bluuebunny/crossref_metadata_2025 huggingface dataset:
Determinants of appetite in the first year of life: Results from a prospective study of infants
Authors: Demetriou C A , Singhal A , Lanigan J , Iacovides P , Yiangou P , Hileti D
Published: October 2024

Childhood obesity, a growing public health problem, was shown to be associated with appetite traits (ATs) in infancy but little research exists on the determinants of early appetite. We aimed to examine the association between parental, pregnancy and infant variables on ATs during the first year of life. We followed up 450 healthy term infants assessing Enjoyment of Food (EF), Food Responsiveness (FR), Satiety Responsiveness (SR) and Slowness in Eating (SE), using the Baby (at 2-4 weeks (wk) & 6m) and the Child (at 12m) Eating Behaviour Questionnaires. Associations between parental sociodemographic and lifestyle, pregnancy, infant feeding and anthropometric factors, and these ATs were investigated. Multivariable linear regression models were built for each AT, incorporating statistically significant variables from minimally adjusted models (sex, gestational age, and ethnicity).

Results primarily focus on ATs at 2-4wks, as later ATs were largely influenced by these values. Higher father’s BMI (β = 0.013, p = 0.022) was associated with increased EF at 2-4wks. Later gestational age (β = 0.106, p = 0.032), and gestational diabetes (β = 0.538, p = 0.002) were associated with higher FR 2-4wk while mixed feeding compared to exclusively breast feeding (β =-0.281, p = 0.013) with lower FR 2-4wk. Female sex (β = 0.174, p = 0.009) was positively, while gestational age (β=-0.076, 0.022), father’s educational attainment (β=-0.199, p = 0.003), father habitual smoking (β=-0.167, p = 0.020) and 4wk WFA z-score (β = 0.087, p = 0.037) were negatively associated with SR 2-4wk. Lastly, higher 4wk WFA z-score (β=-0.151, p = 0.012) and bottle feeding (β=-0.378, p = 0.003) were associated with decreased SE 2-4wk. Acknowledging that a causal association cannot be established in an observational study, this data suggests that parental lifestyle and pregnancy factors could influence infant ATs and hence risk of later obesity, highlighting the importance of preconception health in mitigating the problem of childhood obesity.

Key messages

• Appetite traits in early infancy are influenced by infant feeding and anthropometric variables, but also by parental and pregnancy characteristics.

• The importance of preconception health is paramount in mitigating the problem of childhood obesity.
Impact of MaNu dietary counselling on Oxidative Stress and Gestational Weight Gain during pregnancy
Authors: El Sherbiny S , Bellisario V , Ghelli F , Lenta E , Dalla Costa C , Bono R
Published: October 2024

According to the WHO guidelines, to counteract the excessive weight gain during pregnancy and to mitigate the increase in oxidative stress (OS) which naturally increases during pregnancy, a healthy lifestyle and a correct diet are crucial as preventive measures to promote health. The MaNu project was conceived precisely to control these factors through dietary counselling. We expect that pregnant women who voluntarily undergo an educational program consisting of specific and accurate dietary advice will be able to emphasize weight control and contain the increase in OS. Our randomized controlled trial (RCT) has a parallel group design and takes place in the Obstetrics and Clinical Nutrition Departments of Michele and Pietro Ferrero Hospital (Verduno, north-western Italy), where physiological pregnant women are enrolled between 12-17 gestational weeks (GWs). The educational intervention takes place between 12-24 GWs. Dietary habits were collected with a questionnaire and urine samples were analysed to quantify the OS using 15-F2t-isoprostane, malondialdehyde and total antioxidant power. The descriptive analyses are based on paired t-tests. Preliminary analyses on 76 women who completed two out of three time points (T0 and T1) indicate that, of women who received the intervention, 35% experienced excessive weight gain (based on guidelines), compared to 39% shown by controls. Following the counselling, the 15-F2t-isoprostane decreased significantly (mean T0=5.1 ng/ml vs. mean T1=3.5 ng/ml, p = 0.02). Concerning nutrient intake, a statistically significant reduction in sugar consumption has been found in the intervention group (mean T0=92.2 g vs. mean T1=83.3 g, p = 0.03). Conversely, no correlations have been detected between OS and the main pro and anti-oxidant macronutrients. Although promising, our findings need further verification since the RCT is still ongoing, and it is imperative to attain the anticipated sample size before drawing any definitive conclusions.

Key messages

• Dietary counselling during pregnancy should be implemented as a preventive strategy used to counteract potential pregnancy complications and ensure the well-being of both the mother and the baby.

