 months. At each time, we considered 6 variables such as (i) breastfeeding (no, mixed, exclusive), consumption of formula (no, yes): (ii) regular formula, (iii) hypoallergenic, (iv) with pre-/probiotics, or (v) extensively hydrolyzed/soya, as well as (vi) solid foods introduction (no, yes: 0, 1, ≥2 allergenic foods). Children with similar feeding profiles over the first year of life were grouped together using multidimensional longitudinal cluster analysis. Socio-demographic and health determinants of these profiles were examined using multinomial logistic regression models.

Results

Five distinct profiles were identified. Profile 1 (45%) included children mainly fed with regular formula. Children from Profile 2 (27%) were exclusively breastfed during the first 3 months. Children from the other three profiles were moderately breastfed and differed regarding the type of formula consumed: pre-/probiotics for Profile 3 (17%), hypoallergenic for Profile 4 (7%), or extensively hydrolyzed/soya for Profile 5 (4%). Profiles did not seem to differ regarding timing of solid foods introduction, except Profile 5 starting later. Compared to Profile 1, children from Profiles 2 to 5 were more likely to have parental history of allergy and higher family socioeconomic status (SES). Profile 5 appeared to be influenced by early health outcomes such as eczema or food reactions.

Conclusions

We identified different early feeding profiles. Parental history of allergy, SES and early health outcomes seem to be important determinants of these profiles. Associations of these profiles with the development of allergic disease will be studied.

Key messages

These results are important to better understand early-life feeding practices and their contributors. Their possible role in helping to prevent allergic diseases in later life will be further studied.
Breastfeeding knowledge and attitudes of young people
Authors: Dimovski D , Gajic J , Vukajlovic B , Jevtic M , Komlenic A
Published: November 2019

Background

One of the World Health Organizations (WHO) global nutrition goals by 2025 is to increase the rate of exclusive breastfeeding of infants under six months to at least 50%, which can be achieved only through educating future parents on the importance of breastfeeding. The goal of this research was to establish the current effects of the public health campaigns in raising awareness on breastfeeding by analyzing the opinions of young people towards maternal milk.

Methods

The study was conducted as a prospective study for six months in 2018. and in 2019. 281 people participated (158 female, 123 male) of whom 127 psychology students.The participants had no children, and were aged between 18 and 26.. The survey consisted of socio-demographic questions and the Iowa Infant Feeding Attitude Scale (IIFAS) with 17 questions. Data processing included methods of descriptive and inferential statistics using the MedCalc program. Values of p < 0,05 were considered statistically significant.

Results

More than one out of two female and almost two out of five male participants recognized milk as a diet optimal for their infant (53% female, 38% male). Over twice as many participants considered maternal milk to be extremely positive in comparison to baby formulas as positive. Only 12% of respondents acknowledged that infants had beneficial effects from breastfeeding throughout their lives.

Since only 12.8% of infants in Serbia are exclusively breastfed (according to the available data), the public health authorities need to take more drastic measures in order to complete the WHO set goal by 2025.

Key messages

Current public health campaigns aren’t showing sufficient effects. Both sexes need to be included in education process about the importance of breastfeeding.
Digital technology interventions to reduce loneliness in adults: a systematic review
Authors: Sarwar Shah S G , Nogueras David , van Woerden Hugo , Kiparoglou Vasiliki
Published: November 2019

Background

Loneliness is an emerging public health issue and its burden is increasing in developed countries. Loneliness is associated with social, emotional, physical and mental health issues. Tackling loneliness is important to reduce its adverse impacts on individuals with loneliness and their families. Various digital technology-based interventions are used to tackle loneliness. Assessing the effectiveness of these interventions is important from the health, social care and public health perspectives.

Aim

To undertake a systematic review of published primary research on digital technology interventions to reduce loneliness in adults.

Methods

Databases searched: PubMed, Medline, CINAHL, EMBASE and Web of Science. Inclusion criteria: empirical research articles involving the application of digital technology interventions for tackling loneliness; participants aged ≥18 years and publication in the English Language from 1 January 2010 to 14 January 2019. Two researchers systematically screened articles and data were extracted from shortlisted articles applying a population, intervention(s), comparator(s) and outcome(s) (PICO) framework.

