bluuebunny/crossref_metadata_2025 huggingface dataset:
Using market data to understand corporate behaviour
Authors: Hiscock R
Published: October 2020

Background

Tobacco companies sell tobacco in order to invest in the business and make profits for shareholders. One element in creating profitability is via data driven marketing. Such data are also useful for public health because an understanding of pricing and sales patterns can help with the development of effective tobacco control methods by understanding how the tobacco industry is making profits.

Methods

Study 1) Public and commercial databases which provide free or paywalled access to market data were identified. Internet searches were conducted to understand more about their ownership, mission of the owners, funding and accessibility

Study 2) University of Bath studies using such datasets to understand the tobacco industry were reviewed to synergise the ways in which corporate behaviour has undermined tobacco control policy.

Results

The United Nations provides freely accessible national level statistics on imports and exports of raw tobacco and manufactured tobacco products. Limited survey data may be available on the last product smoked. Proprietary databases are expensive, may have usage restrictions and links to the tobacco industry but can provide a detailed picture of tobacco product sales and prices. Research on such databases has illustrated how the tobacco industry kept cheap tobacco available despite tobacco taxes, used tax rises to increase their own revenue and used a standardised packaging sell through period to keep branded packs on the market for longer.

Conclusions

Governments should require the tobacco industry to provide market data in an easily publishable form

Key messages

The most detailed data on the tobacco market is proprietary. Proprietary databases are expensive, may have usage restrictions and links to the tobacco industry. Understanding of pricing and sales patterns can help with evaluating the effectiveness of tobacco control policy.
Evaluation of colistin consumption in swine and poultry of Marche region during the 2017-2019 period
Authors: Aconiti Mandolini N , Perugini G , Filippini G , Pierucci P , Baiguini A , Vaccaro A , Pelagalli G , Marinelli F , Capuccella M
Published: October 2020

In Italy, the National Plan against Antimicrobial Resistance (PNCAR 2017-2020) involves both human and veterinary sectors. The last one was requested to reduce colistin consumption, a first choice antibiotic for human health. Indeed, the Plan defines specific limits to reach within 2020. In Marche region, there is a project from 2017, consisting in monitoring antibiotic consumption in livestock, with particular reference to Critically Important Antimicrobials (CIAs), like colistin. The project represents an AMR stewardship, which involves regional Veterinary Services, veterinary professionals and the IZS Umbria e Marche, developing a specific training and education path ad hoc.

In this work, we have considered data coming from swine and poultry prescriptions of Marche region in the 2017-2019 period, using these for the calculation of ADDD (Animal Defined Daily Doses), a method already used in human. In practice, we have first established DDDvet values, as suggested by ESVAC, obtained from the Italian drugs containing colistin made for the considered species.

Colistin prescription in swine reduced of 97% (from 20.60 in 2017 to 0.69 DDD/1000 animals-die in 2019). In poultry, a reduction of 69% was obtained (from 5.07 in 2017 to 1.56 DDD/1000 animals-die in 2019). Then, there was an evidence of reduction more than 70% in colistin consumption, demonstrating the importance of the education and awareness program sponsored by Competent Authorities and the other stakeholders involved. The used method of calculation (ESVAC) is different from the currently applied one, as it consists of standardized unity of measures, using prescription data rather than sales ones.

Monitoring antibiotic consumption both in human and veterinary sector is essential to understand AMR, as well is important the possibility to compare the data to each other. The present work demonstrate that, also in veterinary, is possible to apply the DDD-method to evaluate antibiotic consumption, like colistin.

Key messages

Colistin consumption has reduced in swine and poultry sectors in the 2017-2019 period. A standardized method of calculation of antibiotic consumption in animals is strongly needed.
Accuracy of the need for dental prosthesis and associated factors between elderly in Recife, Brazil
Authors: Santos L F R , Carvalho E P , Oliveira S R A , Moreira R S
Published: October 2020

Background

The latest national oral health survey showed a high prevalence of the need for dental prostheses between the Brazilian elderly. To classify this need, normative (clinical) and subjective (self-reported) criteria must be considered since patients' self-perception takes into account social and functional issues that arise with oral health problems. Few studies investigate the agreement between these criteria, as well as its determinants. Thus, this study aimed to investigate the accuracy of the need for the use of total dental prosthesis and factors associated with the agreement between criteria.

Methods

Cross-sectional study, carried out in three municipalities in the Metropolitan Region of Recife, with a random sample of 816 elderly people from 65 to 74 years old. The dependent variable was the accuracy, calculated by the agreement between the self-reported and the normative need for a total dental prosthesis, and the independents were assembled in three blocks (socioeconomic/demographic, access to oral health services and self-perceived oral health). Hierarchical logistic models were conducted for total upper prosthesis (TUP) and total lower prosthesis (TLP).

