bluuebunny/crossref_metadata_2025 huggingface dataset:
Quality of life assessment in breast cancer patients during palliative treatment in Indonesia
Authors: Gayatri D , Efremov L , Wienke A , Mikolajczyk R , Kantelhardt EJ
Published: October 2022

Background

This study aimed to prospectively assess quality of life (QOL), QOL domains, and pain severity in advanced stage breast cancer patients during palliative oncology treatment in Indonesia.

Methods

Advanced stage breast cancer patients > 18 years (n = 160) who began palliative oncology treatment were enrolled in the study using convenience sampling. They completed the EORTC QLQ-C15-PAL questionnaire and pain severity (Visual Analogue Scale, VAS) score at three-time points (baseline (T0), three-(T1) and six-months (T2) follow-up). The repeated measures analysis of variance (ANOVA) model was used to assess the QOL, QOL domains, and pain severity changes over time adjusted for age, place of residence, marital status, and Karnofsky Performance Status score at baseline. We classified the change over time in three qualitative groups (deterioration, improvement, or trivial/no difference). We considered it clinically relevant if patients had a 10-point difference.

Results

The mean age of included patients (n = 159) was 50 years. Most lived in an urban area (72.3%), had low education (71.7%), and were married (81.8%). The repeated measures ANOVA showed that the QOL score, emotional functioning, fatigue, dyspnea, appetite loss, constipation, and VAS pain score remained stable over the 6-months period. In contrast: physical functioning declined (medium to large deterioration (-19.8 (95% CI -27.2 to -12.5)) between T0 to T2), however there was an improvement in the insomnia domain (medium improvement (-13.4 (95% CI -19.9 to -6.9)) between T0 to T2).

Conclusions

Our findings indicated that advanced stage breast cancer patients adapted well to palliative oncology treatment over six months of observation. There was deterioration in physical functioning, but improvement in insomnia. However, more attention is needed from clinicians to achieve improvement in the overall QOL score and specific QOL domains.

Key messages

• Focusing on improvement overall QOL score and specific QOL domains will lead to better advanced stage breast cancer patients’ satisfaction and care.

• Information is limited on palliative treatment satisfaction in low and lower middle-income countries, therefore this study has important impact on further policy considerations in Indonesia.
Hospital admissions and mortality for STEMI and NSTEMI during COVID-19 outbreak: a meta-analysis
Authors: Altobelli E , Angeletti PM , Marzi F , D'Ascenzo F , Petrocelli R , Patti G
Published: October 2022

Background

During SARS-CoV-2 pandemic, various studies have shown a significant reduction of Emergency Department (ED) presentations for acute cardiac diseases requiring in-hospital management. The aim of our study was to quantify hospital admission and mortality, comparing pandemic period and pre-pandemic period in different countries.

Methods

We performed an updated meta-analysis of observational studies to quantify on a large basis the impact of the SARS-CoV-2 outbreak on patients admitted to the ED for STEMI and NSTEMI. The literature research was conducted on PubMed, EMBASE, Scopus, Science Direct, Web of Science and Cochrane database registry on 6 January 2022. We performed a random-effect model meta-analysis.

Results

A total of 61 studies were included: came from Italy, China, Germany, Israel, Turkey, France, Helvetic Confederation, India, Poland, Spain, US, UK, Albania, Austria, Egypt, Greece, Iran, Ireland, Japan, Pakistan, Portugal, Saudi Arabia and Canada. Hospital admissions for STEMI decreased in most country. The countries with the high levels of reduction were Italy (IRR = 0.68) and Germany (IRR = 0.69). Mortality rates for STEMI increased differently among countries analyzed: p = 0.003. The highest mortality rate was in Serbia (OR = 2.15), followed by Italy (OR = 1.97), Pakistan (OR = 1.69) and France (OR = 1.55). Among the High-Income countries, the highest mortality rate was in Italy (OR = 3.71), the highest among the Upper-Middle-Income was in Serbia (OR = 2.15) and the highest among Low- Middle-Income was in Pakistan (OR = 1.69). Regarding NSTEMI, hospital admissions showed that Italy had the lowest value for with IRR = 0.59. Among countries, the meta-regression subgroups analysis, showed statistical difference (p < 0.001).

Conclusions

Our meta-analysis may represent a robust snapshot that might help healthcare systems manage and assist an expected higher number of people coming to the hospitals for severe, post-acute cardiological issues in the future.

Key messages

• The study shows hospital admission and mortality, comparing pandemic period and pre-pandemic period in different countries.

• Epidemiological data suggests that one-fourth to one-third of MI patients, in large areas of the globe, during the COVID-19 pandemic in 2020, remained at home and did not have access to ED.
Temporal trends of suicidality among adolescents in the last decade in Piedmont, Northwestern Italy
Authors: Berchialla P , Bersia M , Koumantakis E , Ferracin E , Comoretto RI , Charrier L , Dalmasso P
Published: October 2022

Background

Over the last decade, trends of suicidality among adolescents remain unclear. We conducted a cross-sectional study using surveillance data collected over the past 10 years in the Piedmont region, Italy, to explore temporal trends in suicidality among hospitalized adolescents.