• Healthy diet is essential to control the increase in oxidative stress levels during pregnancy and to prevent excessive weight gain, factors that can lead to the onset of pregnancy complications.
Influence of vegetable knowledge in preschooler’s vegetable consumption: Veggies4myHeart project
Authors: Novo R , Edra J , Vieito L , Lages M , Guarino M P , Simões Dias S , Braga-Pontes C
Published: October 2024

Background

Vegetable consumption among children is below recommended. Food rejection, especially vegetables, is common in preschool-aged children. Impoverished food knowledge is associated with this rejection. The Veggies4myHeart project aims to promote vegetable consumption and knowledge among preschoolers’. This study assesses the project’s effectiveness in increasing vegetable knowledge and consumption and whether increased knowledge influences vegetable consumption.

Methods

Veggies4myHeart is a prospective longitudinal study with children 2-6 years old attending preschools. Two preschools participated in a five-week intervention in the 2023/24 academic year. A distinctive pedagogical tool was tested in each preschool: a storybook and a digital game. Knowledge and vegetable consumption were assessed before and after the intervention. Knowledge was evaluated through a questionnaire with taxonomic categorization. Consumption was assessed by recording the portions of eight vegetables (carrot, lettuce, red cabbage, cucumber, tomato, onion, beetroot, and red bell pepper). Wilcoxon test was applied to compare vegetable knowledge and consumption before and after the intervention. Spearman’s correlation was used to examine the association between knowledge and vegetable consumption before and after the intervention.

Results

98 children (55.1% female, mean age 4.15 ± 0.868 years) participated. Statistically significant increases in both knowledge and total vegetable consumption were observed post-intervention in both preschools (p < 0.001). A moderate correlation of 0.412 (p = 0.013) in the storybook group post-intervention suggests that increased knowledge may contribute to increased vegetable consumption.

Conclusions

This study demonstrates the potential of the Veggies4myHeart project as an effective strategy to promote knowledge about vegetables among preschool children, highlighting the critical role of educational interventions in promoting healthier dietary patterns.

Key messages

• To increase vegetable knowledge may lead to higher consumption in preschool children.

• Veggies4myHeart demonstrated its effectiveness as an educational project for preschool children.
Lunchbox content and dietary outcomes of Dutch primary school children explored by sociodemographics
Authors: Wargers A , Jansen W
Published: October 2024

Background

Most children fail to meet recommended guidelines for a healthy diet. Children living in low socioeconomic areas are less likely to have healthy eating behaviours. In this study we investigated the food Dutch primary school children bring from home, and their dietary, health and school related outcomes explored by sociodemographics.

Methods

5 primary schools, with high deprivation scores and a high percentage of overweight, have been included in this study (ClinicalTrials.gov NCT06058325). With observations in September 2023 we mapped the content of lunchboxes, including snacks, of children. Questionnaires for all parents and children in grade 5-8 focused on dietary and health outcomes of children and perceived class factors. Preliminary baseline data were analysed using descriptive statistics. Exploratory analyses will be conducted to show differences by sociodemographics (e.g. age, sex, parental financial stress).

Results

297 lunchboxes were observed, 98.7% contained sandwiches, half being brown bread. Most children brought fruit from home for either lunch or morning snack, 13.8% not at all. 21.9% brought vegetables. 135 children completed the questionnaire: 43.0% boys, mean age 9.3 years old (SD 1.12). Children ate fruit and vegetables on an average of 5.9 (SD 1.69) and 4.9 (SD 2.23) days a week. Whereas 80% of children eats fruit every day at school, only 20% of children eats vegetables every day at school. Most children perceived their health as good (89.3%) and felt happy (89.6%). On a scale of 1 (low) to 5 (high), they rated concentration, social climate and comfort in class an average of 3.8 (SD 1.05), 4.3 (SD 1.07) and 4.3 (SD 0.92) respectively.

Conclusions

Lunchboxes of Dutch primary school children mainly contain sandwiches. Whereas most children eat fruit at school, the majority of children do not eat vegetables at school. A healthy school lunch might increase vegetable consumption of children and could affect health and school related outcomes.

Key messages

• Most Dutch primary school children eat sandwiches during lunch at school, but in half of the cases this is not brown bread as recommended by nutritional guidelines.

• Most Dutch primary school children bring fruit to eat as snack or lunch, but no vegetables to eat at school. The majority also self-reported the lack of eating vegetables at school on a daily basis.
Double-sided effect of selenium on blood lipids: A dose-response meta-analysis
Authors: Urbano T , Vinceti M , Fiore G , Wise L A , Filippini T
Published: October 2024

Background

Selenium, a trace element with both nutritional and toxicological properties, has been suggested to increase cardiovascular risk, particularly concerning diabetes and blood pressure levels. However, the impact of selenium exposure on the risk of dyslipidemia remains uncertain. This meta-analysis explored the shape of the relation between selenium exposure and its effects on lipid profiles in the most relevant experimental human studies, randomized controlled trials (RCTs).

Materials and methods

The review was registered in PROSPERO (ID: CRD42022380432). Through a bibliographic search conducted on PubMed, Web of Science, Embase, and the Cochrane Library, we identified RCTs investigating the impact of selenium supplementation on lipid profile. We then compared the results between intervention and control groups and, whenever possible, evaluated the non-linear relationship using a dose-response approach.

