bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors associated with patient activation in a Turkish population with diabetes and/or hypertension
Authors: Sakarya S , Kulak E , Gorcin Karaketir S , Dogan E , Akman M , Cifcili S , Gunes E D , Ormeci L 
Published: November 2019

Abstract

Background
Patient activation (PA), which is known to improve health outcomes, describes the knowledge, skills and confidence a person has in managing their own health care. We investigated the extent of PA and associated factors in adults with diabetes (DM) and/or hypertension (HT). This study is the first in Turkey evaluating PA, using the Patient Activation Measure (PAM) scale. The results of the study provide practitioners with information on the characteristics of patients who need support to increase their activation.

Methods
We conducted this cross-sectional study in 14 Family Health Centers in Istanbul. The participants were DM and/or HT patients. A questionnaire including the PAM, questions on patient characteristics, life style behaviors, healthcare utilization and health status was applied to 431 patients. Based on PAM score, patients were classified into two activation levels: level 1-2 (poor activation) and level 3-4 (good activation). χ2, t-test and logistic regression (LR) analysis were used. LR analysis was performed for all participants and for women and men separately.

Results
Of 431 patients (mean age: 63.6), 65% were women; 45% had a poor activation level (PAL). Based on LR analysis; low socioeconomic status (SES) (OR = 1.6; 95% CI:1.01-2.5), being illiterate (OR = 3.9, 95% CI: 1.5-10.7), being primary school graduate (OR = 2.1, 95% CI:1.1-4.2), lack of adult vaccination (OR = 1.9, 95% CI:1.1-3.1), higher BMI (OR = 1.1, 95% CI: 1.09-1.13) and worse self-reported health (OR = 1.2, 95% CI: 1.1-1.3) were factors associated with low PAL. The latter was associated with low PAL for both sexes; high BMI was an associated factor only among women, while low SES and lack of vaccination were factors only in men.

Conclusions
Almost half of the patients had low activation level in our sample. Associated factors may serve as the basis for the development of interventions needed to enhance activation for patients with DM/HT.

Key messages
Low patient activation is associated with low level of education, low SES, high BMI, lack of vaccination and worse self-reported health. The factors associated with patient activation vary by gender. A qualitative study with patients having different levels of activation would be useful to understand the underlying motivations.
Breast Cancer burden in Tunisia: situation in 2017 and projections by 2030
Authors: Cherif A , Dhaouadi S , Osman M , Hsairi M 
Published: November 2019

Abstract

Introduction
Despite advances in diagnostic and treatment of cancer, burden of this disease is increasing worldwide. Breast Cancer is one of the leading cancers and major causes of death among female worldwide. The aim of this study was to describe the breast cancer burden in Tunisia in terms of disability adjusted life years (DALY) in 2017 and to perform projections by 2030.

Methods
DALYs for cancer are the sum of years of potential life lost due to premature mortality (Years Life Lost (YLL) and the years lived with disability (YLD). We used epidemiological data (incidence rate, death rate, DALY, YLL and YLD) estimated by the Institute for Health Metrics and Evaluation (IHME). Demographic data were provided by the National institute of statistics. The projection of DALYs for breast cancer through 2030 was performed by a Poisson Regression analysis with Age -Period -Cohort (APC) using SPSS software while using IHME estimated data for the period 1990-2017.

Results
In 2017, breast cancer incidence and mortality rate among females in Tunisia were 50.17/100000 persons years and 14.04/100000 persons years respectively. Breast cancer DALY values were 25145 (438 /100000 persons years). The percentage of YLL in DALYS was 92.4%. Without effective interventions, the number of DALYs due to breast cancer would reach 40071 in 2030 with a standardized rate of 507/100000 persons years (IC 95% = [501/100000 to 514/100000]. The number of YLL predicted will attain 36457 with a standardized rate of 461/100000 persons years.

Conclusions
The burden of breast cancer among Tunisian women in 2017 is relatively high mainly due to the lack of screening program. There is an urgent need of a strong plan of early detection and appropriate care.