Results

We selected 14 studies mostly from developed countries such as the US (n = 5) and Sweden (n = 3). We found a wide variation in the sample sizes (range 5-591 participants), participants’ age (range 32-90, average 66.4-82.5 years) and the follow-up measurement period (6 weeks-12 months) in the selected studies. Digital technology interventions tested were Internet-based social activities and networking through video or phone calls (using Skype (n = 6) and Facebook (n = 2)), communicating via emails (n = 2). Most of the studies used the UCLA loneliness scale (n = 9) and reported reductions in loneliness in follow-up measurements compared to baseline measurements.

Conclusions

Digital interventions are associated with reduced loneliness in adults; however, further studies such as clinical trials involving larger sample sizes are needed.

Key messages

Loneliness is associated with social, emotional, physical and mental health problems and the burden of loneliness is increasing, especially in developed countries. Digital technology interventions help in reducing loneliness in adults but further research including clinical trials involving large sample sizes and longer follow-up periods are required.
The Villeneuve renovation program Health Impact Assessment
Authors: Anzivino L
Published: November 2019

We conducted a health impact assessment (HIA) on a french urban renovation program in a disadvantaged neighborhood: the Villeneuve, symbol of the architecture of the great ensembles of the 1970s. The ambitions of this new program are opening to the city, simplification of traffic, requalification of the housing stock, creation of living spaces renovation of public facilities enhancement green spaces ... so many challenges to be met for the attractiveness of the territory and its inscription in the heart of the Metropole. The HIA was conducted collaboratively with the services of the city of Grenoble, Echirolles, and the Metropole.

The information used to inform the assessment included profiling the community of the Villeneuve, a comprehensive literature review focussing and semi-structured interviews. Many components of the project were evaluated: access to good quality of green and public spaces; urban design; mobility; access to shops and services and social cohesion.

The HIA shows that the urban renovation program is likely to have a mix of negative and positive impacts on health, mental health, wellbeing and social cohesion. In particular on the living environment, the attractiveness, the perception of the neighborhood, on physical security and sense of security, opening of neighborhoods, mix functionality, opportunity for leisure and sports practices. In addition the program provides an opportunity to specifically target reducing health inequalities in the area.

The HIA working group has co-built 47 recommendations. These recommendations were than hierarchized according to four criteria: political portability - cost- technical feasibility - temporality.

This HIA is a structured approach that allowed the renovation program to be observed with a holistic vision of health around the determinants of health and encouraged partnerships and anticipate health issues as early as possible in the decision-making process of urban programs.

Key messages

The HIA is a structured approach that allows urban projects to be observed with a holistic vision of health around the determinants of health. The HIA encourage partnerships and anticipate health issues as early as possible in the decision-making process of urban programs.
Emotional demands at work and risk of depressive disorder: A nationwide Danish cohort study
Authors: Madsen I E H , Svane-Petersen A C , Framke E , Sørensen J K , Rugulies R
Published: November 2019

Background

Studies suggest that high emotional demands at work are associated with increased risk of depression. However, most previous studies have measured emotional demands using self-report and estimates may be inflated due to reporting bias. Furthermore, no study has yet accounted for the potential selection of individuals with increased risk of depressive disorder into occupations with high emotional demands.

Methods

We analyzed data from two separate nationwide register-based Danish cohorts, The Danish Work Life Course Cohort (n = 955,712; person-years=6.99 mill.), and the JEMPAD study (n = 1,680,214; person-years=21.73 mill.). We measured emotional demands annually by job exposure matrices, and depressive disorder using registers on psychiatric hospital treatment. Emotional demands were categorized as quartiles. To account for selection into jobs with high emotional demands, we adjusted for numerous confounders, including health services use before workforce entry, parental socioeconomic position, and psychiatric and somatic diagnoses. The present abstract reports preliminary results based on a subset of the study population used as a development sample (n = 16,163, person-years=168,889). Final results will be available for the conference.

