bluuebunny/crossref_metadata_2025 huggingface dataset:
Educational program for multipliers to promote health literacy
Authors: Tuttner S , Movia M , Hofer-Fischanger K
Published: October 2020

The HL-Survey-EU-2011 showed limited health literacy (HL) among the Austrian population (51,6%). “On health course - health literacy in Feldbach” focuses on individual and organizational HL. As a part of the project, an education program for multipliers from 11 companies to promote health literacy of employees and customers took place in autumn 2019. Basic knowledge on 'finding, understanding, evaluating and applying of health information' and 'health communication' represented the basic structure of the training and supported the participants in the implementation.

The training for the multipliers (n = 12) was divided into 3 focus areas, each was structured in 2 modules. Individual health literacy, organizational health literacy and special approaches to promoting health literacy were important components of the program. In this context, the quality criteria of health information were content of the training. Subsequently, there were inputs concerning health communication. In order to be able to evaluate health information critically, the multipliers learned how they recognize good and reputable health information and where they can find it. The participants studied how they could prepare and provide good health information for their employees and customers. The participants implemented projects to increase health literacy in their companies.

The evaluation showed that the structure and content of the education program was appropriate. The attendees were able to put what they had learned into practice. The difficulty lay in conveying numerous contents in a very short time (3 days/8 ours). The different industries and company sizes of the participating companies and the resulting different needs also presented a major challenge during the training.

With the content of the training and the experience of project implementation, a massive open online course (MOOC) is being created, which will be offered to all companies and interested parties in autumn 2020.

Key messages

It is important to train multipliers in order to increase the organization-related health literacy. The provision of practical examples for the implementation of measures to promote HL is crucial for the success of an HL education program.
Understanding international variation in national low-risk drinking guidelines: health policy report
Authors: Kirkby V
Published: October 2020

Background

The harmful use of alcohol is associated with adverse health, social, and economic consequences. National low-risk drinking guidelines provide evidence-based advice on how to reduce the risks associated with alcohol consumption and provide a basis for other alcohol-control interventions. There is substantial variation between guidelines and no international consensus on what constitutes 'low-risk' drinking. These discrepancies may lead to misinterpretation of the guidance, and such variation may undermine public confidence in experts and be exploited by the alcohol industry.

Methods

This project had two main components: (i) a literature review, to identify any new evidence from January 2016 to August 2019 suggesting a recommended threshold for 'low-risk' drinking; (ii) the analysis of six examples of national guidelines. Those from the UK, Ireland, Australia, New Zealand, Canada, and USA were examined for information about the utilisation of evidence to inform guidance, as well as details of the guideline development process. Thematic analysis of the UK, Canadian and Australian guidance explored wider influences on the guidelines.

Results

The literature review highlighted that all alcohol consumption carries some degree of risk. Content analysis of the guidelines emphasised the substantial variation in national guidance. Differences in the use of evidence and guideline development process may have given rise to at least some of the observed variation. Thematic analysis suggested that wider influences, such as differences in societal values, may also have contributed to disparities in the guidelines.

Conclusions

It may be possible to standardise certain areas of the development process, such as agreeing what constitutes an 'acceptable' level of alcohol-attributable risk. Further research is required to verify whether these results are generalisable to other countries, and to determine the most appropriate statistical model for risk calculations.

Key messages

The factors which determine guideline development are manifold and complex. Any level of alcohol consumption carries some degree of risk.
Analysis of mercury concentration in former mine areas in Slovakia
Authors: Kimáková T , Poráčová J
Published: October 2020

Background

Mercury is ubiquitous in the biosphere, occurring in the air, water, land, and soil, as well as in the living organisms. Mercury release in the environment is mainly the result of human activity, particularly from coal-fired power stations, waste incinerators and as a result of mining for mercury and other metals, which have led to wide spread global mercury pollution. The excessive exposure to mercury is a public health concern since it is associated with a wide range of adverse health effects including damage to the central nervous system and the kidneys. Mercury poses a threat to the development of the child in utero and early in life. We answer the question whether the monitoring of mercury is important even though the ore processing factories ended their production.

Methods

A total of 5,579 samples of foodstuffs from food retails in Slovakia and 24 species of plants within 100 meters to the former ore processing factory in Eastern Slovakia have been collected over the last two decades. The samples were selected randomly and the material was homogenized. Atomic absorption spectrometry standard solutions for mercury were used at a wavelength of 254 nm.

Results

The maximum mercury level set by the European Commission Regulation was exceeded in 314 samples. 50.52% of the total 384 fish samples from food retails in Slovakia were above the limit. The concentrations of mercury in the plants and in the soils taken to a depth of 0.25 m exceeded the maximum levels more than 6-times and 50-times, respectively.

