bluuebunny/crossref_metadata_2025 huggingface dataset:
An assessment of environmental awareness of internally displaced people in the north east of Nigeria
Authors: Kashim I , Kashim R
Published: October 2020

Background

In the North-East of Nigeria, an 11-year insurgency resulted in displacement of 2.1 million people. This study examined the environmental awareness of Internally Displaced Persons (IDPs) in two States (Borno, Taraba States) in the region to determine whether environment factors may have contributed to their displacement. 2 aspects of the environment were studied i) Water quality & sources ii) Land cover.

Methods

Focus Group Discussions were held with IDPs in 2 camps per State. The target groups interviewed were; Adult men, Adult women, Traditional Leaders.

Results

When asked of the quality of drinking water in their homeland, all the Traditional Leaders in Taraba State said the water was not clean, polluted or harmful. Adult Women in the same camp said: “We get water from the river shared with cattle, this led to crises between us and the herdsmen.” “Our water is polluted due to the death of frogs”. When asked of landcover/trees etc. and the environment in their homelands, some Taraba camp Leaders said, “Trees are being constantly cut for firewood.” When asked if there were changes in their homeland environment in the last 10 years; the predominant response was that there was reduced land cover. In addition, water sources and quality has reduced.

Conclusions

The IDPs in the 2 States are aware of environmental changes in the last 10 years, Taraba was characterized by dwindling tree/land cover, and changes in water quality as a result of drying with sharing water sources with cattle. Displacement was directly as a result of invasion of Herdsmen. Borno is characterized by loss of tree cover with flash floods occurring, the cause of displacement is the Boko Haram insurgency. Recommendations: Validate findings by further studies on the environment in the region, especially conflicts related to water scarcity and implications for displacement. In addition, increase efforts to prevent deforestation resulting from climate change and displacement.

Key messages

Environmental protection systems should be set up and enforced by State government. Internal displacement in Taraba is from environment related causes with attendant negative impact.
A shared battle against cancer: overcoming screening uptake differences within European countries
Authors: Villani L , Riccardi M T , Barbara A , Sabetta T , Nurchis M C , Sabetta A , Solipaca A , Ricciardi W
Published: October 2020

Cancer is the second leading cause of dead in Europe and it is responsible of more than 30% of all deaths. For this reason, European Union (EU) identified the battle against cancer as a priority for the European Research Program 2021-2027.About 40% of total deaths for cancers could be prevented with screening.Validated screening test are available for breast (BC), cervical (CC) and colorectal cancers (CRC).

In 2003 the Recommendation of the European Council indicated the right timing and the population target but, nowadays, the percentage of screening within EU is low and consistent differences persist among States.In 2020 there are still countries that don't have population-based screening programs. Last data available for all 28 EU countries are referred to 2014. Data were retrieved from “Osservasalute” reports and Global Burden of Disease database.Pearson test and a paired t test were used to describe correlation between mortality and screening coverage rates.

In 2014 the mean percentage of screening was 70.7% for CC, 68.7% for BC and 31.3% for CRC and the mean of mortality rate was of 2.1, 10.4 and 17.2 for 100,000, respectively.The rate of mortality did not change significantly in 2017 (2, 10 and 16 for 100,000 respectively).The median coverage is 67 for BC [IR: 43-91], 21.4 for CRC [IR: -3-46] and 70.6 for CC [IR: 54-87]. Pearson test resulted in a negative correlation for all three cancers equal to -0.045, -0.060 and -0.561, respectively.A higher adherence to screening programs is significantly associated to lower mortality rates in all the three types of cancer (p < 0.01).

Even if many factors determine the rate of cancer mortality, screening represents the best method to early diagnosis and treatment.Up-to-date data are needed to correctly monitor progress towards the common goal of reaching the entire target population with screenings.A strong leadership at international level is necessary to improve screening programs all over EU and support screening campaigns.

Key messages

Screening is one of the most efficient and life-saving way to prevent cancer. It is needed to improve screening adherence through population-based programmes both at international and national level. Last data available for all EU countries are referred to 2014. It is necessary to update the data in order to enhance the understanding of screening efficiency.
Cardiovascular Risk estimates in ten years in the Brazilian population, a population-based study
Authors: Carvalho Malta D , Cisalpino P , Teixeira R , Eloah Machado I , Malta dos Santos F , Martins Dias de Andrade F , Michelete Gomide A C , Vitral Pinto I , Pinho Ribeiro A
Published: October 2020

Background

Cardiovascular diseases are the leading cause of morbidity and mortality, high health costs and significant economic losses. The Framingham score has been widely used to stratify the risk of the evaluated individuals, identifying those at higher risk for the implementation of prevention measures directed to this group.

Objective

Estimate the cardiovascular risk of developing cardiovascular event in 10 years, in the adult Brazilian population.

