bluuebunny/crossref_metadata_2025_split huggingface dataset:
Politicians’ view on their role in promoting health – developing a questionnaire
Authors: Svanholm S , Carlerby H , Viitasara E 
Published: October 2020

Abstract

Background
Although the political context is recognized as an important determinant of health, there is limited research on politicians' role in health promotion. No fitting questionnaire to study the subject could be identified, therefore a new questionnaire was developed.

Methods
An inductive approach was used and the first step was semi-structured interviews with six politicians. They represented two different municipalities and four different political parties from different sides of the Swedish political spectrum. The interviews focused on the politicians’ view on their role, responsibility and possibility to promote health. The data was analysed by means of qualitative content analysis. Five categories were created with several sub-categories each. The categories formed the sections of the questionnaire. Statements and questions were created to cover all the sub-categories. The statements were assigned Likert-scales (strongly agree to strongly disagree) for answers and some of the sentences were turned into questions. Lastly, face validity of the questionnaire was tested by the interviewees who filled out the questionnaires, two by thinking aloud as they did and three by filling out the online version of the questionnaire and leaving comments on the questionnaire.

Results
This resulted in a questionnaire with five sections focused on: Politicians view on health and health promotion; to affect health as a politician; collaboration between actors; the politics of health; the municipality/region organisation and prerequisites.

Conclusions
The questionnaire opens up for explorative studies on politicians' view on their role, responsibility and possibility to promote health. It is currently being used in a study exploring local and regional politicians in the north of Sweden and their role in health promotion.

Key messages
Politicians’ view on their role in health promotion is of importance to explore. The developed questionnaire can be used to study politicians’ role in health promotion.
Opportunities for drowning interventions using existing government policy and programmes in India
Authors: Gupta M , Zwi A , Jagnoor J 
Published: October 2020

Abstract

Background
Children living in coastal, rural India face a particularly high risk of drowning due to rurality, presence of open water, lack of accessible health systems and poor infrastructure. No drowning interventions are currently implemented in India. Interventions that build on existing policy targets or government programs are more likely to be sustainable and scalable.

Methods
For the first time to our knowledge for an injury-related issue in India, detailed content review of policy was conducted to identify both policy principles and/or specific government programs that may be leveraged for drowning interventions. The reach, enablers and barriers of these programs were assessed through a systematic literature review. Identified policies and programs were also assessed on how they catered for underserved groups and took into consideration equity.

Results
Three programs may be leveraged for drowning interventions: The Integrated Child Development Scheme (ICDS), Self-Help Group (SHG) and Accredited Social Health Activist (ASHA) programs. All three had high coverage and considered underserved groups such as women and rural populations.

Conclusions
Programs targeting specific health outcomes should consider interventions outside of the health sector that address social determinants of health. This may enable the program to better align with relevant government agendas and increase sustainability.

Key messages
This is the first systematic analysis of both policy content and execution of government programs to provide comprehensive insights into possible implementation strategies for an injury intervention. This methodology may be applied by other researchers identifying sustainable intervention options supported by government policy and/or programs.
Risk factors for death within 90 days of Clostridium difficile infection
Authors: Koziol M K , Z.urek M Z 
Published: October 2020

Abstract

Background
The conducted analysis emphasizes increasing problem of Clostridium difficile infections (CDI) in Poland. There are no other publications based on Polish healthcare data that would more precisely indicate the impact of risk factors for death after the infection. The purpose of the analysis was to present the incidence of CDI in the overall population of Poland in the years 2009-2018 and to evaluate the risk factors for death within 90 days after CDI infection.

Methods
In order to detect the incidence of CDI the data of the National Health Fund from years 2009-2018 were used. Code A04.7 from International Classification of Diseases (ICD-10) allowed to identify CDI. Risk factor analysis was based on 14 212 patients' hospitalizations in the year 2017. The risk factors were related to patient's medical history and demographic profile. Logistic regression was applied to estimate the impact of the defined variables on the death within 90 days after CDI infection.

Results
CDI incidence increased from 952 hospitalizations in 2009 to 14 582 hospitalizations in 2018. Morbidity of CDI infections (48,3/10 000 patient days in 2017) indicated Poland as the country with the highest prevalence in the European Union (average 2,38/10 000 patient days in 2016). 37,1% of the patients died within first 90 days after CDI infection in 2017. The most important factors that increases the chance of death are: age (&gt;85 OR = 25,8, 65-84 OR = 10,5, 50-64 OR = 4,7 in comparison to age &lt;50), AIDS/HIV (OR = 4,6), metastatic cancer (OR = 4,6), weight loss (OR = 2,6) and alcohol abuse (OR = 2,1).