Conclusions

The acceptance of mercurýs environmental impacts require several decades of research and public health activities. The monitoring of mercury worldwide is important, since we found that the end of ore processing does not solve the issue of contamination. We recommend developing procedures and legislation for the consumption of selected foods from the areas of ore processing companies for children, adolescents, pregnant women and nursing mothers.

Key messages

The systematic monitoring of mercury is still very important, since we found that the end of ore processing does not solve the issue of contamination in the former ore processing areas. It is not recommend the consumption of selected foods and plants from the former ore processing areas for selected groups of the population – children, pregnant women and nursing mothers.
Alcohol policy in the Netherlands in a National Prevention Agreement: results of three studies
Authors: Van De Mheen D , Bovens R , Friele R , Van De Goor I , Kools N , Roodbeen R , Schelleman-Offermans K , Rozema A
Published: October 2020

Introduction

On 23 November 2018 in the Netherlands more than 70 organizations signed the National Prevention Agreement. This document had been set up by the Dutch government aiming to create a healthy generation in 2040. It focuses on alcohol, next to overweight and tobacco control. Participants are a.o. NGO's, the sports sector, insurance companies, municipalities but also the alcohol industry and retailers.

Methods

Three studies were performed aiming to map how alcohol use might be reduced. 30 days without alcohol: the IkPas (No Thanks) campaignAlcohol screening and interventions for patients in General HospitalsPrioritizing alcohol enforcement and prevention efforts by combining prevalence and success-rate for minors purchasing alcohol.

Respectively a quantitative survey among adult alcohol users (n = 15.947), qualitative interviews among health professionals (n = 21), a quantitative survey among youngsters (n = 510) and purchase attempts (n = 1.373) of alcohol by mystery shoppers were performed.

Results

Beside on youth, in the Prevention Agreement priority has been laid on elderly, pregnant women, members and visitors of sports clubs and students. Also important are measures in primary and secondary health care and health policy in industrial companies. Measures are proposed in the field of the 'three best buys' (higher prices, lesser advertisement and restrictions in availability). The three studies showed that participants of the IkPas campaign feel fitter, sleep better, lose weight and drink less after 6 months follow-up. Furthermore, implementation of alcohol screening and interventions for patients in Dutch hospitals is still in its infancy. Lastly, bars/cafes/discos should be given priority for enforcement and prevention.

Conclusions

The question that will be discussed is whether the Netherlands by this agreement really do make a step forward in developing a healthy alcohol policy. Will the ambitious goals formulated in the agreement be reached in 2040?

Key messages

Alcohol policy measures are needed to reach a healthy population in 2040. Campaigns, screening and brief interventions, and alcohol enforcement are promising.
Carnival in Brazil as production of health care: narratives from a samba school community
Authors: Cordeiro M , Santos D , Magalhães F , Martins G , Barbosa J , Riquieri M , Silva M , Andrade M , Ferreira B , Lima R
Published: October 2020

Introduction

Carnival is a popular festival that was introduced in Brazil from the European heritage. However, it was the enslaved African people who saw forms and processes of resistance for the construction of identity during this festive period. The reframing and resistance that blacks establish with carnival is the result of a cultural need to stay alive both as a subject and as a collective. This is how samba schools emerge in the urban peripheries of Rio de Janeiro as a form of artistic, cultural and leisure production. Associations acquire for themselves the role of the State in providing access to rights that many are denied, neglected or scrapped. In these schools, it is possible to observe a relationship of belonging and donation (”principle of gift”) on the part of their so-called community, they are passions and meanings that produce relationships of self-care reaffirmation of intersubjectivity.

Objective

This work aims to identify the carnival as a space for the production of projects, resistances and protagonisms and to analyze the meanings of the subjective processes of health, disease, care and carnival, through the narratives of a samba school community.

Methodology

This is an exploratory analysis of a qualitative approach in public health. A samba school was chosen from the special group of the capixaba carnival, which is located in a peripheral region. We will use it to define snowball technical sampling. The data will be collected through semi-structured interviews and on-site observations by the researcher. The data analysis methodology used will be discourse analysis.

Expected Results

It is expected to understand the different practices and processes of health, disease, care and carnival, among a peripheral community that is part of a samba school.

Key messages

This work aims to analyze health care about a cultural aspect of marginalized populations and how health policies are related to carnival. Impact on the production of knowledge about popular culture and health.
48 hours public response to Corona epidemic status in Indonesia. Perceived risk and panic buying
Authors: Herman B , Herya Ulfah N , Fauzi R , Pongpanich S
Published: October 2020

Background

President of Indonesia, Joko Widodo has announced two confirmed CoVid-19 cases who live in Depok, West Java, on Monday, March 2nd, 2020. A rapid assessment of public response toward the new status was conducted, focusing on perceived risk and panic buying.

