bluuebunny/crossref_metadata_2025 huggingface dataset:
Cervical cancer screening information flow in Northern regional administrative service in Portugal
Authors: Portela D , Cruz V , Monteiro H , Tavares F
Published: October 2020

Management of a population-based screening program circuit depends on characteristics and technical barriers of its application and implementation. The aim is to clarify the information flow, to understand and build a vision of cervical screening information flows in Northern Regional Health Administration Portuguese Public System and to identify the constraints among them. A total of 5 cluster meetings were presented and two expert interviews were conducted allowing to present an informational flow and its constraints. Aims addressed in each interview where based on the expertise of the interviewed. Cervical cancer screening program depends on the use of SiiMA application. This is an information system for the management of population-based screening program which involves mainly 3 entities and allows a longitudinal data collection and study. Three main constraints were reported. The time for updating data for the list of eligible women was bigger than accorded reaching up to 3 months delay. A duplicate of records and discharges in hospital care since the discharge was done both in the hospital system and the SiiMA platform manually in order to the woman re-enter the screening program. Pendencies were seen due to other screening programs running in parallel which had to be sorted out manually in the regional level or by the entity involved. The existence of a screening application is vital for the implementation purposes of a screening program. The lack of integration of the systems increases bureaucratic work, costs and causes time delay. To improve the efficiency of digital transformation ensuring the quality of the process it is necessary to adapt the design of the health informatic systems to the daily practice and its wants and needs. The strategies of forcing an ever-increasing number of frameworks have demonstrated not to be so effective. Therefore, it is a cornerstone to understand these flows in order to improve its structure, intervention and optimization.

Key messages

The existence of a screening digital application is vital but its expanding use arises constraints. Due to the complexity of such programs, a digital strategy is crucial for management and monitoring of the screening at this scale.
Underreporting of chronic kidney disease according to laboratory criteria of Brazilian adults
Authors: Carvalho Malta D , Kellen Alenkar L , Martins Dias de Andrade F , Santos de Magalhães Cardoso L , Malta dos Santos F , Gomes da Silva A , Junio Sady Prates E , Thalita Almeida Alves F , Eloha Machado I , Landman Szwarcwald C
Published: October 2020

Background

This is the first study in Brazil that evaluates the prevalence of low renal function in the Brazilian population and associated factors, using biochemical measures.

Methods

This is a cross-sectional household-based epidemiological survey, the National Health Survey (PNS), conducted in 2014 and 2015. The explanatory variables were: sociodemographic characteristics, lifestyles, chronic diseases, anthropometry. The prevalence of kidney filtration rate (KFR) <60 ml / min / 1.73m2 was estimated, using Poisson regression to calculate the Prevalence Ratio Adjusted (RPaj) by age and gender.

Results

The prevalence of low renal function was 6.48% (95% CI 5.88-7.09). After adjusting remained associated: female (RPaj 1.4 CI (95% 1.16-1.68), age 45-59 years was RPaj = 7.3 (95% CI 3.8-14.1), 60 years or older RPaj = 33.6 (95% CI 17.8- 63.4), obesity RP 1.32 (95% CI 1.1-1.7), diabetes PR = 1.4 (95% CI 1.2-1.8), poor / very poor self-rated health PR = 1.5 (95% CI 1.2-1.9).

Conclusions

Renal function <60 ml / min / 1.73m2 was higher in females, increased with age, was associated with obesity, diabetes and poorer health assessment. CKD through biochemical tests and risk and protection factors are essential to support public health policies.

Key messages

The prevalence with laboratory data was 4 times higher than self-reported studies, showing the underreporting of low renal function in Brazil population. The primary care team should request simple biochemical tests, such as creatinine, routinely in the target population, especially the elderly, for prevention and early management of kidney diseases.
Workplace violence in the health sector: An assessment of prevalence and pattern
Authors: Ogboghodo E O , Okojie O H
Published: October 2020

Background

Workplace violence has gained significant attention over the last few decades. Violence against health care workers is a complex and persistent occupational hazard facing the health profession and constitutes almost a quarter of all violence at work. This study was conducted to assess the prevalence and pattern of workplace violence among Healthcare workers in Tertiary Health facilities in Benin - City, Nigeria with a view to making recommendations that will enhance the safety of the healthcare workers and improve patient care.

Methods

A descriptive cross-sectional study was carried out among healthcare workers in tertiary healthcare facilities in Benin City. Benin City is the capital of Edo State, Nigeria. Edo State is in the South-South geo-political zone of Nigeria and is the country's central gateway to the North, East, and West. Respondents were selected using the stratified sampling technique. Data was collected using a pre-tested structured questionnaire adapted from the International Labour Organization/World Health Organization joint programme on workplace violence in the health sector confidential survey. Data analysis was carried out using IBM SPSS version 22.0 software. A p-value <0.05 was considered statistically significant.