Results

We could include 26 RCTs involving different populations, i.e. healthy individuals, pregnant women, and subjects with health conditions such as cardiovascular diseases and Alzheimer’s dementia. Study endpoints were levels of total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides. Our dose-response analysis indicated that selenium supplementation exceeding 200 µg/day adversely affected total cholesterol, HDL, and triglyceride levels. Hence, a threshold for such a detrimental effect of selenium was observed on total and HDL cholesterol and triglycerides, while opposite and inconsistent results emerged for levels below 200 µg/day and for LDL-cholesterol. Blood selenium levels at the end of the studies were positively associated with adverse effects on all endpoints.

Conclusions

This first dose-response meta-analysis of the effects of selenium on blood lipids highlights the potentially adverse effects of this trace element, in the amount and the chemical forms used in the trials.

Key messages

• Elevated selenium levels correlated with adverse effects on lipid profile.

• Selenium doses exceeding 200 µg/day showed adverse effects on total and HDL cholesterol and triglycerides levels.
Evaluation of front-of-pack labeling’s impact on unhealthy food consumption in Israeli households
Authors: Samuel H , Katz E , Maoz Breuer R , Blaychfeld Magnazi M , Fliss Isakov N , Endevelt R
Published: October 2024

Background

In 2020, Israel introduced front-of-pack labeling (FOPL), marking unhealthy foods high in sugar/salt/saturated fat in red and Mediterranean diet-conforming foods in green, aiming to facilitate healthy choices through clear nutrition information.

Methods

Two cross-sectional telephone surveys assessed food purchasing, red/green food consumption frequency, label exposure, and perceived impact before labeling (944 households, 2019) and 3 years post-implementation (500 households, 2023).

Results

Over 90% of respondents in 2023 reported seeing red labels on packages. Nearly 70% checked for red labels when shopping, vs. only 48% who examined the full Nutrition Facts panel on the back of the package. 60% reported preferring unlabeled alternatives within unhealthy categories. Although 50% reported that compared to the period before the labeling, they purchased fewer red-labeled products, a significant decrease in purchasing rates between timepoints was found only for 2 out of 11 unhealthy food categories-sugary drinks (which during 2022 were also taxed by sugar content) and salty snacks. At both timepoints, rates of purchasing and consumption frequency of unhealthy foods were higher among households with children, compared to other households. Multivariate analysis showed that having children under 18, lower education and bigger household size predicted a higher overall unhealthy consumption score. Red label checking was associated with better scores.

Conclusions

FOPL raised awareness and shows potential for reducing unhealthy consumption, especially when combined with policies like sugar taxation. Their impact on reducing purchases of nutritionally valueless foods (snacks/sugary drinks) is highly valuable. However, red-labeled food consumption remained high among households with children, a strong predictor of higher unhealthy consumption scores. Continued label promotion, child-targeted interventions, and product reformulation incentives are recommended.

Key messages

• FOPL shows potential of enhancing healthy choices especially when combined with supportive policies.

• Results regarding households with children highlight the need for continued promotion, child-targeted interventions, and product reformulation incentives for impacting long-term habits.
Nutrition of children up to one year of age what public health topic
Authors: Zemanová M , Mičíková L , Petráková A , Hujová A , Váverková B , Puhlová E , Vostrý M , Cmorej P , Lulková M , Rothová M
Published: October 2024

Background

Nutrition is one of the most important factors for a person that affects the quality and length of life. Nutrition has a fundamental influence on the maintenance of health or the development of disease and participates in the correct growth and development of an individual. Nutrition is especially important in the early stages of life, when a child’s organism develops dramatically. Mothers have the greatest influence on a child’s nutrition, and therefore it is advisable to educate them appropriately and also educate them early, from child birth or before. And early nutrition is provided through breastfeeding.

Objectives

To improve the knowledge of healthcare workers in the field of breastfeeding and nutrition of children up to one year of age. To strengthen the breastfeeding skills of mothers. To motivate healthcare workers to educate mothers in maternity wards and GP offices.

Results

Using a questionnaire, we analyzed the knowledge of 716 mothers of children under two years of age. 91 % of female respondents knew that the child should be breastfed according to his/her needs. Only 66 % of women were educated and informed about the importance and technique of breastfeeding. Educational material was prepared and distributed for midwives, nurses and doctors on breastfeeding and feeding children up to one year of age.

Conclusions

The level of awareness of health professionals about breastfeeding and nutrition is still insufficient. There is a need to continue to educate and support healthcare workers in this area and to motivate them in providing information to mothers.

Key messages

• Breastfeeding and feeding children up to one year of age are important for a child’s health.

• The advisory activity of healthcare workers is key to improving public health. Health workers should help mothers not only with advice but also with practical help with breastfeeding.
Revealed and stated preferences for sharing of patient-reported data in Austria
Authors: Drexler S
Published: October 2024

Objectives

Routine collection of health data is essential for creating sustainable, efficient, and equitable health systems. While administrative health data are collected automatically, successful routine collection of patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) depends on voluntary participation. The aim of this study is to investigate how to increase participation in routine patient-reported data collection.