Methodology

A cross-sectional survey was conducted within 48 hours after the announcement through an online questionnaire. A demographic data including, sex, age, education, occupation (medical vs nonmedical), income, health insurance, island domicile (Java vs non-Java), mobility, history of contact with a foreigner, and history of overseas travel within a month. Knowledge regarding Covid 19 was determined by the average score of 38 5-Likert scale questions (5 indicates better knowledge). Perceived risk was measured with a 10-scale question, and panic buying was assessed through an average score of 6 5-Likert scale questions (5 indicates panic buying). Mann-Whitney and Linear regression were performed to identify the associated factors.

Results

As a total of 214 respondents, panic buying was lower (2.28 ± 0.79 on a 5-scale) except for perceived risk (5.91 ± 2.13 on a 10-scale). No difference between medical and nonmedical staff in panic buying (p = 0.619) and perceived risk (p = 0.477) and the domicile of respondents (Java VS nonjava) in panic buying (p = 0.810) and perceived risk (p = 0.101). Younger age, working in a medical field and living in Java are associated with higher perceived risk in the linear model whereas panic buying is solely affected by knowledge (β -1.459. p < 0.001). The respondents agreed that scarcity of single-use components (mean 4.32 out of 5) such as masker and goods inflation particularly groceries (mean 4.31 out of 5) will appear soon

Conclusions

It is important to disseminate the correct information to the public to reduce panic buying. Collaborative action between the government and medical staff should be done particularly in Java as the first locus of CoVid 19 in Indonesia.

Key messages

Knowledge regarding corona virus affects the Panic Buying. An intervention to disseminate the correct information should be done. To reduce the perceived risk, a rigorous action should be done in Java and a collaborative work between the government and medical staffs should be established.
Housing spaces in Europe: a comparative analysis of standards in nine European Countries
Authors: Raffo M , Appolloni L , D'Alessandro D
Published: October 2020

Introduction

In recent years, Public Health devoted a growing interest to housing conditions. In particular, housing dimensions and functional characteristics are relevant, mainly considering population ageing and disability. Aim of the study is to compare housing standards of some European countries to analyse their ability to satisfy new population needs.

Methodology

The dwellings dimensional standards of 9 European countries (Sweden, UK, Denmark, The Netherlands, France, Germany, Portugal, Spain and Italy) are compared. From the websites of the official channels of the various countries the regulations have been downloaded. The standards have been compared.

Results

A wide variability in the dimensions of room among the standards is observed (e.g. single room: from 9 sqm in Italy, to 7 sqm in France, to the absence of any limit in UK, Germany - Hesse and Denmark). Italian and French regulations define housing dimension considering the room use (eg. bed or living room) and the number of people. The Swedish regulation provides performance requirements and functional indications but does not specify the minimum dimensions of habitable rooms. The rooms' minimum height varies between the standards. In Italy and Portugal, the minimum height of the ceiling is intended to be 2.70 m, while in the other nations the minimum heights vary from 2.60 m in the Netherlands to no limit in UK.

Conclusions

A diverse approach among European Countries is observed: from a market-oriented logic (e.g., UK), in which minimum dimensions are not defined, to a prescriptive one (Italy), to a functionality-oriented (the Netherlands). The regulations of some Countries are health-oriented especially for most fragile social classes, since, defining larger dimensional standard, they reduce the risk of overcrowding, indoor air pollution and mental distress. However, considering the health, social, environmental and economic trends, many of these standards should be revised.

Key messages

Optimal housing standards promote the health and well-being of occupants. Healthy housing, healthy people.
An individual care plan for a high risk elderly population in the Local Health Authority of Bologna
Authors: Ciotti E , Catalani F , Martino F , Camplone I , Valisella C , Petroni M , Randazzo C
Published: October 2020

Issue

Fragility is a major challenge that demand a comprehensive public health response, since a high rate of population is aging and becoming vulnerable.

Description of the Problem

The Local Health Authority of Bologna, about 850,000 inhabitants, has implemented a new qualitative and quantitative Project on fragile patients. Frailty was measured by the “Risk Profile of the Emilia-Romagna region,”, an algorithm that provides a risk index, based on patients'record, which divide population in risk categories (high/very high, moderate and low risk) of hospitalization. The 585 General Practitioners (GPs) have enrolled their fragile patients with high and very high risk (about 6% of the population). GPs and other healthcare professionals are asked to define an Individualized Care Plan (ICP) according to an integrated and multi-professional management perspective. Patients' and healthcare professionals' subjective experience was collected throughout a structured interview.

Results

From October 2018 to April 2019, 260 patients were included in the project and they received a ICP which included different interventions such as: integrated nursing care (105), nursing care in chronic ambulatory (55), community hospital care (9), social assistance (92), physiotherapy (88), specialist activities (114). Qualitative data highlighted high level of satisfaction both in patients and clinicians. The strengths of the Project are: 1) an integrated management (with a multi- professional team) of frailty population, 2) proactive and individualized treatment plan. Limitations are: 1) different approaches among clinicians in the Local Health Authority of Bologna with possible inequalities of accessibility to the treatment; 2) difficulties in the relationships among clinicians.