Methods

This was a retrospective study over an 11-year period of time. The target cohort was adolescents aged 13-19 discharged from inpatient/day-hospital care with at least one suicidality-related ICD9-CM code (i.e., suicidal ideation-SI, suicidal risk-SR and suspected suicide-SS) between 2011 and 2021 in Piedmont (Northwestern Italy). Social-economic related data is available from Census 2011. Yearly incidence rates (IR) were calculated based on the overall hospitals’ catchment population and by sex. Poisson regression model was estimated to evaluate the trend over time and the association with sex, and a potential effect of the COVID-19 pandemic. A non-linear trend was allowed by modelling natural splines.

Results

We included 490 adolescents (median age: 15 years, IQR: 13-16), 380 girls and 110 boys, with ICD9-CM codes for SI (264; 53.9%), SR (142; 29%), SS (90; 18.4%) at first discharge. Girls showed a higher risk of repeated inpatient care than boys (19.2% vs 7.3%, p < 0.01). Since 2013, yearly suicidality IRs started increasing linearly in boys (+1.7/100,000 per year, 95%CI: 0.7-2.8). Apparently, suicidality IRs increasing in girls were observed since 2011 (+5.8/100,000 per year, 95%CI 2.8-8.9) and were significantly higher than in boys (p < 0.001).

Conclusions

Suicidality among young inpatients increased in Piedmont during the last decade. Females seemed to be more affected than males. Further research is needed to better understand gender-related risk factors for suicidality.

Key messages

• There has been an increase in the number of adolescents reporting suicidal ideation in the last decade, especially in girls.

• Intervention strategies are urgently needed to reverse a potentially alarming trend in suicidality among young people.
Dietary supplements intake among youth: preliminary results of a multicentric survey
Authors: Protano C , De Giorgi A , Valeriani F , Gallè F , Liguori G , Spica VR , Vitali M
Published: October 2022

Background

In the last decades, a wide spread of dietary supplements (DSs) has been observed worldwide. However, DS use is not always motivated by real nutritional needs. In this context, commercial strategies and peers’ suggestions seem to play an important role in determining this habit, with harmful effects on consumers’ health. This cross-sectional study was aimed to evaluate the DS consumption patterns among a sample of undergraduate students attending 14 Italian universities.

Methods

An anonymous web questionnaire was used to collect information about DS use and consumption habits, related motivations and possible adverse effects. The survey is still ongoing and its conclusion is expected to be on May 2022.

Results

On a total of 2019 participants enrolled so far (69.7% female, mean age 22.8±4.7), 72.6% reported the use of at least a DS in the last six months. Multivitamin and multimineral products were the most used, being reported by 35.8% of the participants, while caffeinated energy supplements were the less reported (2.0%). The main reason for DS use was to deal with a specific deficiency following a physician or nutritionist indication (47.8%). The 3.4% of participants reported the occurrence of negative outcomes, mainly gastrointestinal disorders (74%).

Conclusions

These preliminary results evidenced a wide use of DSs in the studied population. Although the main motivation was a nutritional need with a medical recommendation, a notable proportion of the sample assumed DSs without any specific prescription. Thus, it is essential to increase the knowledge about DSs and related threats deriving from their inappropriate use in the population, especially among youths. Further analysis will allow to identify possible correlations with socio-demographic and behavioural variables.

Key messages

• It is essential to increase the knowledge about dietary supplements to avoid an inappropriate use in the population.

• Youths are the most exposed to this consumption.
Nutritional composition of substitutes for meats and sausages on the German market
Authors: Gréa C , Roser S , Hoffmann I , Storcksdieck genannt Bonsmann S
Published: October 2022

Background

Substitutes for meats and sausages are growing both in demand and supply in Germany. Monitoring their nutritional composition helps characterise this novel product group in terms of its dietary contribution.

Methods

Data on substitutes for meats and sausages were collected in a baseline survey in 2016 and an in-depth follow-up survey in 2021. In both surveys, mandatory nutrition declaration (“Big 7”) and other packaging information were collected via online research and supermarket visits. Products were categorised according to the substituted animal products and their contents of energy, fat, saturated fatty acids, and salt investigated. Changes in energy and nutrient contents between baseline and follow-up survey were assessed statistically using Welch’s t-test.

Results

The follow-up survey included 421 meat substitutes and 292 sausage substitutes, split into 27 subgroups. Substitutes for meat products like meat strips and schnitzel show widely varying energy contents. Sausage substitutes show higher medians for fat, saturated fatty acids and salt than meat substitutes; spans of salt content (0,1-4,0 g per 100 g product) and saturated fatty acids (0,1 g - 23,0 g per 100 g product) are particularly wide. Relative to the baseline survey, which included 69 meat substitutes and 61 sausage substitutes, the follow-up revealed significantly higher contents of energy and saturated fatty acids overall and in some subgroups (e.g. nuggets and burger patties). The sole significant reduction was seen for energy in substitutes of precooked sausages.