Results

The self-perception of the need for prosthetic use presented an accuracy of 75.9% (95% CI = 72.8-78.7%) for TUP and 78.6% (95% CI = 75.6-81.3%) for TLP. In the multiple analysis, the accuracy for TUP and TLP needs holds an association with the variables: family income, age and time since the last dental appointment.

Conclusions

In conclusion, the self-perception of need for dental prosthesis demonstrates potential applicability for the elderly, presenting notable accuracy values. It suggests that studies based on patients' self-reports should be stimulated, aiming for the evaluation and validation of self-reported criteria in different contexts and cultures. Furthermore, the identification of accuracy associated factors can help to build more meaningful questions to be used in future surveys.

Key messages

The use of the self-reported need for total dental prosthesis may be feasible when considering lower cost, reduced time of execution and ease of use in population epidemiological surveys. Application of self-reporting as an epidemiological tool for planning and monitoring oral health services, incorporating it in the form of indicators for oral health surveillance.
A systematic review on resource allocation in public health
Authors: Barbosa E , Gonçalves A , Guerra M , Cruz C
Published: October 2020

Background

Research in resource allocation is a need arising from State interference by the allocative function, which seeks to promote resource adjustments with the provision of certain goods and public services (Musgrave, 1974; Musgrave & Musgrave, 1980, Longo & Troster, 1993). In this perspective, a research question arises: how has international literature on the field of Business, Management and Accounting been approaching resource allocation in public health?

Methods

Systematic Literature Review through the Scopus Database. keywords: “public health” and “resource allocation”. The types were Article and Review. Language: English, since it is internationally accepted in scientific articles, and Portuguese, in order to include Brazilian research. Search period: from 1976 to 2017. Areas: “Business, Management and Accounting”. The performed analysis technique was qualitative meta-synthesis and by using the MAXQDA Analytics Pro 18 software.

Results

The first identified study was in 2000 Sweden, pulished in Health Care Management Science. The most recente in 2017 Brazil, published in Evaluation and Program Planning. Among the countries that presented the largest production, the United States is highlighted (4). Dispersion of publication among reviews was noted. Generally, publications are grouped in four perspectives: adequate allocation, resource management and effective cost; resource allocation for treating specific diseases; resource allocation for decision-making; and health evaluation and the need of informing resource allocation. The prevailing lack of theoretical grounding must be highlighted.

Conclusions

Can be inferred that this production is recent, that it does not possess a specific focus or outline, as there is a variety of approaches, most of them being geared towards healthcare and disease control, such as cancer, diabetes, overweight, rabies, malaria and infectious diseases.

Key messages

International literature indicates that the theme is yet unexplored in the field of Business, Management e Accounting and most studies are geared towards healthcare and disease control. Allocation in the public-health policy as a function of the role of the State in providing the necessary budget for financial availability and not cost-wise, suggests lack of research.
Early genotoxic effects from exposure to environmental pollutants young people from South Italy
Authors: Lavorgna M , Angelillo S , Gentile M , Nugnes R , Orlo E , Russo C , Isidori M
Published: October 2020

Children and young people are particularly sensitive to the environmental pollution which is closely related to degenerative diseases. Several studies show that a genotoxic damage during young age can increase the risk of chronic diseases in adulthood. The young people are more vulnerable than adults to the environmental pollutants because they spend more time outdoors, they have immaturity of some organs and of the mechanisms involved in the cellular repair. In the present study, the early biological effects of exposure to a particularly polluted area of Southern Italy were evaluated in 200 children (6-10 year-old) and 100 young people (18-25 year-old). This area, worldwide known as Sarno basin, is characterized by strong anthropization, many agro-food processing industries, massive use of fertilizers and pesticides in agricultural practices and a strong river pollution. The comet assay was chosen because it reflects cumulative exposure to a variety of environmental factors and it was performed on salivary leukocytes in the children selected for the survey, while in the young people the DNA damage was evaluated in human peripheral blood lymphocytes. As in previous studies were not find significant differences between salivary leukocytes and blood lymphocytes we preferred the sampling of saliva for the children to avoid bloody practices. Furthermore, before cell sampling the children's parents were interviewed using an ad hoc questionnaire designed to gather additional information about exposure sources. A questionnaire was administered also to the young people to have more information on their lifestyle and some characteristic of the area of exposure (vehicular traffic and so on). The results showed a clear damage from exposure in the children differently from young people.

Key messages

Comet assay was performed in vitro on lymphocytes of 200 children (6-10 year-old) and 100 young people (18-25 year-old) exposed to a particularly polluted area of Southern Italy. An evident DNA damage was observed in lymphocytes coming from children; no genetic material alterations were observed in young people.
Family physicians’ barriers to addressing patients smoking: cross-sectional data from 2002 and 2014
Authors: Põld M , Pärna K
Published: October 2020

Background

Family physicians have an excellent opportunity at primary health care level to influence patients' smoking behavior. Routine screening of all patients for tobacco use is recommended. The objective of the present study was to explore factors related to addressing patients' smoking habits among FPs.