The early recognition and the specialistic management of the fragile population have to be considered a priority in health practice in order to provide effective medical intervention.

Key messages

Individualized Care Plan (ICP) and integrated and multi-professional management. Importance of fragility early recognition.
Institutional strengthening for evidence-based health policies in the DR Congo (RIPSEC): Impact
Authors: Mwembo-Tambwe A , Chenge F , Criel B
Published: October 2020

Issue

In the DRC, the need to strengthen the health system for a more equitable charge of the health of the population in a perspective of universal health coverage proves to be relevant. Develop a culture that promotes decision-making based on scientific evidence, essential to improve the overall performance of the health system from this perspective

Description of the Problem

The RIPSEC program aims to (i) develop the capacity to manage health knowledge in the DRC through the creation of a Health Knowledge Center in the DRC, (CCSC- Asbl); to strengthen the scientific capacity of the Public Health Schools and the National Institute of Biomedical Research in health systems research and education and to strengthen the training capacity of the Public Health Schools by Development of Learning and Research Health Districts (LRHD). We assess the level of achievement of the results of this program.

Results

The majority of objectives have been reached.The CCSC-Asbl, created is an autonomous institution with legal personality. It produces scientific evidence and support for decision-making. The Ministry of Health has been strengthened and diversified. Institutional capacities and visibility have been strengthened through continuing education and the publication of scientific articles. But, no doctorals theses has been completed yet. Establishment of a consultation framework for health science training institutes: online training, short-term joint training on health system research. The third component concerns the development of LHRD; Transformation processes in the district went through a strengthening of the capacity of the district health teams and via a process of action-research.

Lessons

The RIPSEC program is increasingly becoming part of the Congolese health system as a strong partner.

Key messages

This experience can be used elsewhere in different contexts This program could be continued to perpetuate these fragile achievements. It corresponds to the felt needs and the priority of the health education system in the DRC or elsewhere.
Drugs in the environment: Do we know the risks?
Authors: Caminada S L , Caminada M L , Bocchiglieri M M , da Silva Paganini W
Published: October 2020

The occurrence of residual drugs in sewage and natural waters is an important international topic. The behavior of compounds in the environment and sewage treatment plants (ETEs) is influenced by their physicochemical properties, which govern partition in water, soil or biota.

The present study aims to identify the presence of clonazepan, simvastatin, paracetamol, atenolol, carbamazepine and fluoxetine drugs in biosolid from TEE before and after the composting process.

Based on the Environmental Protection Agency's Structure-Activity Relationship Model (ECOSAR) Program (EPA), and according to ZAGATTO (2006), the octanol/water partition coefficient (Kow) observed for ibuprofen drugs, fluoxetine and sinvastanin was 3.97, 3.82 and 4.68, respectively, denoting its bioaccumulation potential, which does not happen with the other compounds, as they present logKow < 3, being log kow = 0.03 for atenolol; 2.3 for carbamazepine; 0.49 for paracetamol and 2.53 for clorazepam.

AQUINO, 2013, mentions that drugs with logKow < 2.5 have high hydrophylycity and low absorption trend in biomass and lipid fractions of suspended solids. For Log Kow values between 2.5 and 4.0, there is a moderate tendency of absorption in these matrices.

Data on ecotoxicity, provided by the ECOSAR program, indicate the effects observed in fish, at the concentration of 30 μg/L for Sinvastatin and 20 μg/L for Fluoxetine.

The agricultural use of biosolids is a controversial subject due to the potential adverse impacts on human health. In the name of safety, strict standards, high quality criteria and restrictions on use are imposed, and standards should be based on risk assessment, but there is a lack of data on the subject, and there is still no clarity as to what constitutes tolerable risk in the brazilian context for the composition of a pattern.

Key messages

According to the results obtained, it is verified that the studied compounds have the potential to cause deleterious effects on the evaluated organisms, according to the ECOSAR model. Considering the little information available on the subject, especially in relation to the incidence and persistence of drugs in the environment, the continuity of studies is necessary.
Policy framework for building integrated care for TB patients in Romania: setting up the scene
Authors: Furtunescu F , Serban A , Mahler B , Munteanu I
Published: October 2020

Problem

Romania put many efforts for TB control, but despite a constant decreasing trend since almost two decades, TB remained a public health concern, due to the notification rate (highest in EU), the number of resistant cases and the mortality. A national strategy for TB control has been issues for 2015-2020, but its implementation was fragmentary.

