bluuebunny/crossref_metadata_2025_split huggingface dataset:
Young multiple sclerosis in Italy: attitude towards present life and expectations for the future
Authors: Bezzini D , Vaccaro M C , Bandiera P , Messmer Uccelli M , Battaglia M A 
Published: October 2020

Abstract

Background
Multiple sclerosis (MS) is usually diagnosed between 20 and 40 years, affecting the most productive and active period of life.

Aim
To analyse the health perception of young people with MS and to compare the present results with a previous one.

Methods
A descriptive cross-sectional study was conducted in 2017. A validate and anonymous questionnaire was administered to 613 Italian young, aged 18-40, affected by MS (women 78.5%).

Results
Analyzing the declared health status, most of young MS defined good health status (76% good or excellent health) with differences between age class (82% at 25-29 years vs 71% at 35-40) and with a reverse trend with the increasing of disability (92% in subject with no disability vs 34% in ones with a medium or severe disability). The comparison against 2004 data highlights an improvement in the health conditions perceived, also for ones with a serious disability. Regarding the time elapsed from diagnosis, the trend was not linear, since respondents with a diagnosis &lt;1 year indicated a worst health condition than those with a diagnosis from 5 to 10 years. Significant percentage of them paid attention to positive attitudes in health promotion: 71% practiced physical activity, 70% controlled smoke and alcohol consumption, 38% was on a special diet.

Conclusions
Diagnosis and disability constitute a decisive factor in the assessment of the state of health, but the perception goes to stabilize with time, even if the conditions tend to worsen. In this regard, the worst declared conditions in patients with a recent diagnosis seem to be influenced by psychological factors. So, the moment of diagnosis need a better management. Only 30% got adult vaccination (vs 61% in young Italians) due to lack of information on vaccine safety in MS patients. The improvement of perceived health in young with MS is another proof of the progress of MS treatments, which appears transversal to all the conditions of disability.

Key messages
The perception of health is strongly related to disability and to time elapsed from diagnosis. In the last 15 years the progress of MS management improved well-being of all MS young patients.
Multisector prevention of childhood obesity in a Finnish municipality - factors perceived as crucial
Authors: Koivusilta L , Alanne S , Mustila T , Kamila M , Ståhl T 
Published: October 2020

Abstract

Background
Obesity among children threatens health and life expectancy. Risk factors interact in complex ways on individual, household, and community levels. Interventions on lifestyle factors have been targeted at children. Although some have impacted weight gain positively, environment and policy approaches by multiple actors across the society, especially when integrated in everyday life could have longer lasting effects. In Finland, multisector collaboration is enabled by several institutional structures, such as child welfare clinics and student welfare services. We studied in a municipality how administrative sectors and some key NGOs contributed to the prevention of childhood obesity, and particularly, which were the factors seen as potentially crucial.

Methods
The informants were purposely selected, being those, who had operated in the process of health promotion in the City of Seinäjoki (Finland) in 2009-2016. They represented several administrative sectors, either as office holders at the managerial level or as working at the operational level or in NGOs. In total, 37 participated (1 refusal) the semi-structured interviews, which were recorded, transcribed verbatim (355 pages), anonymized, and analyzed with deductive content analysis.

Results
There emerged six entities of factors crucial for obesity prevention: strong and long-term commitment to health promotion both at the administrative and executive levels; activity aiming at well-being of all inhabitants; a shared view of the importance of preventive work and multiprofessional collaboration; competent and development minded personnel, appropriate administrative structure and the strong leadership role of the health promotion coordinator; the light administrative structure of the Finnish municipality; convenient size of the municipality.

Conclusions
There was a shared opinion among the interviewees about the crucial elements of multisectoral collaboration for obesity prevention.

Key messages
Multisectoral collaboration and strong commitment to long-term activity both at the administrative and executive levels form key elements in the prevention of childhood obesity. A supportive administrative structure in a municipality together with strong coordination of health promotion are important prerequisites for the prevention of childhood obesity.
Mediterranean nutrition and physical activity education program at deaf and hard of hearing community
Authors: Bizirgianni V , Bakola M , Kitsou K S , Sakaretsanou A K , Jelastopulu E 
Published: October 2020

Abstract

Background
Today's eating reality includes a more westernized dietary pattern which seems to erode sensitive groups of our populations, such as people with disabilities. Deaf and hard of hearing people(DAHOHP) are a marginalized community in our country, whose access to the health system, health education, nutrition and exercise is limited. Our aim was to promote health education, focusing on Mediterranean diet and physical activity, through an alternative approach, that of the Greek sign language.