Key messages
Burden of breast cancer among women in 2017 is high and will rise in 2030. Renforcing screening program is urgent.
High resolution data to estimate effects of pollution and temperatures in Italy: The BEEP project
Authors: Cernigliaro A , Stafoggia M , Gariazzo C , Viegi G , de’ Donato F , Scondotto S 
Published: November 2019

Abstract

Introduction
The BEEP (Big data in Environmental and occupational Epidemiology) project aims to estimate the health effects of several environmental risk factors on the Italian population at municipal level. Specific focus is being devoted to the risk of hospitalizations and mortality at the national level and within the major metropolitan areas and the risk of occupational injuries.

Results
Particulate matter concentrations and mean air temperatures (1x1km) were estimated using satellite data, land use data and observed data from monitoring networks for the Italian domain for 5 yrs. The short-term effects of PM and air temperature on morbidity and mortality only in Sicily, Lazio, Puglia, Emilia Romagna and Piedmont, were assessed. The preliminary results show: an increased risk of natural mortality, cardiovascular and respiratory hospitalizations in subjects exposed to PM, as well as higher effects in the older age on respiratory admissions in males. Associations were found also in the municipalities of medium and low level of urbanization; a non-linear relationship was found with increased risk of hospitalizations and mortality for high and low temperatures. Effects of heat were observed on respiratory hospital admissions, and effects of cold temperature were found on both cardiovascular and respiratory admissions. Larger effects of heat and cold were estimated in the elderly and in municipalities at a higher urbanization; a larger risk of occupational accidents in the construction industry for hot temperatures and in the transport sector for cold temperatures were evidenced.

Conclusions
Results of the BEEP project provide innovative findings on the health risks of environmental exposures in both urban and rural settings and provide decision makers with important information for the definition of prevention measures.
Acknowledgement: The BEEP project is supported by INAIL and is described in the website: www.progettobeep.it.

Key messages
Using Big Data (environmental and Health) is possible estimate the effect of pollution and temperature on mortality and morbidity among the residents in cities or rural areas. Pollutant increase the risk on natural mortality and cardiovascular and respiratory hospitalizations.
Implementation of a nationwide Waterborne disease outbreak surveillance system in France
Authors: Mouly D , Pouey J , Galey C , Chesneau J , Jones G , De Valk H 
Published: November 2019

Abstract

Issue/Problem
Waterborne disease outbreaks (WBDOs) remain a public health issue in developed countries, but to date the surveillance of WBDOs in France, mainly based on the voluntary reporting of clusters of acute gastrointestinal infections (AGIs) by general practitioners to health authorities, is characterized by low sensitivity. In this context an integrated and automatized approach to detect WBDO relying on the identification of clusters of medicalized AGI cases sharing a same drinking water networks (DWN) was developed, evaluated in a simulation study and tested in a pilot study by the French National Public Health Agency.

Description of the problem
Two national big databases support the detection process of potential WBDO: health insurance database for AGI, ministry of health database for drinking water system information. Each detected outbreak has to be investigated regarding environmental criteria during the days before the onset of the outbreak: results on bacterial water monitoring, weather (e.g. heavy rain), technical incidents in the drinking water system (e.g. chlorination breakdown, alarm malfunction). To evaluate the strength of association with drinking water, four levels are proposed based on epidemiological and environmental criteria (strong, probable, possible and undetermined).

Results
The WBDO surveillance system has been implemented in all french departments since start of 2019 and support by the ministry of health. A web-application, named “EpiGEH”, was also developed to support the surveillance system. A retrospective study between 2010 and 2017 has detected almost 300 to 550 potential WBDO per year while voluntary reporting identified 2 to 3 WBDO each year during the same period.

Lessons
Such a specific surveillance system should help health authorities to formulate recommendations regarding the management of drinking water systems and propose appropriate preventive measures, in accordance with the water safety plans.