Methods

This mixed methods study used representative survey data from the Austrian population aged 18-70 (N = 1260) and 15 semi-structured narrative interviews with citizens and health data experts collected in 2024. Survey respondents were shown examples of PREMs and PROMs and indicated their willingness to share them, depending on the recipient and purpose. Interviewees answered the same questions while providing insight into their decision-making process, which was analyzed using thematic analysis. Wilcoxon rank sum tests were used to assess differences in willingness to share across recipients and data collection purposes.

Results

Survey respondents were more willing to share PREMs than PROMs (“rather yes” vs. “rather no”, p < 0.001). One explanation given in the interviews is that PROMs are more personal and convey sensitive information. In terms of sharing PROMs, people were most likely to share with their GP (81%) and least likely to share with private companies (7%). Facilitators for sharing identified in the interviews were improving personal care and the health system, while barriers were use for profit generation and fear of negative consequences for the person sharing.

Conclusions

The results suggest handling the collection of PROMs demands greater caution compared to PREMs. Furthermore, clearly communicating personal and societal benefits arising from the collection and analysis of self-reported health data may increase participation in routine self-reported health data collection.

Key messages

• The collection of self-reported health data depends on voluntary participation. Clearly communicating personal and societal benefits of sharing self-reported data can motivate participation.

• Self-reported data collection is essential for sustainable and efficient health systems. Compared to PREMs, people are more reluctant to share PROMs because they contain sensitive information.
Primary clinics achieving regular follow-up of patients: Teamwork aspects among healthcare staff
Authors: Khazen M , Golan Cohen A , Rose AJR
Published: October 2024

Backgrounds

Studies have shown that more temporally regular primary care visits, or visits more evenly spaced in time, are associated with improved patient outcomes. However, no study has examined what clinic staff can do to encourage greater temporal regularity (TR). We aimed to understand factors related to healthcare staff dynamics that contribute to higher TR for adults with chronic conditions.

Methods

The study is part of a two-stage mixed methods project. In the first stage, we ranked clinics according to their TR level. In this qualitative stage, we interviewed staff at 6 clinics with extremely high TR (regular follow-up with primary care physician, or PCP), and 6 clinics with extremely low TR. Interviews were conducted with 15 PCPs, 12 nurses, 15 administrative staff, and 4 pharmacists between July 2022- September 2023. Interviews were audiotaped, transcribed, and analyzed using Atlas qualitative analysis software.

Findings

Themes emerged regarding best ways to promote regular follow-up of patients with chronic conditions. Strategies included having a defined system to reach out to no-show patients, having routine staff meetings to discuss no-shows, adapting workflow to meet the needs of challenging patients, dealing with bureaucracy on patients’ behalf, informal channels of communication with patients, and consulting social workers more often. Relational aspects among staff members at high TR clinics emphasized flat as opposed to hierarchical relationships, as well as high levels of teamwork.

Conclusions

Teamwork between staff members in primary care settings can contribute to more proactive care delivery, with greater potential to prevent long-term complications. The findings suggest that a high-functioning multidisciplinary care team that focuses on creating the right sorts of interactions and teamwork among staff members, and uses proactive strategies to help engage patients, can contribute to more temporally regular care and thus improved outcomes.

Key messages

• Stronger teamwork and flat relationships between staff members in primary care settings can result in proactive medicine and developing strategies that improve patients’ regular follow-ups.

• Programs focusing on how medical staff utilize their dynamics/relations to improve health outcomes and how doctors’ role align with the staff, can facilitate regular follow-ups of challenging patients.
Defining medical deserts—an international consensus-building exercise
Authors: Brînzac M G , Kuhlmann E , Dussault G , Ungureanu M I , Chereches R M , Baba C O
Published: October 2024

Background

Medical deserts represent a pressing public health and health systems challenge. The COVID-19 pandemic further exacerbated the gap between people and health services, yet a commonly agreed definition of medical deserts was lacking. This study aims to define medical deserts through a consensus-building exercise, explaining the phenomenon to its full extent, in a manner that can apply to countries and health systems across the globe.

Methods

We used a standard Delphi exercise for the consensus-building process. The first phase consisted of one round of individual online meetings with selected key informants; the second phase comprised two rounds of surveys when a consensus was reached in January 2023. The first phase-the in-depth individual meetings-was organized online. The dimensions to include in the definition of medical deserts were identified, ranked and selected based on their recurrence and importance. The second phase-the surveys-was organized online. Finally, external validation was obtained from stakeholders via email.

Results

The agreed definition highlights five major dimensions: ‘Medical deserts are areas where population healthcare needs are unmet partially or totally due to lack of adequate access or improper quality of healthcare services caused by (i) insufficient human resources in health or (ii) facilities, (iii) long waiting times, (iv) disproportionate high costs of services or (v) other socio-cultural barriers’.