Results

A total of 386 healthcare workers, with a mean age (SD) of 33.9 ± 6.0 years and male: female ratio of 1:1.7 participated in the study. Physical, verbal, sexual and emotional violence were suffered by 285 (73.8%), 267 (69.2%), 133 (34.5%) and 104 (26.9%) respectively in the workplace. Overall, majority, 323 (83.7%) of respondents had experienced workplace violence. Being female, single and nursing profession were significantly associated with workplace violence (p < 0.001).

Conclusions

The prevalence of workplace violence was high among the studied group. Interventions focusing on the fundamental role of prevention in effectively combating violence at work is recommended.

Key messages

Violence against health care workers is an occupational hazard facing the health profession and constitutes almost a quarter of all violence at work. Prevalence of workplace violence was high among the studied group. The most common pattern of workplace violence was physical violence.
Personas of young adults and substance use
Authors: de Jonge M C , van Leeuwen L , Onrust S A , Bukman S
Published: October 2020

Background

To develop targeted interventions for (young) adults who use drugs, developers need a better understanding of how different subgroups engage with substances. Personas - archetypes describing distinct patterns of goals, attitudes and behaviours of subgroups - may contribute to this understanding. No substance use-related personas have yet been developed. The purpose of this project was to develop evidence-based personas of young adults, based on their involvement with alcohol and drugs.

Methods

Data was collected among young adults (18-25 yrs) through in-depth interviews (N = 43) and a questionnaire (N = 4182). The questionnaire was based on the insights from the interviews. Participants answered questions about their experiences and intentions with substance use, expectations, descriptive norm and intention to quit. For developing personas from the quantitative and qualitative dataset, we combined Goodwin's methods for persona development with latent class analyses.

Preliminary Results

Ten personas are distinguished: a non-user, moderate alcohol user (no drugs), social bingedrinker without druguse intentions, social bingedrinker with druguse intentions, drug-starter, drug-stopper, stimulant-user, hallucinogens-user, coping user and actual quitter. Each persona has a detailed profile that describes their distinct pattern, supported with illustrative quotes from the interviews.

Conclusions

The personas lead to a better understanding of different perceptions and experiences of young adults regarding substances. Currently, the personas are presented among professionals working with the target group in order to validate the personas and to determine suitable health promoting strategies for each persona. Eventually, the personas will be used to improve the development and implementation of interventions that aim to reduce (risks associated with) substance use.

Key messages

The developed personas provide a better understanding of the perceptions and experiences of young adults and their involvement with substances. In the current phase of the project, health care professionals are involved, matching health promoting interventions and communication strategies to each persona.
Family life stress, maternal depression and child behavioral health in industrialized Italian cities
Authors: Bansal E , Renzetti S , Xhani N , Cagna G , Conversano M , Patrono A , Claudio L , Lucchini R , Placidi D
Published: October 2020

Although family life stress adversely impacts child health, few tools measure its relationship to child outcomes in the setting of maternal variables. This study validates the Italian version of Crisis in Family Systems-Revised (CRISYS-R) and characterizes relationships between family life stress, maternal depression and child behavior in two Italian cities.

This cross-sectional study was nested in current research on health impacts of neurotoxic environmental exposures in children. 101 mother-child pairs (child age=9.91±2.17yrs; 53% female) and children's teachers were enrolled in Taranto (south Italy) and Brescia (north Italy). Mothers performed the Italian CRISYS-R and PHQ9; teachers completed Child Behavior Checklist (CBCL/6-18). Spearman's rank correlation coefficients showed associations of family CRISYS-R, maternal PHQ9 and child CBCL/6-18. Wilcoxon Rank-Sum test compared groups of continuous variables.

Mothers with depressive symptoms (PHQ9≥5) reported higher ongoing stress and proportion of negative stressors on CRISYS-R than non-depressed mothers (p < 0.05). Children of depressed mothers performed worse in all CBCL/6-18 domains: Internalizing Problems, Externalizing Problems and Total Problems (p < 0.01). Specifically, children of depressed mothers scored higher on subscales of Anxious-Depressed (p < 0.05), Withdrawn-Depressed (p < 0.01), Rule-Breaking (p < 0.01) and Aggressive Behavior (p < 0.05). Maternal depressive symptoms correlated with ongoing stress (rs = 0.27; p < 0.01), child Internalizing Problems (rs = 0.34; p < 0.001), Externalizing Problems (rs = 0.28; p < 0.01) and Total Problems (rs = 0.35; p < 0.001).

This study describes links among maternal depression, family life stress, and child behavioral health. It is first to validate Italian CRISYS-R and to explore these factors conjointly in Italian contexts with known neurotoxic exposures. Findings support considering maternal depression and family life stress in child behavioral and environmental health research and policy.