Conclusions

The observed wide spans of energy and nutrient content imply 1) the potential to reformulate substitutes for meats and sausages at the top end of the spectrum 2) the availability of healthier choices within the various subgroups. The increases shown in energy and saturated fatty acids content warrant further monitoring.

Key messages

• Wide spans of energy and nutrient contents reveal the potential for the development of more nutritionally favourable substitutes for meats and sausages.

• As substitutes for meats and sausages are perceived to have nutritional advantages the observed increases in energy and saturated fatty acids contents over time should be further monitored.
How can policies to reduce obesity be more effective and equitable following the COVID-19 pandemic?
Authors: Gallagher Squires C , Isaacs A , Coleman P , Hawkes C
Published: October 2022

Despite being a public health priority in the UK for decades, rates of childhood obesity are continuing to rise along a highly unequal socioeconomic gradient. COVID-19 has radically changed daily life, altering the economy, work, social lives and engagement with the food environment. This research aimed to investigate families’ lived experiences of food in the COVID-19 pandemic to understand how policies to reduce obesity can be more effective and equitable. We conducted a remote longitudinal qualitative study, engaging 62 parents of school or nursery age children in England. Participant demographics were diverse in terms of socioeconomic status and ethnicity. Participants took part in semi-structured interviews and photo-elicitation three times at six-month intervals between October 2020 and December 2021. The role of food in day-to-day life shifted in the context of changes brought about by the pandemic. Whether this led to healthy or unhealthy food practices was shaped by socioeconomic resources. Food became a key source of pleasure in daily life as social and leisure activities were restricted in lockdowns. As schools and childcare closed, when this work fell on one parent food became a source of relentless work and parents sought more convenient options. Those with financial resources were able to access healthier convenient options (e.g. meal boxes), while low incomes restricted parents to low-cost options (e.g. ready meals and fast food). For those experiencing financial insecurity, food became a financial management strategy and parents sought discounts and promotions to save money to cover other non-food essentials. These contexts have the capacity to occur again both on a large scale (e.g. disruptions to the food system) and in the context of an individual’s lifetime (e.g. ill health or job loss). Policy now has a window of opportunity to implement learnings from this period and shape obesity prevention policy to be more effective and equitable.

Key messages

• COVID-19 has revealed the multiple resources and systems of support that underpin families’ ability to eat well and, when disrupted, can limit capacity to procure and prepare nutritious foods.

• Policies designed to improve diets must consider the multiple roles food plays in everyday life, beyond just a source of nutrition, to ensure actions are effective and equitable.
Cost-effectiveness of hospice-based palliative care in Kazakhstan
Authors: Salikhanov I , Crape B , Wieser S , Katapodi M
Published: October 2022

Background

According to the Quality of Death Index, Kazakhstan ranks 50th out of 80 countries assessed. Currently, some form of inpatient end-of life care in Kazakhstan is provided by only 9 hospices, palliative care units and mobile teams. In 2020, the total number of palliative care beds did not exceed 980 across the country, while around 135,000 patients need palliative care at any given time.

Objective: To assess the effectiveness and cost-effectiveness of hospice-based palliative care for cancer patients compared to usual hospital care in cancer centers across Kazakhstan from societal perspective.

Methods

A total of 182 family caregivers were recruited, 104 in a hospice group and 78 in a control (palliative units). Patients’ state of health and family caregivers’ burden been measured using Palliative Outcome Scale (POS) and Zarit Burden Inventory (ZBI) on 14th day of the inpatient palliative care. Direct and indirect medical costs as well as family caregivers’ out-of-pocket expenses associated with the care has been collected. The cost-effectiveness analysis was conducted by calculating the difference between mean cost of treatment, including OOPs, over 14 days of treatment. Uncertainty around the cost-effectiveness estimates was explored by generating 10,000 resamples using bootstrapping.

Results

At 14 days, patients’ mean quality of life was 2,4 points better (95% CI: 0,06 - 4,9) in the hospice group compared to the control. Family caregiver burden was 4,6 points better in the hospice group (95% CI: -0,26 - 9.3). Mean treatment costs, including direct medical costs and out-of-pocket expenditures over 14 days were $31 lower for the hospice group (95% CI: $29 - $32). There was a significant correlation between the total cost of treatment and patients’ quality of life (rxy = 0,58; p < 0,01). The cost-effectiveness plane graphically represents 10,000 replications, 85% of them showed that hospice care has better outcomes and lower costs than the control group.

Key messages

• Hospice-based palliative care is cost-effective compared to the care provided in palliative units of cancer centers.

• There is a significant correlation between patients’ quality of life and family caregivers’ burden.
Development of a refugee health assessment toolkit for specific populations to support primary care
Authors: Boshari T , Hassan S , Hussain K , Billett J , Garry S , Weil L
Published: October 2022

Issue/problem

The United Kingdom (UK) hosts c.136,000 refugees and last year received the most asylum applications in two decades. Despite this, expertise in migrant health is not widespread in general practice, with few comprehensive toolkits available to support crucial initial health assessments of new arrivals.