Conclusions

The five dimensions of access to healthcare: insufficient human resources in health or; facilities; long waiting times; disproportionate high costs of services and; other socio-cultural barriers, ought to be addressed to mitigate medical deserts. The term medical deserts might not be the most appropriate term for defining areas with insufficient access to health services as it excludes essential domains, such as access to public health and preventive services.

Key messages

• Medical deserts directly and negatively impact the health outcomes of the people living in it.

• Medical deserts might not be the most appropriate term for defining areas with insufficient access to medical services, as it excludes public health and preventive services.
Healthcare in police custody: a conceptual framework for measuring and improving quality of care
Authors: Zinger N D , Slev V N , Verheij R A , Bos I , Kringos D S
Published: October 2024

Background

Individuals in police custody are often in poor (mental) health and can be in need of medical attention. The delivery of primary healthcare in police custody differs from other custodial and non-custodial settings, due to its short-term character and the reliance on custody officers and healthcare professionals to access care. Therefore, medical care for detainees in police custody requires its own standards and indicators to measure the quality of care. We aimed to develop a conceptual framework for (actionable) indicators to measure the quality of care for people detained in short-term police custody settings in the Netherlands.

Methods

We conducted a scoping review and consulted with experts. The scoping review involved Embase, Medline, PsycINFO, CINAHL, Criminal Justice Abstracts, PiCarta and Cochrane, and was supplemented with grey literature searches. We consulted twenty-seven stakeholders with a wide variety of expertise in the field of healthcare in police custody to discuss and validate the conceptual framework.

Results

The conceptual framework consists of 14 domains of structures (e.g. staff and facilities), processes (e.g. triage and coordination of care) and outcomes (e.g. effectiveness and satisfaction) that need to be considered when developing quality indicators for the healthcare provision in police custody. The scoping review yielded 68 publications providing information on common health issues and recommendations related to quality assurance or improvement.

Conclusions

The conceptual framework will guide the development of (actionable) quality indicators, which will be evaluated on relevance and measurability. These are crucial for monitoring care quality and enhancing a learning health systems approach. This study fills a gap in the existing scientific literature by shedding light on the factors contributing to the quality of primary healthcare provision for people detained in short-term custody settings.

Key messages

• The conceptual framework guides the development of (actionable) quality indicators for healthcare in police custody.

• This study contributes to the creation of a learning health system for healthcare in short-term police custody settings.
A systematic review of cancer overdiagnosis in multimorbid patients
Authors: Slight S P , Abdalla H , Hassan N , Wilson S , Slight R
Published: October 2024

Background

Cancer screening looks for early signs of cancer in people who do not currently exhibit symptoms. However, screening can also identify abnormalities that do not progress to produce symptoms or death. This could include the identification of tumours, which stop growing or grow very slowly; patients usually die with them rather than from them. We systematically reviewed the literature to investigate the harmful consequences of cancer overdiagnosis in multi-morbid patients.

Methods

We followed the PRISMA reporting guidelines and registered the review with PROSPERO (CRD42024475175). A Population, Intervention, Comparator, Outcome and Study design (PICOS) framework was used as an organising framework. Peer-reviewed studies were included except case series, case report reviews and conference abstracts. Four large databases (Medline, Embase, APA Psych INFO and Scopus) were searched in Nov23 using appropriate keywords grouped into categories: multimorbidity, overdiagnosis, patient harms, cancer screening. Titles were screened according to the eligibility criteria and their quality assessed. Studies needed to have investigated the extent of harm caused by overdiagnosis (e.g., overtreatment).

Results

A total of 200 articles were retrieved, with seven meeting our inclusion criteria. All included studies were based in the US. Breast and prostate cancer overdiagnosis was reported to be 15% higher in multimorbid populations compared to the average-risk population. Multimorbid individuals were more vulnerable to the harms of cancer overdiagnosis, with psychological, physical and financial harms reported.

Conclusions

These findings contribute valuable insights into the intricate interplay between comorbidities, cancer overdiagnosis, and associated harms. Radical treatment interventions in multi-morbid patients can carry greater risk of complications. Current screening guidelines only address average-risk populations; future guidelines need to reflect these findings.

Key messages

• Cancer overdiagnosis was found to be higher in multimorbid populations compared to the average-risk population.

• Multimorbid individuals are also more vulnerable to the harms of cancer overdiagnosis.
Experiences with paediatric hospital health care: a cross-sectional study among paediatric patients
Authors: Murko E , Kralj M , Poldrugovac M , Zaletel M , Ropret N
Published: October 2024

Background

The measurement of patient experiences is gaining importance in many healthcare systems, including the Slovenian one. The need for a national survey on patient experiences in the paediatric inpatient settings emerged recently.