Key messages

Family life stress, maternal depressive symptoms, and preadolescent behavioral health were highly interrelated in two industrialized Italian cities. The Italian version of CRISYS-R is a useful instrument for assessing and understanding family life stress, a crucial yet under-explored contributor to child behavioral health outcomes.
Improving cultural competence in medical curricula of Algarve University to reduce health disparities
Authors: Pinto de Oliveiraa A , Nunes S , Marreiros A , Palmeirim I
Published: October 2020

The increasing diversity of the Portuguese population and the globalization of health care require advance practice physicians to be culturally competent. Greater appreciation exists for the impact of culture on health care: health seeking behaviors are affected by cultural mores. The field of 'cultural competence' has emerged as one strategy to address these disparities.

The Integrated Master of Medicine at the University of Algarve realized that the development of culturally responsive clinical skills is vital to the effectiveness of behavioral health services. To achieve this realization, Cultural Competence Seminars were included as obligatory course in medical curricula, since 2017. Although some cultural competence topics were addressed at different moments of master, in PBL approach and electives.

The seminars offered in Year 6 were structured in 3-h interactive lectures per week covering the following topics: gipsy ethnicity, vulnerable groups, Jehovah's Witnesses, Islamic Culture and Ethics in different cultural contexts. These thematic areas were taught by social scientists and interested “experts” or inviting personal testimonys. The learning objectives are related to knowledge-based that focus on information, such as definitions about culture and related concepts; attitudes that seeks to improve provider awareness of the impact of socio-cultural factors on patients' values and behaviors and skills that focus on learning communication regarding the context.

The integration of seminars in the medical curricula has been a successful project as it has been well received by students. Reflecting on the conceptualization and implementation of the cultural competence seminars, there are still some challenges to address. That is, cultural competence needs to be further integrated in the curriculum by incorporating in additional clinical communication and clinical skills sessions.

Key messages

It is a model that can be applied regardless of the meaning a school of medicine attaches to the notion of cultural competence, and can build on existing strengths within the organization.
Collaborative strategies for knowledge translation: the African-German CEBHA+ research network
Authors: Sell K , Pfadenhauer L M , Jessani N , Schmidt B M , Levitt N , Chapotera G , Akiteng A R , Mpando T , Ntawuyirushintege S , Rehfuess E A
Published: October 2020

Background

The Collaboration for Evidence-based Healthcare and Public Health in Africa (CEBHA+) is an NCD research consortium that seeks to engage policy-makers and practitioners throughout the research process in order to build lasting relationships, enhance evidence uptake and build long-term capacity among partner institutions in Ethiopia, Malawi, Rwanda, South Africa and Uganda. This integrated knowledge translation (IKT) approach includes the formal development and implementation of country-specific engagement strategies.

Methods

An early-stage evaluation is taking place in Mid-2020. Online surveys and qualitative interviews with researchers and policy-and-practice partners will inform adaptation of country-specific strategies, advance the initial programme theory and contribute to the science of IKT.

Results

We present three pertinent observations based on the development and implementation of an overarching CEBHA+ IKT approach and five country-specific strategies over the last two years: Despite being informed by an overarching IKT programme theory, the site-specific strategies and resulting partnerships vary markedly, representing the whole continuum of integrated knowledge translation.The diversity of approaches is due to different understandings of IKT, discontinuity of staff, lack of IKT training, and perceptions of usefulness (compared to ongoing research activities) among CEBHA+ researchers.The individual, dynamic and often pre-existing relationships of researchers and partners from policy and practice are central to IKT, but capturing these within the programme theory and monitoring them remains challenging.

Conclusions

These observations are useful to guide further evaluation and cross-country comparison. Close examination of relationships and conceptualisation of IKT as a continuum may provide valuable insights into the circumstances that make IKT efforts worthwhile.

Key messages

Translating evidence into policy and practice is reliant on partnerships between researchers and policy-and-practice partners. These can be formalised but the relationships remain complex and dynamic.
Tai Chi and workplace wellness for health care workers: a systematic review
Authors: Dorelli B , Cocchiara R A , Gholamalishahi G , Longo W , Musumeci E , Mannocci A , La Torre G
Published: October 2020

Background

Several studies show positive effects of new non-medical therapies known as complementary and alternative medicines, such as the discipline of tai chi. As healthcare professions are among the most vulnerable for work-related stress, this systematic review aims to investigate the relationship between tai chi practice and wellness of healthcare workers.

Methods

Cinahl, Scopus, Web of Science and PubMed were searched in September 2019. Full-text articles, written in English and published after 1995, were recruited if they focused on positive effects of tai chi on the psychophysical wellbeing of healthcare workers, in comparison with alternative techniques (such as yoga or traditional care). Outcomes were reduced work-related stress, better physical and psychological function, improvement in attention and/or productivity; no restrictions about study design were applied. Quality assessment was performed with the Newcastle-Ottawa Scale on cohort/cross-sectional studies, the Jadad scale for randomized clinical trial, AMSTAR for systematic reviews and CASE REPORT scale for case study.

