bluuebunny/crossref_metadata_2025_split huggingface dataset:
Personalized action plans for patients with multiple chronic diseases in Andalusia
Authors: Carriazo A M , Cosano I , Lama C , Bedoya J J , Ollero M , Lafuente N , Rodriguez S , Rodriguez-Acuña R 
Published: November 2019

Abstract

Issue/problem
Complex chronic patients (CCPs) present multiple chronic conditions and complex healthcare needs. Comprehensive care by multiple healthcare professionals at different settings is required to improve their outcomes. This challenge is faced by the Andalusian Public Health System (APHS), responsible for the provision of healthcare and public health services to the entire Andalusian population (8.5 million inhabitants).

Description of the problem
Almost 250000 CCPs have been identified within the APHS in 2018. The very complex ones (4%) utilise up to 30% of primary care and hospital resources.
The Comprehensive Healthcare Plan for Patients with Chronic Diseases was launched in 2012 to ensure the comprehensive care for these patients with a multidisciplinary response. Together with the Integrated Care Process Healthcare for Multimorbidity Patients, set the scene for implementing integrated healthcare with coordination of professional services and/or centres over time, helping to decrease clinical variability and improve quality of care.

Results
Since 2016, Personalized Action Plans (PAPs) were introduced as key-elements to provide a holistic care coordinated at primary healthcare, including: taking patient’s individual needs, preferences and own resources as a starting point for their evaluation and the development their PAPs,involving of patient’s informal caregivers,involving all relevant care levels and health disciplines,ensuring the multidisciplinary care with a coordinating team.

Lessons
PAPs are a key element in the healthcare process for CCPs, and the assessment of its implementation in Andalusia is contributing to generate evidence within the Joint Action on Chronic Diseases (CHRODIS+, www.chrodis.eu).

Key messages
PAPs implementation and assessment are crucial to better address CCPs health needs, facilitating a patient-centred healthcare approach, and contributing to a European model of care. Involving patient, family carers together with the professional team facilitates achieving better healthcare outcomes.
Sugary drink consumption and cancer risk: results from NutriNet-Santé prospective cohort
Authors: Chazelas E , Srour B , Kesse-Guyot E , Julia C , Deschamps V , Galan P , Hercberg S , Latino-Martel P , Deschasaux M , Touvier M 
Published: November 2019

Abstract

Background
The objective was to assess the associations between the consumption of sugary drinks (sugar sweetened beverages and 100% fruit juices), artificially sweetened beverages and cancer risk.

Methods
Overall, 101,257 participants aged ≥18y (mean age: 42.2) from the French NutriNet-Santé cohort (2009-2017) were included. Consumptions of sugary drinks and artificially sweetened beverages were assessed using repeated 24h-dietary records, designed to register participants’ usual consumption for 3,300 different food and beverage items. Associations between beverage consumption and the risk of overall, breast, prostate and colorectal cancer were assessed by multi-adjusted Fine&Gray Hazard models, accounting for competing risks.

Results
The consumption of sugary drinks was significantly associated with overall cancer risk (n = 2,193 cases, sHRfor a 100mL/d increase=1.18, 95% confidence interval 1.10 to 1.27, P&lt;.0001) and breast cancer risk (n = 693 cases, sHRfor a 100mL/d increase=1.22, 95% confidence interval 1.07 to 1.39, P = 0.004). The consumption of artificially sweetened beverages was not associated with cancer risk. In specific sub-analyses, the consumption of 100% fruit juice was significantly associated with overall cancer risk (n = 2,193 cases, sHRfor a 100mL/d increase =1.12, 95% confidence interval 1.03 to 1.23, P = 0.007).

Conclusions
In this large prospective study, the consumption of sugary drinks was positively associated with overall and breast cancer risks. Of note, 100% fruit juices were also positively associated with overall cancer risk. These results need replication in other large-scale prospective studies. They suggest that sugary drinks, which are massively consumed in Western countries, may potentially represent a modifiable risk factor for cancer prevention.