Results

Preliminary findings showed a tendency towards an increased risk of depressive disorder for employees in occupations with the highest level of emotional demands (hazard ratio: 1.20 (95% CI: 0.85-1.69). The association was similar with and without adjustment for confounders and was not explained by selection into occupations with high emotional demands.

Conclusions

If confirmed in analyses of the full study population, our results suggest that high emotional demands at work may be associated with increased risk of depressive disorder, and that this association is explained by neither reporting bias nor a selection of individuals vulnerable to depression into occupations with high emotional demands.

Key messages

Emotional demands may be associated with an increased risk of depressive disorder. Further research is needed to explore the potential for workplace prevention of high emotional demands.
Life style habits of truck drivers in France
Authors: Bourdin V , King G , Josseran L
Published: November 2019

Background

European truck drivers’ (TD) lifestyle behaviors is a topic of great interest but not frequently studied. Unhealthy behaviors such as smoking, alcohol consumption, drug abuse or a lack of physical activity infer a greater risk for cardio-vascular diseases and road accidents. This study aimed at describing life TD habits.

Methods

A prospective cross-sectional study was conducted in April 2018 on 4 rest areas with the support of the nonprofit organization “Fondation VINCI Autoroutes pour une Conduite Responsable”. 515 TD were interviewed randomly at 4 highway rest stops. Life habits data were collected and analysis was conducted using univariate statistics.

Results

38.6% (n = 199) declared to be daily smokers, with no significant difference when reported to nationality or age. 24.6% (n = 126) are normal weighted, while 72.4% (n = 373) have a BMI superior to 25. 58.8% (n = 303) of the TD drink alcohol on a regular basis, and 8.5% of them (n = 26) on a daily basis. High blood pressure is significatively associated with alcohol consumption (5.2% vs. 12.9%, p < 0,05) and obesity (19.4 % vs. < 10%, p < 0,001). 2.5% (n = 13) of the TD consume psychoactive drugs, most of them cannabis. As concerns diet: 32.8% (n = 169) consider it as balanced, 32.6% (n = 168) not balanced, and 34,6% can’t qualify it. When TD think their diet is unbalanced, they judge it too fat (75.6%), too sweet (61.9%) or too salty (50.6%).

Conclusions

The most striking results concern TD expectations, since 41.7% of the daily smokers and 5.3% of the alcohol consumers would be interested in help measures to stop. TD with the highest BMI are the most demanding for a diet help. Motorway operators, unions and compagnies should fulfill these expectations, since TD in better health are less frequently involve in road accidents. TD spend a lot of time on rest area and this offers interesting periods of time to develop health education specifically for them.

Key messages

Many truck drivers prove to be daily smokers and/or with excess weight, and/or eating an unbalanced diet. High blood pressure is significatively associated with alcohol consumption and obesity. Expectations are high as concerns help measures to reach healthier behaviors and live a better life.
Sexual harassment at work: Design of a new questionnaire to measure sexual harassment
Authors: Nielsen M B D , Madsen I E H , Clausen T , Skov S S , Kjær S , Kvorning L V , Aldrich P T , Rugulies R , Folker A P
Published: November 2019

Background

Sexual harassment is a complex phenomenon and our knowledge is hampered by a lack of consensus on the definition and measurement. However, workplaces need reliable instruments that provide a nuanced understanding of sexual harassment and input for action to mitigate negative consequences. The aim of this project is to help workplaces prevent and manage sexual harassment, which include developing a new and comprehensive instrument to monitor sexual harassment (Inventory of Workplace Sexual Harassment). In this abstract, we explain the process of designing the questionnaire.