Methods

Two postal cross-sectional surveys were conducted among the sample of all practicing physicians in Estonia (n = 4140 in 2002, n = 5666 in 2014). Questionnaires of under 65-year-old FPs were included (n = 473 in 2002, n = 468 in 2014). Frequency of addressing patients' smoking habits and agreement with statements concerning perceived barriers, along with confidence intervals (CI) were calculated. Associations of addressing patients' smoking habits at least once during last 7 days with perceived barriers were calculated using logistic regression analysis. Fully adjusted odds ratios (OR) were determined with corresponding 95% (CI).

Results

The prevalence of addressing patients' smoking at least once during last 7 days was 96.4% (95% CI 94.2-98.7) in 2002 and 97.1% (95% CI 95.0-99.1) in 2014. FPs who agreed that lack of time is a barrier to addressing patients' smoking, were significantly more likely to address patients' smoking (OR 3.53; 95% CI 1.36-9.16) compared to FPs who did not agree with the statement. FPs who agreed that lack of habit is a barrier, were significantly less likely to address patients' smoking (OR 0.14; 95% CI 0.06-0.34) compared to FPs who did not agree. FPs smoking status was not significantly associated with addressing patients' smoking.

Conclusions

Majority of family physicians addressed patients' smoking habits. Addressing patients' smoking habits was significantly associated with agreeing that lack of time and lack of habit is a barrier to addressing patients' smoking. Results of the present study are useful for policymakers and other institutions involved in organization and development of smoking prevention training and cessation services.

Key messages

Majority of family physicians addressed patients’ smoking. Addressing patients’ smoking was significantly associated with lack of time and lack of habit as barriers to addressing patients’ smoking. Smoking prevention training and organization of cessation services would further enable family physicians to routinely address patients’ smoking habits.
Comparing quality of care using patient-reported outcomes in patients with localized prostate cancer
Authors: Kowalski C , Sibert N , Breidenbach C , Feick G , Carl G , Roth R , Dieng S , Wesselmann S , Burchardt M , Fichtner J
Published: October 2020

Introduction

The Prostate Cancer Outcomes (PCO) study, funded by the Movember Foundation, has been recruiting patients in prostate cancer centers in Germany, Austria and Switzerland certified by the German Cancer Society (DKG) since July 2016. It is a joint project of the Federal Prostate Cancer Self-Help Association (BPS), DKG, OnkoZert and meanwhile over 100 participating centers. The aim of the study is to compare the outcome quality between the centers for mutual learning and to use patient-specific evaluations for treatment planning.

Materials and Methods

The protocol was set up according to the International Consortium for Health Outcomes Measurement (ICHOM) Standard Data Set with patients filling out the EPIC-26 before and at least once (after 12 months) after treatment. The EPIC-26 includes the functional outcome domains 'incontinence', 'irritative / obstructive', 'gastrointestinal', 'sexuality', and 'hormonal “. Questionnaire data are linked to disease and treatment data in the centers. The EPIC-26 domain scores are then analyzed centrally to provide case mix adjusted center comparisons stratified by treatment.

Results

As of May 2019, 11,303 patients were recruited the PCO study. For 3,953 of them, results of the follow-up survey after 12 months were available for analysis. The results show changes in the scores similar (e.g. an adjusted decrease in the incontinence domain by 15 points for patients receiving radical prostatectomy) to what was known from the international literature 12 months after primary therapy. Results vary significantly between the centers, suggesting differences between providers that warrant improvement interventions.

Conclusions

The results are used to develop strategies for improvement together with providers and patients and to implement patient-specific evaluations for treatment planning in everyday treatment.

Key messages

A patient-reported outcome routine was successfully implemented in over 100 prostate cancer units in central Europe adopting the same data infrastructure. Benchmarking results demonstrate meaningfully differences across units that warrant improvement interventions.
A coprological survey of zoonotic tapeworm Bertiella spp. in free living nonhuman primate in Brazil
Authors: Tietz Marques S , Meyer J , Meller Alievi M
Published: October 2020

Background

Bertiella genus is parasitic tapeworms of non-human primates in nature. B. studeri and B. mucronata have been identified in children and adults with some contact or association with non-human primates. This study aimed to identify zoonotic tapeworms of the genus Bertiella in stool samples from Alouatta guariba clamitans, a primate from the New World, living free in a human community.

Methods

The study of Bertiella spp. comprised a coprological survey of feces collected from 131 brown howler monkeys, male and female, infant and adult, from free-living troops in nine neighborhoods in southern Porto Alegre, including places with increasing anthropization and population pressure, and an estimated population of 83,312 inhabitants. The study lasted four years (2015 to 2018), with stool samples collected from primates under care at the Centre for Wildlife Rehabilitation and Conservation of the Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, Brazil. As per usual protocol, all wild animals treated at the Center undergo parasitological examination. Individual freshly collected samples were subjected to the Willis-Mollay method and the Lutz technique.