Conclusions
The results indicated increasing problem of CDI in Poland. It is important to take precautions and use more effective treatment methods particularly in case of the most exposed populations. Furthermore, policy makers should pay attention to compliance with the principles of restricted sanitary procedures and increase awareness of CDI epidemiology among doctors.

Key messages
CDI is an increasing problem, unmentioned in health policy. Restricted sanitary procedures should be implemented in case of hospitalizations of older patients with comorbidities.
Indigenous suicide in Brazil, the self-killing of a vulnerable population
Authors: Saldanha R C O , Abe G M , Abe A H M , Mariano M E O , Pierson I D S , Santana B F , Lima P H R O 
Published: October 2020

Abstract

Introduction
One of the Sustainable Development Goals is to promote mental health. It is then mandatory to know the death profile of this population and to develop public policies to reduce it.

Methods
Epidemiological descriptive study regarding the proportion of indigenous deaths according to the variables: age group, year of occurrence, gender, region, municipality and ICD-10 category, in the period 2008 to 2017 in Brazil, using data from the national database DATASUS.

Results
From 2008 to 2017, there were 5,489 indigenous deaths due to external causes in Brazil, with 1,107 (20.1%) due to self-caused lesions. The annual average was 110.7 cases per year: 100 in 2008, 95 in 2009, 93 in 2010, 97 in 2011, 90 in 2012, 113 in 2013, 117 in 2014, 132 in 2015, 120 in 2016, and 150 in 2017. Regarding causes, strangling/hanging/suffocation were 979 (88.4%), self-intoxication was 31 (2.8%) with other chemicals and 21 (1.8%) with pesticides. Regarding age group, 365 (32.9%) were between 15 to 19 years old, 325 (29.3%) between 20 to 29, 150 (13.5%) between 30 to 39, 131 (11.8%) between 10 to 14, and 136 (12.2%) in other age groups. Regarding gender, 807 (72.9%) were male, 299 (27.0%) were female, and 1 (0.09%) was ignored. Regarding region, the Northern Region had 575 (51.9%) cases and the Central-Western Region had 403 (36.4%) cases. The municipality of São Gabriel da Cachoeira was the one with the highest amount of cases: 132 (12.7%).

Conclusions
The 50% increase in the amount of deaths by suicide among indigenous people in the analyzed period reveals the infficacy of established public policies in Brazil. The number of deaths among the youth reveals the community trauma of exploration, violence and dignity loss. The Nothern and Central-Western regions had conflicts due to land demarcation and prospecting, which explain the high rates. The reduction of such tragedy demands capacitation of all the public spheres.

Key messages
Evaluate the aspects that promote it and to propose effective interventions in environments of difficult access and in a historically vulnerable population. Discuss some relevant characteristics among natives who are vulnerable to practicing self-made injuries, in order to make it possible to create new ways to protect this population.
A qualitative review of maternal health care provision for migrant and refugee women
Authors: Kasper A , Mohwinkel L-M , Nowak A C 
Published: October 2020

Abstract

Background
The number migrants increased worldwide. Pregnant migrant/refugee women are considered a vulnerable group. How do professionals manage their care? The aim was to summarize the current evidence regarding maternal health care provision for migrant/refugee women.

Methods
We conducted a systematic review and searched the databases PubMed (MEDLINE); CINAHL; PSYNDEX, PsycINFO and Cochrane Library. Studies were judged for eligibility: a study had to address maternal health care provision for migrant/refugee women who immigrated to an OECD member state. Publication date was restricted to 1990-2019, and language to English or German.

Results
16 primary (qualitative) studies were included. Heterogeneity of the included studies exists regarding e.g. origin of the women, migration background, receiving country. Nevertheless, synthesis can provide valuable information on challenges and how to deal with migrant/refugee women in maternal health care. Communication difficulties pose challenges on professionals (15 studies). Possibilities to deal with them: bridge-languages, non-verbal communication and interpreters. In addition, finding one's way in the unknown health care system is a barrier for women, which professionals can meet by informing the women and coordinating care (8 studies). The perceived diversity of women can lead to conflicts in care (10 studies). While some studies recommend 'cultural recipes', other authors emphasize the individuality of women and prefer a holistic care approach.

Conclusions
Professionals face different barriers when providing maternal health care to migrant/refugee such as communication barriers, coordinating care and handling women's diversity. Initiating and enhancing public health activities such as training courses for professionals that convey general principles such as woman-centered care, communication techniques are valuable opportunities to improve migrant/refugee women's maternal health care provision.