Methods

The design process follows three steps: (1) Identification of a theoretical and conceptual framework, (2) item development and (3) field testing. First, we identified relevant theoretical and conceptual frameworks, which we discussed with an expert group consisting of researchers and stakeholders (employer and trade unions). Second, we developed items based on expert inputs and previous surveys. We adapted the first version of the questionnaire following a feedback round with the expert group. Third, we will complete field testing in 2019-2020. Field testing encompasses cognitive interviews (n = 15) and in-depth interviews with men and women exposed to sexual harassment to assess clarity and relevance (in 2019), and a pilot study at 15 workplaces to assess prevalence and usability (in 2020).

Results

Based on the theoretical and conceptual model from Fitzgerald et al, we developed a preliminary version, consisting of 22 items that cover three domains: (1) unwanted sexual attention, (2) gender harassment and (2) sexual coercion. The survey draws on questions from SEQ-DoD and Bergen Sexual Harassment Scale. Results from field testing will be available for the conference.

Conclusions

The Inventory of Workplace Sexual Harassment will provide a comprehensive and validated measurement of workplace sexual harassment and will help workplaces prevent and manage sexual harassment.

Key messages

Sexual harassment is a complex and multifaceted phenomenon, but our knowledge is hampered by a lack of consensus on the definition and measurement. This study contributes with a new instrument measuring the prevalence of workplace sexual harassment and tools for prevention and management of sexual harassment.
Attitudes of Polish employers towards smoking/e-cigarette use in workplaces
Authors: Balwicki L , Juszczyk G , Dela A , Tyranska-Fobke A
Published: November 2019

Background

For many years Poland has been undertaking initiatives aimed at reducing the problem of smoking among citizens. Many educational and legislative activities have been carried out. One of them was introduction of smoking ban in workplaces and other public places in 2010. The aim of the was to look for attitudes of Polish employers towards smoking and e-cigarette use in workplaces.

Methods

The cross-sectional survey was carried out on representative group of 2,501 employers from Poland in July/August 2018. Respondents answered to the original questionnaire with help of Computer Assisted Telephone Interview (CATI) method. Questionnaire consisted of 19 questions regarding attitudes towards smoking and e-cigarettes use in their workplaces. Data were analyzed with the help of descriptive statistics, correlation analysis methods. Statistical significance was set at p < 0.05.

Results

Only 44.9% employers agree they should not take care for creation conditions for smoking tobacco/e-cigarettes use during working hours. The majority of respondents (53.7%) believe that non-smokers (without going out to smoke) have fewer breaks in their work. In addition, 51.8% of respondents believe that smoking tobacco/e-cigarettes by employees brings economic losses to the company, and 55.0% think that smoking tobacco/e-cigarettes use during work spoils the company’s image. At the same time, as many as 88.5% of respondents indicated that their workplaces did not carry out activities encouraging them to quit in the last two years and 52.8% do not believe in their effectiveness.

Conclusions

Although respondents indicated the negative consequences for their companies because of tobacco smoking/e-cigarettes use by employees, the majority of employers do not take actions to reduce this problem. As big part of them sees also economical and image problems they should be supported in their activity to reduce the tobacco/e-cigarette use among employees.

Key messages

Employers see economical and image problems cause by smoking/e-cigarette using employees. Employers should be supported by public health professionals as they do not believe nor undertake effective activities to reduce tobacco smoking/e-cigarettes use.
Health benefits through prevention: there is still a lot to be gained
Authors: Van Gils P F , Suijkerbuijk A W M , van der Vliet N , Polder J J , de Blaeij A , de Wit G A , Staatsen B
Published: November 2019

Introduction

In November 2018, the Ministry of Health, Welfare and Sports presented the National Prevention Agreement (NPA). Within this NPA, interventions targeting smoking, being overweight and problematic alcohol use were proposed to induce lifestyle changes. In addition to measures aimed at these three themes, there is also a range of interventions that are promising, either because they could be cost saving or cost-effective, or because they have a positive impact on burden of disease. We explored which preventive interventions are promising in the Dutch context and systematically quantified costs, savings and health effects.

Methods

In a literature search via the website kosteneffectviteitvanpreventie.nl we selected interventions that: a) have not yet been introduced in the Netherlands; and b) were promising with respect to effectiveness and cost-effectiveness. All interventions, including health protection and environmental measures, were eligible. We estimated the number of people who are eligible and compliant, costs and possible savings related to the interventions and health effects in terms of DALYs avoided. Interventions were ranked with regard to possible savings and DALYs avoided.

