bluuebunny/crossref_metadata_2025 huggingface dataset:
Regular consumption of red meat and health behaviors in the Brazilian population
Authors: de Assumpção D , Álvares Domene S M , Pita Ruiz A M , Stolses Bergamo Francisco P M
Published: October 2020

Background

The consumption of red meat should not surpass 500 g of cooked weight per week. Regular consumption can exceed this recommendation, increasing the risk of chronic diseases.

Objective

Estimate the prevalence of the regular consumption of red meat according to health behaviors in Brazilian adults (≥18 years).

Methods

A cross-sectional study was conducted with data from the 2013 National Health Survey, which is a household inquiry with a representative sample of the population ≥18 years of age. The regular consumption of red meat (beef, pork, goat) was defined as ≥ 5 days/week. Prevalence ratios (PR) and 95% confidence intervals (CI) were estimated according to health behaviors (healthy and unhealthy eating patterns, smoking, practice of physical activity during leisure and alcohol intake).

Results

A total of 60,202 adults were interviewed, 52.9% of whom were women and mean age was 42.9 years (95%CI: 42.6-43.2). The prevalence of regular red meat consumption was 36.7% (95%CI: 36.0-37.5) and was higher among those who ingested soft drinks/artificial juice (PR = 1.08) and sweets (PR = 1.05) ≥3 days/week, ingested beans (PR = 1.07) and raw vegetables (PR = 1.03) ≥5 days/week, ingested fatty meat (PR = 1.09), smokers (PR = 1.05), individuals who were inactive during leisure (PR = 1.04) and those who consumed alcohol ≥2 times/week (PR = 1.06). The prevalence was lower among those who ate fruit (PR = 0.99) and chicken (PR = 0.95) ≥5 days/week, those who ate fish (PR = 0.90) at least 1 day/week and those who drank no fat/low fat milk rather than whole milk.

Conclusions

The regular consumption of red meat was higher among individuals who ingested unhealthy foods more often, those who ingested fatty meat, smokers, those who ingested alcoholic beverages and those who did not practice physical activity. Actions are needed to reduce the frequency of red meat consumption.

Key messages

Regular consumption of red meat can exceed the recommendation of 500 g of cooked weight per week. The regular consumption of red meat was associated with the more frequent ingestion of unhealthy foods and fatty meat.
Life expectancy in the Emilia-Romagna region: an analysis of social and geographical variability
Authors: Di Girolamo C , Rosaia E M , Miglio R , Bartolini L , Caranci N
Published: October 2020

Italy and the Emilia-Romagna region record among the highest life expectancy worldwide. However, differences among geographical areas, social strata and genders have been reported at regional level. The aim of this work is to measure both geographic (among provinces) and social (among education levels) inequalities in life expectancy and to evaluate the association between education and cause-specific mortality, in the Emilia-Romagna region during the period 2012-2016.

The data source is an integrated dataset based on the linkage at individual level of the regional health population register, the mortality register, and the 2011 census; this system of microdata, which is the base of the Emilia-Romagna Longitudinal Study, allows a precise calculation of the person-time at risk. The study population consisted of all individuals who were residents in the Emilia-Romagna region at the 1/1/2012 and took part to the 2011 census.

Life expectancy was estimated through mortality tables reconstructed with a mixed cohort-period approach and combined with the Kannisto's method. Inequalities in mortality were estimated using a longitudinal approach and Poisson models.

Educational disparities were evident even in the Emilia-Romagna region in the early 2010s; life expectancy was shorter among low-educated subjects and the gap varied: 3 years among men and approximately 1.5 years among women. Life expectancy varied also among provinces, although the gaps were smaller and men and women were closer, and there was an indication of an interaction between education and geographical areas. The risk of dying revealed social pattern and disparities were greater for respiratory diseases and for some cancers, particularly among men.

This study is the first attempt to describe, through the Emilia-Romagna Longitudinal Study, educational and geographical disparities in life expectancy in the region and to suggest entry points for actions to tackle these differences.

Key messages

Geographical and social inequalities in life expectancy have been reported at regional level. Those inequalities and the mortality relative risks within Emilia-Romagna during 2012-2016 were estimated. The estimates by the Emilia-Romagna Longitudinal Study highlighted disparities in life expectancy in the Emilia-Romagna region and suggest entry points for actions to tackle these differences.
Do patients value similar hospital characteristics and quality metrics for different treatments?
Authors: Kuklinski D , Vogel J , Geissler A
Published: October 2020