Description of the Problem

Benefiting for a series of programs financed by the Global Fund to Fight AIDS, Tuberculosis and Malaria, Romania performed a detailed analysis of the national context, on four pillars (governance and accountability, service delivery, organizational capacity, resources). Quantitative data collected through routine systems were combined to interviews with key informers and focus groups with medical staff, patients and NGOs active in supporting key vulnerable population.

Results

A national framework for strengthening the implementation of the strategy was set up under a Tailored to Transition Global Fund Grant. This framework put together the policy and the technical levels and the civil society sector. Main interventions aimed to strengthen the governance, to improve the procurement and supply mechanism, to develop the ambulatory patient-centered model of care and to create tools for improving the access of key vulnerable population to basic integrated medical and social services.

Lessons

Translating the good practice models developed by the NGO sector to permanent (governmental) structures was difficult due to more rigorous legislative framework for public systems.

Key messages

Multisectoral approach is essential for building integrated care for TB patients. Integration of services should focus not only to complex medical needs, but also to the social ones.
Experience report on strategy design for effective public health policies in the Piauí, Brazil, 2020
Authors: Vilarinho L , Amorim A , Fé C , Cardoso O
Published: October 2020

Aim

Report of the ascending, collective and participative process of construction of the Strategic Action Plan of the State Secretariat of Health of Piauí for the period from 2020 to 2023 and its compatibility with the Planning and Management Instrument of the State of Piauí - PPA (Plano Pluri Yearly). Action developed for the Institutional Development Program of SUS. We sought consistency and compatibility for health needs and Government priorities, implementing public health policies, technical, operational and financial feasibility and feasibility, impact and improvement in living conditions and health of the population, reducing inequalities, expanding the access to inclusive health policies, increase in citizen's life expectancy and life expectancy at birth.

Methods

Workshops, with technical staff from the Health Secretariat and the State Planning Secretariat, using the Situational Strategic Planning-PES, in addition to the Balanced Scorecard, and the SWOT Matrix. The SESAPI Strategic Map was previously built, with priorities for the identification of plans and results oriented to the goals.

Results

The SWOT Matrix focused on analyzing the environment or scenarios, internal and external, with strategies to maintain strengths, reduce the intensity of weaknesses, use opportunities and protect against threats. The technical health priorities were legitimized and made compatible with the State Planning Secretariat, in Workshops with Social Representations of the 12 Regional Development Territories of the State.

Conclusions

The prioritized strategic actions embodied the definition of Budgetary Actions for the health area that conform to the LOA- Annual Budget Law, linking the estimated amounts to a set of indicators and desired and possible results to be achieved in the established period. The entire process was technically monitored and submitted to analysis and approval by the Social Control bodies in compliance with the provisions of the legislation in force.

Key messages

The prioritized strategic actions embodied the definition of Budgetary Actions for the health area and linked the estimated amounts to a set of indicators. All production has generated the formation of a government staff with managerial capacity to strategic planning and evaluation as part of training teams trained by the government.
Mortality of youth in changing socio-economic situation in the Russia
Authors: Sabgayda T P , Semyonova V G , Zubko A V
Published: October 2020

The past three decades in Russia (from 1989 to 2018) are characterized by significant changes in the socio-economic situation with corresponding fluctuations in death rate. Mortality of children (under 15 years of age) reflects a steady decline without pronounced ups; the dynamics of youth mortality (aged 15-29 years) shows three peaks (in 1995, 2000 and 2005), while in the mortality dynamics of people aged 30 years and over there were two peaks (in 1994 and 2003).

We analyzed what determines the uniqueness of the dynamics of young mortality. We revealed the next 8 specifics. The growth rate of youth mortality before reaching the first death rate (1995) as well as the rate of decline in mortality after the last peak (2005) are higher than in other population groups (1994 and 2003, respectively).Gender differences in youth mortality are more pronounced: among young people, male mortality decreased significantly faster than female mortality; in 2018, the ratio of male to female mortality was 1.3, 2.7, and 2.0 for age groups respectively 1-14, 15-29 and 30+ years old.Youth mortality is determined mainly by avoidable causes.Avoidable mortality of young people is more determined by living conditions and lifestyle.The quality of medical care has a more pronounced effect on the mortality of young men.There is a large variation in the avoidable mortality levels among youth for the analyzed period.For the analyzed period, the unavoidable mortality of young people increased to a greater extent than in the age group 5-64 (for which as a rule avoidable mortality was determined by the end of the last century).In youth mortality, the contributions of external death causes and infection diseases are greater than in older age group.

Conclusion. The regularities found allow us to conclude that the death rate of youth, which responding faster and more clearly to changes in socio-economic situation, can serve as quick indicator of avoidable population losses.