Methods

Cross-sectional study using laboratory data from da National Health Survey, 2014 and 2015, were used to calculate cardiovascular risk (CVR). Algorithms proposed by D`Agostino (2008) were used, based on the Framingham study, stratified by sex, was used. According to the guidelines of the Brazilian cardiology society, the following cutoff points for cardiovascular risk in 10 years were used: a) low CVR <5%, medium CVR (5 to < 20%) and high CVR (≥ 20%). The study estimated the general cardio vascular risk and the respective confidence intervals (95% CI).

Results

Most women 58.4% had low cardiovascular risk, 32.9% medium risk and 8.7% high risk. Among men, 36.5% had low cardiovascular risk, 41.9% medium risk and 21.6% high risk. The risk increased with age. The difference in CVR according to years of schooling was about five times, between high schooling (12 years of schooling and more) and (<8 years of schooling) (3.2%: 95% CI 2.4 - 4.4 versus 15, 7%: 95% CI 13.5-18.3). Black women had a higher proportion in the highest risk group ( > = 20%), 14.4% (95% CI 9.7-20.9), than white women, 7.3 (95% CI 5.8 - 9.1). The poor self-rated health showed the greatest difference, the population that self-rated with very good health 2.9% (95% CI 1.3-3.6) and very poor health 25.6% (12.7-45, 0).

Conclusions

The risk score is useful to support the prevention practices of these diseases, considering the clinical and epidemiological context.

Key messages

This is the first national population-based study to estimate RCV for the Brazilian adult population using laboratory data, being useful to identify the priority population for public health. Population with less education has a higher risk cardiovascular, and should be a priority for prevention actions in public health.
Night shift work, sleep quality and risk of endocrine-related cancer: a systematic review
Authors: Ling L , Shah S , Hussain J , Stranges S , Anderson K
Published: October 2020

Background

Cancer is a major public health concern as it is a leading cause of death worldwide. The risk of endocrine-related cancers may be associated with suboptimal sleep quality due to disruptions in circadian rhythm. However, the extent of this relationship is not clear and warrants a review summarizing recent research findings. This systematic review aims to provide an updated summary of the literature surrounding the association between night shift work, sleep quality, circadian rhythm disruption and the risk of endocrine-related cancers.

Methods

MEDLINE, EMBASE, CINAHL, and Web of Science databases have been searched for related cohort, case-control, and cross-sectional studies. The search was limited to studies published in English, after the year 2000. Non peer-reviewed literature and randomized control trials, were excluded. Reviewers will independently extract data on study characteristics, sleep quality measures, circadian rhythm measures, cancer diagnosis, and outcome measures. Risk of bias assessment will be performed using the CLARITY tools.

Results

Data synthesis is ongoing. Associations between sleep quality, night shift work, circadian disruption and risk of endocrine-related cancer will be summarized and risk estimates will be reported for four endocrine-related cancers: breast, prostate, thyroid, ovarian, and endometrial cancer. If data are available, subgroup analyses will be carried out by cancer type, study design, and age group.

Conclusions

This review qualitatively synthesizes current literature to determine the extent of the association between sleep quality, night shift work, circadian rhythm disruption and the risk of endocrine-related cancers. These findings can contribute to population-level cancer prevention efforts and aid public health promotion of healthier sleep-related behaviours.

Key messages

The relationship between sleep quality and endocrine-related cancers should be explored further in public health research due to inconclusive evidence from current literature. The findings of this project can help promote healthy sleep behaviours and population-level cancer prevention.
A community-based cohort study: the incidence of MS and exercise behavior change in Taiwan
Authors: Hsu H F , Yeh Y P , Luh D L
Published: October 2020

Background

Recently, there has been renewed interest in metabolic syndrome (MS) and exercise. In the past 3 years, most of the research articles discussed the relationship between MS and exercise focused on the intervention methods such as diet and medicine. Limited research showed the evidence about exercise behavior change naturally and the incidence of MS. Using community-based integrated screening in Changhua County (CH-CIS), the purpose of this study was to clarify the relationships between exercise behavior change and the incidence of MS.

Methods

We used secondary data from CH-CIS database from 2006 to 2018. In the 13 years, a total of 164299 people enrolled. In order to understand the incidence of MS, we excluded (1) those who self-reported MS at first records, and (2) those who participated just once. Remaining 22915 participants were included in the following analysis. Incidence of MS was based on the results of biochemical examination in the last CH-CIS. Exercise habits were self-reported from screening questionnaire and were divided into 4 group: (1)never、(2)irregular、(3)regular but insufficient and (4)regular and sufficient. The change of exercise habit was defined as comparing the first and the last record. Using SAS software (version 9.4). Logistic regression analysis were used to evaluate the associations between exercise behavior changes and incident of MS. The experimental protocol was accepted by the IRB of CSMU Hospital.