Quality competition among hospitals, induced by patients freely choosing their hospital in a price regulated market, can only be realized if quality differences between hospitals are transparent, understandable, and thus influence patients' hospital choice. We use data from ∼145,000 German patients and ∼900 hospitals for colorectal resections and knee replacements to investigate whether patients value quality and specialization when choosing their hospital. Using a random utility choice model, we estimate patients' marginal utilities, willingness to travel and change in hospital demand for quality improvements. Patients respond to service quality and specialization and thus, quality competition seems to work. Colorectal resection patients are willing to travel longer for more specialized hospitals (+9% for procedure volume, +9% for certification). Knee replacement patients travel longer for hospitals with better service quality (+6%) and higher procedure volume (+12%). However, clinical quality indicators, often difficult to access and interpret, barely play a role in patients' hospital choice. Furthermore, we find that competition on quality for colorectal resection is rather local, whereas for knee replacement we observe regional competition patterns. Consequently, future quality transparency initiatives need to entail the development and publication of understandable outcome quality indicators (e.g. patient reported outcome measures). Moreover, clinical quality indicators need to be explained and presented more intuitively.

Key messages

Quality competition among hospitals is beneficial for all participants in the health care system. Our paper reveals the quality information that is decisive in the patient’s decision making process. Accessibility and comprehensibility of quality information plays a large role in its impact on patient hospital choice. Thus, policy makers need to raise quality transparency and patient emancipation.
18.L. Workshop: Public mental health policies - experiences and challenges
Authors:   Organised by: EUPHA Public mental health section,   Chair persons: Jutta Lindert – EUPHA-PMH, Marija Jakubauskiene – EUPHA-PMH
Published: October 2020

The workshop has the aim to help developing and strengthening policies for Public Mental Health and support experience sharing platform for Public Mental Health policy development. Mental health policy defines the vision for the future mental health of the national population and internationally. The WHOs developed three recommendations for the development of mental health policy, strategic plans and for organizing services which are to deinstitutionalise mental health care; to integrate mental health into general health care; and to develop community mental health services. For each this aim a situational analysis and needs assessment is recommended as first step. Therefore, this workshop consists of four talks in the development of mental health policies at the regional and national level. First, the process of population consultations and participatory research is described (Felix Sisenop). Participatory research enables exchanging experiences, results and key challenges in Public Mental Health. Participatory research can contribute greatly in empowering people to discuss and deal with mental health issues and therefore is a step towards a more involved and active general public. Second, a policy development at the regional level is described (Elvira Mauz). On behalf of the federal ministry of health the Robert Koch Institute as the German public health institute is currently developing a concept for a national Mental Health Surveillance (MHS). In the talk objectives, framework model and work processes are presented. The MHS should systematically gather, process and analyze primary and secondary data, thus an integrating and monitoring system is working. Third, the Public Mental Health policy in Malta will be described (John Cachia) Over the last 7 years CMH Malta developed a strategic framework for the mental health with the input of patients, families, service providers, NGOs and civil society. The Maltese National Mental Health Strategy 2020-2030 was published in July 2019. This strategy will be described in the Talk. Fourth presenter (Ignas Rubikas) will introduce the national perspective on development of Lithuanian mental health policy addressing major public mental health challenges of suicide prevention, alcohol control policies and mental health promotion in a broader context of national mental health care.

Key messages

Participatory research in Public Mental Health is an approach to involve the population in policy development. Development of mental health policies can benefit from sharing experiences and lessons learned on a national and regional levels.
The service user voice in shaping mental health policy
Authors: Cachia J
Published: October 2020

Background

Over the last 7 years CMH Malta provided holistic evidence for a mental health strategic framework with the regular input of patients, families, NGOs and civil society.

Methods

This evidence featured in published Annual Reports, conference presentations, bilateral meetings, and media interventions. The National Mental Health Strategy 2020-2030 was published in July 2019. CMH proffered advice, experience and supporting documents to the Strategy Team. 80% of the action points in the strategy reflect CMH recommendations.

Results

The philosophy of care should emphasise person-centred multi-disciplinary care. The primary health care system must be an effective gatekeeper providing mental health promotion and care in the community thus preventing hospital admissions. Acute psychiatric care must be provided within the acute general hospital setting with active support of A&E and 24/7 intervention services that deal promptly with emergencies. Transition of youngsters to adult psychiatry and of adults to old age psychiatry should be flexible. Community-based rehabilitation is required for Adult Psychiatry, Child/Adolescent/Youth Psychiatry, Old Age Psychiatry, Forensic Psychiatry and Learning Disability. Policymakers must provide care options for older persons with chronic mental disorders, safe settings for youngsters with severely challenging behaviour, and shelters for persons suffering from substance misuse who resist treatment or rehabilitation.

Conclusions

Implementation of the Mental Health Strategy requires substantial capital investment and new resources. Service re-engineering and synergy are necessary to avoid duplication and waste. Better complements of professionals must be available to provide alternative therapies to the current medical pharmacological model.