Methods
A three-day training program was created for the members of the Association of deaf and hard of hearing persons in Central Greece. Analysis of the nutritional profile of everyone was performed and an in-depth presentation of all aspects of the Mediterranean nutrition was showed. Furthermore, an experiential training on the size of food portions of all categories was performed and information and recommendations on physical activity were given. Adherence to the Mediterranean diet was assessed by the MedDietScore (range 0-55), Body Mass Index (BMI) and frequency of food consumption were evaluated.

Results
A total of 25 individuals (25-70 years old, 62% men) participated in the program. The average BMI was 26.2 kg/m2 in women and 25.9 k/m2 in men. Increased body weight was observed in women, whereas in men it was normal. The average questionnaire score was 31/55 for women and 29.6/55 for men, which indicates a good compliance with the Mediterranean-Diet in both. Women consumed smaller portions and fewer meals in all food groups/day, whereas men showed a high intake of alcohol/day.

Conclusions
Concerning DAHOHP's knowledge and adherence at the Mediterranean nutrition pattern, a good compliance was observed. However, hearing loss tends to disrupt interpersonal communications. Consequently, it severely restricts/isolates such individuals to their own closed groups with possibly experiencing diminished self-esteem and becoming more vulnerable to abuse.

Key messages
A need to promote health and dietary-behavior modification in people with disabilities such as DAHOHP, is obvious and immediate, by exploring incentives to improve their quality-of-life.
Importance of health education actions to improve quality of life of vulnerable populations
Authors: Jara Baraybar Alvarenga de Oliveira A , Albertini Reis B , Fedrigo B , souza vasconcellos G , Bertaglia L , Espinosa M V , Benevides M H , Nagano Nishida N , Succi G , Moreira A 
Published: October 2020

Abstract

Introduction
Health Education (HE), which is an integral part of Brazilian basic health care policy, reflects on the actions of a specific service or area. In regions where access to health care is precarious and poor socioeconomic conditions predominates, HE is fundamental for the comprehension of the health-illness process which aims at promoting a better quality of life. This study aims to assess through experiment the viability and adhesion of HE actions conducted in indigenous and Riverside communities in the Brazilian Amazon region.

Methodology
This study aims at reporting field trips during health expeditions between July and August 2019 in communities of the state of Pará, Brazil. The HE was composed by seven students and professors. Throughout patient's medical care, the team selected individuals to participate in different group dynamics at common spaces in the community area. The topics covered had been pre-screened based on epidemiological surveys conducted in previous expeditions. Visual and ludic resources were adapted to match local reality.

Results
2860 medical and dental care consultations were given. The adherence to the dynamics in was significant and covered the majority of them. The topics approached by the HE team were breast-feeding, family-planning, non-transmissible chronic diseases, healthy eating habits, hygiene, and awareness for natural resources. It has been observed that culture was a determinant factor for small a number of individuals in the comprehension of actions taken by the HE team.

Conclusions
Despite the strong cultural influence, HE proves to be a fertile ground and it must be encouraged in indigenous and riverside communities. The actions taken by the HE team should consider the local reality in every step of the process of implementation. In spite of the context in which locals of indigenous and riverside communities are inserted, HE promotes an autonomous development of their quality of life.

Key messages
Health education is one of the pillars of the national policy of basic health care in Brazil and is fundamental to promote better quality of life in vulnerable populations. Encouraging interventions in vulnerable communities contributes directly to the autonomous development of quality of life.
Health Literacy regarding people with intellectual disability 'Our right to a healthier future'
Authors: Skes M , Lukavečki V , Radašević H , Živec M , Polić-Vižintin M , Šostar Z 
Published: October 2020

Abstract

Background
People with disabilities make 10,1% of the City of Zagreb society in 2019. Intellectual disability makes 4,8% of total disability population. One of the main goals of Zagreb Strategy of Equal Opportunities for People with Disabilities from 2017 to 2020 is the accessibility to health care and services. Andrija Stampar Teaching Institute of Public Health undertaken public health initiative “Our right to a healthier future” in the City Zagreb in 2019.

Objectives
The aim was to recognize the need for early risk factors prevention, to increase health literacy and to improve access to health-care for adults with intellectual disability in Social-humanitarian organization and Daily Center Ozana.

Results
In order to assess the health status and health-related lifestyle attributes a multidisciplinary approach was carried out including a total od 53 adults with intellectual disability in Center Ozana. Activities included preventive exams, conducted workshops with individual counseling about healthy and unhealthy lifestyles. Hypertension was found in 14,9% adults with intellectual disability using standard diagnostic criteria (i.e. BP ≥ 140/90 mm Hg). High blood sugar was found in 15,7% adults. Body mask index (BMI) was calculated. The awerage was slightly higher in woman (28.8) then in man (27.6).