Results

6/111 papers were included: 3 clinical trials, 1 observational study, 1 systematic review and 1 case report. The methodological quality was of medium level. 2/3 trials found a significant increase in individuals' wellbeing and improvements in stress levels and nursing staff’s motivation in their work. In the observational study tai chi was a prevalent mind-body practice to reduce stress. The systematic review suggested that tai chi could be a useful tool to reduce stress-related chronic pain. In case report the effectiveness was observed in medical students.

Conclusions

This study highlights the full potential and possible beneﬁts derived from tai chi but its application to improve health professionals' wellbeing is still limited, and the absence of a standardized intervention impacts on the methodological quality and reduces the robustness of the retrieved evidence.

Key messages

Tai chi can improve many pathological conditions and reduce work-related stress. Further research is needed to gain robust evidence of its efficacy for wellbeing of healthcare workers.
Risk of nasopharyngeal cancer in productive sectors and formaldehyde exposure in bakeries industry
Authors: Miligi L , Massari S , Paredes Alpaca R I , Piro S , Airoldi C , Ranucci A , Romeo E , Scondotto S , Cenni A , Aprea M C
Published: October 2020

Background

The International Agency for Research on Cancer evaluated formaldehyde (F) as carcinogenic for human in association with Nasopharyngeal Cancer (NPC). Occupational exposure to F occurs in many industrial sectors also in those non-traditional. For example in Tuscany F was detected in a bakery where a NPC case had ever worked.

Methods

In this study a) A case control approach (OCCAM) was used for monitoring occupational risks based on current information sources. Three Italian Regional Operating Centres, collected NPC cases from cancer registries and/or hospital discharge records. Controls were randomly sampled from the regional health service population data. Occupational histories were available through record linkage with the social security pension database (INPS). Study results were reported by industrial sectors, area and gender. b) A specific study on F exposure was conducted in bakeries and pastry industry carrying out measurements to determine the concentration of F in specific tasks and positions.

Results

717 cases linked with INPS database. Increased ORs for several industrial sectors such as iron and steel, wood and plastic were observed. In two regions also health and veterinary services and hairdressers were at increased risk, but based on few cases of exposed workers. In the non traditional sector of bakeries and pastry industries, where workplaces were monitored, high levels of F in personal air samplings were found, in particular in processes that involve a strong leavening.

Conclusions

Many productive sectors, in which F exposure could occurred, were observed to be at higher risk. The measurements performed in the non traditional sector monitored, confirmed the F exposure in some phases of the work process. With this study we contributed to increased knowledge on the risk of NPC within the monitoring system of occupational risks, and to deepen exposure to F in a non traditional productive sector such as bakeries and pastry industries.

Key messages

The epidemiological method used (OCCAM) in this study provides further information on the role of occupational exposure in the development of nasopharyngeal cancer. The measurements performed in the bakeries and pastry industries provide new additional information on the exposure to formaldehyde in some work process phases of a non-traditional productive sector.
Addressing lead exposure in children in Georgia: challenges and successes of a multi-agency response
Authors: Ruadze E , Khonelidze I , Sturua L , Lauriola P , Crabbe H , Marczylo T , Leonardi G S , Gamkrelidze A
Published: October 2020

The national response for reducing lead (Pb) exposure in Georgia is coordinated by the National Centre for Disease Control and Public Health (NCDC&PH) and implemented as a multi-agency (CDC, UNICEF, WHO, University of Emory) response. Given concerns about the extent of Pb exposure, in 2018 Multiple Indicator Cluster Surveys (MICS) of representative samples of children have been conducted to study several demographic and health aspects, including a study of the prevalence of blood Pb levels among 2 to 7 years old children (n = 1578). This survey was conducted in collaboration with the Italian Instituto Superiore di Sanita' (ISS), UNICEF and NCDC.

The laboratory analyses were conducted at ISS in Italy. Initial results showed that in 41% of all children, blood Pb concentration was ≥ 5 µg/dl, a challenge which motivated public agencies to establish an initial public health action plan to assess environmental samples (paint, dust, water, soil, selected food items such as spices and imported sweets) in families where Pb concentrations were ≥ 10 µg/dL. A State intervention programme, monitoring Pb blood concentration among MICS children and their family members, provided relevant information on exposed households and led to a reduction of Pb blood concentration across the most exposed households.

In collaboration with Public Health England, NCDC has conducted a small Pb isotope ratio study aimed at identifying the most relevant sources of Pb exposure contributing to elevated blood Pb in MICS children. It is expected that these data will support the design of more detailed public health interventions to reduce exposure to key sources of Pb, thus leading to further reduction of Pb-induced health effects in Georgia.