Description of the problem

A large influx of Afghan refugees entered the UK in autumn 2021. In London, primary care practitioners quickly identified a lack of readily accessible, comprehensive guidance to support them in conducting health assessments for arrivals with a complex range of needs. This was compounded by many in primary care having little or no experience of migrant health.

Results

To address this gap in advice on conducting initial health assessments, a bespoke toolkit was created. The toolkit consolidated advice from a range of partners and resources: the UK Afghan migrant health guide, clinicians with humanitarian experience, front-line practitioners, Doctors of the World, and those leading on the health and public health response. The toolkit ensured greater consistency in the nature and content of assessments, considered not only primary needs but also broader wellbeing, and was responsive to both anticipated and known health priorities.

Lessons

The initial health assessment toolkit for Afghan migrants was well received by frontline staff and has implications for international practice in other areas providing similar health support. The toolkit and associated supporting information has formed a template that can be rapidly adapted to suit emerging needs, as has been done for new arrivals from Ukraine. This work has fed into best practice by the UK National Asylum Steering Group and is to be a case study for a WHO project on country-specific health assessments.

Key messages

• The toolkit is a proof of concept for partnership working towards holistic initial health assessments of new migrants in primary care, bringing together best evidence and pragmatic practice.

• This work has implications for other countries experiencing similar trends in migration and providing health support to an increasing number of new refugees.
Mina Svar: A tool for measuring social impact
Authors: Salari R , Westberg J , Moum Å ,   Youth in Save the Children programs, Thell M , Dyar O , Sarkadi A
Published: October 2022

Background

Each year, numerous initiatives are carried out to improve the outcomes for youth living in vulnerable areas. However, the impact of these initiatives is rarely measured, partly because there is no reliable, valid, relevant and easy-to-use tool available to measure the impact of social investments from the youth perspective. Mina Svar is an app co-created with youth that aims to address this gap.

Methods and results

Save the Children led the collaboration in defining a measurement framework. Experts from Save the Children, researchers from Linköping University, and representatives from Accenture, Skandia and Apoteket as well as youth themselves were involved in an iterative process. Five interconnected areas were identified as central: democracy and influence, education, work, housing and neighbourhood, and health. The first version of Mina Svar included 34 items. Researchers from Uppsala University were involved to help with testing the psychometric properties of Mina Svar in a sample of 237 youths. We examined the tool’s internal consistency, content validity and structure validity. Analyses showed that all the subscales except democracy and influence had good internal consistency (0.70 and higher). However, inspection of individual items revealed that several items lacked clarity and many items did not comprehensively reflect the related constructs as intended. Confirmatory factor analysis suggested a poor fit for the proposed model (CFI = 0.52 TLI = 0.56, and RMSEA = 0.103). Currently, we are going through a second iterative process to increase the reliability and validity of Mina Svar. The work involves refining the framework, rewriting ambiguous items, generating new items, and re-examining the psychometric properties of the revised version.

Conclusions

Mina Svar is a promising short multidimensional survey tool which offers a potential solution to tackle the problem with measuring the impact of social investments from the youth perspective.

Key messages

• Mina Svar is an app-based assessment tool co-created with youths living in vulnerable areas.

• Mina Svar is a promising short multidimensional tool which offers a potential solution to tackle the problem with measuring the impact of social investments.
Self-esteem associated with the use of social networks in university students
Authors: Villegas Dominguez JE , Muñoz Bautista BL , Gonzalez David EA , Vazquez Garate R , Uscanga Alcantara S , Pavan Gallardo JJ , Reyes Hernandez C , Cruz Garduza AJ , Marquez Celedonio FG
Published: October 2022

Introduction

Currently, the consequences of social networks on the self-esteem of users have been demonstrated in dissemination sources, and can generate problems in their mental and physical health.

Objective

To determine the association between self-esteem and addiction to social networks in university students.

Methods

A cross-sectional, prospective study was carried out between January and April 2022, including male and female university students, aged between 18 and 26 years, excluding participants with already diagnosed psychological disorder, such as depression, anxiety and body dysmorphia. A survey was applied through Google Forms, including the Rosenberg self-esteem scale and the social network addiction test (Cronbach’s alpha 0.91). SPSS v22 software was used for data analysis, X2 test with Odds Ratio (OR) and 95% confidence interval (95%CI), assigning statistical significance with p < 0.05.

Results

A total of 407 students were included, with moderate social network addiction in 57.4% and severe in 8.1%, with low self-esteem in 22.1% and moderate in 50.6%. Values of p < 0.05 were obtained for low self-esteem (OR/95%CI) when the most used social network is WhatsApp (0.5/0.2-0.8) and Instagram (1.8/108-3.2), as well as when having a number of followers between 1501-2000 (0.2/0.1-0.7) and 2501-3000 (10.8/1.1-106). Regarding network addiction, studying a humanities degree showed OR of 12(1.6-88.1). The rest of social networks such as Facebook, tik-tok, twitter, youtube, among others, showed values of p > 0.05 for both addiction to social networks and low self-esteem.