Key messages

Patients, families, NGOs and civil society are critical partners in strategy development. Action points and implementation plans must reflect service user views and advice.
The roles of gender affirmation and discrimination in the resilience of transgender individuals
Authors: Lelutiu-Weinberger C , English D , Sandanapitchai P
Published: October 2020

Background

Transgender individuals face severe stigma-driven health inequities structurally, institutionally and interpersonally, yielding poor individual-level outcomes. Gender affirmation, or being recognized based on one's gender identity, expression and/or role, may be considered a manifestation of resilience.

Methods

To provide intervention and policy guidelines, we examined latent constructs representative of gender affirmation (legal documentation changes, transition-related medical procedures, familial support) and discrimination (unequal treatment, harassment, and attacks), and tested their impact on mental, physical, and behavioral health outcomes among 17,188 binary-identified transgender participants in the 2015 US Transgender Survey.

Results

Confirmatory factor analyses revealed high standardized factor loadings for both latent variables, on which we regressed outcomes using structural equation modeling. Fit indices suggested good model fit. Affirmation was associated with lower odds of suicidal ideation (p < .001) and psychological distress (p < .001), and higher odds of substance use (p < .001), and past-year healthcare use and HIV-testing (p < .001). Discrimination was associated with higher odds of suicidal ideation (p < .001), psychological distress (p < .001), substance use (p < .001), and past-year HIV-testing (p < .001). Affirmation and discrimination interaction analyses showed lower odds of past-year suicidal ideation (p < .01), with affirmation having a significant moderating protective effect against discrimination.

Conclusions

Gender affirmation is paramount in upholding transgender health, and these findings carry global significance, beyond the US. Clarification of affirmation procedures, and increases in its accessibility, equitably across racial/ethnic groups, should become a priority, from policy to the family unit. The impact of discrimination demands continued advocacy via education and policy.
Health and human rights - what is the added value?
Authors: Toebes B
Published: October 2020

This short presentation will note the current international legal framework and obligations.
Ecopsychosocial environments for health and mental health
Authors: Chrysikou E , Rehn J , Savvopoulou E , Petelos E
Published: October 2020

Theories of architectural morphology and society contributed to understanding the interconnections and synergies between society and space. Lack of knowledge of how space influences communities can foster social issues (Hillier & Hanson, 1984). This complements links between health and society identified by epidemiolohists (Marmot, 2015). Thus, theories connecting health and the environment unite all three disciplines by connecting health to the built environment. We characterise this holistic interconectedness of space, health and society as ecopsychosocial (Chrysikou, 2019) and we will use it as the underlying theory of the workshop. Spatial interventions could support prevention or disease-fighting mechanisms. We briefly mention anthropocentric examples related to space and vulnerability from the field of therapeutic architecture. The aim is to utilise those spatial features that could affect vulnerable people's physiology and perception. This approach does not replace medical intervention or treatment. Contrary, it aims to support healthcare professionals, carers and patients optimizing the healthcare delivery and recovery processes and subsequently reduce efforts required to overcome stressful situations through restaurative environment. This ecopsychosocial system would is more helpful for of low diagnostic and interventional accuracy such as mental illness (Christensen et al., 2009).

References

Christensen, CM., Grossman, JH. and Hwang, J. (2009) The innovator's prescription. New York USA: McGraw-Hill

Chrysikou, E. (2019) Psychiatric institutions and the physical environment: combining medical architecture methodologies and architectural morphology to increase our understanding. Journal of Healthcare Engineering, vol. 2019, Article ID 4076259, 16 pages

Hillier, B. & Hanson, J. (1984) The Social Logic of Space. Cambridge: Cambridge University Press

Marmot, M. (2015) The health Gap: the challenge of an unequal world. Bloomsbury Publishing, London
Moving forward: Cost-Effectiveness of PrEP in HIV prevention for Men Who Have Sex with Men in Italy
Authors: Nurchis M C , Riccardi M T , Sapienza M , Pascucci D , Damiani G
Published: October 2020

Globally, in 2018 1.7 million people contracted Human Immunodeficiency Virus (HIV) and 770,000 people died from AIDS-related illnesses. Men Who Have Sex with Men (MSM) have one of the highest probabilities of HIV transmission.

In Italy, in 2018 2,847 new HIV cases were diagnosed, of which 39% among MSM. The MSM population accounts for 16,690 individuals whereof 50% already underwent the Highly Active Antiretroviral Therapy (HAART). The aim of this study is to evaluate the cost-effectiveness of daily Pre-Exposure Prophylaxis (PrEP) in the Italian MSM susceptible population.