In addition, this experience will clarify elements of an ongoing monitoring of environmental factors such as an Environmental Public Health Tracking system, to support national capacity to manage the risks to public health.

Key messages

Environmental health response requires extensive research and multi-agency approach. If State implements adequate intervention it is possible to reduce blood lead (Pb) level.
Mediterranean diet and mental health in university students: an Italian cross-sectional study
Authors: Corezzi M , Bert F , Lo Moro G , Buda A , Gualano M R , Siliquini R
Published: October 2020

Background

Well-being is essential for positive mental health among university students, influencing their later attitudinal and career outcomes. Many factors contribute to endanger students' mental health, including academic stressors, as well as unhealthy lifestyles. Following a Mediterranean diet (MD), widespread in Europe, is proved to have a protective role for mental health. Our aim was to investigate mental well-being and adherence to the MD in university students.

Methods

In 2019, a cross-sectional study was performed in Turin, Italy. Totally, 502 university students were enrolled. A socio-demographic form, the Mediterranean Diet Adherence Screener (MEDAS) and Warwick-Edinburgh Mental Wellbeing Scale (WEMBS), were used. Mainly, multivariable linear and logistic regressions were performed to investigate potential predictors of adherence to the MD and of psychological well-being (p < 0.05 considered significant).

Results

The 24% of the sample resulted at high risk of depression (WEMWBS score<40) and the 22.7% at high risk of psychological distress (WEMWBS score 41-45). The median MEDAS score was 6 (IQR=2, non-normal distribution) in a possible range between 0 and 14 (the higher is the score, the higher is the adherence). Preliminary results showed that a MEDAS score ≥6 was associated to a lower risk of depression (OR = 0.78, p = 0.006). Not being on time with university exams (OR = 2.65, p = 0.002) and not having an excellent health status (OR = 1.94, p = 0.23) led to a higher depression risk instead. The main variables that had a negative association with MD adherence were WEMWBS<40 (coef=-0.65, p = 0.001) and not cooking personally (coef=-0.30, p = 0.04).

Conclusions

Students who reported greater adherence to the MD were those with the lowest risk of depression. The potential protective role that MD has for mental health in young adults could be used to help developing more comprehensive intervention strategies of health promotion among European university students.

Key messages

Adherence to the Mediterranean diet and good mental health seem to be related in a sample of university students analyzed through multivariable regressions. European policies and strategies addressing unhealthy lifestyles and encouraging Mediterranean diet adherence could be useful to improve well-being and mental health of university students.
Use of dietary supplements among male fitness club members in Nis, Serbia
Authors: Ramic M , Jovanovic M , Nikolic M , Ramic M , Nikolic K
Published: October 2020

Background

Dietary supplements use continues to increase in many countries. They are often used without a full understanding of the potential benefits and risks associated with their use, and without consultation with a health care professional. This study aimed to explore health beliefs and patterns of dietary supplement usage among fitness club participants.

Methods

This cross-sectional study was conducted in fitness clubs of the city of Nis, Serbia. Male adults, age 18-45 years, participated. Data from participants were collected through an original structured, self-administered questionnaire describes the prevalence and type of supplements used, the reasons for using and the information source.

Results

The prevalence of dietary supplement intake among participants was 85.86%. Most participants were between the age of 20 and 40 years, had a college degree (57.1%), non-smokers (80.5%), without chronic disease (86%), perform exercise at least thrice weekly (76.2%) and 63% had at least1 hour. The percentage of participants who had favorable health views on dietary supplements was significantly higher among the supplement users than among the non-users (P < 0.0001). Most participants (76.19%) perform exercise from 3 to 5 times weekly and 82.85% had from 1 to 2 hours exercise duration. The percentage of subjects who think supplements have side effects was significantly higher among the supplement non-users than among the users (p < 0 .05). Proteins (83.33%), amino acids (63.09%) and creatine (52.38%) were the most commonly reported supplements used. The places of buying dietary supplements most mentioned were specialized supplement store (78.57%), online (11.9%) and pharmacy (9.52%).

Conclusions

Male fitness club member are large consumers of dietary supplements. Public health campaigns could be useful to educate Serbian population regarding using dietary supplements during fitness activities.

Key messages

Male fitness club members are large consumers of dietary supplements in Serbia. Public health campaigns are needed to educate fitness participants about using dietary supplements.
Effectiveness of health promoting school program: The relationship of HPS award level and outcome
Authors: Tsai M , Chen F , Luh D , Wang Y , Lo K
Published: October 2020

Background

According to Taiwan health promoting school (HPS) accreditations program, the school was recognized with a gold award, silver award, bronze award, participation award, and non-awards. Previous studies have foci on the effectiveness of the HPS from the perspective of students' health behaviors. The main purpose of this study is to compare the students' health and social outcomes in different HPS award levels to assess the effectiveness of the HPS program.