Key messages
The WBDO surveillance system based from health insurance databases constitutes a daily surveillance system of drinking water quality. The WBDO surveillance system should drastically improve the detection sensitivity by a factor 100 to 200 compared to voluntary reporting.
A mobile device to reduce airborne particulate and prevent surgical site infections
Authors: Messina G , Spataro G , Catarsi L , De Marco M F , Grasso A , Carta G A , Cevenini G 
Published: November 2019

Abstract

Background
Surgical Site Infections (SSI) are the second main cause of Hospital Acquired Infections (HAI) in Europe and in the United States (US). In US and Europe hospitals the overall annual medical costs of HAI is about $40 billion and the SSI represent a relevant part of this spending. It is known that air particulate is a carrier of pathogen bacteria. The aim of this study is to verify if a mobile unit for air particle filtering can improve the environmental airborne conditions of an operating room (OR).

Methods
We carried out a cross sectional study in March 2018 in an Italian University Hospital. A novel mobile device to purify air was tested during surgical procedures. It is provided with: an air decontamination-recirculation system unit; a patented crystalline ultraviolet C reactor; a highly efficient particulate air filtering. The environmental contamination has been monitored in the following phases: I) device off and OR at rest; II) device off and OR in operational; III) device on and OR in operational; IV) device off and OR in operational. We used a particle counter to measure airborne particles of different sizes: 0.3; 0.5; 1.0; 3.0; 5.0; 10 µm. Air samples were withdrawn in four spots of the OR periphery. Wilcoxon rank test was used for the statistical analysis setting the significance level to 95% (p &lt; 0.05).

Results
From phase II (device off) to phase III (device on), there was a reduction of any particulate matter size, ranging from 50% to 73% (p &lt; 0.05). When the device has been turned off again (phase IV), particle dimensions of 0.3, 0.5, 1.0 and 3.0 µm were lower in the percentage range of 51-62% (p &lt; 0,05). Particle dimensions of 5 and 10 µm were also lower in the range of 56% and 76%, respectively.

Conclusions
During mobile device operation, the amount of particulate matter remains significantly lower, reducing the probability of SSI.

Key messages
Air particulate in surgical room may play a role in preventing Surgical Site Infections. The mobile device was able to significantly improve air quality during real operation conditions.
Association between heat waves and number of deaths for old-age in slovenia, from 2013 to 2017
Authors: Percic S , Cegnar T , Hojs A 
Published: November 2019

Abstract

Background
Heat waves are associated with incresed mortalitiy, especially in old-age population.

Methods
We estimated relative risks for number of deaths, for the observed diagnoses, sex, and area, as well as 95% confidence intervals and excess deaths associated with heat waves occurring in the years from 2013 to 2017, for population 75+ years old.

Results
Statistically significant were: in 2014: all causes of deaths (RR = 1.27, CI 1.12-1.44); male, all causes of deaths (RR = 1.27, CI 1.04-1.56); female, all causes of deaths (RR = 1.26, CI 1.08-1.48); all, circulatory system diseases (RR = 1.19, CI 1.01-1.43); female, circulatory system diseases (RR = 1.23, CI 1.01-1.51); rural area (RR = 1.28, CI 1.09-1.51); urban area (RR = 1.35, CI 1.11-1.64); and in 2015: all causes of deaths (RR = 1.28, CI 1.15-1.41); male, all causes of deaths (RR = 1.27, CI 1.08-1.5); female, all causes of deaths (RR = 1.27, CI 1.12-1.45); all, circulatory system diseases (RR = 1.27, CI 1.1-1.48); male, circulatory system diseases (RR = 1.38, CI 1.06-1.79); female, circulatory system diseases (RR = 1.23, CI 1.03-1.47); rural area (RR = 1.31, CI 1.16-1.47). No significant association in 2013, 2016 and 2017 appeared.

Conclusions
Despite increasing heat load in observed years, we did not notice a statistically significant association between heat waves and the number of deaths in the last observed years 2016 and 2017. The results indirectly show that we are on good way with our public health efforts concerning awareness of Slovenian people about the dangers heat waves bring.