Results

The incidence rate of MS was 3.24%(n = 4036) in the CH-CIS participants during 2006 to 2018. Comparing with consistent regular exercise, those exercise habit change from regular to irregular had significantly more likely to get MS(OR = 1.19; 95% CI=1.02-1.33) after adjusting for other control variables such as social demographic factors and other health-related behaviors.

Conclusions

Exercise habits change getting worse from regular to irregular are more likely to have MS than who still keep regular exercise.

Key messages

Exercise habit changes have an important relationship with MS incident, especially changes from regular to irregular in exercise habits. The incidence rate of MS was 3.24% in the CH-CIS participants during 2006 to 2018.
Eryptosis and circulating blood cells microparticules in sickle cell diseases
Authors: Moumni I , Khalfaoui K , Safra I , Chebbi M , Barmate M , chaouechi D , Ben khaled M , Ouederni M , Mellouli F , Menif S
Published: October 2020

Sickle cell disease(SCD)is a monogenic disease, in which the severity and symptoms vary widely.The sickle cell mutation is the origin of all functional and structural alterations of red blood cell(RBC)which induces the acceleration of eryptosis and formation of Circulating blood cells microparticules(MPs)which has the consequence of acute anemia and increasing the thrombotic risks in sickle cell patients. Eryptosis is the suicidal erythrocyte death characterized by erythrocyte membrane scrambling by phosphatidylserine(PS)externalization. MPs are an extracellular vesicules released following cellular activation, stress or apoptosis. These parameters are able to modulate many biological functions, and considered as biomarkers of preventive diagnostic of SCD. This present study aims to determine the cellular biomarkers to implementation new and innovative methods of the preventive diagnosis of SCDacute complications. We propose to study the mechanisms involved in the triggering of eryptosis and to quantify microparticles derived from platelets and erythrocytes of homozygous sickle cell patients.

Following clinical diagnosis, homozygous SCDpatients and healthy donors were sampled for hematological and cellular assays. The exploration of eryptosis and MPs was performed by a flow cytometry by determining the viability parameters of red blood cells.

The outcome of our study indicated that Eryptosis in sickle cell patients is triggered essentially by high Ca2 + entry and narrowing of red blood cells. However, the pathway of ceramides and ERO can also considered a stimulating factor of eryptosis. Eryptosis ensures healthy erythrocyte quantity in circulation whereas excessive eryptosis is the cause of acute anemia and may contribute to vaso-occlusive crisis in SCD patients.For MPs study,microparticles derived from platelets and erythrocytes clearly increased in SCD patients. This suggests that erythrocytes MPs may contribute to thrombotic risk andchronic hemolytic anemia.

Key messages

Potentiel biomarkers in the preventive diagnosis of sickle cell disease. Eryptosis and plasmatic microparticules as potentiel biomarkers.
Translating instruments into multiple Mayan languages for a hypertension T4 study in Guatemala
Authors: Peralta A , Paniagua-Ávila A , Fort M , Gulayín P , He J , Irazola V , Mansilla K , Hernández D , Ramírez-Zea M
Published: October 2020

Issue

Guatemala is a culturally and linguistically diverse country. Mayan languages are primarily spoken languages; few people know their written form. Health features and outcomes are difficult to assess due to the lack of validated instruments in these languages.

Description of the Problem

A cluster randomized trial to improve hypertension control is being conducted in 36 municipalities where Mayan languages are spoken in addition to Spanish. Instruments for measuring study outcomes were developed in Spanish and cross-culturally adapted into five Mayan languages following WHO's methodology. First, data were gathered on the proportion of people only fluent in a Mayan language in each district. We prioritized those Mayan languages spoken by more than 20% of the non-Spanish speaking population: Achí, K'iche', Kaqchikel, Tz'utujil and Mam. Second, forward translation to the Mayan languages was conducted by a local healthcare professional, who verbally recorded each instrument. The study team identified key words and concepts to guarantee content equivalence. Third, back-translation was conducted by two independent healthcare providers, who were blinded to the original instruments. The research team formally compared the original questionnaires with the back-translated versions to ensure they were conceptually equivalent and culturally adapted. Discrepancies were corrected as needed. Finally, local interviewers were trained on how to accurately use the written Spanish questionnaires and the Mayan language verbal recordings.

Results

By following this methodology, we achieved cross-culturally adapted instruments to improve the information-gathering process in communities where only Mayan languages are spoken.

Lessons

Having culturally adapted tools will allow researchers to reach a broader range of the target population, obtain more accurate information, and take into account participants' culture and cosmovision.

Key messages

Translating questionnaires to people’s native language allows researchers to obtain more accurate information in a standardized way and better understand participants’ culture and cosmovision. The described methodology is beneficial for conducting research in linguistically diverse countries. It promotes effective and inclusive communication among researchers and participants.
Training of the spiritual dimension of health in India – an innovative ‘thought model’ approach
Authors: Bhatt M
Published: October 2020

Background

The complexities in defining Spirituality, its association with religions, and misfit in modern scientific healthcare settings are the reasons behind the neglected attitude in training of spiritual dimension of health in religiously diverse and secular India.