Key messages
In this large prospective study (n = 101,257), the consumption of sugary drinks (including 100% fruit juice) was associated with an increase in overall and breast cancer risk. In specific sub-analyses, 100% fruit juices were also associated with an increased risk of overall cancers. The consumption of artificially sweetened beverages was not associated with cancer risk.
An automated diagnostic device for children under 5 years of age: A proof-of-concept study in Malawi
Authors: Shah M , Jenda G , Nsona H , Gigi E , Dadlani P , Swedberg E 
Published: November 2019

Abstract

Background
Automated diagnostic device to measure child’s vital sign is a global unmet demand. Having separate diagnostic devices to measure multiple vital signs is more expensive, and can be complex for health workers. An automated “all-in-one” device would help avoiding extra costs as well as maintenance challenges associated with multiple devices. In addition to improve classifying childhood illness, such an automated device would also increase adherence to guidelines, optimal use of antibiotics, and a reduction of unnecessary referrals.

Methods
We studied an automated device in Malawi, which was designed to measure multiple key vital signs (SPO2, respiratory rate, temperature) among newborn, infant and children &lt;5 years. The device collected photoplethysmogram (PPG) signals for SpO2 via a universal pediatric sensor, placed on child’s finger. Temperature was measured via infra-red signal from child’s forehead. Accelerometry measures respiratory rate, by placing the device around the child’s belly. The CO2 sensor data together with video recordings of child’s respiration offered the reference for child’s respiration count.

Results
Preliminary analyses of valid PPG signals, video annotated respiratory count and CO2 sensor data revealed the following key results:
- For SPO2, the performance of the target probe among 170 subjects appears extremely well with even the smallest and largest children.
- Among 145 subjects with valid CO2 data, 93 subjects were fully calm and had a regular breathing pattern. Comparing accelerometry measurements from 93 calm subjects with the reference data, the root of mean square error (RMSE) was only 1.18 respiration per minute (RPM). Excluding four outlier measurements from 145 subjects’ dataset, the RMSE for the remaining 141 subjects was 1.76 RPM.

Conclusions
This study results demonstrated the proof of concept that the device measures key vital signs among newborn, infants and children &lt;5 years, using a reusable single-based probe.

Key messages
Automated diagnostic device measures key multiple key vital signs (SPO2, respiratory rate, temperature) among newborn, infant and children &lt;5 years. Such an automated device may have potential to ensure accuracy in diagnosis, increasing adherence to recommended guidelines, optimizing use of antibiotics, and reducing unnecessary referrals.
Minority stress, intra-minority stress and social anxiety: Examining an extended psychological mediation framework among sexual minority men
Authors: Mahon C , Kiernan G , Gallagher P 
Published: November 2019

Abstract

Background
Compared to their heterosexual counterparts, sexual minority men (SMM) are at an increased risk of social anxiety disorder. Distal (i.e., everyday discrimination) and proximal (i.e., internalised homophobia, rejection sensitivity, concealment of sexual orientation) minority stress processes are associated with heightened social anxiety for SMM. Stressors emerging from within the sexual minority male community, termed intra-minority stress, and psychological processes that may foster resilience (i.e., a sense of coherence, connectedness to the LGBT community) are less explored in this area. This study examined potential pathways between everyday discrimination, intra-minority stress, proximal minority stressors, resilience and social anxiety.

Methods
Self-identified SMM (N = 255) residing in the Republic of Ireland completed an online survey containing measures of minority stress, intra-minority stress, resilience and social anxiety. Structural equation modelling was used to examine the model.

Results
The model yielded a good fit to the data, X2(16) = 26.61, CFI = .99, TLI = .97, RMSEA = .05, and SRMR = .03. Rejection sensitivity and a sense of coherence had a significant indirect effect in the relationships between both exogenous variables (i.e., discrimination and intra-minority stress) and social anxiety. There were no significant pathways to social anxiety involving concealment of sexual orientation, internalised homophobia or LGBT community connectedness.

Conclusions
For SMM, minority stress processes and intra-minority stress are important determinants of social anxiety. Our findings demonstrate that proximal minority stressors may operate differently in a social anxiety context for SMM in western European countries. A sense of coherence was an integral factor in the model and demonstrated the strongest association with social anxiety.
Risk of fall among the hospitalized over-49 population. A retrospective cohort study in a hospital
Authors: Gilardi F , Mariani T , Liotta G , Musolino M , Caredda E , Morciano L , Giliberti C , Morbidelli S , Lucaroni F 
Published: November 2019

Abstract

Background
Despite the copious efforts made to prevent the problem, inpatient falls remain one of the most common adverse events in hospitals, with high risks in term of morbidity and mortality rates, as well as high costs for the healthcare system. This study aims to evaluate the inpatient falls incidence rate in a hospital in Rome, Italy.