Methods

This cross-sectional survey was conducted to 121 schools registering HPS accreditation program in 2018. Overall, a total of 8812 elementary, junior and senior high school students completed the questionnaire. The accredited schools were classified into four categories according to the award level: excellent (5 schools with gold), good (32 schools with silver), fair (23 schools with bronze and 18 schools with participation), and poor (44 schools with non-award). The outcome variables included perceived health status, well-being, and quality of life. The descriptive statistics and ANOVA were analysed using SPSS 20.0 software.

Results

There were awards level differences of students' health (F = 10.66, p<.001) and social outcomes (e.g. well-being: F = 3.76, p<.01; quality of life: F = 11.58, p<.001). From the perspective of health outcomes, the results found that schools with excellent level (Mean=3.59), good level (Mean=3.52), and fair level (Mean=3.47) were better in students' perceived health status than schools with poor level (Mean=3.38). Similarly, the results showed that schools with excellent level were better in students' well-being (Mean=7.63) and quality of life (Mean=34.56) than schools with poor level (Mean=7.25; 33.56).

Conclusions

Students from schools with excellent levels exhibited better health and social outcomes. The finding suggests that future studies evaluate and track the effectiveness to conduct the longitudinal study, and the HPS program should be effectively implemented and sustained.

Key messages

To explore the effectiveness of the health promoting school program in health and social outcomes. Note: This work was funded by the Health Promotion Administration, Ministry of Health and Welfare. Health promoting schools award level is related to students’ perceived health status, well-being, and quality of life.
Potentials of a school-based health education program – a theory based analysis of a good practice
Authors: Árva D , Herczeg V , Terebessy A , Eörsi D
Published: October 2020

Background

The gap between our knowledge about healthy lifestyle and health behaviours is significant especially in regions with lower socioeconomic conditions. Promoting lifestyle change requires multilevel approach as described by the Capability, Opportunity, Motivation - Behaviour (COM-B) model and school-based interventions can combat inequalities. Our innovative school-based health program in Northern Hungary might serve as an example for future initiatives.

Objectives

Our objective was to develop a sustainable one-year health education program in all five secondary schools of the town of Balassagyarmat including broad spectrum of health related topics. We attempted to find new methods so our classroom setting intervention can target the most factors of COM-B with the integration of best practices and novel tools from the field of education and prior health promotion programs.

Results

It seems possible to integrate elements influencing all levels of COM-B, but in different extent. C: besides knowledge transfer we also focus on improving health-literacy by small-group based, interactive and experiential education enhanced with gamification and an e-learning module. We believe that adolescents have the physical ability for a healthy lifestyle. O: by targeting all students from each class we shape social norms, nevertheless realizable changes in the physical environment is limited. M: both reflective and automatic mechanisms are reinforced by 30-day challenges and rewarding managed by a shared online educational platform ensuring continuality and peer-educators who serve as role-models. The involvement of earlier participants as educators assures the sustainability of the program as well as the internalization of its main messages.

Conclusions

Well-designed school-based health education programs may aspire for multilevel effect in promoting healthy behaviours even between the restricted opportunities of classroom settings with weakest potential in environmental change.

Key messages

Health education in classroom setting might shape social norms, and motivation. Targeting change in physical environment is challenging in school-based health programs.
Sociodemographic profile of people with disabilities in rural areas in southern Brazil
Authors: Lopes Gomide P , Schmidt Alves L M , Magedanz M C , Sausen A G , Mocelin G , Portela de Assis M , Pereira Corrêa C S , Dias Weigelt L , Linhares Garcia E , Frantz Krug S B
Published: October 2020

Background

People with disabilities (PWD) living in rural areas are subject to various vulnerabilities and inequalities that add to the barriers faced due to disabilities. The study aims to identify the sociodemographic profile of PWD living in rural areas of southern Brazil.

Methods

Quantitative study and a section of the ongoing research 'Work, Inclusion and Health Problems of People with Disabilities in Rural Scenario: an analysis in the southern region of Brazil', from the Health Studies and Research Group of the University of Santa Cruz do Sul (UNISC)/Brazil. Conducted in six municipalities in the state of Rio Grande do Sul with 37,333 inhabitants, 84.3% in the rural area and 32.7% are PWD. The first stage of data collection occurred through the survey of PWD older than 18 years and the second stage through a questionnaire. For statistical and descriptive analysis, the Software SPSS 22.0 was used. The research comply with the Resolution 466/2012 and the Ethics and Research Committee of UNISC approved it under nº. 341658.