Methods

The survey took into account various aspects of inpatient healthcare such as admission, hospital staff, safety, food and discharge from hospital. As part of the study, children/parents were able to give praise and suggestions for improvements. We used three different questionnaires adapted to the cognitive abilities of children - a child questionnaire for the age group 9-13 years in paper form, an online adolescent questionnaire for the age group 14-18 years, and an online parent questionnaire for the age group 0 (1 month)-8 years. The questionnaires were cognitively tested and piloted before national rollout.

Results

The national survey was conducted between September 2023 and March 2024 and included paediatric patients who spent at least one night in an acute paediatric hospital ward. The survey included 25 paediatric wards and totally 1965 questionnaires were valid for analysis. The rough response rate was 17,6 %. The first preliminary results of the qualitative analysis suggest that surveyed paediatric patients and their parents rate highly inpatient health care services received, however they point out also to areas that need improvement such as environmental factors (noise, temperature), food, infrastructure (outdated facilities & equipment) and in some cases attitude of hospital staff.

Conclusions

National institute of public health carried out the first national survey on paediatric patient reported experience measures in acute hospitals in Slovenia. The results of this survey will be used to improve the quality of inpatient health care services in paediatric wards, as well renew focus on the requirements of European charter of children rights and United Nations Convention on the Rights of the Child.

Key messages

• National institute of public health carried out the first national survey on paediatric patient reported experience measures in hospitals in Slovenia.

• The results of this survey will be used to drive hospital quality improvements.
Time-dependent networks for the treatment of acute coronary syndrome in South East Tuscany
Authors: De Luca A , Limaj S , Capitani E , Taddeini F , Limbruno U , Turillazzi R , D’Amato M G , Quercioli C , Nante N , D’Urso A
Published: October 2024

Introduction

The importance of timely reperfusion therapy in Cardiovascular diseases is crucial, leading to the creation of time-dependent networks for Acute Coronary Syndrome treatment. The ACS-STEMI treatment network in Tuscany operates across three health authorities (LHAs),including South-East Tuscany. The network ensures ACS-STEMI treatment in 12 hospitals integrating new territories such as Piombino and Elba into the network. Aim of the study is to assess the impact of an analytical monitoring system of the times to reperfusion treatment and the actions to improve the performance of the network.

Methods

In this retrospective study an analytical evaluation of the network’s performance was conducted. We utilized data on patient transport, symptom onset to medical contact times, and outcomes from the National Outcomes Program (PNE).Analytical evaluations in 2021 measured the network’s performance, identifying main delay causes. The treatment process is divided into periods from symptom onset to coronary reperfusion, and interventions like public campaigns, ECG transmission and fast-track transfers have been implemented.

Results

South East Tuscany LHU had the lowest 30-day mortality rate for ACS patients in Italian hospitals with 300 cases annually in 2020 and 2021.Improvements continued into 2022 and 2023, further reducing mortality rates in patients initially admitted to SPOKE hospitals. For Piombino and Island of Elba residents,30-day mortality decreased from 8.8% (2017-2020) to 5.7% in 2022. The Grosseto hub treated 80% of STEMI patients within 90 minutes in 2022.

Conclusions

The establishment of a well-organized time-dependent network for ACS-STEMI treatment in Tuscany has significantly improved patient outcomes, demonstrating the critical role of timely and efficient care pathways. The network’s success is attributed to several factors, including improved accessibility, enhanced coordination among healthcare facilities, and effective use of technology and resources.

Key messages

• Treatment networks for ACS/STEMI can improve health outcomes in peripheral areas.

• Structured clinical-care pathways in delivering high-quality care for ACS patients reduces ACS mortality.
Chronic Illness and visiting clinic before hospitalization at the onset of Stroke: Shiga Registry
Authors: Kiyohara M , Miyamatsu N , Harada A , Takashima N , Ogawa N , Shitara S , Urushitani M , Yoshida K , Miura K , Nozaki K
Published: October 2024

Background

Prompt action at stroke onset is required to improve prognosis. Some previous studies indicated that visiting local clinics may initially delay access to specialized care. We examined the relationship between the presence of chronic diseases known as risk factors for stroke and visiting a local clinic before admission to the hospital for acute stroke care.

Methods

This study utilized data from stroke patients aged 18 and older who were registered in the Shiga Stroke and Heart Attack Registry (SSHR) from January 2011 to December 2015. We excluded cases with onset during hospitalization or those with impaired consciousness assessed by the Japan Coma Scale (JCS > =10). The presence of comorbid chronic diseases was determined based on the past history and medications presented at admission. Local clinics are defined as clinics or hospitals that are not equipped to provide acute stroke treatment. Multivariate logistic regression analyses, adjusting for sex, age, modified Rankin Scale score before onset, and stroke subtypes, were performed to calculate odds ratios and 95% confidence intervals for visiting a clinic before hospitalization according to the presence of chronic diseases such as hypertension, diabetes, dyslipidemia, and atrial fibrillation, respectively.