Methods
A retrospective cohort study has been set out based on data collected by a Risk Management Unit concerning the falls of patients over 49 years, which happened in the hospital between 1st July 2008 and 30th June 2013. Data collected from the incident report forms were inserted in a database and analyzed using the statistical program SPSS, 20.0 Illinois version.

Results
During the period observed, 516 falls were reported. Patients who fell had a mean age of 68.8 years (SD ± 16.2). The falls are distributed for these age groups: 109 (21.1%) in 50-64; 129 (25%) in 65-74; 181 (35.1%) in 75-84; 97 (18.8%) in &gt; 84. Fall incidence rate was calculated on the overall number of hospital admissions in the observed period (N = 35,812) (1.44 per 100 hospital admissions IC95% 1.32-1.56). Most of the patients were men (333; 64.5%) and older than 75 (53.9%). Inpatient falls were more frequent in the medicine wards (incidence rate 2.2 per 100 hospital admissions, IC95% 1.85-2.55,). The 51.6% of falls happened during the night shift. Severe outcome resulted in 13.6% of falls. Most of the falls (52.3%) happened within three days from the hospital admission. At multivariate analysis, a period of 2-3 days from hospital admission is the main risk factor to determine severe outcomes such as death or cranial trauma (p = 0.02; OR 2.87 IC95% 1.16-7.09).

Conclusions
The study contributes to measure the phenomenon in older adults and age group 50-64, identifying a specific indicator to properly measure inpatient falls incidence rate in the elderly. The study gives indications on the main risk factors related to this adverse event and on prevention strategies.

Key messages
Falls in hospital is an important adverse event not only in the elderly. The first period of three days from the hospital admission constitutes the main risk factor for the falls.
WHO Approach
Authors: Kuchenmueller T 
Published: November 2019

Abstract
Despite considerable investments into the generation of research worldwide, research is frequently not used in practice or policy. A substantial body of evidence is showing that using research requires significant and planned change at individual, organizational and systems levels.
To support and guide WHO Member States in the endeavor of strengthening evidence-informed policy-making, the WHO Regional Office for Europe launched the Evidence-informed Policy Network (EVIPNet) Europe at the end of 2012. It is a capacity building initiative that aims to create, train, guide and institutionalize innovative, multisectoral and multidisciplinary partnerships and teams at the country level. Assisted by EVIPNet Europe, these teams initiate and implement national research-to-policy processes, such as developing user-friendly evidence briefs for policy on high-priority policy issues targeted and tailored to policy-makers, holding policy dialogues, and creating linkages and exchange between the research and policy communities.
In this presentation, an overview of EVIPNet Europe’s mandate, approaches, tools and activities will be given. Participants will gain an understanding of how knowledge brokering and integrated, interactive mechanisms can help to bridge the gap between research and policy and improve health outcomes.
2.O. Workshop: Climate change and the impact on public and occupational health
Authors:   Organised by: Academic Collaborative Centre Environment and Health Chair persons: Peter Van Den Hazel - EUPHA (ENV), Moniek Zuurbier - Netherlands
Published: November 2019

Abstract

Objectives
Climate change has an impact on people’s physical, mental, and community health. This impact can arise directly and indirectly. Some natural disasters are exacerbated by climate change, like floods, heat waves, storms, wildfires, and landslides. Some effects occur more gradually for example from changing temperatures. Heat waves can weaken the infrastructure (transport, construction) and make food systems less secure (infections, less access). But heat waves can also directly cause severe health effects. Heat waves are examples of direct and indirect climate impacts on society’s physical and mental health. Climate change creates visible impacts in many countries. The number of heat waves increased across the globe the last few decades. This change has an impact on communities’ health both in private life settings as in occupational settings. There is an overlap of impact which influences the effects seen in both settings. The awareness of this overlap is not clear for most stakeholders. Health advisories before, during and after heat waves do not consider this issues in their health promotion activities.
This workshop aims at describing different ways how public health could benefit of a more integrative approach of health promotion by linking messages directed at the general public and the occupational work force. Therefore, examples on national as well as regional and local level are presented discussed with specific emphasis on requirements and processes for success on one hand and obstacles on the other.
The examples reflect different European regions and country heat waves plans as well as results from the EU-funded projects HEATSHIELD and SCORCH.