Results

The average prevalence of Bertiella spp. was 31.3% (41/131). The annual frequencies were 27.3% (6/22), 30% (11/37), 25% (5/20) and 36.5% (19/52), respectively for the years 2015, 2016, 2017 and 2018.

Conclusions

The results demonstrate that Bertiella spp. was present in parasitic fauna over the four years studied and represents a zoonotic potential. Therefore, these methods should be carried out routinely, as they help in the appropriate treatment when necessary. The control and the prevention of this zoonosis are difficult since the intermediate hosts are cosmopolitan. It is suggested that an epidemiological inquiry in humans be performed to ascertain the true prevalence of this parasitosis.

Key messages

Create a schedule of routine test with underserved populations to monitor zoonoses. Poor communities need to be included in government programs.
Valorising Public Health activities, a regional shared Methodology: Final Products 2017-20, Italy
Authors: Smaniotto C , Del Bianco F , Bolzonello C , Bomben L , Candela G , Caffieri C , Oppi C , Campanale C , Cinquini L , Brusaferro S
Published: October 2020

Issue

Italian Public Health services still lack adequate measuring systems for effectiveness and sustainability, as well as standard definitions for many Public Health activities (PHA), meaning a shortage of data reflecting performance and generation of value. Within the Friuli Venezia Giulia region, the Final Products (FP) project created a process-based management system for PHA to support scheduling, allocation of resources and the assessment of quality and appropriateness.

Description of the Problem

From June 2017 to October 2018, 68 Public Health professionals (PHP) from 10 Public Health areas composed flowcharts and dossiers for 102 processes (named FP). Within each of them, they traced and collected PHA in a regional glossary of 184 items, providing standard definitions for them. A Committee of 18 PHP from the original team validated the system to perform from June to July 2019 a valorisation phase, in which all regional PHP were asked to valorise PHA through a matrix-based assessment in terms of personnel involved and time required.

Results

Valorisation was performed by 445/557 PHP (80%). Data were analysed both as a regional output and as grouped for Public Health district, allowing comparative assessments. A Summary Document (SD) for each FP was created, tabulating time and personnel data. SDs will be returned to the Committee in 7 regional meetings (February-October 2020), one for each Basic Healthcare Levels (A-G) category, and a wrap-up document will be presented to regional policymakers in November 2020.

Lessons

The project allowed the region to acquire a document summarising process standards for PHA. Mapping and standardising processes while framing the current organisational set-up defined more clearly the role of all PHP within Departments of Prevention to add value to each professional figure. Time quantification, especially, showed different approaches to PHA and processes among different regional Public Health settings.

Key messages

Process management can be successfully used to identify current specific issues in Public Health activities, in order to implement solutions based on a shared methodology and reliable data. Departments of Prevention can make output assessments easier and better structured through the application of process analysis and managerial competencies.
Hospital-territory integration: the role of the Integrated Access Point service of Udine
Authors: d'Angelo M , Panzera A , Favro R , Paulin G , Innocente A , Roncastri F , Vinicio S , Moimas D , Canciani L
Published: October 2020

Background

The Integrated Access Point (PUI) is a service of the district of Udine, of the then University Health Agency (ASUI-Ud), which guarantees access to local health services for patients reported with a protected discharge path. The following study aims to evaluate the progress of the reports taken in charge from January to August 2019.

Methods

The reports were analyzed according to age (mean; standard deviation) and gender (M; F) of the patients; reporting date both 24 hours (h) from entering the ward and 72 h from discharge; hospital transfer, discharge with or without activation of home care services; transfer to intermediate care facilities (RSA) and evaluation date (UVM), nursing home (CDR) or Hospice (HO). The study also includes protected discharge with: non-dischargeable patient, no service provided and more. The data was extracted and analyzed with the Business Object XI program and Microsoft Excel.

Results

From January to August 2019, 24 hour reports were processed by the PUI relating to 2223 patients: 45.8% of these were M (74.8; 14.2); the remaining 54.2% instead of F (79.8; 12.8). The greater proportion of reports was also accompanied by the reporting form at 72 h 88.5%. Territorial services were activated as follows: home care services (ADI) for 42.1%, HO (2%), CDR (1.3%) and RSA (19.1%). The percentage of UVM is 22.6%; those concerning the remaining categories are respectively 10.5% (no service), 5% (other). Finally, by evaluating the monthly trend of the processings, it emerges that 27.1% of these refer to reports from the winter months (from January to February).

Conclusions

The higher volumes of the activities of the Integrated Access Point (PUI) were reported in the first two months of the investigation period. The service represents a strategic hub: ensuring continuity of care for most patients reported with protected discharge, allows for integration between hospital and local care.