A Markov transition model was calibrated to the HIV epidemic among MSM in Italy, comparing PrEP to naïve patients (NP). Model parameters were retrieved by querying scientific databases. Transition probabilities were adjusted for incidence of HIV while costs and benefits were discounted at an annual rate of 3%. The impact on results of critical parameters was explored through a Monte Carlo-based sensitivity analysis. The cost-effectiveness analysis results were reported as Incremental Cost-Effectiveness Ratio (ICER) express as € per Quality Adjusted Life Year (QALY) gained.

The introduction of such a PrEP program would result in a total cost of €822,398,199 million and lead to a gain of 70,762 discounted QALYs over an 85-year time horizon.

Assuming a 92% efficacy of PrEP therapy, the ICER for the PrEP program is €4,346.16/QALY gained. This value is definitively lower than acceptability NICE threshold (£20,000).

PrEP can reduce the infection rate up to 60% in a five-year period. The Monte Carlo simulation confirmed the robustness of the model results.

This analysis showed PrEP to be cost-effective when used in a susceptible population. Even if PrEP doesn't protect from other sex-related infectious diseases, it could prevent HIV transmission, thus breaking down HIV-infection incidence rate. Each country should reflect on the real possibility to implement a robust Public Health program pondering the adoption of PrEP.

Key messages

PrEP is very effective at reducing HIV infection when taken correctly. It is the backbone in the “combination prevention”, necessary to reach the SDG of ending the AIDS epidemic by 2030. This preliminary analysis suggests that the introduction of a daily PrEP program for MSM in Italy is cost-effective and possibly cost saving in the long term.
HIV infection and AIDS reported cases in two municipalities near Lisbon between 2015 and 2019
Authors: Cunha I , Lopes D , Bragança Pereira M , Duarte S , Moreira A , Abreu Gomes F , Machado Gil M , Esteves H
Published: October 2020

Background

In the WHO European Region, in 2018, there were 16.2 newly diagnosed HIV infections per 100,000. In Portugal, there were 9.5 new cases per 100,000 population. The aim of this study is to analyse HIV/AIDS's notifications in the group of primary healthcare centres of Loures-Odivelas (ACES LO), with 340,000 inhabitants, between 2015 and 2019.

Methods

An observational, descriptive, retrospective, quantitative study was performed. Data was collected in March 2020, from the National System of Epidemiological Surveillance Database. Variables included were age, sex, HIV's presentation, country of probable origin of infection, probable form of transmission, partner characteristics, pregnancy at diagnosis, reason for testing/consultation, anti-retroviral therapy (ART) before diagnostic of AIDS. Descriptive analysis was performed for all variables.

Results

In ACES LO, there were 83 notified cases of HIV infection/AIDS between 2015 and 2019, with 36.1% of cases notified in 2019. The male to female ratio was 1.4. The average age was 41.7 years old. At time of notification, 56.6% of cases were asymptomatic and 25.3% had clinical criteria for AIDS. Guinea-Bissau was the probable origin of infection in 43.0% of cases (n = 23). Men having sex with men (MSM) was the probable form of transmission in 19.3% of cases. In 19.6% of cases of heterosexual contact, the partner was known to have HIV infection. Six women were pregnant at time of diagnosis. Testing was done on a routine basis in 22.2% of cases (n = 54). Among those with clinical criteria for AIDS (n = 21), 5 cases had previously taken ART.

Conclusions

There was an increase in notified cases of HIV infection/AIDS from 2015 to 2019 in ACES LO. The male to female ratio was lower than for Portugal in 2018.The proportion of cases with AIDS at time of notification was higher than for Portugal in 2018. Preventive strategies should be reinforced for people with partners diagnosed with HIV infection and perhaps for people.

Key messages

More than one third of cases were notified in 2019. Preventive strategies should be reinforced for people with partners diagnosed with HIV infection.
Development an app for monitoring stress level and early detection of mental disorders in Indonesia
Authors: Puspitasari I M , Sinuraya R K , Witriani W , Aridarma A
Published: October 2020

Background

Stress may contribute to physical and mental health problems. The number of people with mental-emotional disorders has reached up to be 19 million people in Indonesia in 2018. Monitoring stress levels and early detection are important to prevent serious mental health problems. Therefore, we are developing De-stres©, a mobile app for monitoring the stress level and early detection of mental health disorders in Bahasa Indonesia.

Methods

De-stres© was developed for android OS and web-based app by using the web2py framework and PostgreSQL database. The app used the PSS-10 and Beck Depression-II questionnaires that were available in Bahasa Indonesia. It had six main functions: creating an account, approving the informed consent, filling the questionnaire, generating test results automatically, advice from psychologists based on the test result and saving test history.

Results

A month since its launch, the six functions test ran well on the Android OS and the website. A preliminary result showed that the app was downloaded more than 100 times from Google Playstore. Among the 420 data records, 71.6% (301) app users were students, with 60.7% (255) using the app to measure only stress level, 25.5% (107) resulting in severe stress and 4% (17) severe depression.

