bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health of adolescents with migration background in Germany: cross-sectional results from KiGGS wave 2
Authors: Koschollek C , Bartig S , Rommel A , Lampert T , Santos-Hövener C 
Published: November 2019

Abstract

Background
Although 36.5% of minors in Germany had a migration background (MB) in 2017, data on their health situation is scarce. The project ‘Improving Health Monitoring in Migrant Populations’ (IMIRA) initiated in 2016 aims to expand health reporting on the health situation of people with MB, for which a core indicator set was developed. We are describing the health situation of adolescents based on selected core indicators.

Methods
Data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS wave 2) (2014-2017) are used; adolescents from 11 to 17 years are considered. Prevalences and 95% confidence intervals are calculated for the following indicators: General health status, overweight, hazardous alcohol consumption and use of pediatric or general practitioner’s services. These indicators are stratified along socio-demographic (gender, age, socio-economic status (SES)) and migration-related characteristics (MB, parents’ duration of stay, language spoken at home).

Results
There are hardly any migration-related differences in the general health status and the use of general medical services. While adolescents with MB are more often affected by overweight (without MB: 11.2%, one-sided: 18.9%, both-sided: 19.8%), they show less often risky alcohol consumption (without MB: 14.5%, one-sided: 7.8%, both-sided: 4.4%). There are differences in health behavior according to SES, parents’ duration of stay in Germany and language spoken at home.

Conclusions
Overall, the health of adolescents is good, regardless of their MB, and general medical services are used equally. Differences in health behavior cannot be reduced solely to the (non-)existence of a MB, but need a deeper consideration of more specific migration-related characteristics and the SES.

Key messages
The general health status and health care utilization do not differ between adolescents with and without MB. In contrast, the results on indicators of health behavior vary.
Development of a dictionary for transcultural care in Europe: a deliverable of the TNP project
Authors: Lavranos G , Prodromou M , Erken A 
Published: November 2019

Abstract

Background
Transcultural care remains a hot domain in current nursing practice, especially due to the challenges relating to increased population mobility due to both medical tourism and financial / political instability. The TNP (transcultural nursing for practice) Erasmus plus project was implemented between 2017-2019 to attempt to detect best practices regarding intercultural care in Europe as well as to develop suitable training materials to improve the communication among people of diverse ethnic, cultural and religious background.

Methods
A study was conducted in January 2019 in all six countries participating in the TNP project. 6 healthcare professionals per country we invited to identify key terms relevant to 15 distinct domains of healthcare and health-related cultural and educational topics. After initial open term brainstorming, the terms were graded by all participants according to their perceived relevance to the project aim using a 3 round Delphi approach.

Results
A total of 36 expert responders from all six countries agreed to participate of which 70% women. Age varied significantly between 35-75 years. After the final Delphi round, consensus was achieved, with a total of about 1100 words included in the final joined statement. The highest degrees of consensus was achieved for terms relating to parts of the body, common symptoms and conditions and healthcare-associated structures and professionals. On the other hand, a significantly lower degree of consent was determined regarding terms relevant to regional health topics, spiritual care, emotional / mental health and role of family and environment.

Conclusions
Transcultural care is a necessary component of everyday practice in modern healthcare provision institutions. Despite significant language and cultural barriers, the main priority domains are almost universally uniform, thus justifying the development of suitable health promotion / education materials to minimize the relevant gap.

Key messages
Transcultural care is a current challenge in health promotion. Despite cultural differences, major terms of healthcare provision remain largely uniform across Europe.
Workshop: MigHealthCare - strengthening Community Based Care to minimize health inequalities
Authors:   Organised by: Mig-HealthCare consortium Chair persons: Pania Karnaki - Greece, Allan Krasnik - EUPHA (MIG)
Published: November 2019