Key messages

The Integrated Access Point (PUI) guarantees the continuity of care for most patients reported with protected discharge. The major volume of the activities of the Integrated Access Point (PUI) were reported during the winter months of the investigation period.
Descriptive analyse of a case control study in Portugal: identify to prevent
Authors: Braz P , Machado A , Santos J , Lacerda C , Didellet C , Dias C M , Group H W
Published: October 2020

Background

Prenatal exposure to environmental risk factors are one of the known causes of congenital anomalies (CA). In 2015, a cluster of anorectal anomalies, a rare malformation, in Setúbal district raised interest in researchers. The aim of study was to assess the impact of prenatal exposure of the mothers on the occurrence of CA in the offspring.

Methods

A Case-control study (1:2) was implemented between 2016-2019. Newborns with CA (cases) and newborns without CA (controls) are identified and recruited. Parents were personally interviewed by a health professional using a standardized questionnaire. A descriptive analyses was performed and cases and controls were described based on maternal residence during pregnancy. Chi-square test was used to compare cases and controls.

Results

97 cases and 194 controls were identified. There was a male predominance in the case group (60 vs. 34) and no difference in gestational age between case and control groups. The mean birth weight was similar (3115g in cases vs. 3221g in controls). There was no difference related to mean mother's age nor the presence of maternal chronic disease. Smoking had more expression in the case group (21,2% vs. 16,3%). Moita (37,8%) is the municipality with higher frequency of cases. Musculoskeletal anomalies were the most frequent (35.4%), followed by genital (22.2%) and other anomalies (11%). During the study period, five cases with anorectal anomalies were reported, 4 of them born at 2016 and in 3 the mothers residence place was Moita.

Conclusions

In this study, the high proportion of cases from Moita suggests a possible environmental exposure to a teratogenic agent. Also smoking during pregnancy could be a high risk to anorectal anomalies, as suggested in other studies. More investment in public health measures could protect population from harmful environments.

Key messages

Pprenatal exposure to environemental risk factors increase the risk of congenital anomalies. Mothers residence and place of work could be a risk factor to pregnancy.
Expenditure trends in ambulatory care sensitive conditions in Piauí, Brazil, 2009 a 2018
Authors: Sousa R , Silva F , Silva R , Santos R , Justino A , Cardoso T , Cardoso O
Published: October 2020

Introduction

Hospitalizations for ambulatory care sensitive conditions (ACSC) are an indicator that assesses the effectiveness of Primary Health Care. Such hospitalizations burden the public health budget and use the resources that could subsidize other health actions.

Aim

Analyze expenditure trends in hospitalizations for Ambulatory Care Sensitive Conditions (ACSC) in Piauí, Brazil, from 2009 to 2018.

Methods

Ecological time-series study based on data from the Hospital Information System (SIH). For temporal trend analysis, a linear regression model was built using the Stata version 14 program.

Results

US$ 119,559,009.56 (Average = US$ 6,292,579.45/year) was spent on ACSC, representing 17.3% of the total hospitalizations (US$ 690,714,037.24). 2010 was the period with the highest cost (14.8%). In contrast, 2018 was the year with the lowest expenditure (5.8%). 23.7% of the costs went to hospitalizations for gastroenteritis. There was a significant decrease in total expenses with ACSC (β = -1.27; 95%CI: -1.65; -0.89; p < 0.001). There was also a reduction in expenses per individual hospitalized, while in 2009, the average expenditure was US$ 230.97/hospitalization, in 2018 it was US$ 157.30/ hospitalization, representing a significant reduction of 31.9%, (β = -12.4; 95%CI: -18.2; -6.6; p = 0.001). The “asthma” and “hypertension” groups showed the greatest cost reductions, 84.8% and 80.7%, respectively. However, an increase in spending on diseases related to prenatal and childbirth (4.1 times) and skin infection (3.9 times) was identified.

Conclusions

Part of the cost reduction is explained by the reduction of hospitalizations for ACSC. The reduced spending averages are compatible with lower hospitalizations by most expensive groups. Linked to these findings, it is observed that Brazil has faced a period of recession since 2015. To this end, additional research must be carried out to relate the expansion of health coverage with the results presented.

Key messages

The costs of hospitalizations for PHC-sensitive conditions reflect the policy of inducing health system coverage, being lower for greater coverage. The evaluation of the cost of specific groups allows the induction of PHC policies focusing on the specific care for each group with a higher cost so as not to burden the health system.
Evaluation of Access on the perspective of adult users of Primary Health Care in Fortaleza, Brazil
Authors: Borges Costa L , Salles Gazeta Vieira Fernandes C , Custódio Mota T , Torquato Santos E , Moura de Almeida M , Vaudelice Mota M
Published: October 2020