Conclusions

De-stres© is successfully developed and a promising instrument that can be implemented for Indonesia, by providing preliminary self-administered questionnaire.

Key messages

De-stres© is an app for monitoring stress levels and early detection of mental health problems and successfully developed with preliminary self-administered questionnaires in Bahasa Indonesia. De-stres© is a promising app that can be implemented for preventing serious mental health disorders in Indonesia.
Barriers and facilitators to a health information exchange system for general practitioners
Authors: Centemero N S , Rechel B
Published: October 2020

Background

Health information exchange (HIE) systems, that are computer-based tools used by healthcare providers for secure access to share patient's medical information electronically, seem to help reduce the use of specific resources and improve the quality of care. This highlights the importance of this issue in the Public Health sector. This research goal is to identify barriers and facilitators perceived by general practitioners (GPs) when using an HIE system in a Southern Switzerland area.

Methods

we performed a qualitative study using semi-structured interviews, interviewed 10 GPs, randomly selected among some 500 HIE system local users and analysed interview transcripts using thematic content analysis with an abductive approach (a mix of deductive and inductive approaches).

Results

findings showed the following key facilitators: a) perception of dealing with a secure system; b) possibility of delegating management to secretaries and healthcare assistants; c) technical support and training; d) high quality of the information exchange; e) positive impact on clinical practice; and f) regional context. However, major challenges persist, and GPs reported the following main barriers to using an HIE system: a) frequent lack of all patient information needed; b) no effective workflow improvements; c) lack of some technical features.

Conclusions

We propose four recommendations based on findings: 1. Future initiatives should focus on developing HIE systems giving GPs access to all possible patient medical information; 2. Crucial data privacy and security issues should never be overlooked; 3. Technical and workflow improvements should particularly consider the socio-technical nature of HIE systems; 4. Much attention needs to be paid to the importance of relationships between health care providers and between these and local health institutions when implementing HIE systems.

Key messages

This study filled a research gap as it is the first that tackles HIE system barriers and facilitators in Ticino. When information sharing for clinical practice focuses on improving the quality and costs of healthcare, GP's trust in HIE system security is crucial.
The role of mHealth in chronic disease management in Sub-Saharan Africa
Authors: Pedrosa V M , Abrantes A V
Published: October 2020

Background

The burden of non-communicable diseases has been increasing in Sub-Saharan Africa, mainly due to the adoption of behavioral risk factors by the population. At the same time, there has been an exponential growth in the information and communication technologies sector, which has attracted interest in the development of mobile health strategies (mHealth) through the potential use of mobile phones in the management of chronic conditions such as hypertension.

Methods

It was performed a systematic review of the literature using scientific databases (Cochrane, B On, Science Direct, and Google Scholar). Inclusion criteria included: quantitative and qualitative studies developed between 2010 and 2018 in Sub-Saharan African countries, with adult participants of both sexes, diagnosed with hypertension, with access to mobile phones and attending primary health care or outpatient appointments.

Results

Five studies were selected for review (four from South Africa and one from Ghana). However, only two studies managed to obtain results which proved that the use of text messages was efficient and accepted during hypertension treatment, as well as it could allow understanding the factors that influence and hinder therapeutic adherence. Those results were supported by information from a randomized trial (use of clinical comparators as evaluation of blood pressure values during a follow-up period of 12 months) and a qualitative study (self-reported changes in the knowledge and health behavior of 15 participants from focus groups and individual interviews).

Conclusions

There's still a lack of evidence available proving that mHealth can be efficient and feasible in Sub-Saharan Africa. However, it was possible to present a conceptual framework, adapted from the literature, which identifies potential strategies for the use of mHealth in areas of prevention and management of chronic diseases in the region.

Key messages

Provide guidance to improve research about the adoption of mHealth in low and middle-income countries. Promote the potential of this type of technology as a model for mutual health education.
Cardiovascular Diseases and Health Literacy Skills of students in the City of Yaoundé, Cameroon
Authors: Wamba A , Soh G , Ngoumou R-D
Published: October 2020

Background

Cardiovascular diseases will attack, from 2020 in sub-Saharan Africa, according the World Health Organization (WHO, 2018), one in two students aged 20-25. They would constitute the main public health concern for the states of this part of the continent, where the control of the skill level of the populations in health literacy (HL) still escapes the authorities in charge of public health policies. Provided that such control represents a great opportunity for better effectiveness of health promotion policies and preventive, educational and health care for cardiovascular diseases and therefore, a guarantee of good health for citizens (Beauregard, 2010).