Results

Data from 11,111 out of 14,620 registered cases were analyzed. Among these participants, 5,774 had hypertension, 1,951 had diabetes, 2,111 had dyslipidemia, and 882 had atrial fibrillation. A total of 2,405 (21.6%) cases visited a local clinic at stroke on set. The adjusted odds ratios for visiting clinics by the presence of hypertension were (1.22, 95% CI: 1.11 -1.34), diabetes (1.14, 1.01-1.28), dyslipidemia (1.07, 0.95 -1.20), and atrial fibrillation (0.80, 0.67 -0.95).

Conclusions

The present study indicated that individuals with hypertension and/or diabetes are more likely to initially visit a local clinic at stroke onset, whereas those with atrial fibrillation were not.

Key messages

• Approximately 20% of mild stroke patients first consult local or primary care doctors at stroke onset. This trend was particularly observed in individuals with hypertension and diabetes.

• Emphasizing the need for direct access to specialized emergency care for individuals with chronic diseases is important to avoid delays in acute stroke care.
Data ecosystem using smart home technology to support healthy aging
Authors: Wang K , Cao S , Morita P
Published: October 2024

Background

Smart home technology has been widely used to mitigate the challenges that population aging brings. However, the lack of a centralized data ecosystem has prevented these technologies from realizing their full potential. This project aimed to construct a data ecosystem compatible with smart home sensors to monitor healthcare for seniors, improving their quality of life.

Methods

The infrastructure was constructed using a user-centered design approach, allowing smart devices such as motion, temperature sensors to operate independently and communicate through a Wi-Fi mesh network. API technology provides a reliable channel for real-time data collection. To ensure data privacy and security, extracted data is hosted in a cloud environment that provides comprehensive data protection, and cloud computing is utilized for high-performance computation tasks. Analytical models such as Machine Learning can be implemented to recognize indoor activities, achieving the goal of remote monitoring.

Results

This data ecosystem advances in privacy and security, interoperability, accessibility, and data-sharing. Unified authentication mechanism ensures data is transmitted among heterogeneous devices with minimal vulnerability. Additionally, the common communication protocol provides the foundation of interoperability between devices. With unobtrusive devices, inhabitants are not burdened with operation, ensuring their accessibility and improving their user experience. Lastly, the data is exchanged in a standardized JSON data format, enabling efficient data-sharing board data integration.

Conclusions

This project developed a data ecosystem based on existing smart home environments. The ecosystem is compatible with smart devices that families already have, effectively reducing additional healthcare costs. Implications of this study include helping health policy and decision makers to adopt more smart home ecosystems to keep older people healthy at home.

Key messages

• Study constructed a data ecosystem compatible with smart home sensors, achieving remote monitoring of indoor activities and improving the quality of life for seniors.

• The developed ecosystem offers promotion in privacy and security, interoperability, accessibility, and efficient data-sharing, reducing healthcare costs.
Youth mental health care use during COVID-19: Evidence from administrative data in Alberta, Canada
Authors: Hilario C , Russell M , Urichuk L , Agyapong V , Rittenbach K , Dyson M , Parker N , Babins-Wagner R
Published: October 2024

Background

The COVID-19 pandemic affected health care service delivery and accessibility. Our study examined how Canadian youth used mental health services before and during the COVID-19 pandemic, and whether youth access and use patterns differed for subgroups based on social determinants previously associated with health care access.

Methods

Cross-sectional population-based administrative health care data from the province of Alberta in Canada was used to examine youth (ages 15-24) mental health care use from 2018/19 to 2021/22. Data was analyzed using an interrupted time series design and segmented regression modeling on type of mental health care use. Outcome measures were mental health care use for: general physician visits, psychiatrist visits, emergency department, hospitalization, and different mental health diagnoses. We stratified by factors related to social determinants, including gender and socioeconomic status.

Results

The analysis indicates an overall increase in the proportion of youth that used mental health care from 2018/19 to 2021/22 (14.4% vs 17.5%, respectively). There was an immediate drop in use with the onset of the COVID-19 pandemic in Canada, followed by a steady rise during the pandemic years, which was largely due to an increase in general physician visits. This rise was seen for most mental health diagnoses of study (i.e., anxiety, adjustment, attention-deficit/hyperactivity disorder, schizophrenia, and self-harm disorders). Service use increased for young women/girls compared to young men/boys and for youth from wealthier neighborhoods.

Conclusions

This study provides evidence to support health services planning and delivery to respond to the mental health needs of youth and to prepare for future public health emergencies.

Key messages

• Our study findings indicate changes in health care use for mental health among Canadian youth (ages 15-24) during the COVID-19 pandemic, with use patterns differing for youth subgroups.

• Administrative health data can provide evidence to support health services planning and delivery to respond to the mental health needs of youth and to prepare for future public health emergencies.
The impact of diabetes pay-for-performance program on hyperglycemic hyperosmolar state (HHS)
Authors: Chen T-T
Published: October 2024

Background

To examine the effects of a diabetes pay-for-performance (P4P) program on the negative metabolic outcome: hyperglycemic hyperosmolar state (HHS) of patients in Taiwan.