Key messages

The youth mortality, which responding faster and more clearly to changes in socio-economic situation, can serve as quick indicator of avoidable population losses. For period 1989-2018, the unavoidable mortality of young people increased to a greater extent than in the age group 5-64.
Adults with young children are more satisfied with their lives than other adults
Authors: Haapala E , Peltomäki H , Jääskeläinen T , Koponen P , Mäntymaa P , Lundqvist A
Published: October 2020

Background

Limited research exists on the differences in the wellbeing of adults with young children and those without. The aim of this study was to compare the well-being of adults with and without young children.

Methods

The study is based on the FinHealth 2017 Study of a nationally representative sample on adults aged 18-50-years (n = 4764, 58% participated). Information on wellbeing was collected through self-administered questionnaires. Adults living in a household with young children (under 7-years old, n = 762) were compared to adults living in a household without young children (n = 1864). Inverse probability weights were used in the analysis to correct for the effects of non-response and different sampling probabilities.

Results

Nearly 90 % of adults with young children rated their quality of life as good or very good and were more satisfied with their family life (women 84% vs. 76%, men 87 % vs. 78%) and life achievements (women 82% vs. 69%, men 78% vs. 58%) compared to other adults. No difference was observed in satisfaction with the financial situation. Differences in the experience of psychological distress (Mental Health Inventory, MHI-5 score ≤52) were statistically insignificant. 6% of women and 7% of men with young children experienced psychological distress while the equivalent percentage of other adults was 9% in both sexes. Differences in symptoms of depression (Beck Depression Inventory, 6 item score >4) were also statistically insignificant, although the prevalence was somewhat lower for those with children (women 12% vs. 15%, men 6% vs. 12%). Adults with young children reported sufficient sleep less often compared to other adults (women 64% vs. 76%, men 67% vs. 77%).

Conclusions

Most parents of young children have a good quality of life and are satisfied with their life. Getting sufficient sleep is one of the main challenges of adults with young children.

Key messages

Adults with young children are more satisfied with their life compared to other adults. There is still a need for holistic lifestyle guidance, especially to promote mental well-being and sufficient sleep of adults with young children.
MisuMedPT - Morbi-mortality consequences of misuse of psychoactive prescription drugs in Portugal
Authors: Araújo A , Bulhosa C , Goulão J , Martins A P
Published: October 2020

Background

In Portugal, there are no published data on the health-related consequences of prescription drug misuse, which is therefore a public health issue of unknown dimension in our country. Poison control centres and other pharmacoepidemiological sources can be part of a surveillance system for monitoring medicine's use and misuse.

Methods

Retrospective observational study of intentional exposures to opioid analgesics, antiepileptics, antidepressants, anxiolytics, hypnotics and sedatives reported to the Portuguese Poison Information Centre (CIAV) between 2014 and 2018. Variables studied were demographic characteristics of individuals, geographic distribution of calls, co-exposure to alcohol or illicit drugs, call origin, case evaluation and guidance.

Results

CIAV received 24624 calls reporting 34203 intentional exposures to any medicine, 31169 (91.1%) of which involving one of the studied psychoactive medicines and 20906 exposures having emergency room advice or effective hospitalisation. The most frequently involved medicines were benzodiazepines (62.0%) - alprazolam (15.4%) and diazepam (12.0%) - with trazodone ranking fifth (6.0%). Combination with non-medicinal products was seen in 2169 calls (9.4%), 2052 (94.6%) of which with alcohol.

Conclusions

There is female predominance in the poisonings reported involving any of the medicines studied. Benzodiazepines and antidepressants are the top classes reported. The rate of intentional exposures to psychoactive medicines is higher in Coimbra district, whose significant university student population requires further analysis of data. To adjust for the variability in the level of medicines' use in the population, work is undergoing to include rates of intentional poisonings in patients prescribed the studied medicines. To better characterise the potential consequences of misuse of psychoactive prescription drugs in Portugal, additional data on deaths involving these medicines will also be included in the project.

Key messages

First published Portuguese data on prescription drug poisoning reported to CIAV. First Portuguese project to analyse prescription drug poisoning, forensic and hospitalisation data.
Assessment of the attractiveness of robotic-assisted radical prostatectomy in the hospitals in Milan
Authors: Greco M , Mosillo M , Papa M T , Zanardi S , Tinaglia V , Nicolosi D
Published: October 2020

Background

Robotic-Assisted Radical Prostatectomy (RARP) performed in the hospitals of the Health Protection Agency (ATS) of Milan increased from 302 in 2011 to 1275 in 2019. On the contrary, Traditional Radical Prostatectomy (TRP) remained essentially unchanged (919 hospitalization in 2011, 937 in 2019). The increase in RARP occurred both for Lombardy (L) (223,7%) and particularly for out-of-Lombardy residents (EL) (565,5%). In 2011 66.5% of all EL treated with Radical Prostatectomy (RP) (RARP + TRP) in the ATS area were enrolled in hospitals equipped with robots, while in 2019 this percentage rose to 97.5%. In view of this important increase and considering the high density of hospitals with robots in Milan, it was analyzed if the reason for the EL displacement could be due to the possibility of performing a RARP.