Objective

Given the fact that the level of HL skills varies according to socio-political and economic contexts, according to the culture and the environment in which we find ourselves (WHO, 2013), this study seeks to describe the level of HL skills of students in link with appropriate use of the means of prevention of cardiovascular diseases. Methodology. The study concerns 500 students/ youths enrolled in secondary and university education, whose ages vary between 12 and 20 years. Based on quantitative design, the study aims to describe and report on all of the students and young people's practical experiences related to health literacy skills.

Results

The results indicate, in general, unequal access of students to health knowledge. In addition, the level of their skills in cardiovascular health literacy varies according to the economic capital of their family, the possession or not of an Android phone with internet connection, the level of prestige of the cultural capital of family.

Conclusions

The study suggests not only to encourage students to develop their health literacy skills, but also the need to put a particular emphasis within schools and universities on knowledge related to health literacy, in order to better enhance capacities of students to cope with cardiovascular health problems.

Key messages

The level of their skills in cardiovascular health literacy varies according to the economic capital of their family. The need to put a particular emphasis within schools and universities on knowledge related to health literacy.
Virtual Reality-based and gender-sensible alcohol prevention in adolescents: a systematic review
Authors: Prediger C , Helmer S M , Stock C
Published: October 2020

Background

Virtual Reality (VR)-simulations offer new opportunities for alcohol prevention in adolescents. As an innovative medium VR can be attractive for young people, and avatar-based pathways offer possibilities of tailoring prevention in a gender-specific manner. At the same time, tailoring can reproduce gender stereotypes and be exclusive. Therefore, this review aims (1) to identify and summarize existing evidence regarding VR-simulations for alcohol prevention targeting adolescents and (2) to examine if and how gender is taken into account.

Methods

A systematic review was conducted. 7 medical, psychological, and educational research databases were searched, including all research designs to assure all studies of the emergent research field are detected. Two reviewers independently performed screening and data extraction. Results are reported in a narrative way.

Results

Of 224 search hits, 4 publications met inclusion criteria. These derived out of an Australian and a Danish project. Designs were qualitative (2), mixed methods (1) and review (1). In all studies, gender was assessed in male-female dichotomy. The Australian project scripted a gender-specific simulation, while the Danish project was to a larger degree gender neutral. In the Australian project during development differences occurred between the homogenous and mixed gender groups: Gender homogeneous groups showed greater degree of involvement, which could be due to higher homogeneity of group composition or higher sensitization incentive, as the authors acknowledge.

Conclusions

So far 2 VR-based approaches for alcohol prevention in adolescents are developed. Gender is partly considered during development and application, but not discussed or reported as a central aspect. Further gender-sensitive research is needed to develop and test the possibilities and pit falls of tailoring VR-simulations. Hence, cooperation with previous developers and researchers as well as the target group can be promising.

Key messages

VR-simulations offer new opportunities for gender-specific alcohol prevention programmes in adolescents. This review serves as foundation for researchers, developers and future applications. So far 2 VR-simulations for alcohol prevention in adolescents have been developed. Cooperation for and further gender-sensitive research is needed to develop and enhance existing programmes.
Self-perception of oral health in the elderly associated with health literacy and related factors
Authors: Tenani C F , De Checchi M H R , Bado F M R , Mialhe F L
Published: October 2020

The aim of this study was to evaluate the self-perception of oral health in the elderly and to verify its association with oral health literacy and sociodemographic factors, through a cross-sectional study. Data collection took place in a probabilistic sample consisting of 535 elderly people over 60 years of age, who did not have cognitive problems, and were residents of the areas covered by six Family Health Units of the public health service, as well as users of a Center for Dental Specialties and dental clinics at the Faculty of Dentistry of Piracicaba (FOP), all located in the city of Piracicaba, Sao Paulo. A questionnaire with sociodemographic and health issues was applied, as well as the Health Literacy in Dentistry (HeLD-14) instrument for the assessment of oral health literacy. Poisson regression was used to estimate the associations between self-perceived oral health and literacy in oral health, as well as sociodemographic and general health characteristics. The data were analyzed using the SAS statistical software. The final regression model demonstrated that the elderly who were more likely to report poor oral health self-perception were associated with a low level of oral health literacy, were of the “non-white” ethnic group, had chronic illnesses and had sought the dentist for curative reasons in the last year. It was concluded that the self-perception of oral health in the elderly is influenced by variables that go beyond the dental sector, a fact that demands multiprofessional and intersectoral actions for their care. This fact highlights the importance of integrating aspects of health literacy in health and sociodemographic factors into the process of assessing oral health in the elderly, expanding the perspective of public health assessment for actions focused only on normative needs.