Results

Our exploration shows a number of preventive interventions that are cost saving or cost-effective. These interventions are aimed at anxiety and depression, heart disease, skin cancer, fractures, air quality and road safety. Examples of cost-saving or cost-effective interventions are a food tax on food and drinks with high fat/sugar content, screening an aneurysm of the aorta and fully subsidized sound insulation of homes.

Conclusions

Our study shows that there are much more preventive opportunities than those presented in the NPA. The substantiation of the interventions is often based on foreign research and findings therefore cannot be simply translated to the Netherlands. However, the interventions identified in this study are promising and deserve further consideration.

Key messages

Health gain by environmental measures. Many interventions are not systematically implemented.
Hospitalization patterns of uninsured as base for services and health need assessment
Authors: Ciutan M , Florescu S , Dosius M , Scîntee S G , Vlădescu C
Published: November 2019

Background

Solidarity is crucial for shifting from centralized to social health insurance model. Uninsured receive at least emergency and basic services free-of-charge. To which extent this policy really covers their health and services needs remains to be assessed.

Methods

DRGNational database (457 hospitals) was interrogated for continuous hospitalization of uninsured, 2014-2018. Use patterns were identified by episodes, LOS, diagnose, admission criterion. Avoidable admissions were assessed according to OECD criteria.

Results

Number of hospital episodes in uninsured varied annually, difference ranging from -13.5 to 6.3%; largest decrease in 2015 possibly due to day surgery implemented in 2014. About 2.5-3% of all episodes and hospitalization days were for uninsured. Use patterns identified: Most common admission criterion: Emergencies (95%) compared to Specific diagnosis&treatment, Births, Potentially endemic/epidemic diseases; Most frequent diagnosis: Emergency around birth,Mental disorders, Respiratory infections; Men 45 years old living in rural areas prevailed significantly; significant gender difference by age (9 years; t-test, p < 0.05); 3% of hospitalizations could be avoided by assistance in prehospital (asthma, COPD, CHF, Diabetes&utation).

Conclusions

The use patterns identified show inequity in access and gaps in policy meant to ensure solidarity in health. Day surgery was inittially beneficial in reducing financial burden, but addressing to prehospital health services continues to be low inducing overload of emergency units. A solution could be higher involvement of other sectors to ensure socio-economic security for all. Free-of-charge emergency hospital services ensure access for life threatening conditions but shortcut pre-hospital and postpone initial visits until non-preventable/-manageable stages.

Key messages

Reconsider services package to increase access for uninsured. Develop bridges between domains able to meet health related needs by intersectorial collaborations: labor, social, economic, health etc. Periodic analyze hospitalizations of uninsured, together with legal framework and sectoral policies to allow an appropriate decisions making and tailored intervention design.
Geographical accessibility to permanent care centers of family doctors from Bihor County, Romania
Authors: Tirt D P , Rahota D
Published: November 2019

Accessibility (geographic or spatial) to health services is a component of health care services access that through measurement can assess inequities in health. Geographical accessibility can be measured using a geographic information system (GIS) where travel time is calculated from the patient’s home to the place where a service is delivered. Permanent care centers of family doctors (PCCs) are units providing family medicine services (consultations, injections, solving minor emergencies) outside the work schedule of family doctors (night and holiday), for overloading prevention of emergency hospitals services by direct addressing or by calling to the unique emergency number 112. Bihor County has 617118 inhabitants in the 101 administrative-territorial units (458 localities), 334 family medicine practices, and there were 34 PCCs.

We intended to identify the number of localities in more than 10, 20 or 30 minutes of travel by car from the PCC (based on end-2018 data). A GIS was created using the QGIS application, which includes layers: the county border, the 454 localities and the georeferenced addresses of PCC. Using the ORS Tools plug-in, the appropriate isochrones were created. Then overlapping isochrones and localities (points), the number of localities for which the travel time to the nearest PCC is greater than 10, 20 and 30 minutes, respectively, was obtained.