Key messages
Heat waves will become more intense, will last longer and will appear more frequent. We must take care after old age population. Chronic noncommucating diseaes increase and life expectancy also increases, so the burden of deaths during heat waves is expected to increase too.
Evaluation of Norovirus contamination in bivalve molluscs harvested from Northern Adriatic Sea, Italy
Authors: Rubini S , Barbieri S , Losio M N , Taddei R , Bertasi B , Pavoni E , Bolognesi E , Berardelli C , Govoni G , Suffredini E 
Published: November 2019

Abstract

Background
Norovirus (NoV) is the leading cause of acute gastroenteritis in developed countries. Transmission is through direct contact, unsanitary food handling or ingestion of contaminated water or food. Shellfish bioaccumulate NoV and current post-harvest depuration is not effective for its removal.
Materials and

Methods
A monitoring programme for NoV in bivalve shellfish harvested from Northern Adriatic Sea was initiated in 2016. From January 2016 to March 2019, 418 samples including 257 Manila clams, 73 mussels, 46 striped clams, and 42 oysters, were examined. Mollusc samples were tested for NoV genogroups I (NoV GI) and II (NoV GII) contamination by RealTime RT-PCR according to ISO 15216-2.

Results
Ninety-three out of 418 tested samples (22.2%) were contaminated by at least one NoV genogroup, the simultaneous presence of the two genogroups was detected in 19/418 of the cases. Positive samples were distributed among the tested species as follow: 29/73 (39.7%) mussels, 51/257 (19.5%) Manila clams, 8/42 (19.0%) oysters, 5/46 (10.9%) striped clam. In 2016 (n = 135), 2017 (n = 122), 2018 (n = 132) and in the first trimester of 2019 (n = 12), prevalence of NoV was 6.7%, 24.6%, 31.8% and 41.4%, respectively. NoV GII was largely predominant being detected, alone or in association with GI, in 98.9% of the contaminated samples. On the other hand, GI prevalence increased from 1.5% (2016) to 12.1% in 2018, maybe reflecting a higher circulation of this genogroup in production environments.
The vast majority of positive samples (91.4%) were detected during the cold season (November to March).

Conclusions
Overall positive samples have increased over the years (from 6.7% in 2016 to 31.8% in 2018). NoV GII was the most frequently detected genogroup, but NoV GI prevalence significantly raised in 2018. The routine application of quantitative RT-PCR (ISO 15216-1) to determine the viral load in bivalve molluscs would expand knowledge on potential for foodborne transmission.

Key messages
Overall positive samples have increased over the years. The routine application of quantitative PCR to determine the viral load in bivalve molluscs would expand knowledge on potential for foodborne transmission.
A set of pedagogical recommendations for improving the integrated approach to childhood obesity
Authors: Ruiter E L M , Molleman G R M , Fransen G A J , Wagenaar M , van der Velden K , Engels R C M E 
Published: November 2019

Abstract

Background
Studies increasingly emphasize the importance of the parents’ role in interventions designed to prevent overweight in children. The aim of this study was to develop a unified set of recommendations for healthy parenting practices that can be applied by all professionals who work with children age 4-13 years and can contribute to strengthening the integrated approach to childhood overweight.

Methods
A modified Delphi procedure was used to reach consensus regarding what these pedagogical recommendations should encompass. The 30 panelists were professionals and researchers who work with children in the domains of health care, overweight, parenting, education, nutrition, and/or sports. The procedure consisted of: i) extracting existing pedagogical recommendations from national guidelines and professional protocols, ii) appraising and prioritizing these recommendations in terms of relevance through two rounds of questionnaires, and iii) meeting to discuss and approve the set of recommendations.

Results
Consensus was reached for one set of eleven pedagogical theme-based recommendations designed to support and instruct parents how to stimulate healthy energy balance-related behaviors in their child. Each recommendation contained information regarding: i) which behaviors are important, ii) why this is important, and iii) how parents can stimulate this behavior by applying parenting skills. The eleven themes were: modeling, positive parenting, breakfast, varied diet, sugar-sweetened beverages, snacks, physical activity, playing sports, quantity of screen time, screen time during meals, and sleep.