Key messages

We show the importance of assessing the oral health of the elderly in association with health literacy, expanding the perspective of public health assessment to actions beyond the normative needs. Despite the importance of the topic, there is still a scarcity of studies on health literacy and its impact on oral health behaviors and outcomes, impacting public health.
The International Classification for Human Functioning, Disability and Health in e-Health of Bulgaria
Authors: Tzacheva N , Kundurjiev T , Stoycheva M , Hristova L , Nikolova R
Published: October 2020

The study is based on the National Science Program 'eHealth in Bulgaria (e-Health)', funded by the Ministry of Education and Science. Partnership Contract No. D-01-200/16.11.2018

Issue

In the last years in Bulgaria has been working hard to improve the information and communication environment through the National Science Program 'e-Health'. The links between the health of working people and the social and environmental determinants of public health are best identified by the WHO through the International Classification for Human Functioning, Disability and Health (ICF). In Bulgaria, about 650 occupational health services (OHSs) that use heterogeneous software products.

Description of the Problem

A targeted study of the ICF's capabilities opens the horizon to integrate social and environmental health factors in an increasingly aging and morbid workforce, with people with disabilities, and with electronic access to social and medical services. The creation of an electronic system for dynamic monitoring of any change in human functioning health of workers and their determinants, allows the OHS, the organs of workability expertise to make the right decisions in work placement.

Results

A scientific toolkit has been developed for the introduction of the ICF Module for updating the electronic health integrated dossier for all STMs with a view to applying the common methodology of EUROSTAT, EC, Directorate-General F5 for the consolidation of occupational disease data and other health problems in functioning, disability and health to working people.

Lessons

The ICF module supports both the company's occupational health and safety policy, the OHS, and the implementation of a higher class electronic network, a challenge that inevitably faces the digitalisation of every European country. The module contributes to the extension and refinement of information. Data will be provided on priority risk factors that have harmed workers' health.

Key messages

The ICF module creates opportunities for rapid and correct measures to ensure good occupational health. The ICF module creates opportunities for rapid and correct measures people with disabilities in a changing demographic and health environment.
Validation of ICD-10 codes for identifying cases of chlamydia and gonorrhea
Authors: Dixon B E , Ho Y A , Broyles A A , Wiensch A , Arno J N
Published: October 2020

Background

Public health researchers seek to use administrative health data captured in digital health systems to examine outcomes for individuals with sexually transmitted infections (STIs). Yet the International Classification of Diseases, Tenth Revision (ICD-10) codes used to identify cases of chlamydia and gonorrhea have not been validated.

Objective

We sought to assess the validity of using ICD-10 codes to identify cases of chlamydia and gonorrhea.

Methods

We utilized data from electronic health records gathered from private and public health systems from 1 October, 2015 to 31 December, 2016. Patients were included if they were aged 13-44 and received either 1) laboratory testing for chlamydia or gonorrhea or 2) an ICD-10 diagnosis of chlamydia, gonorrhea, or an unspecified STI. To validate ICD-10 codes, we calculated positive and negative predictive values, sensitivity, and specificity based on the presence of a laboratory test result, or any STI laboratory test results in case of unspecified STI. We further examined the timing of clinical diagnosis relative to laboratory testing.

Results

A total of 238,876 individuals (16.0% of population) were either tested for chlamydia or gonorrhea, or diagnosed with an ICD-10 code of interest, during the study period. For cases in which a patient was diagnosed with chlamydia or gonorrhea, 82% and 78% of cases were confirmed, respectively. The positive predictive values for chlamydia, gonorrhea, and unspecified STI ICD-10 codes were 87.6%, 85.0%, and 32.0%, respectively. Negative predictive values were high (>92%). Sensitivity for chlamydia diagnostic codes was 10.6% and gonorrhea was 9.7%. Specificity was 99.9% for both chlamydia and gonorrhea.

Conclusions

Disease specific ICD-10 codes accurately identify cases of chlamydia and gonorrhea. However, low sensitivities suggest that most gonorrhea and chlamydia cases could not be identified in administrative data alone without laboratory test results.

Key messages

Disease specific ICD-10-CM codes accurately identify cases of chlamydia and gonorrhea. Low sensitivities suggest that most gonorrhea and chlamydia cases could not be identified in administrative data alone without laboratory test results.
Identifying emotional facial expressions in practice: a study on Indian medical students
Authors: Bandyopadhyay A , Sarkar S , Mukherjee A
Published: October 2020

Background

Successful identification of emotional expression in patients is of considerable importance in the diagnosis of diseases and while developing rapport between physicians and patients. Despite the importance of such skills, this aspect remains grossly overlooked in conventional medical training in India. This study aims to explore the extent to which medical students can identify emotions by observing photographs of male and female subjects expressing different facial expressions.

Methods

A total of 106 medical students aged 18-25 without any diagnosed mental illnesses were shown images of the six universal facial expressions (anger, sadness, fear, happiness, disgust and surprise) at 100% intensity with an exposure time of 2 seconds for each image. The participants marked their responses after each image was shown. Collected data were analyzed using SPSS.