The time needed for the inhabitants to reach the PCC is: more than 10 minutes for 247 localities; more than 20 minutes for 81 localities and over 30 minutes for 10 localities. The results are presented in the form of maps and in tabular form (localities).

Using GIS, accessibility to medical services in a territory (city, county, country) can be measured. The application of free GIS software, QGIS, requires hardware, staff training, procedures (for work and decision-making) to research and improve population access to health services.

Key messages

Access to health services can be assessed using geographic information systems. The use of appropriate maps facilitates decision making to optimize health services.
Research Management Committee as strategic device for Implementation Research
Authors: Treichel C A S , Silva M C , Presotto R F , Onocko-Campos R T
Published: November 2019

Issue/problem

Implementation Research (IR) are particularly useful in identifying whether when an intervention does not succeed, this is because the intervention was ineffective in the new scenario or if a good intervention was poorly implemented. In order to do this, it is important to establish evaluation strategies capable of provide feedback and encourage learning and incorporation of changes. However, the best strategies for this are not clear yet.

Description of the problem

Despite the existence of references with clear definitions of the outcomes for IR, it is still unclear what are the best strategies for the stakeholders’ participation in these outcomes evaluation. By identifying that, the framework of participatory research could contribute to the choice of these strategies. We sought to retrieve some of the devices already used in other research to test whether they would be able to respond to the assumptions of IR. The chosen device was the Research Management Committee (RMC) which has its use evaluated by a qualitative study with focus group and the data review of the minutes of meetings held by the RMC.

Results

The RMC functioned as a space where members of the research team, managers and workers from the services where the intervention occurred could meet systematically to plan, monitor and make adaptations in the IR. Besides its success as a tool for accessing outcomes, the RMC has also proved to be an important strategy to promote the increasing of acceptability, adoption, penetration and sustainability.

Lessons

The RMC was an important promoter of the participation for the stakeholders in several aspects of the research; made possible the evaluation and monitoring of the meaning and feasibility of the research in the field of study from the point of view of those who live the experience of daily work and care; and favored access to the outcomes of IR in a transversal and organic way.

Key messages

The RMC is a strategic device for Implementation Research and configures a possibility to make the research a more dialogic and potentially transformative process. Besides its success as a tool for accessing outcomes, the RMC has also proved to be an important strategy to promote the increasing of acceptability, adoption, penetration and sustainability.
Two-year supervised tooth brushing program evaluation in preschools in Southern Israel
Authors: Dekel D , Zusman S P , Pikovsky V , Natapov L
Published: November 2019

Background

Dental care for children was included into National Health Insurance Law in 2010 and eligibility age went up gradually to 18 in 2019, providing universal dental care. As a part of dental care reform, community based preventive School Dental Services were extended to preschool children. School dental service (SDS), funded entirely by the State, was extended to younger ages providing supervised tooth brushing module. The national supervised teeth brushing program (STBP) was first implemented in 2015-2016 amongst 3-4 year old children attending 600 nurseries in Israel. Due to the program’s success, it was gradually extended to more nurseries in low socio economic regions across the country, reaching 2200 settings in 2019.

The objective of this study was to assess dental health among preschool children participating in the program during the last two years, comparing to those who did not.

Methods

Participant and non-participant kindergartens were randomly selected in Jewish and Bedouin Arab towns in the Southern district matched according to SES level. DMFT index measuring mean number of decayed, missing and filled teeth was recorded among preschool 5 years-old children.

Results

283 children were examined, 157of them Jewish (86 participants in STBP, 71 non-participants) and 126 Bedouins (59 vs 67 respectively). Mean untreated carious teeth (d) was 1.15 vs 1.8 for Jews and 3.22 vs 3.9 for Bedouins. Percent of treated teeth within total caries experience index (f/dmf) was higher in tooth brushing group: 37% vs. 29% for Jews and 23% vs. 8% for Bedouins.