The Alma-Ata Conference promoted Primary Health Care (PHC) worldwide as a form of universal and continuous access to quality and effective health services. In Brazil, PHC, through the Family Health Strategy (FHS), aims to be the gateway to the health system and its structuring axis. For this, it is necessary to promote access, an essential condition for the quality of health care services, following the attributes systematized by Barbara Starfield. The aim of this study was to evaluate the presence of the attribute “First Contact Access” on the perspective of adult users of public PHC services in the city of Fortaleza, Ceará, Brazil. A transversal study was carried out, in 19 PHC Units, from June to December 2019, using the Primary Care Assessment Tool (PCATool) Brazil version for adult users. Kruskal-Wallis test was used for statistical analysis. 233 users participated, mostly women (69.5%), aged 30 to 59 years old (55.3%), mixed-race (69.5%), with complete high school (38.2%), without private health coverage (89.3%), homeowners (68.7%) and belonging to families of up to 4 members (87.9%). The “Accessibility” component had the lowest score, 2.83, and the “Utilization” had the highest score, 8.06. Older age was associated with higher “Accessibility” scores (p = 0,018), while lower values of “Utilization” were associated with higher education (p = 0,004). The main problems observed were: low access for acute demand consultations, lack of access at nighttime and weekends, little access through non-personal ways, bureaucratic barriers and a long time for scheduling appointments. We conclude that, although there was an improvement in PHC coverage in the city over the years, mainly due to FHS, there is still a lot to improve to ensure timely access to health services.

Key messages

Users consider PHC as the usual source of care, demonstrated by the high score of 'Utilization', however, they are unable to use it when necessary, demonstrated by the low score of 'Accessibility'. Expanding forms of access is essential to contribute to the strengthening of PHC in Fortaleza, Brazil, facilitating the entry to its national Universal Health System.
Drinking water quality surveillance for the state health care clinics in the city of Manaus, Brazil
Authors: Menezes M D S , Menezes A C S , Costa C F , Barroso G G S , Oliveira R P , Figueira E A G , Serrao R C S
Published: October 2020

Introduction

Microbial contamination of drinking water is a public health problem due to its pathogenic potential. In Brazil, the MS/GM no.5/2017 ordinance, sets guidelines for monitoring water quality for human consumption (VQACH). The state of Amazonas is part of the Amazon biome as one of the seven states from the north region of Brazil and its capital, Manaus, located in the geographic center in the Amazon is shelter to more than 2.000.000 inhabitants.

Objectives

Evaluate microbiological parameters of water quality in state health care clinics in Manaus.

Methods

In the period between, January 2017 to December 2019 through actions of the Health Surveillance Foundation (FVS) and Amazonas Central Laboratory (LACEN) actions of VQACH were implemented following the current legislation standards. 62 health care clinics were monitored, making a total of 1,715 water samples, which resulted in the same number of microbiological analyzes; the reports issued had their results arranged in monthly and annual tables, allowing a comparative study between the number of samples analyzed and the percentages with absence of total coliforms and satisfactory for Escherichia coli (E.coli).

Results

The VQACH actions, resulted in significant gains in terms of improving water quality in the monitored clinics. The number of samples analyzed in the period increased from 355 to 757 (53%); the average positive index for total coliforms decreased from 28% to 19%; the average satisfactory index for E.coli increased from 93% to 97%, corroborating the result of the actions and strategies that were carried out.

Conclusions

For the period prior to 2017, there are no data released regarding the VQACH of the health care clinics in Manaus. Surveillance actions are an essential measure for restoring water quality. It is suggested to maintain the actions carried out, along with measures of a permanent educational awareness.

Key messages

Measuring the effectiveness of surveillance actions are necessary for water quality control. Vigilance actions are important to reduce morbidity and mortality due to water transmission problems.
Interventions aimed at lowering risk of falling at home in Parkinson's disease: a literature review
Authors: Faggian E , Buzzo G , Gregori D , Martinato M , Reginato E
Published: October 2020

Background

Falls are the most frequent domestic accidents and their impact on subjects' quality of life, healthcare system and potentially serious complications, make their prevention fundamental. 80% of patients with Parkinson's disease fall in their homes, therefore the prevention of falls becomes a priority in caring for these patients. The aim of the study is to identify the evidence relating to home falls prevention interventions in patients with Parkinson's disease.

Methods

A literature review was performed considering articles published between 2000 and 2017 and indexed in PubMed, Cinhal and Cochrane Library. 655 articles were identified and 28 selected and considered for review.

Results

Four macro types of intervention have been identified: environmental and educational interventions, through the preparation of aids, lighting systems, room adaptation, adequate footwear and involvement of caregivers; physical and rehabilitative interventions, through programs of Qigong Baduanjin, Hi-Balance, Tai-Chi, Ai-Chi, vestibular rehabilitation and exercises marked by the metronome; pharmacological interventions, through a continuous infusion system of Rivastigmine or Levodopa; alternative therapies such as vitamin C and Macuna Pruriens.

Conclusions

The available literature points out the effectiveness of multiple interventions in reducing the risk of falling at home for Parkinson's disease patients. To ensure these interventions, a multidisciplinary team management is needed. This approach allows an improvement in the management of the Parkinsonian patient, promoting the maintenance of health and quality of life, preventing complications and optimizing subject's residual abilities and promoting caregivers' involvement.