Results

Participants could identify 76.54% of the emotions on average, with higher accuracy for positive emotions (95.6% for happiness) and lower for negative emotions (46% for fear). There were no significant variations in identification with respect to gender of observers. On the other hand, statistically significant differences were observed in identification when gender of the expressors were considered.

Conclusions

Male participants identified emotions better from male faces, while females identified positive emotions better from female faces and negative ones from male faces.

Key messages

Misidentification of emotions, especially negative emotions, from static facial expressions was common in physician students of both sexes. This is an aspect that needs to be addressed during the training of medical students in India.
Exposure to a National Communication Campaign to Prevent Stunting in Indonesia
Authors: Daines C , Norton A , Hunt L , Friedbaum E , Topham D , West J , Torres S
Published: October 2020

Background

Reducing childhood stunting continues to be a priority in Indonesia. In 2015, the National Nutrition Communication Campaign (NNCC) implemented mass media and interpersonal communication (IPC) interventions to disseminate stunting-related information. The purpose of this study was to understand the factors associated with exposure to the media and IPC components of NNCC. The mass-media component was designed to influence attitudes, norms, and behaviors, while the IPC component was designed to develop skills to lead to behavior change.

Methods

The media campaign targeted a national audience and the IPC component of the campaign operated at a district level. IMA World Health collected data in three rural districts targeted with both media and IPC intervention components. Using simple random sampling, a sample of 1,734 caregivers was collected. Responses relating to demographic and socioeconomic factors, use of social media and WhatsApp, and electronic device ownership were analyzed using multiple linear regression analyses.

Results

Participants averaged 28.9 years old and most completed primary school. Exposure to the media component was higher than exposure to IPC. Ownership of an internet-accessible device (IAD) and social media use was negatively associated with exposure to IPC. Mothers who used a device to access health information were more likely to have been exposed to the media component. Exposure to the media campaign was positively associated with owning an IAD with WhatsApp.

Conclusions

Access to internet-accessible devices was predictive of positive exposure to mass-media and negative exposure to IPC. This latter finding was unexpected and may suggest people with IADs consume health online and feel less inclined to participate in IPC activities. Caregivers with technology and internet access may benefit from media-based interventions, whereas those with limited access may benefit from traditional interpersonal mediums.

Key messages

Future community health efforts in similar rural regions, should consider the use of both mass media and interpersonal communication interventions to influence health behaviors. Use of internet-accessible technology was positively related to exposure to the mass media campaign while negatively related to IPC exposure.
Infodemic: analysis of global and local 2019-20 Coronavirus epidemic search flow
Authors: Antinolfi F , Brunelli L , Cocconi R , Brusaferro S
Published: October 2020

Background

The excessive amount of information (infodemic) about SARS-COV2 is a global challenge for healthcare authorities in tackling misinformation. Aim of the study was to investigate SARS-COV2 global and Italian web search amount made through a reliable information source during 2019-20 SARS-COV2 epidemic.

Methods

From December 15th, 2019 to February 23rd, 2020, we used Google Trends to analyze global changes in the volume of searches about “Coronavirus” in relation to reliable sources: “World Health Organization”, “WHO” and the Italian equivalents of “Ministry of Health” and “National Institute of Health”. Primary searches and associated queries (AQs) were analyzed by nation and Italian Region.

Results

Global interest on “Coronavirus” progressively rose from mid-January, with 2 peaks on days 28th and 31st, fell on February 20th and rose again until day 23rd. “WHO” searches fluctuated with no clear pattern but increased on January 26th and February 3rd. 'WHO' term was among the most frequent “Coronavirus” AQs and viceversa. Singapore, Italy and New Zealand were the most interested nations in “Coronavirus”, while China was at first place in “Coronavirus+WHO” searches. In Italy from January 21st interest in “Coronavirus” gradually increased, with peaks on days 28th and 31st and a higher peak on February 21st. The other terms showed a fluctuating trend, with peaks on January 31st for “WHO” and “Ministry of Health” and on February 21st for all of them. “Coronavirus” was most frequently AQ to “Italy” and “China”, while AQs for the other terms were “Coronavirus” and “WHO official website”. The most interested Italian Regions for “Coronavirus” and “Coronavirus+WHO” were Lazio and Friuli Venezia-Giulia, respectively.

Conclusions

Interest in SARS-COV2 globally increased during the considered period, especially within most affected areas. The associations between terms thus highlighted seems to confirm that the general population relies on trustworthy information sources.

Key messages

Infodemic can be at the same time a danger and an opportunity during global and local health emergencies. Health systems should take advantage of current search flow in order to foster reliable information sharing.