Results

The subjects represent 1.33% of the total population and 1.57% of the rural population of the 6 municipalities. Data were compiled from 495 subjects and 22 of them answered the questionnaire. It was identified 271 subjects from three municipalities, 52.8% were male. The deficiencies were 39.1% intellectual, 25.5% physical, 18.1% auditory, 8.9% visual and 8.6% multiple. Of the 22: 12 were men; 12 were between 18 and 35 years old; 16 with white skin color; 11 did not complete elementary school; 13 with intellectual/mental disabilities; in 18 subjects the deficiencies are of congenital origin; 17 never worked; 5 have already worked and one still work.

Conclusions

The study shows that the PWD are mostly young men with low level of education, who did not perform work activity and with congenital mental disabilities. Such data are important for planning public policies that are more effective.

Key messages

Identifying data and the profile of PWD in rural contexts contributes to the development of public policies in the municipalities investigated and can contribute to other locations and regions. People with disabilities (PWD) living in rural areas are subject to various vulnerabilities and inequalities that add to the barriers faced due to disabilities.
The access to complementary and integrative health practices in public health system in Brazil
Authors: Magalhaes F , Santos D , Martins G , Barbosa J , Riquieri M , Cordeiro M , Silva M , Lima R , Sarti T , Andrade M
Published: October 2020

Background

A qualitative and exploratory study that analyzed the perspective of access to Integrative and Complementary Practices in Health (PICS) by listening users from a selected service of primary care of a municipality.

Objective

Analyze the access to PICS in a health public service of a municipality in a state of Brazil, from the perspective of users, as well as aimed at understand the needs and desires of health care these users in the search process and use of PICS, identifying facilitators and barriers in this trajectory.

Methods

The theoretical reference from Frenk on access was used, which systematizes the flow of events at the moment when the health need is perceived until the effectiveness of the care, besides the demand and entrance in the health services and the continuity of the treatment. The data collection was done by participant observation and semi-structured interview with 29 users of the service. The narratives were worked through the analysis of thematic content.

Results

The results indicated two groups of PICS: complex medical systems and therapeutic resources. There were differences in the organization of the offer with consequent influence on the different forms of access. It was registered the interest for the use of health care in a non-biomedical logic and a re-signification of the health-disease process in PICS users, contributing to the continuity of health production.

Conclusions

It was concluded that the current models of access analysis do not contemplate the diversities of access to the PICS, and the various possibilities of encounters with these practices allow the identification of the marginality of this care in all cases analyzed.

Key messages

Integrative and Complementary Health Practices gain national relevance as they contribute to the development of health promoting activities, focus on the individual, prevention and comprehensive care. However, considered a controversial topic in a hegemonically biomedical scenario, the incorporation of these new knowledge and practices in the health field occurs in a marginal way.
Participatory health research with migrants: opportunities, challenges, and way forwards
Authors: Roura M , Dias S , LeMaster J , MacFarlane A
Published: October 2020

Background

Migration has become one of the most politically pressing issues of the 21st century. Still, migrant health remains an under-researched area in global health. Participatory Health Research (PHR) can potentially contribute to a paradigm shift, from a pathogenic deficit model that sees migrants as passively affected by policies to their re-conceptualization as creative, inspiring, and actively engaged citizens in search of solutions. However, PHR is not a panacea and there are specific challenges in enacting meaningful and impactful projects in this field.

Methods

This literature review examines the opportunities and challenges posed by the use of this approach in migrant health research. We highlight critical issues for consideration and provide some examples of successful PHR with migrants.

Results

A number of successful initiatives illustrate the value of engaging migrants in the definition of the research agenda, the design and implementation of health interventions, the identification of health protective factors, and the operationalization and validation of indicators to monitor progress in this field. Still, within fragmented community landscapes that are not necessarily constructed along ethnicity traits, and real-world contexts that are far from the ideals of justice and equality, inadequate structures of representation and power dynamics can hamper a meaningful implementation of PHR with migrants.

Conclusions

For each particular research context it is essential to reflect on what is the “optimal” level and type of participation that is more likely to leverage migrants' empowerment so we can better advocate for our voices to be heard, and our rights to be addressed.

Key messages

Participatory Health research can potentially contribute to address migrant health challenges. The level and type of participation must be tailored to each research context.
The evaluation of pre-hospital emergency care providers' attitudes towards refugees in Turkey
Authors: Çalışkan Pala S , Kılınç A , Arslantaş D , Ünsal A
Published: October 2020

Background

Health for all is one of the fundamental rights for eliminating inequalites. Within the scope of Sustainable Development Goals, health services should be provided to everyone without any discrimination regardlass of race, religion, political view, gender, economic and social status. The increase of violence in their home country caused about 3 million 666 thousand 59 people to flee to Turkey and they've been experiencing economic, social and cultural problems as well as a problem of acceptance and adaptation. We aimed to evaluate the attitudes of emergency healthcare providers towards refugees and their perception of social distance.