Key messages

The literature points out the effectiveness of multiple interventions in reducing the risk of falling at home for Parkinson's disease patients. Four macro types of intervention have been identified: environmental and educational, physical and rehabilitative interventions, pharmacological and alternative therapies.
Contraceptive use in Italian young adults in 2013 and 2017/18
Authors: Martellucci M , Bori T , Acuti Martellucci C
Published: October 2020

Background

Investigations regarding knowledge and utilization of contraception for the prevention of unwanted pregnancies as well as of sexually transmitted diseases are carried out regularly in low- and middle-income countries. The same might not happen in high-income countries, were these topics could be regarded with less priority. We aimed to asses trends in contraception use among young adults in Italy.

Methods

From the Italian Institute of Statistics (ISTAT) Survey on Health Status and Use of Health Care, we collected aggregated data on contraception use among Italians aged 18 to 24 years old, by sex, for the year 2013. From the National Fertility Study of the Italian Higher Institute of Health (ISS) we collected aggregated data on contraception use among a nationally representative sample of Italian university students with a mean age of 22 years old, for both sexes, for years 2017 and 2018. We compared the estimates of prevalence of use of different contraceptives across the two surveys, utilizing, for the 2013 survey, the mean of the results for the two sexes.

Results

The use of at least one type of contraceptive grew from 89.3% in 2013 to 95.0% in 2017-2018, while the use of condoms increased from 69.7% in 2013 to 71.2% in 2017-2018. The use of coitus interruptus increased as well from 15.9% in 2013 to 24.0% in 2017-2018. The use of modern contraceptive methods was not comparable across the two surveys.

Conclusions

The two surveys from 2013 and 2017-2018 were not comparable for all the estimates of contraception use. While the prevalence of use of at least one type of contraceptive and of condoms increased from 2013 to 2017-2018, the contemporary increase of use of coitus interruptus raises some concerns. There is a need for reproducible surveys conducted at shorter intervals, and also for investigating trends in access and utilization of medical counselling about contraception, especially among young adults.

Key messages

Use of any kind of contraceptive and of condoms has slightly increased in Italy from 2013 to 2017-2018, but in the same period the use of coitus interruptus increased by around 8%. Surveillance systems for contraception use in Italy should be strengthened through regular surveys with reproducible methods, including assessments of medical counselling about contraception.
Does work disability influence work trajectories around vocational labor market training in Finland?
Authors: Leinonen T , Viikari-Juntura E , Räisänen H , Sundvall S , Kauhanen A , Solovieva S
Published: October 2020

Background

People with health problems have lower employment rates than the general population and they require special attention with respect to interventions promoting work participation. However, the contribution of health problems and work disability to labor market participation in relation to vocational training is unclear.

Methods

Using nationally representative Finnish register data on 42,691 job seekers entering vocational labor market training in 2008-2010, we constructed latent trajectory groups of work participation in the open labor market three years before and three years after training, identifying groups called “High-High”, “High-Low”, “Low-High”, and “Low-Low”. We plotted other labor market participation within these trajectory groups and using multinomial logistic regression examined assignment to these groups among those with and without previous work disability.

Results

Of the vocational trainees, 29.7% had previous work disability. Those with compared to those without previous work disability more often had previous employment and they spent less time in economic inactivity within the two trajectory groups with low pre-training levels of work participation. Having previous work disability was associated with assignment to the “High-Low” trajectory group of work participation instead of the “High-High” comparison group. The associations of other background factors with assignment to the different trajectory groups were relatively similar among those with and without previous work disability. However, some of these associations were weaker among the former.

Conclusions

A relatively large proportion of vocational labor market trainees had previous work disability, which influenced work participation in the open labor market and other labor market participation before and after training. Along with other key background factors, previous work disability should be accounted for when assessing the effects of vocational training.

Key messages

Previous work disability contributes to trajectories of labor market participation among vocational labor market trainees. Problems of health and work disability should be accounted for when assessing the effects of vocational training.
Assessing linkages between public health and population densities in cities and urban environment
Authors: Negrón-Martínez E
Published: October 2020

The global challenges and trends of our time include natural ecosystems disturbances and the global burden of disease attributable to Non-Communicable Diseases (NCDs) and emerging infectious diseases like coronavirus (COVID-19) pandemic. Summed to this problem is the still undervalued accountability of economic and environmental sustainability in most nations. Many densely population settled cities around the world account for up to 70% of global greenhouse gas emissions mainly because of their substantial use of energy for buildings, industries, and transportation. Continued increases in urbanization are also driving more exposure to air pollution, water shortages, and waste-related risks to the population.

This research aimed to show key connections between the multi-sectoral and interdependent determinants of health. The method followed a systematic review of primary and secondary data on various topics, including global health, environmental health indicators, socio-economic factors, and linkages between economic and environmental sustainability.