Conclusions

Instagram is identified as a social network that facilitates the presence of low self-esteem in its users, while addiction to social networks is not associated with self-esteem. The number of followers is an associated factor for low self-esteem, and may be preventive or risky according to their total.

Key messages

• We must propose the legislation of social networks, requesting the guarantee of studies for the algorithms that compose them in order to avoid harm to users from them.

• Work with students to have mental health and emotional intelligence should be one of the aspects to be covered by universities, as part of the comprehensive care for students.
Health services gaps experienced by non-standard workers in Ontario, Canada: Policy implications
Authors: Gunn V , O'Campo P , Buhariwala P , Muntaner C , Lewchuk W , Baron S , Bodin T
Published: October 2022

Background

While the Canadian universal health system provides access to basic services, key health benefits are employer dependent. Given that non-standard workers (NSWs) only rarely have access to such benefits they have increased vulnerability to the many insecurities derived from their precarious employment, as clearly seen during the pandemic. The growing problem of non-standard work and workers’ heightened risk for health status deterioration, followed by a possible accentuation of health inequities, is a population health concern. This study summarizes several health services gaps experienced by NSWs and discusses policy implications and possible solutions.

Methods

From January to July 2021, we conducted semi-structured interviews with a purposive sample of 40 NSWs in Ontario, Canada, part of a larger mixed-methods six-country study, including three European countries. The target population consisted of workers aged 25 to 55 who, at the time of the survey, were in non-standard employment or lost their job due to the COVID-19 pandemic.

Results

Our findings highlight complex physical and mental health problems and an overall high burden of disease facing NSWs during the pandemic as linked to a combination of constant stress and worry arising from their employment insecurity, the limited and inconsistent income available to cover their basic needs, and the inadequate and unsafe working conditions they are afraid to challenge. Despite their increased health needs, given that specialized health services are not available to them for free they face financial barriers in accessing much needed health services that could help improve their health status and as a result, delay seeking care or avoid it altogether.

Conclusions

Sustainable multi sectorial policy solutions are needed including the adoption of relevant labour market legislation and increases in social and health expenditures along with re-adjustments in the ways in which health services are delivered.

Key messages

• During the pandemic non-standard workers in Ontario, Canada experienced complex health problems and, despite increased health needs, encountered barriers in accessing specialized health services.

• The growing problem of non-standard work and workers’ heightened risk for health status deterioration, followed by a possible accentuation of health inequities, is a population health concern.
Linking health system inputs, processes and outputs to identify medical deserts in Serbia
Authors: Mandić-Rajčević S , Šantrić-Milićević M
Published: October 2022

Background

Medical deserts (regions where the population does not have adequate access to health care) indicate the failure of the health system to achieve the goals of improving the health of the population. Identifying medical deserts (MD) is far from simple. The aim of this study is to describe the approach to identification of medical deserts in Serbia using indicators for the health system inputs, processes and outputs.

Methods

We investigated the basic healthcare-related medical deserts using the indicators of primary health care centers’ inputs (accessibility: annual number of patients per physician), processes (performance: annual workload of patient visits per physician) and outputs (unmet needs: percentage of patients unable to access health services) in all 25 Serbian districts in 2020, using data of the Health Statistical Yearbook of the Republic of Serbia and the National Patient Satisfaction Survey of the Institute of Public Health. We developed a Multiple Criteria Scoring System (MCSS) incorporating the weighting and scoring of accessibility and performance for four types of physicians (general practitioners, pre-school pediatricians, youth pediatricians, and gynecologists) and five dimensions of unmet needs (financial reasons, waiting times, lack of personal time, long-distance and COVID-19). MCSS final scores 0 (none) - 100% (MDs on all indicators) are assessed using the regulatory norms.

Results

MDs partially overlap by different criteria: accessibility, 4-10 districts; performance, three districts; unmet needs: 2-5 districts. Top five medical deserts identified according to the MCSS are Mačvanski, Šumadijski, Moravički, Srednjebanatski, and Podunavski district.

Conclusions

Serbia has at least one MD per administrative region according to the objective normative indicators and patients’ subjective experiences. The study findings can be used to inform district stakeholders on how to use health workforce policy and planning to address medical deserts.

Key messages

• MCSS indicates potential medical deserts in 20% of all districts in the Republic of Serbia.

• Evidence on poor health workforce accessibility and performance in light of the patient unmet healthcare needs could be used to inform stakeholders on medical deserts in the country.
Associations of dietetic care and pregnancy outcomes in women with gestational diabetes
Authors: van der pligt P , Absalom G , Zinga J , Margerison C , Abbott G , O'Reilly S
Published: October 2022

Background

Gestational diabetes mellitus (GDM) is a significant, global public health problem. Subsequent strain on healthcare systems is widespread and multidisciplinary care may be inadequate. We assessed current nutrition management of GDM in a large, metropolitan maternity hospital in Melbourne, Australia and associations between the model of dietetic care and maternal and neonatal health outcomes.