Key messages
Heat will be an increasing issue in public health. Health advisories need to be improved during periods of heat.
Preventing heat stroke and heat illness on the workplace: a study on knowledge, attitudes and practices of safety representatives from Northern Italy (2016-2017)
Authors: Ricco M , Vezzosi L , Balzarini F , Giosuè Mezzoiuso A 
Published: November 2019

Abstract

Introduction
Heatwaves (HWs) and rising environmental temperatures are significant health threats also for workplaces. This study will investigate knowledge, attitude and practices towards heat-related health issues in a sample of safety representatives from Northern Italy (SRs).

Methods
A cross-sectional questionnaire survey was conducted in 2016-2017 among 327 SRs. Knowledge status was measured both in general and focusing on first-aid issues. Assessment of risk perception included severity and frequency of heat-related events. Multivariate logistic regression analysis assessed individual and work-related characteristics associated with SRs’ risk perception.

Results
258 questionnaires were retrieved (participation rate 78.9%; mean age 48.2±25.2 years). Knowledge status was relatively good on technical/preventive issues (62.3%%±16.8) and first aid measures (67.1%±25.2), but a large share of respondents ignored the risk from exertional heat stroke (35.7%), and for heat strokes elicited by non-environmental heat (e.g. machineries, use of protective equipment, etc. 47.7%). The majority of respondents acknowledged the high frequency of HW events (90.7%), but only 44.6% agreed on their potential health threat. had received A specific first-aid formation was reported by 49.2% of respondents, while 10.9% had any previous interaction with heat-related disorders. Specific countermeasures had been put in place by parent company in 3.9% of cases. Eventually, previous participation to formation courses was associated with higher risk perception regarding severity and frequency of HW (OR 3.18 95%CI 1.40-7.23, OR 5.54 95%CI 1.59-19.23 respectively), while previous interaction with heat-related disorders apparently raised the perceived severity of heat-related health risk (OR 3.92 95%I 1.10-13.14).

Conclusions
Although SRs exhibited a fairly good understanding of heat-related health issues on the workplaces, our findings also suggest the need to enforce specific countermeasures.
Socioeconomic consequences for adults with atrial septal defect: A register based follow-up study
Authors: Nyebo C , Fonager K , Larsen M L , Andreasen J J , Lundbye-Christensen S , Hjortdal V E 
Published: November 2019

Abstract

Background
Atrial Septal Defect (ASD) is considered one of the most benign defects among congenital heart disease. The very good short and midterm outcomes after closure in the recent decades has led to believe that the ASD population is almost comparable to the background population after treatment. However, recent studies indicate that these patients are much more affected by their disease than first assumed. In this nationwide cohort study, we report the first long-term follow-up of use of permanent social security benefits and work participation in adults with ASD.

Methods
All Danish patients born before 1994 and diagnosed with ASD between 1959-2013 (n = 2,277) were identified from the Danish registries. A comparison cohort was created using the Danish Civil Registration System, matching every verified ASD patient with 10 persons from the general population on gender and birth year. We used Cox proportional hazards regression to compare the risk of receiving permanent social security benefits in the ASD patients compared with the matched cohort. Using the DREAM database we calculated the proportion of patients and controls not working at the age of 30 years.

Results
ASD patients had a higher risk of receiving permanent social security benefits (hazard ratio 2.3 (95% confidence interval 2.1-2.6)) compared with the comparison cohort; 24% of the ASD patients was receiving permanent social security benefits at the end of follow up compared with 12% of the comparison cohort. At the age of 30 years, the proportion not working was 28% in the ASD cohort and 18% in the comparison cohort. Of patients not working 23% had a psychiatric diagnose compared to 6.8% of the controls.

Conclusions
The risk of receiving permanent social security benefits was twice as high in patients with ASD and the work participation was reduced compared with the background population.