Objectives

To define spirituality independent from religious views and scientifically sound for modern healthcare practices in a diverse society of India. For this, a 'Thought Model' developed with spirituality as the most evolved thought in the form of humanity and human values with transcendence, connectedness, and purpose of human life, which works as a controlling, communicating, and correcting thought in the ecosystem of human thought processes. Review and testing with healthcare professionals (completed in Nov 2019), leading to few pilot projects (in progress till Sept 2020), and finally working with academia to finetune it for training curricula for health systems.

Results

The 'thought model' presented to health experts from July to October 2019. 98% [80 out of 82(N)] considered this simple, comfortable to belief systems, and practice. 96% found it helpful in solving the issues where the physician and patient or the members of the medical team are from different religions. 99% considered this model scientific and useful in responding to the spiritual needs of all, including atheists. So, we planned to start a pilot project in two selected medical institutions for medical interns with the new session; results are awaiting.

Conclusions

Review results by health experts indicated that the 'thought model' can address the complexities and ambiguities in defining spirituality on religious grounds by simplifying its definition and independent of religious beliefs for the training of the spiritual dimension of health and healthcare in diverse and secular societies makes it easy to discuss spiritual aspects of health in communities with various religions and belief systems.

Key messages

Religiosity makes spirituality complex, communal, and unscientific in religiously diverse societies leading to reluctance in public health practices and training. Simplifying spirituality as an evolved thought can change the perspective by abolishing religiosity; it becomes comfortable with belief systems and science and suitable for training and research.
Sharing place and space to promote wellbeing for old and young people in a neighbourhood
Authors: Raynes N
Published: October 2020

The increasing number of older people in many countries is often seen as a burden. Alternatively, these numbers can be seen as a longevity dividend, providing a resource for our communities. We sought to find a way to use the resource by working with schools in a range of socio- economic neighbourhoods & explore the benefit for all stakeholders & the sustainability of such an approach. The issues we addressed are of relevance in most of Europe, despite the variations in the school systems.

Intergen is the name of the model developed over 20 years in England. 3 schools in a neighbourhood work in partnership.An older person is appointed by the school to recruit older people in the neighbourhood with the skills and knowledge the schools require to enhance the learning opportunities of their pupils.Coordinators in each school meet once a term to review progress, problems & organise a social gathering for volunteers.

All stakeholders' views of the value of the programme were collected. Key questions to be answered are: Can older people be a resource for pupils to improve performance & wellbeing in both the younger & older populations?Is the model sustainable and affordable?How can it be mainstreamed?

Results

26 schools, primary and secondary in 7 municipalities engaged in the project after 10 years development phase with 10 schools in one municipality. Schools in London and Greater Manchester areas. 15 schools remained in the programme paying for the service for 5 years. A review of the impact of the programme showed all head teachers thought it innovative, & made a difference in their pupils' wellbeing. Older people were seen as a positive resource by both teachers & pupils. Older people felt valued & part of community. Reduction of negative stereotypes occurred. Interactions went beyond the operational tasks set for the older people.

Only a public health approach can promote sustainability of the model & its benefits for communities.

Key messages

A tried and tested model sharing place and space to promote wellbeing in neighbourhoods for old and young citizens. The important role of Public Health in promoting innovative practice in silo ridden health and social care systems building the evidence base and building bridges.
The application of a new policy on recreational cannabis use in the Canadian military population
Authors: Therrien M , McCuaig Edge H
Published: October 2020

In October 2018, the Canadian federal government passed the Cannabis Act, making Canada the first G7 nation to legalize the possession and consumption of recreational cannabis nationwide. Given the potential health and safety implications, this makes it a pivotal time for both policy makers and researchers to understand the effects of cannabis use and the implications in the workplace. In response to legalization, the Canadian Armed Forces (CAF) was one of the first major organizations to create a policy specifically targeting cannabis use for its military personnel, with directives outlining expectations for standards of conduct, and general and specific prohibitions relating to the possession and consumption of cannabis products. An important part of understanding the potential impact of cannabis use in the Canadian military and the suitability of the current policy is to first determine the proportion of CAF members that have consumed cannabis since its legalization. The first available data on this comes from the Recruit Health Questionnaire, a health and lifestyle survey completed by military recruits early in their basic training. 1,219 recruits completed the survey between October 2019 (exactly one year post-legalization) and February 2020 (88% response rate). Preliminary results suggest that one-third (34%) of recruits reported having consumed cannabis during the 12 months prior to starting basic training, and since the Cannabis Act came into effect. The vast majority (95%) of this group reported having consumed cannabis on more than one occasion. Given these large proportions, it is imperative that we continue to study the medical, behavioural, and cognitive effects of cannabis to understand if the current guidelines set out in the CAF policy on recreational cannabis use are adequate. Constant monitoring and, as necessary, updates to the policy, are essential to continue ensuring the safety of CAF members and the public, and an operationally ready force.