Methods

Hospital medical record data from The Women’s Hospital, Melbourne for women with GDM (n = 1,185) (July 2105-May 2017) was retrospectively analysed. Adjusted linear and logistic regression were used to assess associations between the number of dietitian consultations and maternal and neonatal health outcomes.

Results

Half of all women received two consultations with a dietitian. Nineteen percent of women received three or more consultations and of these women, almost twice as many were managed by medical nutrition therapy (MNT) and pharmacotherapy (66%) compared with MNT alone (34%). Odds of maternal complications increased with number of consultations (p = 0.008). Lower odds of infant admission to the Neonatal Intensive Care Unit were observed among women receiving one (OR = 0.38 [95% CI: 0.18, 0.78], p = 0.008), two (OR = 0.37 [95% CI: 15 0.19, 0.71], p = 0.003), or three+ dietitian consultations (OR = 0.43 [95% CI: 0.21, 0.88], p = 0.020), compared to no consultations.

Conclusions

The optimal schedule of dietitian consultations for women with GDM in Australia is unclear. Alternative delivery of nutrition education for women with GDM such as telehealth and utilisation of technology may assist in relieving public health and healthcare system pressures and ensure optimal pregnancy outcomes.

Key messages

• Delivering medical nutrition therapy through individual consultations does not deliver a linear benefit to women with GDM and their offspring.

• Alternative delivery modes are needed to optimise outcomes for healthcare services and their patients.
Collaboration and health promotion for the health care system – evaluation of the WOL healthcare
Authors: Schorlemmer J , Jung B , Zeller C
Published: October 2022

Background

Health care and social services are industries with special challenges: Constant emotional demands, the shortage of skilled workers is noticeable (in Germany) and special organizational stresses, not only since the Corona pandemic. This study evaluates the Working out Loud (WOL) program for healthcare, which aims to create a learning culture for interdisciplinary collaboration and network-oriented learning and increases growth-oriented thinking at organizational level.

Methods

The sample consists of 51 participants. From 16 persons data could be analyzed in the pre-post-design of the 10-week intervention accompanied by individual coaching. All respondents work in the health care system in Germany. Dependent variables were collected with validated scales for psychological safety, psychological flexibility, cooperative learning, emotional energy, engagement and voice behavior.

Results

Effects of moderate strength were shown for all variables: psychological safety (Mt1= 4.86, Mt2 = 5.45 t(15) =-1.86, p =.083, d = 0.46), psychological flexibility (Mt1= 3.57, Mt2 = 3.82 t(15) = -2.12, p = .051, d = 0.53), cooperative learning (Mt1= 4.63, Mt2 = 4.81 t(15) = -2.18, p =. 045, d = 0.54), emotional energy (Mt1= 2.70, Mt2 = 2.75 t(15) = -0.82, p = .423, d = 0.20), engagement (Mt1= 2.87, Mt2 = 3.05 t(15) = -1.65, p = .119, d = 0.41)and voice behavior (Mt1= 3.84, Mt2 = 4.05 t(15) = -1.64, p = .120, d = 0.41). Correlations are shown for psychological safety with emotional energy (r = .426, p = .012) and job satisfaction (r = .612, p = .000).

Conclusions

The 10-week WOL Healthcare program can strengthen employees in the important area of health promotion and care. The program serves as behavioral prevention and, by empowering individuals, brings about job crafting structural prevention in the workplace. The intervention follows a bottom-up principle, it is an approach for health promotion in the healthcare sector, that can strengthen patient's safety.

Key messages

• Evidence for the effectiveness of a health promotion intervention for health care workers.

• Organizational learning promotes workers health.
Nutrition Literacy of Overweight/Obese and Non-Overweight/Obese Turkish Women and Affecting Factors
Authors: Kozan Çıkırıkçı EH , Esin MN
Published: October 2022

Background

Nutrition literacy is having the skills and abilities required to prepare food, make healthy food preferences, and understand its effects on health, environment, and economy. Inadequate nutrition literacy can lead to an unhealthy diet, overweight, or obesity. Along with inadequate nutrition literacy, gender is also a risk factor for obesity. In this regard, it is seen that women’s level of nutrition literacy has an important role in gaining healthy eating habits and preventing chronic diseases related to nutrition such as obesity. This study aims to determine the level of nutrition literacy of adult Turkish women and the factors affecting.

Methods

In this comparative descriptive research, 239 women were selected into 2 groups by their BMI, from Public Education Centers in Istanbul, Turkey, by using simple random sampling method. Data were collected using Introductory Characteristics Form and Adult Nutrition Literacy Assessment Tool. For statistical analysis, Pearson Chi-Square, Mann Whitney U and logistic regression were used.