Conclusions
Healthcare service have predominantly focused on the primary disability. The multidisciplinary approach and collaboration could help to achieve better health for people with intellectual disability. Obesity is a significant health problem for people with intellectual disability. Causes are multifactorial and obesity leads to a higher risk of developing chronic conditions, such as diabetes and heart disease. It is important to understand where and how they need help and support in health terms and what resources and assets they already have or can access if needed.

Key messages
The health literacy concept for people with intellectual disabilities should not be dominated by specific perspectives, such as functional health literacy. Caregivers, family and supporters are a very important factor for health-related decision-making and health literacy for people with intellectual disabilities.
The burden of low back pain in Malta at a population level
Authors: Cuschieri S , Calleja N , Gorasso V , Devleesschauwer B 
Published: October 2020

Abstract

Background
Low back pain (LBP) is a leading global cause of all-age years lived with disability (YLD). Studies conducted in Malta reported that musculoskeletal complaints were the commonest in primary care. The aim was to estimate for the first time the burden of LBP at population level in Malta in terms of disability-adjusted life years (DALYs) and compare to estimates obtained by the Global Burden of Disease (GBD) study.

Methods
LBP prevalence data were obtained from the Maltese European Health Interview Survey dataset for 2015 through representative self-reported history of chronic LBP for 12 months in combination to the extent of daily activities limitation. Proportions of LBP severity (with and without leg pain -mild, moderate, severe and most severe) and their corresponding disability weights followed values reported in GBD study. YLDs for LBP were estimated for the whole population by sex. Since LBP does not carry any mortality, YLDs reflected DALYs. The estimated local DALYs per100,000 were compared to the GBD study for Malta for the same year.

Results
Point prevalence of LBP causing a limitation was of 6.3% (5.6% males; 7.0% females), contributing to a total of 27,006 Maltese suffering from LBP. Global LBP DALYs were of 783 per100,000. Females experienced higher LBP burden per100,000 (876 DALYs) than males (689 DALYs). On comparing these DALYs to those reported by GBD study, a discrepancy was observed per 100,000 (Global LBP 1,828 DALYs; Males 1,657 DALYs; Females 1,999 DALYs).

Conclusions
LBP imposes substantial burden in Malta, which is expected to increase with the ageing population. Since etiology of LBP is multifactorial, it is suggested that a multi-disciplinary targeted preventive and management approach is considered. Differences observed between local estimates and those of the GBD study suggest the integration of locally sourced data into the model in order to improve the DALYs estimates of each country.

Key messages
Low back pain is a public health burden. Locally sourced data is suggested to be integrated with the GBD study to improve the DALYs estimation for each country.
Person-centred care in complementary medicine for individuals with chronic conditions in Australia
Authors: Foley H , Steel A , Adams J 
Published: October 2020

Abstract

Background
Increasing chronic condition diagnoses burden public health systems, individuals and communities. The duration and complexity of chronic conditions require ongoing, multifaceted care - such as person-centred care (PCC) - to address the individual needs and quality of life for patients. Many patients with chronic conditions seek additional care outside mainstream medicine, often consulting complementary medicine (CM) practitioners. This study examines the extent of PCC being experienced by patients with chronic conditions who consult CM practitioners.

Methods
Cross-sectional survey (n = 191), conducted nationally, November 2018 to March 2019, in clinics of the five CM professions most commonly consulted by individuals with chronic conditions in Australia (massage, chiropractic, osteopathy, acupuncture, naturopathy). Participants with chronic conditions (n = 153) were surveyed about experiences of PCC during CM consultation, and regarding consultation with medical doctors, using four validated measures.

Results
During consultation with CM practitioners, patient perceptions of PCC were consistently high. Ratings of PCC were consistently higher for consultations with any CM practitioners (summary mean 3.33) than consultations with medical doctors (summary mean 2.95). The highest mean scores for PCC were reported by patients of naturopaths (summary mean 4.04). Variations in perceived PCC for different items between professions indicate nuance in the experience of consultation across different CM professions.

Conclusions
This study indicates PCC is characteristic of CM consultation, which may reflect CM philosophies such as holism. CM practitioners may present an existing resource of PCC. Further attention should be given to CM professions regarding the potential to address unmet needs of individuals with chronic conditions, and subsequently to better manage the public health burden associated with chronic conditions.

Key messages
Person-centred care appears to be a consistent characteristic of complementary medicine clinical care for individuals with chronic conditions. Due to rising rates of chronic conditions and the associated burden on public health systems, complementary medicine professions should be considered as a resource to optimise chronic illness care.
Towards a positive health approach – a professional perspective
Authors: Overmars-Marx T 
Published: October 2020

Abstract

Background
The current view on health and disease is changing in the Netherlands. When the idea 'from illness and care to health and behaviour' was adopted by one municipality in the Netherlands, a movement to bring positive health into practice was initiated. Accordingly, health professionals, social workers and policy officers were trained to help residents adapt and self-manage in order to improve their health. Two years after the onset of the project, an evaluation study was conducted to evaluate the following research question: “to what extent has the view on health and disease changed from 'illness and care' to a more positive approach focusing on 'health and behaviour'?”