Key messages

Preliminary results suggest that one-third of Canadian Armed Forces recruits have consumed cannabis since its legalization, with 95% of this group having consumed it on more than one occasion. Given the potential health and safety implications, the Canadian Armed Forces policy on cannabis consumption must be constantly monitored and updated to ensure a safe and operationally ready force.
Suicides in Belgrade, Serbia in the period 2009-2018
Authors: Miltenovic S , Vujetic M
Published: October 2020

Background

Suicides fall in violent deaths and more recently have shown an increasing trend in developed and developing countries. This is a major public health problem that could and should be prevented. Unfortunately, it is among the top twenty leading causes of death worldwide. This public health problem exists in Belgrade and Serbia, as well.

Methods

An analysis of death certificates shows an insight into the causes of death of inhabitants of Belgrade. The paper presents data from the Database of deceased persons in Belgrade, for the period 2009- 2018. Data are analyzed using frequencies and incidence rates by sex, age groups, month of death, day of death, and municipality of residence of deceased.

Results

In Belgrade, from 2009 to 2018 the incidence rate of suicides is decreasing. The standardized suicide rate was highest in 2009 (12/100.000). Men often committed suicides at all observed years, and the rates are usually higher as in women. The highest number of suicides occur in April, July and June and observing days within a week Wednesday and Tuesday lead. The average age of men who committed suicide was 57 years and women 59.5 years. The most common method of carrying out the suicide was 'by hanging, strangulation and suffocation' (X70 according to ICD-10) and frequency was 45.2%.

Conclusions

The incidence rate of suicides at Belgrade territory shows the trend of decline in the observed period, between 2009 and 2018. Besides that, other attributes indicate that age-sex-manner of suicides could be changed, as for being targeted for prevention. Preventing suicides is a new challenge for public health and all public sectors have to be involved in prevention. Considering ageing of a population, migration and other negative demographic trends in Belgrade and Serbia, it is necessary to raise our competencies in inhibition of these unfortunate events.

Key messages

Preventing suicides is a challenge for public health. It is necessary to raise competencies in order to prevent suicides.
International survey: real-world pain management strategies
Authors: Hagen M , Georgescu A
Published: October 2020

Background

Pain is a nearly universal experience, but little is known about how people treat pain. This international survey assessed real-world pain management strategies.

Methods

From 13-31 January, 2020, an online survey funded by GSK Consumer Healthcare was conducted in local languages in Australia, Brazil, Canada, China, Colombia, France, Germany, India, Italy, Japan, Saudi Arabia, Malaysia, Mexico, Poland, Russia, Spain, Sweden, UK, and USA. Adults were recruited from online panels of people who agreed to participate in surveys. Quotas ensured nationally representative online populations based on age, gender, and region.

Results

Of 19,000 people (1000/country) who completed the survey, 18,602 (98%) had ever experienced physical pain; 76% said they would like to control their pain better. Presented with 17 pain-management strategies and asked to select the ones they use in the order of use, respondents chose an average of 4 strategies each. The most commonly selected strategies were pain medication (65%), rest/sleep (54%), consult a doctor (31%), physical therapy (31%), and nonpharmacologic action (eg, heat/cold application; 29%). Of those who use pain medication, 56% take some other action first. Only 36% of those who treat pain do so immediately; 56% first wait to see if it will resolve spontaneously. Top reasons for waiting include a desire to avoid medication (37%); willingness to tolerate less severe pain (33%); concerns about side effects (21%) or dependency (21%); and wanting to avoid a doctor's visit unless pain is severe or persistent (21%). Nearly half (42%) of those who take action to control pain have visited ≥1 healthcare professional (doctor 31%; pharmacist 18%; other 17%) about pain.

Conclusions

This large global survey shows that people employ a range of strategies to manage pain but still wish for better pain control. Although pain medication is the most commonly used strategy, many people postpone or avoid its use.

Key messages

More than three-quarters (76%) of respondents across countries seek better pain control. Pain medication and rest/sleep consultation are the most common pain management strategies. More than half of respondents (56%) wait to see if pain will resolve spontaneously before taking any action, and 56% of those who use pain medication try some other approach first.
Networks and social support and its relationship with functional limitation in Chilean older adults
Authors: de Albuquerque Araújo L , Icaza Noguera G , Albala Brevis C
Published: October 2020

Social relationships are multifaceted and can act in many ways on physical and emotional well-being. We aim to study whether social networks and support are associated with functional limitations in Chilean older adults.