Results

In the study, adequate numerical literacy and food label reading rates in overweight/obese women were found lower (p = 0.000) than non-overweight/obese women. It was found that the number of main meals increases the nutrition literacy level of non-overweight/obese women 2.628 times (p = 0.012). In the overweight/obese group, it was found that number of children (p = 0.040), waist circumference (p = 0.048), snack amount (p = 0.022) and Youtube usage (p = 0.041) increase nutrition literacy levels.

Conclusions

The nutrition literacy of both groups was found to be high. However it is highly affected by YouTube usage which provides a new perspective in terms of public health practices and policies. It is recommended for public health professionals to:

• use social media platforms and provide evidence-based information

• monitor the height, weight and BMI of individuals in the risk group

• organize interventions to strengthen nutritional literacy

Key messages

• Adequate numerical literacy and food label reading sub-dimension mean scores of overweight/obese women was lower than the non-overweight/obese women.

• Spending time on Youtube increases the nutrition literacy levels in overweight/obese women by 91,116 times which points to the relationship between nutritional literacy and social media use.
Tools for assessing implementation of health promotion standards in hospital/health service settings
Authors: Katsaros K , Groene O
Published: October 2022

The International Network of Health Promoting Hospitals and Health Services (HPH) was initiated by the World Health Organization as a settings approach toward reorienting health services. Over 600 members from 30 countries promote the integration of health promotion into the hospital/ health service setting. The International HPH Network developed the 2020 Standards for Health Promoting Hospitals and Health Services, representing years of experience and expertise reflected in 5 standards, 18 substandards, and 85 standard statements. Complementary self-assessment tools were developed to operationalize the standards and to identify concrete measurable elements against which each standard can be measured. The aim of the tools is to assist hospitals and health services in transforming the setting into a health promoting one. The standards are comprehensive and address topics to encourage the complete refocusing of an organization’s strategy and to stimulate a process of continuous internal improvement. Standards address management, patient-centered care, occupational health, health literate organizations, environmental sustainability, and target groups such as the elderly and children and adolescents. Excel and pdf tools may be utilized by institutions to measure and track progress in implementing each of the standards. The tools state measurable elements for each standard that were identified by an expert panel of HPH members and external subject experts to be directly observable and applicable across various regional and institutional contexts. As part of internal and external assessment processes, standards can be rated on a scale from 1 (not implemented) to 10 (fully implemented). The tools store data and generate graphs that allow organizations to assess their level of performance, identify areas for improvement, and devise data-driven action plans.

Key messages

• Progress towards transforming the setting must be tracked and included in an organization’s continuous internal improvement processes.

• The transformation of the hospitals/health service setting into a health promoting environment results in better health outcomes for patients, families, the community, and the environment.
Co-construct, implement and evaluate an intervention to prevent a sedentary lifestyle in children
Authors: Laujac S , Cholley-Gomez M , Franceschi J , Rozand A , Pallier L , Basson JC , Vuillemin A , Duché P , Delpierre C , Carayol M
Published: October 2022

Background

In children a sedentary lifestyle is associated with the development of chronic diseases, as well as unfavorable body composition and physical condition, lower levels of self-esteem, sociability, and school results. In Europe 39,8% of children (6-9 years) spend on average more than 2h/day in front of a screen, and 14,6% over 3h/day. In this context, designing and testing effective interventions to decrease sedentary behavior in children is a major public health research gap. The CIPRES intervention aims to reduce sedentary time in school-age children (7-10 years).

Methods

The CIPRES intervention is co-constructed with key local actors, by using a socio-ecological approach, and theory-based on the transcontextual model. The intervention is evaluated by a cluster-randomized controlled study currently ongoing. The target population is made up of 1000 children from 13 primary schools (in years 4-5) from southeast of France with different levels of social deprivation. Main outcomes are assessed by accelerometer and questionnaires before (T0) and after a six-week intervention (T1) and include sedentary behavior, physical activity (PA) and variables of the transcontextual model.

Results

Preliminary data were available in 152 children (53 intervention and 99 control). There was no significant difference across the time in sedentary time between intervention and control group (p = 0.11; η2=0,017); however, moderate-to-vigorous physical activity (MVPA) tended to be better in intervention vs control (p = 0.06; η2=0,023). In the intervention group, sedentary time and MVPA were significantly better across the time (p = 0.028 and p = 0.011, respectively) for children having a father with a university diploma as compared to children having a father with a lower education level.

Conclusions

Preliminary results on a small group of subjects (n = 152) are encouraging and suggest a positive impact of the intervention on children. More results will be available by summer 2022.

Key messages

• Based on the socio-ecological model, the CIPRES intervention aims to prevent sedentary in school-aged children.