Key messages
Maternal health care professionals face different barriers when providing maternal health care to migrant/refugee such as communication barriers, coordinating care and handling women's diversity. Initiating and enhancing public health activities such as training courses for maternal health care professionals are valuable opportunities to improve migrant/refugee women’s maternal care.
A halve salt reduction intervention doesn’t affect the acceptance of school lunch
Authors: Liz Martins M , Freitas A S 
Published: October 2020

Abstract

Background
Considering the high salt consumption by children and their impact on future health, is utmost importance the salt reduction on school meals. Though, it is essential to evaluate the acceptance of less salty meals to guarantee that nutritional requirements are not compromised.

Methods
This case study was performed at a Portuguese primary school, in city of Porto, including all children aged between 3 and 10 years. Added salt per meal was determined for dishes and soups, during 5 consecutive days in 1st and 2nd phases, by weighing salt added during meals preparation and considering the average portion served to children. An intervention for salt reduction was performed by halve the added salt through cooks training. Meals acceptance was evaluated by plate waste determination, using the aggregated weighing method, in order to compare differences in acceptance of school lunch before and after salt reduction.

Results
A total of 475 meals was evaluated. Before intervention, it was observed a mean value for added salt of 0.786g (±0.073g) for soup and 1.156g (±0.411g) for dish, totalized 1.942g (±0.393g) of salt added per meal, value higher than recommended for lunch (about 1.5g). During intervention, it was experienced a reduction of added salt between 45.7% and 52.8% for soup and between 41.3% and 50.6% for dish. The salt mean value added per meal was 1.010g (±0.170g), allowed the achievement of recommendations. There were no differences neither in the dish plate waste (p = 0.094) nor in the soup waste (p = 0.838) between the two phases.

Conclusions
This study showed that a 50% reduction of added salt doesn't affect the acceptance of school lunch by children aged between 3 and 10 years old. The success of this intervention could be important for developing school food policies in order to offer balanced meals either with an adequate salt content to achieve World Health Organization goals for salt reduction and consequently enhance public health.

Key messages
It has been possible to halve added salt on school lunch without affect children’s consumption. School policies aiming to promote healthy eating habits by reducing meals salt availability could be effective.
Designing health risk assessment report for wellness clinic patients
Authors: Bhatnagar A 
Published: October 2020

Abstract

Introduction
With the emergence of electronic medical records and patient portals, patients are increasingly able to access their health records, including laboratory reports. However, laboratory reports are usually written for clinicians rather than patients, who may not understand much of the information in the report. While several professional guidelines define the technical content of test reports, there are very few guidelines on a patient-friendly presentation of such laboratory reports. The complexity of lab test reports poses a major challenge to patient understanding that warrants the development of a report more appropriate for them.

Methodology
User feedback was obtained on the Lab Report / medical summaries of a tertiary level hospital based on a pre-tested questionnaire Health Risk Assessment Report was prepared with a view to address patient barriers Functionality enhancements were arrived at for estimating work effort by business analyst of the Customer Relationship Management team.

Results
Patients' health literacy, awareness of inherited diseases, e-health literacy and risk perception were found to be impacting the interpretation of lab results. Based on the user feedback (88% opting for graphical and pictorial presentation), 13 functionality enhancements have been arrived at and submitted to the Customer Relationship Management team for initiating a change management report taking into consideration the training load and cost implications.

Conclusions
Patient friendly systems (CRM) enhance the understanding on the criticality of their health conditions, impacting health seeking behavior. Effective CRMs help hospitals in providing cost effective health care to the community. The enhancements, however, have to be in adherence to the EHR standards of the country.

Key messages
Effective CRMs help hospitals in providing cost effective health care to the community. Patient friendly systems (CRM) enhance the understanding on the criticality of their health conditions, impacting health seeking behavior.
Health literacy among first-generation Italian immigrants in Norway
Authors: Terragni L , Calogiuri G , Finbråten H 
Published: October 2020

Abstract

Background
People with an immigration background often have poorer health than the general population. Italians in Norway have tripled throughout the past 15-years, but little is known about their health. Health literacy (HL) has been emerging as a fundamental construct in enabling citizens to play an active role in improving their own and theirs community's health. The objective of our study was i) to describe HL among first-generation Italian immigrants in Norway, ii) examine the association between HL and health-related empowerment, and iii) compare HL in Italian immigrants with the general Norwegian population's.

Methods
The data was retrieved from a cross-sectional survey (n = 321) conducted within the study Mens Sana in Corpore Sano (inclusion criteria: age ≥18 years, living in Norway permanently, having lived in Italy at least until age 16). HL was measured using the short form of the European Health literacy survey questionnaire (HLS-Q12; α = 0.83). Empowerment was assessed using a 4-items scale (α = 0.73), developed on basis the World Health Organization's definition of individual empowerment and aspects of patient empowerment. Additionally, information about gender, age, educational level, and self-rated health was collected.