Methods

The Hospital Discharge Cards (SDO) database was used for the analysis. Admissions to be considered were identified through the main diagnosis of localized malignant prostatic cancer and the surgical intervention of RP. The other urological interventions were identified through the discharge ward. The “residency” field allowed to separate L from EL.

Results

Considering the four hospitals where robot technology was already available in 2011, the percentage changes in hospitalizations were compared for: only RP interventions, all urological interventions excluding RP, total hospital production distinguishing between L and EL. RP increased by about 5 percentage points in EL (from 43.5% in 2011 to 48.7% in 2019). For other urological surgeries excluding RP, the increase was about 11 pp (from 16.1% in 2011 to 27.3% in 2019), as well as for general procedures (15.5% in 2011, 26, 2% in 2019).

Conclusions

The increase in EL for RP is lower than the increase observed for other urological surgeries and on all hospital production. It can be concluded that it is not the RARP technique itself that is attractive to EL, but rather the reputation of the hospital.

Key messages

In 2019 the number of robotic-assisted radical prostatectomy increased 4,2 times compared to 2011. R-assisted radical prostatectomy is not a determining factor for health mobility towards Lombardy.
Acute gastroenteritis outbreak: epidemiology at the core of investigation
Authors: Carvalho Sousa S , Fernandes S , Novais L , Verne M , Areias R , Dourado F , Ribeiro M
Published: October 2020

Background

At 28th February 2020, local public health authorities were notified that an occupational activity center headed to adult individuals with disabilities, in Guimarães (Portugal), had several cases of users vomiting or with diarrhea during that week, requesting control measures.

Methods

An outbreak investigation was carried out, with case definition being someone with nausea, vomiting and/or diarrhea. An epidemic curve was made with the number of cases per date of symptoms onset. Attack rate was calculated as the number of cases in the occupational activity center divided by the number of people in the same center.

Results

Mild, self-limited acute symptoms of nausea, vomiting and/or diarrhea were identified in 18 individuals that attended the occupational activity center. The first case developed symptoms on 24th February (day 0); the second case appeared about 24 hours after; the peak occurred at day 4 with seven cases. Attack rate was 27% among users and 15% among monitors. The mean age was 40 years. Two cases went to the emergency department and were clinically diagnosed with acute viral gastroenteritis, no further care needed. Meals were served at a neighbor building, shared with another rehabilitation institution. The rehabilitation institution reported zero cases. Additionally, Hazard Analysis and Critical Control Point process was fully accomplished.

Conclusions

Clinical and epidemiological findings suggest a probable viral outbreak with person-to-person transmission. The incubation period is consistent with norovirus, the most common agent of viral gastroenteritis. No biological samples were collected, because symptoms were mild and there was no chance to do it. Environmental samples were not collected. Preventive hygiene measures were immediatly enhanced, namely hand washing, appropriate disinfection of contaminated surfaces and isolation if symptomatic. These measures are highly efficient breaking the chain of infection and that was obtained.

Key messages

Epidemiological findings are at the core of an outbreak investigation and support immediate implemention of effective control measures. Although laboratory results are important, they are not always available for outbreak investigation.
Change in infectious mortality in Russia and its capital in the post-Soviet period
Authors: Ivanova A E , Sabgayda T P , Zubko A V , Semyonova V G , Evdokushkina G N , Lopakov K V
Published: October 2020

Based on data of Rosstat for 1989-2018, changes in structure of infectious mortality (IM) in population of Moscow are analyzed in comparison with situation in the country as a whole. Age structure of European population was used to calculate standardized death rates. The rise in IM after change in Russian socio-political structure was less pronounced and not as long in Moscow as in the country. During analyzed period, IM increased by 1.4 times among men and 2.2 times among women in Russia while in the capital male IM decreased by 8.9% and female IM increased by 1.4 times. IM of Muscovites was lower than average Russian IM by a quarter in 1989 and twice in 2018. The highest IM was observed at age of 85 years and older in 1989 and at age of 35-39 years in 2018.

Proportion of tuberculosis (TB) has significantly decreased (from 60.8% in the country and 65.5% in the capital to 19.9% and 9.9%). In the country, male TB mortality decreased by 1.8 times and female TB mortality in 2018 approached the 1989 level; in the capital, mortality of men and women decreased by 4.6 and 2.9 times. Proportion of AIDS has increased. The death rates began to exceed TB mortality since 2015 among men and since 2014 among women in Russia and since 2010 and 2007 in Moscow. In 2018, the share of AIDS was 60.2% (58.2% and 62.9%) in country and 55.0% (55.8% and 52.9%) in capital.