• Preliminary data suggests a favorable impact of the intervention on physical activity.
Moveluencer - movement promotion in the context of covid 19
Authors: Tuttner S , Holler P , Amort F
Published: October 2022

In times of a pandemic, regular physical activity is recommended as protection against the additional stressors caused by a significantly changed daily routine and, above all, severe restrictions in social life. Within this context, promoting active mobility is a meaningful approach to improving the health of the population. The project ‘MOVEluencer’ is a physical activity promotion project following a multidimensional and participatory approach. It has been running since July 2021 in six small rural communities in Styria, a province of Austria (average: 2262 residents). These communities were selected based on inequality factors related to health and physical activity. The promotion of active mobility is at the heart of the project. The main target groups include children and adolescents, their parents, as well as older adults. The aim of the analysis phase was to identify infrastructural resources that are favorable to a physically active lifestyle through a photo contest. A total of 268 photos were sent in by 67 people (43% female). In spring 2022, ‘movement events’ were implemented to raise awareness in terms of active mobility among the population. These events were supplemented by the offer of fitness tests and approximately 265 persons (age: 10 to 84 years) participated. As a follow-on activity, 4 to 5 ‘walking buddies’ will be trained in each community and they will subsequently offer regular walking meetings. In the 3rd project phase, specific physical activity programs will be developed and implemented together with the target groups of the project. Aspects for the sustainable anchoring of physical activity promotion are considered in each project phase. It has been shown that awareness of the health benefits of active mobility in rural areas is rather low. Therefore, improving lifestyle and infrastructural conditions as well as measures to promote physical literacy are important.

Key messages

• Awarenes among the population regarding the health benefits of active mobility is low in rural areas.

• Social media campaigns to promote physical activity are successful in all age groups.
Hand Hygiene: do we know the WHO 5 moments?
Authors: Baca Hidalgo J , Pérez Dionisio M , Salguero Cano V , Díaz Campanón J , Gutiérrez Linares S , Padilla Matas R
Published: October 2022

Background

The proliferation of multi-resistant bacteria to antibiotics is one of the main global health problems of the 21st century. The World Health Organization (WHO) has listed antibiotic resistance as one of the top ten public health threats facing humanity. The hands become the main vehicle for transmission by contact of the microorganisms that cause healthcare-associated infections (HAIs). Its control provides a main point in patient safety. Hand Hygiene (HH) is a good practice consolidated in the technical guides of good practices for patient safety, being essential due to its easy use, low cost and effectiveness in preventing the cross-transmission of microorganisms. Our objective is to analyze the knowledge of healthcare professionals in reference to HH according to the WHO’s indications.

Methods

Descriptive study through cross-sectional surveys based on the HH Knowledge Questionnaire for healthcare professionals translated by the Health Ministry, Social Policies and Equality of Spain and validated by the WHO, carried out voluntarily and anonymously between September 2021 and March 2022, prior and after training sessions in HH.

Results

There were total of 558 surveys (questionnaires) with 57% correct answers in the questionnaires before training and 62.9% after the trainning. The highest percentage of correct answers, both before and after the trainning, correspond to the HH technique and the wrong ones are related to the 4th Moment and 3rd Moment of the WHO HH.

Conclusions/ recommendations

Despite being immersed in a pandemic where adherence to the correct technique of HH has been revealed, the need for healthcare professionals to carry out continuous training regarding HH and Health-care associated infection (HAI) is unquestionable.

Key messages

• Hand Hygiene is a crucial good practice to control Health-care associated infection.

• Continuous trainning improves compliance in Hand Hygiene.
Parent-child nature visits and young Finnish childreńs nature connectedness
Authors: Ray C , Kokkonen J , Simonsen N , Wackström N , Ray J , Engberg E
Published: October 2022

Background

It is well-known that frequent nature visits are associated with health benefits in children. Global climate crisis and environmental challenges emphasize the need for reconnecting children to nature, as well. Young children’s nature connectedness (NC) involves enjoyment of nature, sense of responsibility, empathy, and awareness of nature. The study examines whether there is an association between the frequency of parent-child nature visits and young children’s NC.

Methods

The study uses WEB survey data from the Finnish Empowered by Nature project. Respondents, n = 1463, were parents of children aged 2 to 7 years old. NC was assessed by 11-items derived from the NC questionnaire of Sobko et al (2018). Multinomial logistic regression analysis was used and the lowest tertile of NC was used as reference group. Analysis were adjusted for child’s age and gender, and highest education of parent.

Results

Children with moderate (1-2 times a week in previous month) or high (3 times a week or more) frequency of parent-child nature visits were more likely to have strong than weak NC compared to children with low frequency (less than once a week) of adult-child nature visits. Odds ratios (OR) in adjusted models were: moderate frequency 1.67 (1.21- 2.32), and high frequency 2.31 (1.67-3.18). The odds of having medium NC compared to weak NC were more likely in moderate frequency compared to low frequency of parent-child nature visits in the adjusted model (OR 1.46; 1.07-2.00).

Conclusions

The results highlight the importance of parents visiting nature frequently with their children during early childhood. It promotes young children’s NC and may further contribute to raising environmentally responsible children.

Key messages

• More frequent parent-child visits promote young children’s nature connectedness which involves enjoyment of nature, sense of responsibility, empathy, and awareness of nature.

• A strong nature connectedness among children is highly relevant, as it may contribute to raise environmentally responsible children.