Cross-sectional study with baseline of two cohort studies: the SABE cohort (born before 1940) and the Alexandros cohort (born between 1940 and 1948 from Primary Health Care centers), from Santiago. Were considered 1733 elderly. Performance variables were studied in 7 Instrumental Activity of Daily Living (IADL): preparing food, managing money, leaving home alone, making purchases, making calls, doing light housework, organizing and taking medications, and 6 basic Activities of Daily Living (ADL): bathing, dressing, use of the bathroom, transfer, continence of urine and feeding. Having difficulties or inability to perform at least 1 activity was classified with having functional limitations (FL). Social network variables were: housing arrangement and marital status; social support variable was perception of material support, company or advice. Adjustment variables were: sex, age, education, income, depression, cognitive impairment, multimorbidity. Robust Poisson Regression was performed, prevalence ratios (PR) of FL were reported (α ≤ 0.5). Living accompanied (PR 0.96; 95% CI 0.88-1.03) and being married or live as a couple (PR 0.99; 95% CI 0.85-1.6) were not significantly related to functional limitation in IADL, similar in relation to living accompanied and performance in ADL (PR 0.96; 95% CI 0.88-1.03). Married or living couples have a lower prevalence of FL in ADL (PR 0.86; 95% CI 0.81-0.92). Having material support, company or advice was associated with a higher prevalence of FL in ADL (PR 1.84; 95% CI 1.11-3.06) and in IADL (PR 2.48; 95% CI 1, 64-3.74). Being married or living as a couple in old age is a protective factor for functional limitation while having a positive perception of material support, company or advice showed to be a risk factor.

Key messages

Single, widowed or separated Chilean older adults are at greater risk of functional limitation, regardless of sociodemographic and health characteristics. The findings of this study should be confirmed with prospective design studies since the transversal design does not clarify the temporality of the relationship.
Psychometric validation of the revised child injury scale (Cries-13) in Greek population
Authors: Kallianezos P , Bakola M , Kitsou K S , Petropoulos C , Sinopidis X , Jelastopulu E
Published: October 2020

Background

Children and adolescents have an increased risk of post-traumatic stress following exposure to traumatic events. Thus, timely, valid and reliable assessment of the symptoms of the disorder is crucial. The purpose of the study was the psychometric validation of The Child Revised Impact of Events Scale (CRIES 13), following the preceding linguistic validation. Further goal was to evaluate post-traumatic stress disorder (PTSD) in children 6 to 14 years of age with mild traumatic brain injury (mTBI).

Methods

The questionnaire was consecutively administered to 175 parents coming to the Emergency Department of the Pediatric Hospital of Patras, after mTBI of their children. They were asked to respond one week and one month after the accident to assess PTSD of their children. For psychometric validation, exploratory (EFA) and confirmatory (CFA) factor analysis was performed. The questionnaire consists of 13 items rated on a non-linear scale ranging from 0 to 65, and higher scores indicate more PTSD symptoms with a threshold of 30.

Results

The Psychometric validation showed very good reliability (= 0.79) and EFA confirmed the factor structure of the original tool. In addition, CFA showed satisfactory fit for the three-factor model. Parents estimated post-traumatic stress one week after injury in 19% of the children. Statistically significant difference was observed only in monthly income, with parents of low income reporting higher levels of stress in their children (p = 0.046).

Conclusions

A reliable and valid questionnaire is now available in Greek for assessing the risk of PTSD in children. In one of five children presented in our hospital we observed a higher risk of developing post-traumatic stress one week after mild traumatic brain injury.

Key messages

There is reliable and valid questionnaire in Greek for assessing the risk of post-traumatic stress disorder in children.
Care strategy for people in situations of violence low cost and high resolution
Authors: Dacal C S , Batista S H S S , Dias S E , Stoever I , Soares R S
Published: October 2020

Background

Following the guidelines of the World Health Organization, Brazil considers violence to be a public health problem, transversal to the care processes. Notifications are carried out using specific instruments and monitored by the health surveillance sector for non-communicable diseases and conditions. The implementation of Violence Prevention Centers (NPV) in all health services in the city of São Paulo - Brazil was established, composed of professionals from the service itself, which aims to develop actions to care for this population and provide technical support to team professionals, at different levels of care. Difficulty of professionals in dealing with situations was observed, resulting in wrong referrals. The need was identified to establish a training space for professionals in order to improve care and mitigate situations of violence, which would not impact the service agenda and at low costs.

Methods

One meeting per month with NPV members in the region. The situational diagnosis was raised with the workers through conversation circles, a thematic schedule was developed with Active Methodology and exemplified with a previously chosen case.

Results

Frequency of all health services, increase in the completion, specific instruments, correct targeting of victims, establishment of dynamic flows between services and identification of emotional difficulties in dealing with situations.

Conclusions

the results corroborate the findings that place spaces of exchange between professionals as fundamental in the process of caring for people in situations of violence, being a technology accessible to services, not only for carrying out Permanent education, but also as a care strategy for workers. This experience has potential for implementation in other contexts, notably those that, as in the Brazilian reality, still struggle in the face of great social, economic and gender inequalities.