Proportion of viral hepatitis has increased. In the country, mortality increased by 3.8 times for men and 3.0 times for women, in the capital, mortality increased by 1.6 and 13.0 times respectively. In 2018, the share of viral hepatitis was 6.5% (6.1% and 6.8%) in country and 16.5% (7.1% and 37.1%) in Moscow. Proportion of socially significant diseases in IM increased from 63.9% in country and 69.4% in capital to 90.7% and 86.2%. The peculiarities of IM in Moscow, given the greater availability of antiretroviral therapy, suggest that this IM is caused by a fairly wide consumption of injecting drugs by residents of the capital.

Key messages

Proportion of socially significant diseases in infectious mortality increased from 63.9% in country and 69.4% in capital to 90.7% and 86.2%. The peculiarities of IM in Moscow, given the greater availability of antiretroviral therapy, suggest that this IM is caused by a fairly wide consumption of injecting drugs by residents of the capital.
Investigating the Effective Factors on Family Physicians’ prescriptions
Authors: Ghanbarzadegan A , Kavosi Z , Karimi S , Peyravi M , Ghorbanian A , Bastani P
Published: October 2020

Introduction

The physicians are responsible for prescribing medicine rationally. Physician's awareness of prescribing guidelines can lead to the selection of the most effective, appropriate and effective measures to the improved prescription. This study aim is to determine the factors influencing drug prescribing behaviour in family physicians.

Methods

This cross-sectional study was conducted in 2016 on a case study including 150 family physicians from Shiraz City who were selected by systematic random sampling method. A questionnaire related to the behaviour of prescribing physicians was used based on the theory of planned behaviour to collect data. The validity of the questionnaire was confirmed by the experts' opinion and its reliability was confirmed by calculating the Cronbach's alpha. The data were analyzed using structural equation modelling (SEM) by SPSS and Smart PLS software.

Results

It was specified that 39.3% of Shiraz family physicians have prescribed medicines for their most patients (61-70%) during the last month. Furthermore, 60% of physicians have prescribed for about 20% of their patients without any examination. In addition, 63% of doctors have repeated prescription for about 20% of patients with chronic disease. Based on the obtained results of the Research Structural Equation Model, none of the four considered variables explains changes in physicians' behaviour regarding prescribing. Although, “mental and perceived behavioural control” explain 30.2% of the changes in the intention of prescribing medication of family physicians in Shiraz.

Conclusions

The family physicians' behaviour in prescribing medicine shows the impact of factors such as the patient's request, as well as the role of the patients and colleagues pressure for prescribing medicine as a quality criterion for their practice. norms of mental and perceived behavioural control are effective in explaining the purpose of prescribing.

Key messages

Policymakers should implement policies to develop physicians’ behavior and logical prescription by education, financial incentives; consequently. Mental and perceived behavioral control are effective in explaining the purpose of prescribing.
The 15-years trajectory of the Health, Well-being and Aging (SABE) study in São Paulo State, Brazil
Authors: Oliveira A M B , Marques A P , Silva B C S , da Cruz D S , Menezes F S , Duarte Y A O , Santos J L F , Casarotto R A
Published: October 2020

The Health, Well-being and Aging (SABE - Saúde, Bem-estar e Envelhecimento) study was developed by the Pan American Health Organization (OPAS/OMS) to provide information on the living conditions of the elderly. The multi-center survey on health and well-being of the elderly was carried out in seven urban areas in Latin America and the Caribbean. The study took place between October 1999 and December 2000 in Argentina, Barbados, Brazil, Chile, Cuba, Mexico, and Uruguay. In 2006, only in Brazil, the SABE Study became a longitudinal and multiple cohort study with the aid of the São Paulo Research Foundation (FAPESP) and the Ministry of Health. In each cohort (2006, 2010 and 2015), data was collected among the elderly who were participants in 2000, and new 60 to 64-year-old subjects were inserted. The probabilistic sample of the participating individuals was obtained through the method of multi-stage conglomerates sampling by stratifying the primary units. We also considered the socioeconomic strata of the municipality urban area. The baseline for carrying out the sample calculation was the population count of the Brazilian Institute of Geography and Statistics (IBGE). Data was collected by trained interviewers. They used a standardized questionnaire to retrieve information regarding, for example, cognitive assessment, health status, and use and access to services. At the moment, the SABE Study follows 1,224 elderly individuals. The information collected from the SABE Study is available through the electronic address . The aging process occurs differently when factors such as sex and socioeconomic aspects are considered. Thus, accompanying the elderly over time and knowing their living conditions are essential for proposing public policies according to reality.

Key messages

The Health, Well-being and Aging (SABE) study has been monitoring elderly people since 2000 in the city of São Paulo and provides information on their living conditions. The monitoring of the elderly enables the development of public policies that are more focused on the needs presented.