Key messages
The poor affiliation to the work force and high prevalence of psychiatric morbidity is worrying. It demands for an increased psychosocial support by professionals caring for patients with ASD.
RT Accidents mortality in Italy: a population-based study in Piedmont on Vulnerable Road Users
Authors: Pitidis A , Mamo Carlo , Dalmasso Marco , Costa G 
Published: November 2019

Abstract

Background
Among the largest Italian Regions, Piedmont (Northern Italy) had in 2017 a crude rate of road traffic accidents (RTA) deaths greater than the national average. RTA injuries remain a leading cause of injury deaths in Italy. Among them in both Piedmont and Italy many victims are vulnerable road users (VRU): pedestrians, cyclists and users of motorcycles or motorpeds. The study was aimed to describe their mechanisms of injury.

Methods
Observational study of the resident population in Piedmont from 2003 to 2015. Transportation Injuries (ICD-10: V01-V99) were considered, because of their greater comparability rate in bridge coding studies. A number of 5,185 RTA deaths was observed. Role, type of vehicle of the victim and collision were studied.

Results
Piedmont in 2017 had a RTA mortality rate (6.35 deaths per 100,000 inhabitants) greater than Italy (IRR = 1.13, 95% CI: 1.00 - 1.29; p &lt; 0.02), 48.4% of the victims were VRU similarly to national data (49.8%). In the period the proportion of VRU on RTA deaths steadily increased from 25.6% in 2003 to 49.1% in 2015, in a significant way (z = 2.79; p = 0.005), because in a context of marked reduction of RTA mortality (-54.5%), the regional trend for VRU shows only a slight decrease (-12,6%). The VRU were: pedestrians (47.0%), motorized two-wheels users (37.4%) and cyclists (15.6%). Among pedestrians 63.9% deaths were caused by collisions with mainly automobiles (82.1%) and heavy vehicles (12.7%). In case of collision the prevalent causes of death were head injuries (41.5%) and multi-trauma (31.8%). Similar patterns were observed for cyclists, while in motorcyclists 56.5% of deaths were due to loss of control or fixed object.

Conclusions
VRU injuries remain a public health and social concern. Yet despite their extent, this problem is still not adequately considered in public health prevention programs. The observed mechanisms of injury evidence the importance to enhance the protection of VRU in road traffic circulation.

Key messages
In Italy, vulnerable road users are becoming a major group among road traffic injury deaths, because they not follow the general trend of large decrease of RTA injuries. Largest VRU group are pedestrians such as cyclists they are hit by cars or heavy vehicles with major trauma, in the motorized two-wheels loss of control and collision with fixed object are important.
The impact of the housing situation on the health-related quality of life of refugees located in North Rhine-Westfalia, Germany
Authors: Belau M 
Published: November 2019

Abstract

Background
In 2015 and 2016, more than one million people fled to Germany from war-affected countries - mainly from Syria, Afghanistan and Iraq. Nevertheless, little is known about health-promoting and health-damaging living conditions in refugees located in Germany. Strengthening healthy living conditions could be a measure to increase health-related quality of life (HRQoL) of refugees.

Methods
The analyses were based on data from the FlüGe Health Study. The study was conducted in the period from February to November 2018 and included interviews and examinations. Participants were recruited from shared (n = 182) and private accommodation (n = 144) in several cities in North Rhine-Westphalia in Germany. The effect of housing situation on health-related quality of life as estimated from a modified version of the SF-12 questionnaire was examined using univariable analyses.

Results
Three hundred and nine participants ranging in age from 18 to 75 years (Mean 32.4, SD 0.61) gave complete replies. The majority was males (73.0%) and more than half of the respondents (58,4%) were in a partnership. Univariate analysis showed no statistically significant difference in HRQoL scores among participants from shared and private accommodation in physical scale (Mean 51.7, SD 10.05 vs. 49.7, SD 10.88; p = 0.096) and mental scale (Mean 41.9, SD 14.7 vs. 44.3, SD 14.2; p = 0.134).

Conclusions
From the data it appears that refugees living in shared and private accommodation in Germany have HRQoL scores indicating a relatively moderate HRQoL in physical scale and low HRQoL in mental scale compared to the German population.