Conclusions
We developed a set of recommendations for healthy parenting that can be used by various professionals working with children age 4-13 and can contribute to creating an integrated approach to childhood overweight. We also developed a web-based app called “Recommendations for Healthy Parenting” as a convenient tool for following these recommendations.

Key messages
Our set of recommendations for healthy parenting can be used by various professionals who work with school-aged children, thereby helping strengthen the integrated approach to childhood overweight. We developed and released a Dutch web app entitled “11 Recommendations for Healthy Parenting” to provide a convenient tool for easily communicating these recommendations to parents.
Impacts of post-Brexit agricultural policy on fruit and vegetable intake and cardiovascular disease
Authors: Seferidi P , Laverty A A , Pearson-Stuttard J , Collins B , Bandosz P , Capewell S , O’Flaherty M , Millett C 
Published: November 2019

Abstract

Background
The post-Brexit agricultural regime represents an opportunity to positively influence food systems and improve public health. Health-improving measures could include expanding the UK production of fruits and vegetables (F&V), thus increasing F&V availability. Currently, only 1.4% of total agricultural land in England is allocated to F&V. This study aims to estimate the potential impacts of allocating additional land to F&V production on cardiovascular disease (CVD) and inequalities in England between 2021 and 2030.

Methods
We used the previously validated IMPACT Food Policy model to translate changes in land allocated to F&V into changes in F&V intake and associated CVD mortality, expressed in number of deaths prevented or postponed (DPPs) by age, sex, and Index of Multiple Deprivation (IMD) quintile. We modelled two scenarios that assumed a linear increase in agricultural land allocated to F&V until it covers a) 10% and b) 20% of all land suitable for production of horticultural crops in England. We assumed that F&V prices would drop to a new equilibrium. We used Monte Carlo simulations to produce uncertainty intervals.

Results
Our model suggested that by 2030, F&V intake might increase by approximately 4% (95% Uncertainty Interval: 2%-7%) and 8% (4%-13%) respectively, under the first scenario. Under the second scenario, F&V intake could increase by approximately 17% (10%-29%) and 37% (26%-51%) respectively. These increases in F&V intake were associated with 3360 (1760-5920) CVD DPPs under the first scenario and 15700 (9000-24310) under the second scenario in 2021-2030. Our modelled scenarios could also reduce inequalities, with some 16% of DPPs occurring in the least deprived group compared with 22% in the most deprived.

Conclusions
Policymakers should consider the public health impacts of the post-Brexit agricultural regime in England. Increasing the land allocated to F&V production could substantially reduce the burden of CVD and associated inequalities.

Key messages
The post-Brexit agricultural policy can be an opportunity to improve diet and public health in the UK. Increasing the agricultural land allocated to fruit and vegetable production in England could reduce the burden of cardiovascular disease and associated inequalities.
Visual food diary - peer support and better diet quality
Authors: Puranen T , Salokekkila P , Ahlblad-Makinen N , Haggman-Laitila A 
Published: November 2019

Abstract

Background
Healthy Life -groups are targeted to patients with symptoms of metabolic syndrome, problems with coping or overweight at public health centers in Helsinki. The aim of one-year Healthy Life -group is to give support for self-care and empowerment. The groups are generic, and each participant sets her own goal such as smoking cessation, alcohol or weight management.

Methods
To create opportunities for positive and empowering diet intervention for working aged population, we have started a pilot study with visual food diary (MealLogger). The nutritionist are coaching the three-month-intervention aiming at improving the diet quality. Participants share photos of their meals with each other and receive peer support.

Results
During years 2016 - 2018, 445 completed the one-year intervention in Healthy Life -groups. The mean decrease of weight loss was 4 kg (n = 222) and decrease of waist circumference 5 cm (n = 57).

Conclusions
Since the goal for most participants was weight loss, we decided to offer a modern intervention with MealLogger-application. During year 2019 we will complete six groups (about 100 participants) and we will measure participants food quality, weight, waist circumference, quality of life. The results we report in the autumn.

Key messages
To manage overweight epidemic, new prevention strategies are needed in the primary health care. Visual food diary enables positive and empowering approach to improve died quality and weight management.