Key messages

Between professionals as fundamental in the process of caring for people in situations of violence, being a technology accessible to service.
Capacity building in the public health field in the Tunisian medical faculties
Authors: Coman M , Oltean O , Palianopoulou M , Plancikova D , Zedini C , Cheikhrouhou F , Kallel K , Zrig A , Chereches R M , Bozdog M E
Published: October 2020

Over the past years, Tunisia has experienced important reforms in the field of public health. The Tunisian medical faculties (Universities of Sfax, Tunis el Manar, Sousse and Monastir) play a key role in this endeavor by training public health professionals who can contribute to the modernization of the health system. Funded by the EC through Erasmus+ programme, the CONFIDE project (coordinated by Babes-Bolyai University, having as EU partners the Universities of Southern Denmark and Trnava, and the above mentioned Tunisian universities) has established the Research into Policy training programme by strengthening their capacity to provide public health training.

The Research into Policy training programme has been delivered by the Centres for Evidence into Health Policy (C4EHPs) established within the Tunisian partner universities for the needs of CONFIDE. The training programme was implemented in four steps: (1) train the trainer sessions - the European experts trained 18 Tunisian trainers; (2) shadowing sessions - the trainers participated in shadowing sessions in the European partner institutions; (3) training delivery - the CONFIDE trainers, assisted by the European experts, delivered the training to an interdisciplinary group of 25 students and professionals; (4) internships - the students participated in internships in local health institutions. Three modules have been built within the Research into Policy training programme: Public health research, Health promotion policies and Evidence based public health policy. They contributed to increasing the public health knowledge and skills of the professionals trained.

The training programme was well received by the Tunisian universities and the material developed so far during the project was adapted to the Tunisian context in the third step of implementation. On the long term, the project is expected to have an impact at the national level and produce updates at curricula level in the Tunisian medical faculties.

Key messages

Research into Policy training programme developed by the EC partners and culturally adapted by the Tunisian partners to the Tunisian public health context. Research into Policy training is a well-received tool for the high quality learning process in the public health field in Tunisian medical faculties.
Change in fertility rates in southern Ethiopia: Findings from Dale-Wonsho surveillance system site
Authors: Areru H , Dangiso M , Lindtjorn B
Published: October 2020

Background

Even though the fertility in Africa has started to decline, there was no demographic study done in southern Ethiopia except a census done more than a decade ago. Understanding the population dynamics can help policymakers forecasting future health needs. The objective of this study is to investigate the population characteristics in Sidama with an emphasis on fertility estimates, age, and death reporting.

Methods

This is a mixed-method cross-sectional study, conducted in Sidama in southern Ethiopia, using baseline data of the newly established Dale-Wonsho Health and Demographic Surveillance System site in 2018. We used quantitative data of 5179 randomly selected households having 25,144 individuals. We also collected information on deaths in the same study period and from the same population from the traditional burial associations (Iddir). Qualitative data were collected using focus group discussions, and in-depth interviews. Life tables, age reliability indices and logistic regression were used to analyse the data.

Results

The total fertility rate was 2.9 children/woman, the crude birth rate was 22.8/1000 population and the crude death rate was 5.2/1000 population. The dependency ratio was 66/100 working-age population. Urban residents had higher birth rates(OR = 1.4 (95% CL: 1.05-1.78), and women with basic education had lower birth rates(OR = 0.6 (95% CL: 0.46-0.78). The Whipple's, Myer's, and United Nations Joint Score indices showed unreliable age reporting. As the number of deaths increased from 29 to 132 when we included deaths registered at the Iddirs, and as there was an under-reporting of neonatal and deaths of young children; the expected life expectancy became lower to 48-55 years.

Conclusions

The fertility rate in Sidama is lower than previously reported and is affected by age, residence and education. As we have identified important measurement and reporting errors, future demographic surveillance sites should consider these limitations.

Key messages

The reduction in fertility is an important indicator of demographic transition. Age and vital events reporting system are crucial for demographic surveillance.
Patients’ expectations on medicines information
Authors: Sevikyan A , Kazaryan I
Published: October 2020

Background

Medicines information is important for patients as it assists them in achieving more safe and effective use of pharmaceuticals. Many patients seek information from community pharmacies' staff. The objectives of this study were to identify specific topics of medicines information which patients expect to receive at community pharmacies.

Methods

Face-to-face interviews were conducted with 1059 visitors of community pharmacies in Armenia. Previously developed questionnaire was used for interviewing patients. Data were analysed with the SPSS statistical software.