Key messages

Supervised tooth brushing shows favorable effect. Less carious teeth and more treated caries were recorded in STBP group.
Are general practitioners willing to deprescribe in oldest-old patients with polypharmacy?
Authors: Jungo K T , Mantelli S , Rozsnyai Z , Reeve E , Poortvliet R K E , Gussekloo J , Rodondi N , Streit S
Published: November 2019

Managing the growing number of oldest-old patients with multimorbidity and polypharmacy in primary health care poses an increasing public health challenge. Since inappropriate polypharmacy can harm patients’ health, general practitioners (GPs) should regularly review patients’ medications and, if necessary, deprescribe. This case vignette study evaluates the deprescribing decisions of GPs from 31 countries and compares the factors influencing GPs’ deprescribing decisions.

We invited GPs to participate in an online survey, containing a) three cases of increasingly dependent oldest-old multimorbid patients with potentially inappropriate polypharmacy and b) Likert-scale questions assessing the importance of factors influencing deprescribing. We presented each case with and without history of cardiovascular disease (CVD). For each case, we asked whether GPs would deprescribe any medication and, if so, which one(s). We calculated percentages of GPs deprescribing at least one medication in each case, compared cases with/without CVD history and different levels of dependency in activities of daily living, and calculated the percentage of factors rated as important or very important.

Of 3175 invited GPs from 31 countries, 53% responded (N = 1’706) with a mean age of 50 years and 60% females. Results are preliminary, but despite some differences across GP characteristics (male/female, age) and across countries, GPs generally showed a high willingness to deprescribe in oldest-old patients (>80 years) with polypharmacy. GPs were more likely to deprescribe in patients with a higher level of dependency, in the absence of history of CVD, and when patients are on statins, proton-pump inhibitors or potentially inappropriate pain medication. Factors GPs rated as important or very important for the deprescribing decision were patients’ quality of life, risks and benefits of medications, patients’ life expectancy, and potential negative health outcomes resulting from deprescribing.

Key messages

Despite international differences, most GPs report they would deprescribe in older multimorbid patients with polypharmacy. The results will facilitate the development of interventions supporting general practitioners to deprescribe.
Intervention on knowledge and perception of hand hygiene among healthcare workers
Authors: Ben Cheikh A , Ben Fredj S , Bhiri S , Ghali H , Khefacha S , Dhidah L , Ben Rejeb M , Said Latiri H
Published: November 2019

Background

Many studies conducted in healthcare settings with limited resources reported healthcare associated infections (HAIs) rates higher than in developed countries. Hand hygiene is considered as the most effective procedure for reducing infection in a wide variety of settings. The aim of this study was to assess the effectiveness of an intervention program to improve knowledge and perception of hand hygiene among healthcare workers (HCWs).

Methods

We conducted a prospective before-and-after study design in university hospital Sahloul, Sousse, Tunisia, from January 2015 to December 2016. The same questionnaire, constructed by the WHO was distributed and collected at HCWs’ workplace.

Results

A total of 149 and 146 HCWs were enrolled, respectively at pre and post intervention. The majority was nursed women aged between 20 and 35 in pre intervention, whereas in post intervention the majority where physicians. Globally, our results showed tendencies toward improvement, but only two items were significant: the HW is the appropriate technique after injury (73.5% vs 86.8%; p = 0.006) and the hands of HCWs are the lead vehicle of HAIs (65.1% vs 83.6%; p = 0.01). On the other hand, judging by the HCWs’ responses, the probably most effective intervention to enhance hand hygiene compliance was that an alcohol-based hand-rub is available at each point of patient care. In contrast, empowering patients to remind HCWs to perform hand hygiene was mostly rated to be the least effective intervention both in pre and post intervention.

Conclusions

Our intervention to positively influence hand hygiene knowledge was unfortunately less effective than we had hoped it would be, which suggests a HCWs’ reluctance to attend the training program.

Key messages

Hand hygiene is considered as the most effective procedure for reducing nosocomial infection. the intervention to positively influence hand hygiene knowledge was effective.