Methods

Four years (2008∼2011) of data from the National Health Insurance Administration (NHIA) databases were examined. P4P patients included those who were newly enrolled in the P4P group in 2010, and consecutively included in 2011. Patients were never enrolled are defined as non-P4P group in these two years. The caliper matching method and a generalized estimating equation were used to estimate difference-in-differences models (baseline year 2009) and examine the effects of the P4P program on the count of the adverse outcome.

Results

The P4P program was associated with decreases in the incident of HHS (IRR 0.53, P = 0.02).

Conclusions

The disease management component of the diabetes P4P program can be beneficial for reducing the incidences of HHS.

Key messages

• The disease management component of the diabetes P4P program can be beneficial for reducing the incidences of HHS.

• The disease management component of the diabetes P4P program is important.
Data literacy in healthcare: A systematic collection and evaluation of OERs on data acquisition
Authors: Kempny C , Wahidie D , Dereli I , Yilmaz-Aslan Y , Brzoska P
Published: October 2024

Background

Data literacy is crucial in healthcare, as it allows healthcare professionals to recognize, collect, and use data for research efficiently. Teachers can use open educational resources (OERs) to increase data literacy among healthcare staff, covering the entire research process. This study focuses on examining existing OERs with a focus on data acquisition to identify the limitations of existing OERs and to develop new OERs for data collection based on these limitations.

Methods

The platforms ‘Twillo.de’, ‘Orca.nrw’, ‘Merlot.org’, ‘OER Commons’, ‘Serlo’, ‘VIMEO’, ‘Dailymotion’, ‘SlideShare’ and ‘YouTube’ were systematically searched for OERs focusing on quantitative and qualitative data acquisition. Only OERs published under a Creative Commons license were considered. A team of researchers then analyzed existing OERs with respect to production and content quality and sorted them into four competence levels of a learning objective matrix developed by Schüller (2020).

Results

Out of 4,383 search results, we identified 111 suitable OERs for qualitative data acquisition. Only 9 of these were related to health. For quantitative data acquisition, out of 4,415 search results, 145 suitable OERs were identified, 36 of which were health-related.

Conclusions

This study highlights the scarcity of suitable OERs for healthcare professionals to improve their health data literacy. This is for various reasons. Only a few OERs are specifically designed for healthcare professionals and, therefore, do not correspond to the lifeworld of learners in the explanatory examples. Additionally, the existing OERs are not sufficiently detailed in essential areas for learners and are customized to the competence level of the target group of healthcare professionals. Therefore, existing OERs must be adapted for healthcare professionals’ data literacy training.

Key messages

• The search for OERs on qualitative and quantitative data acquisition yields many results, but less than three percent of the results are suitable for training healthcare personnel.

• Few Open Educational Resources (OERs) for healthcare professionals provide sufficient detail and alignment with their competency levels, which necessitates adaptations for data literacy training.
Factors that influence the need for mental health services for older adults in Europe
Authors: Pasupathy R , Hossein R , Queen C
Published: October 2024

Background

Mental health is an integral component of health, and affects close to a 100 million Europeans. Little is known about the predictors of older adult’s mental health demand among health systems in European countries. This study is based on the Andersen’s Behavior Model, that predicts that predisposing characteristics, enabling factors, and behavioral factors, influence need or demand factors of healthcare services.

Aim

This study has two overall objectives: (i) to investigate the determinants of older adults’ mental health services demand; and (ii) examine the relationship between predisposing characteristics, and enabling resources, with services demand.

Methods

Data from Wave 9, of the of the cross-national panel dataset of the Survey of Health, Ageing and Retirement in Europe (SHARE) were examined using a sample of 47, 345 older adults.

Analysis: The Omnibus test was used to evaluate the fit model and Multinomial Logistics Regression were performed to test the null hypothesis that predisposing characteristics, enabling resources, and behavioral factors are not predictors of need or demand.

Findings

Predisposing characteristics such as gender (b=-.43, s.e.=.017, p<.001) and age (b=-1.96, s.e.=2.2, p<.001), and enabling factors such as homecare (b = 2.40, s.e.=0.1, p<.001), social support (b=-.26, s.e.=0.012, p<.001), financial support receiving (b=.51, s.e.=.086, p<.001), income (b=.09, s.e.=.009, p<.001), and behavioral factors such as use of technology are predictors of mental health services need or demand [Chi-Square= 3319.58, df = 15 and p <.001].

Implications for Policy and Practice

Initiatives for the care of older adults should not only aim to increase access to care services for sub populations such as older adults with mental health but also consider enabling resources such as financial and social support and behavioral factors such as use of technology.

Key messages

• Demand for mental health services for older adults are influenced by predisposing, enabling and behavioral factors.

• Investing in financial services, social support and technology may reduce the demand for mental health services among older adults.