Results

Most of participants acknowledged importance of receiving from community pharmacies' staff information on therapeutic indications of medicines (91.1%), dosage and method of administration (90.8%), the duration of treatment (86.3%), expiry date (85.7%), adverse reactions (85.0%), contraindications (84.6%), storage conditions (77.5%) and type of activity (76.0%). Importance of receiving information on some specific topics depends on patients' age. Participants' acknowledgement of information on interaction with other medicines, certain categories of users, and potential effects on the ability to drive is decreasing with patients' age increasing (p < 0.001). The opposite trend was observed with attitude to receiving information on medicine price that was mostly valued by elderly patients (p = 0.046). The number of patients who trust the information provided was higher among those who more often received comprehensive responses from pharmacists and pharmacy assistants (p < 0.001).

Conclusions

Receiving medicines information from the staff of community pharmacies is important for patients, and the majority of them trust to information received. Patients are mainly provided with comprehensive responses to their questions about medicines, and there was dependence between a frequency of receiving comprehensive responses and a level of patients' trust the information provided by pharmacy staff.

Key messages

Increasing patients’ awareness on their right to get medicines information can be beneficial. Comprehensive responses increase patients trust medicines information provided by pharmacists.
Hospital stay frequency of patients with cancer diseases in Rhodes Island, Greece
Authors: Katsaros E , Kitsou K S , Bakola M , Jelastopulu E
Published: October 2020

Background

Cancer is the second leading cause of death globally and a major public health problem that poses a threat to human development. The aim of this study was to investigate the number of hospital stays of cancer patients in Rhodes island in Greece.

Methods

A retrospective study was conducted to examine the parameters of frequency (case numbers) of inpatient hospital stays for a 4-year period of 2015-2018 at the General Hospital of Rhodes (GHR).

Results

In total, 1838 cancer cases were hospitalized during the study period, with an average age of 66.5 years and a male-to-female ratio of 1.9:1. (1199 vs 639). The most frequent diagnosis was urological cancer (incl. prostate cancer, 32.2%), followed by skin cancer (15.6%), gastrointestinal cancer (incl. colorectal cancer, 14.4%), hematological cancer (10.7%), breast cancer (8.9%), gynecologic cancer (5.3%), thyroid cancer (5%), lung cancer (4.1%), ear-nose-throat cancer (2.1%) and connective and soft tissue cancer (2, 0.1%). Surgery was the most common treatment (57.5%), whereas 250 patients (13.6%) received no treatment at the GHR. Most of the patients (66.6%) received one type of drug therapy, whereas the rest received a combination of drug therapies. Due to the lack of an Oncology Department, the therapy was given by other health personnel (e.g. hematologists) according the guidelines/recommendations of oncology-health-care-professionals in tertiary-care-hospitals at the mainland.

Conclusions

Our results do not follow the percentages of hospitalized cancer cases as seen in other developed countries. The island of Rhodes does not have the specialized staff and the means to treat all kinds of cancer, thus the patients with other types of cancer (e.g. lung and breast cancer) were referred to receive tertiary care cancer treatment in mainland Greece. Our results yield information to guide future actions in order to improve health and quality of life in people in remote/island areas

Key messages

An oncology department should be created in the GHR in order patients with common cancers, like lung and breast cancer to be treated in the island of Rhodes.
Federative relation and the process of regionalization in Brazil: strength to resist
Authors: Andrade S K , Mendonça F F
Published: October 2020

The federative relation is an essential tool to face the current challenges in Brazil and defends the public health system, threatened by measures of totalitarianism and individualism. Some of the barriers to promote an effective federative relation on the regional territories based on collective action are the devaluation of the deliberation spaces, the verticalization in making-decision process and marks of submission on federative relation. In this sense, one of the most important factors to structure democratic spaces is the regionalization, what subsidizes the construction of a regional identity, through dialogical strategies. In order to consolidate the regionalization, is important to characterize and apply instruments and strategies of negotiation, agreement and cooperative relations, by the entities. This study aims to identify and understand cooperation strategies, if present or potential on the counties of region practices and propose its sharing and implementation between them. The research has a qualitative, exploratory and interventional approach and it was submitted to the ethics committee approval process. The methodology way contemplates the collect of dates by questionnaires applied during a sixty-hour extension course. The participants are counties managers and supporters of their teams from the five regions of health on the north of the state of Parana, organized on small groups. After this, some individuals are invited for complementary interviews with semi-structured scripts. The adopted methodology for the analysis of the results is the discourse analysis. After identified and categorized the initiatives, they are shared among the participants through some workshops. In this way, the expected results of the study is to allow the strengthening of regionalization process in the territories and contribute for the establishment of a new order on the federative relation, boosting a democratic process of decision-making, cooperation and solidarity.

Key messages

The current challenges in political scenario on Brazilian health system requires new strategies to boost a democratic, cooperative e solidary process of decision-making and federative relation. One of the most important factors to structure democratic spaces on Brazil is the regionalization, which can be strengthened by federative relation based on cooperation and solidariety.