Literature determines by 2050, 66% of the world's population projected to inhabit urban areas mostly. In 2012, the global burden of disease study by using the Disability-Adjusted Life Years (DALYs) metric estimated that 23% of global deaths were attributable to the environment. DALYs metric compares years of life lost due to mortality and years of life lost due to disability by a specific cause, including the burden of risk factors, diseases, lifestyles, or individual's socio-economic status. Leading causes globally due to road traffic injuries, interpersonal violence, and suicide, take a substantial toll on those socio-economic factors.

Health is a crucial attribute of human development in the post-2015 Sustainable Development Goals (SDGs) achievable by scaling up the implementation of these goals in universal, holistic, and inclusive pathways. Hence, advancing sustainability policies to prosperous, healthier humanity.

Key messages

Public health's diverse components attained when there is a shared vision in the multidisciplinary teams to disease prevention and health promotion of all individuals that make up societies. Research and science communication should translate both the ideas of scientific progress and its implications for policies, economies and people's lifestyle choices.
Reporting of noise-induced hearing loss: perceptions of primary health care professionals
Authors: Gonçalves C , Pedroso H , Areosa J
Published: October 2020

Background

Worldwide, workers' health is still a Public Health concern, given the high number of hazardous occupational activities, as well as workers affected by work-related diseases. Among these diseases, occupational Noise-Induced Hearing Loss-NIHL is considered the second commonest occupational disease, and in Brazil, its reporting is compulsory. However, occupational diseases are usually underreported, hindering the knowledge of their actual magnitude, and the elaboration of prevention-oriented public policies.

Objective

To analyze the perception and knowledge of Primary Health Care professionals in Curitiba-Parana State, Brazil, on the compulsory NIHL reporting.

Methods

quantitative and qualitative approach conducted in three steps: analysis of a series of NIHL case histories reported in the official database between 2007 and 2018; application of a questionnaire to Primary Health Care Network professionals; collective interview with Primary Health Care Network nurses, speech therapists and doctors.

Results

NIHL reporting evidenced 82 cases, 67 (81.7%) among males, age ranging 50-64 years, 10 (12.2%) had complete high school level, 27 (32.9%) were formally employed, and 12 (14.6%) worked in the processing industry. Regarding the result of the applied questionnaire among the Primary Health Care professionals, 48 (68.7%) stated that they were prepared to identify workers' health problems, to 33 (68.7%) professionals, guidance to reassure users' comprehensive care is more important than the compulsory reporting, 21 (43.7%) claimed that they were qualified to identify NIHL cases, and 25 (52.1%) did not report the cases. Difficulties in reporting NIHL cases are: not understanding their flow, being afraid of the legal implications, which may generate difficulties in requesting audiometric testing, not having the management support, etc.

Conclusions

Most health care professionals are knowledgeable on NIHL, but they do not report the suspected cases due to lack of guidance.

Key messages

Primary care health professionals does not consider occupational health as part of the service to be provided. Primary care services are not prepared to establish the relationship between the injury and the job.
Association between education and self-assessment of the neighborhood environment
Authors: Photiou G , Middleton N , Panagiotakos D B , Panayiotou A
Published: October 2020

Background

DEpICT is an ongoing observational, cross-sectional study in community-dwellers in Limassol, Cyprus aiming to combine individual-level and community-level risk factors to decode their effect on arterial health (stiffness) as measured with pulse wave velocity (PWV).

Methods

Participants are >40 years who have been living in the same address for ≥5 years. They provide personal information on quality of life and mental health (SF-12 and GHQ-12), physical activity (IPAQ), adherence to Mediterranean diet (MedDiet) and sociodemographic. Anthropometric characteristics are measured on site, as well as arterial stiffness (carotid-femoral PWV) and central blood pressure. Neighborhood is self-assessed using the “Place Standard” Tool, as well as with an independent neighborhood audit using the newly-developed CyNoTes tool.

Results

Out of the first 176 participants (53% male), 45% had a college/university degree with a further 19% having graduate degrees, while the vast majority (92%) reported home ownership. Education was not associated with net family income (p = 0.3) nor home-ownership (p = 0.28). Out of the 14 constructs in Place standard, “Public transport” and “Participation and sense of control” were rated lowest (3.1 ± 1.9 and 3.1 ± 1.8) and “Identity and sense of belonging” and “Safety” highest (4.1 ± 1.9 and 4.5 ± 1.8). Education was not associated with any construct in “Place” or with total neighbourhood score.

Conclusions

Participants rate the social and safety aspects of their neighbourhood higher than the build aspects. Educational attainment may not be a good proxy for neighbourhood socioeconomic assessment in Cyprus, given the high rates of university graduates.

Key messages

Participants express the need for more public engagement in community decision-making; sense of lacking control may affect individual health. Educational attainment is not a good proxy for neighborhood socioeconomic assessment in the cultural context of Cyprus.