Methods
Both quantitative and qualitative methods were applied to gain more in depth information on how the positive health approach was adopted in practice and which barriers and facilitators professionals experienced. Structural questionnaires were filled in by 24 professionals, a focus group interview was conducted with 7 professionals, and one of the researchers attended two peer coaching sessions.

Results
The following four themes were obtained from the qualitative analysis: perception of the training, residents and their self-management, positive health approach facilitates collaboration, and integrating a positive health approach in the (financial) structure of health care.

Conclusions
The training encouraged the positive health approach, in which professionals are enthusiastic about helping residents adopt self-managing skills to improve health. Nonetheless, specific tools for adopting the positive health approach in specific professional settings are still lacking. Furthermore, the participants emphasized the importance of facilitating a partnership between local government and health insurers for further development of the positive health approach.

Key messages
The training sessions encouraged professionals to support the positive health approach. Facilitating a partnership between the local government and health insurers is needed for further development of the positive health approach.
New cervical screening program in Albania. Access and barriers in all levels of health system
Authors: Ylli A , Filipi K , Shundi L , Fico A , Risto M , Xhani A 
Published: October 2020

Abstract

Background
In 2019 Albania started a national screening program which uses as primary screening examination the high risk Human Papilloma Virus (hrHPV) testing. It targets women 40-50 years old providing systematic screening tests, as part of the routine examinations at primary health care centers. The evaluation study aimed to identify the performance of the program in its first year, barriers and satisfaction of women.

Methodology
A representative sample of 200 women, positive in screening test, was retrieved from the database of program information system. They were interviewed during the period October-November 2019, using a standardized questionnaire.

Results
Although the risk of being hrHPV-positive was higher in cities (OR = 1.52; 95%CI=1.29-1.81), the program was used more by women living in rural areas compared to those living in urban areas (OR = 1.81; 95%CI =1.74-1.89). 60.2% of women found the vaginal sampling procedure very simple and 72.4% not at all painful. 95.8% of women received the test results within two months. At the time of the survey, 90.4% of HPV-positive women had gone for follow up visit (71.7%) or were planning to go as soon as possible (18.7%). 35.2% of women who have performed colposcopy, have chosen private healthcare, with 7.8% going abroad. Higher education increased the odds to use a private facility or go abroad for the follow up visit. 87.2% of women reported substantial worries about the positive result. 89.8% of the sample rated the overall service as 'good' or 'very good'.

Conclusions
While results from the first evaluation show good acceptance from users, the program should address the proportion of women who chose private clinics for follow up examination.

Key messages
Results from the first evaluation of the cervical screening program in Albania show good acceptance from users. Program should address the proportion of women who chose private clinics for follow up examination.
Continuing and online education for health professionals in Brazil: Results from UNA-SUS
Authors: Gasque K C S , Lemos A F , Rodrigues M M S , Vilaça J P V , Araujo D G , Campos F , Passos M F D 
Published: October 2020

Abstract
UNA-SUS System was established to enforce the National Policy of Continuing Education in Health, and it is composed of a Network of 34 public institutions (mostly Universities), responsible for online educational offerings, in response to the demands generated by the Ministry of Health. The system produces courses that are committed to the 2030 Agenda for Sustainable Development (specially Goals 3, 4, 5, 10, and 16).

Objectives
to verify the profile of users and the penetrance of UNA-SUS online courses and their contribution to the democratization of Continuing Education of health workers.

Methods
Data were collected from Arouca Platform and statistical analysis was performed by the Open Free Software R 3.6.

Results
There were more than 2.8 million enrollments, counting more than 1 million students, from every SUS health regions, Brazilian municipalities and states. Courses with the greatest demands were related to important clinical situations faced by the Primary Care professionals in Brazil. There was a predominance of women (80%), whites (36%), followed by browns (33%), singles (57%) and in the age group of 21 to 40 years (70%). Nurses, doctors and dentists were the professionals who most sought courses at UNA-SUS. No relationship was found between enrollment in population-weighted self-instructional courses and the Brazilian State HDI, but a negative relationship was established between the Gini coefficient and enrollment in courses, showing that the more unequal the region, the fewer enrolled students it had.

Conclusions
The UNA-SUS is effective in providing continuing education through free, online course offerings, reaching users from different Brazilian geographic regions, including those leaving in areas with few presential or free educational opportunities, contributing to improve the service offered by the Brazilian Public Health System.

Key messages
Continuing education for Health Professionals in Brazil using online education courses is democratic. UNA-SUS is an effective system to consolidate the National Policy of Continuing Education.