Results
Preliminary results indicated that 8% had inadequate HL, whereas about 40% had marginal HL. No significant differences in HL were observed in relation to gender, age, education level or general health. A medium correlation was found between HL and empowerment (r = 0.42, p &lt; 0.001). The Italian's HL was significantly lower than the general Norwegian population's (M±SD = 32.46±4.79 and 33.11 ± 4.12, respectively; p = 0.028).

Conclusions
This is the first study investigating HL and its associations with the health-related empowerment of first-generation Italian immigrants in Norway. More research is needed in order to better understand this phenomenon as well as the effectiveness of HL-enhancing initiatives.

Key messages
We investigated the levels of health literacy and health-related empowerment among first-generation Italian immigrants in Norway. The Italians’ heath literacy, which correlated with empowerment, was lower than the general Norwegian population’s. There were no differences across gender, age, education level or general health.
Quality Evaluation of Mobile Applications for Fine dust Management
Authors: Lee J B , Woo H K 
Published: October 2020

Abstract

Background
Recently, the use of fine dust management mobile applications has been on the rise in South Korea. The aim of this study is to describe the current status of fine dust and air pollution mhealth apps used in Korea and to make qualitative assessments of them.

Methods
App search contents analysis 400 apps were searched using PM2.5, PM10 and yellow dust, the main keywords related to fine dust, referring to the preceding reference from December 30, 2019 to January 2, 2020. Among the apps searched, apps that meet all six criteria, such as those with 1) user score ≥4.0, 2) n of review Top 50, 3) those that do not duplicated, 4) apps that are related to the topic, 5) apps set in Korean, and 6) apps that do not have errors, were selected for the study. App assessment The app evaluation of the study utilizes the MARS scale, an app assessment tool developed overseas. The assessment was conducted for a week from January 3, 2020 to January 10, 2020. Each of the apps averaged scores evaluated over a week for each category and averaged over five categories for an overall quality score.

Results
The standard deviation of the information and functionality of the 30 apps was similar, with 3.62 (SD 0.38) and 3.58 (SD 0.43), respectively. On the other hand, engagement was the lowest with an average of 3.1 (SD 0.44). The average of aesthetics was 3.4 (SD 0.64), indicating that deviations between apps were very large

Conclusions
It is deemed necessary to improve the user interface (UI) and configuration of the app to enhance the application's engagement and aesthetics in order to increase the use of fine dust apps by consumers and gain effect.

Key messages
This research provided information that consumers can reasonably use and select mobile health apps by evaluating and reviewing the contents of fine dust and air pollution mobile health apps. this study is important in that it can serve as a reference for app developers to consider in future app development.
Health care renunciation in Tunisian diabetic patients, 2016
Authors: Rejaibi S , Cherif I , Ben Mansour N , Zoghlami N , Saidi O , Skhiri A , Ben Slama F , Ben Romthane H , Turki Z , Aounallah-Skhiri H 
Published: October 2020

Abstract

Background
Diabetes management requires access to health care, patient awareness about hygiene and diet measures, and patient adherence to prescribed treatment. Health care renunciation (HCR) can make diabetes management really challenging. We aimed to determine the prevalence of HCR in diabetic Tunisian patients and assess associated factors.

Methods
Data were obtained from the 2016 Tunisian Health Examination Survey, a household survey stratified at three degrees. For each household, two people aged 18 and over were randomly selected. Data were collected using: a household questionnaire and an individual questionnaire (risk behaviours and medical history). Diabetic patients were asked whether, they had renounced any health care service, the last time they needed to seek healthcare. Data analysis was performed with R software.

Results
A total of 880 diabetic patients were included in this survey, with a mean age of 61±12 years and a sex ratio M/F equal to 0.9. The prevalence of HCR was 4.9% (95% CI [3.3-6.5]), higher in men (7.4% VS 2.6% in women, p = 0.003) and higher in urban areas (5.4% VS 3.1 in rural areas, p = 0.09). After multivariate adjustment (taking into consideration age, gender, profession, health insurance and place of residence as independent variables), having no health insurance and being aged more than 50, were significantly associated to HCR, with adjusted Odds Ratios equal to (3.8, 95% CI [1.4-9.2]) and (3.4, 95% CI [1.9-10.1]), respectively.

Conclusions
Our study has highlighted a relatively low prevalence of HCR compared to literature data (4.9% VS 10-15%), explained mostly by methodological differences regarding HCR assessment. HCR in diabetic patients is mostly explained by economic reasons, which show how important is a better organisation of Tunisian public health system to ensure equity in access to health care.

Key messages
Health care renunciation in diabetic Tunisian patients is explained mainly by financial reasons (having no health insurance). Moving further towards improving universal health coverage is a key pillar in the proper management of chronic diseases such as diabetes.