Methods

This is a methodological study conducted between January-February 2020. The study group consisted of 372 (77.5%) out of 480 healthcare professionals. Attitude towards refugees was evaluated with the Health Providers' Attitude Towards Refugees Scale (HPATRS) developed by the researchers. Questionnaire form included HPATRS and Social Distance Scale(SDS). The Cronbach's alpha value of HPATRS was 0.694. Multiple linear regression was used for multivariate analysis.

Results

The ages of the study group ranged between 18-60 while the mean age was 32.15 ± 7.50 and 55.1% were female. Of the study group, 50.8% scored below the mean score from HPATRS. Multivariate analysis showed that, having language difficulties, having a master's degree and above and having high social distance was related to negative attitude towards refugees. (F: 7.567 p < 0.001 R²: 0.195). The social distance level was found to be the most important determinant in attitude (β: 0.343).

Conclusions

The attitude towards refugees in emergency care providers were thought to be not positive enough to eliminate the inequalities. It was concluded that; having a master's degree and above, having more social distance and having language difficulties were risk factors for a negative attitude towards refugees.

Key messages

As the first responders, emergency workers’ attitudes towards refugees is an important issue to be addressed in eliminating health inequalities. Mass media campaigns should be used to reduce social distance and trainings should be planned in order to develop positive attitudes towards refugees.
Chronic conditions among children, adolescents, and young adults in acute care settings
Authors: Sentell T , Choi S Y , Ching L , Quensell M , Keliikoa L B , Corriveau E , Pirkle C
Published: October 2020

Background

Despite a growing prevalence of chronic disease risk factors, such as obesity, among young people in the United States and other countries, little is known about actual disease prevalence in this population. Almost nothing is known about this topic in many racial/ethnic groups that are rapidly growing in the United States, including Native Hawaiians, Other Pacific Islanders, and Filipinos. Yet these understudied groups are at high risk. The study goal was to determine the statewide prevalence of chronic disease in acute care for those aged 5-29 years, including Native Hawaiians, Filipinos, and Pacific Islanders.

Methods

Using Hawai'i statewide inpatient and emergency department (ED) data across all payers from 2015-2016, we considered the presence of at least one of five target chronic conditions (asthma, hypertension, chronic kidney disease, diabetes, stroke) from 13,514 inpatient stays by 9,467 unique individuals and 228,548 ED visits by 127,854 individuals.

Results

Twenty-eight percent of youth who were hospitalized and 12% with an ED visit had at least one chronic condition. In both inpatient and ED settings, race/ethnicity, age group, and payer varied significantly when comparing those with a chronic condition to those without a chronic condition. Notably, those with a chronic condition were disproportionately Native Hawaiian, Filipino, and Pacific Islander; 32.3% percent of those with an inpatient chronic condition and 34.9% of those with an ED chronic condition were Native Hawaiian.

Conclusions

Chronic diseases, including those more often seen in adulthood, are prevalent in young people in acute care settings in the state of Hawai'i with notable disparities. This data can help justify, guide, and support programs urgently needed to address these changing epidemiological trends, which may be of particular interest for Medicaid.

Key messages

We show that chronic conditions are prevalent in young people in acute care settings in the state of Hawai‘i with notable disparities. This can help justify, guide, and support programs to address these troubling epidemiological trends.
Epidemiological surveillance of syphilis in Pleven region, Bulgaria
Authors: Karcheva M , Haydudova H , Gospodinov D
Published: October 2020

Background

Syphilis is a sexually transmitted infection whose significance to the public health does not lose its relevance. Changes in the epidemiology of the disease were observed in the last decade. This study describes the trends of syphilis in Pleven region (Bulgaria).

Methods

A retrospective study of the incidence of syphilis in Bulgaria and in the Pleven district was conducted. Documentary method was applied. A comparative analysis of statistical data from National Center of Public Health and Analyses -Sofia, Regional Health Inspectorate - Pleven, and annual reports on the work of the Consulting Room on Sexually Transmitted Infections - Pleven was carried out. The study extends over the period 2009-2018. Extensive and intensive indicators for data analysis were applied - number of cases (n), morbidity (per 100,000 population), sex and age distribution of cases reported.

Results

There were 119 cases of syphilis registered in the Pleven district during 2009-2018, with gender distribution showing a slight predominance of men - 66 (55%) versus 53 (45%) in women. All ages are affected, but the largest group is 25-29 years of age - 28 cases, followed by the age group 20-24 - 25 cases. Three cases of congenital syphilis were registered in the district of Pleven.

Conclusions

The reported incidence of syphilis probably does not correspond to the real one. The observed trend in the spread of the disease can be overcome by improving the effectiveness of control. Such can be accomplished by active search for patients, adequate treatment, monitoring in dispensary, individual approach to risk groups of population, and preventive activities.

Key messages

Syphilis is a disease that is subject to international surveillance and control. Trends of syphilis in Pleven region (Bulgaria).