Abstract

Over the past few years, a large number of refugees, migrants and asylum seekers have reached the south-eastern points of entry of the EU, challenging health and social systems of bordering countries with a spillover effect to the rest of the EU. Refugees, asylum seekers and migrants are at higher risk of poverty and social exclusion compared to the local populations, while the different vulnerable groups face diverse barriers when accessing health services. In many cases they do not receive appropriate health and social care that best meets their needs. Furthermore, in the EU MS, different practices apply to health and social care delivery for migrants/refugees. Research has shown the importance of community-based models to improve health care access of vulnerable migrants and refugees. Such models include elements of good communication, cultural awareness, sensitivity and respect for the diverse cultural and ethnic backgrounds by community health care staff as well health education and primary healthcare services.
Mig-HealthCare - strengthening Community Based Care to minimize health inequalities and improve the integration of vulnerable migrants and refugees into local communities, is a 3-year project, launched in 2017, with the financial support of the European Commission. It is implemented by a consortium of 14 partners among them universities, national authorities and NGOs from ten countries across Europe (Greece, France, Malta, Germany, Austria, Italy, Cyprus, Spain, Sweden and Bulgaria). The overall objective of Mig-HealthCare is to improve health care access for vulnerable migrants and refugees, support their inclusion and participation in European communities and reduce health inequalities. The project’s specific objectives are: Describe the current physical and mental health profile of vulnerable migrants and refugees including needs, expectations and capacities of service providers.Develop a roadmap and toolbox for the implementation of community based care models, following an assessment of existing health services and best practices.Train community service providers on appropriate delivery of health care models for vulnerable migrants and refugees.Pilot test and evaluate community based care models which emphasize prevention, physical and mental health promotion and integration.
The project results are presented on behalf of the Mig-HealthCare consortium.

Key messages
The overall objective of Mig-HealthCare is to improve health care access for vulnerable migrants and refugees. The Mig-HealthCare project focuses on developing a roadmap to facilitate the effective implementation of community care models.
Survey on the physical and mental health among migrants and refugees in ten European countries
Authors: Karnaki P , Zota D , Riza E , Gil-Salmerón A , Durá-Ferrandis E , Tsiampalis T , Linos A 
Published: November 2019

Abstract
This study discusses the main findings of the quantitative research conducted within the Mig-HealthCare consortium countries to explore the physical and mental health of migrants and refugees. The study population is defined as migrants/refugees who have been residing in Europe, for at least 6 months and up to 5 years. In order to be able to capture the recent migration flow, the analysis was based on 1169 questionnaires collected in 10 EU-Member States, answered by adult migrants residing less than 5 years in the specific country.
A total of 29% of migrants stated that their health is poor or fair. Overall, 56.9% of migrants needed health care services during the last 6 months, however approximately one in four did not have access to them. The most frequent problems were long waiting times, not being able to organize an appointment, not knowing where to go, lack of communication and long distances. The most frequent chronic health problem migrants/refugees face is caries and headaches/migraines, followed by psychological disease and sleep disorders. Approximately one in three women have been pregnant since entering the current EU country, whereas one in four have had a miscarriage or abortion and 21.5% are currently pregnant.
Summing up, most of the migrants face common medical problems such as bad teeth, headaches and psychological problems. However long waiting times, not knowing where to go and lack of communication are barriers to accessing healthcare. The fact that the immunization status of migrants/refugees is unclear, a significant number suffer from serious chronic diseases and the limited breast and cervical cancer screening of female migrants/refugees pose serious threats to their health and important challenges for the health services of Europe.
Predictions concerning the use of health care services in Europe by migrants/refugees and the Mig-HealthCare Roadmap & Toolbox
Authors: Zota D , Karnaki P , Gil-Salmerón A , Garcés-Ferrer J , Riza E , Linos A 
Published: November 2019

Abstract
Based on the multiple levels of research conducted within the project the consortium developed a roadmap & toolbox which includes the following categories: Continuity of information, Language Culture & Communication, Mental Health, Vaccinations, Maternal/child health, Health promotion, Oral health/Dental Care and NCDs while the Toolbox contains tools on these categories in different languages. The roadmap & toolbox is accessible through the project website. In addition, different scenarios, giving a comprehensive picture of the foreseen situation and the evidence-based policies and actions needed to maximize the effective delivery and sensitivity in the service of care to culturally diverse population groups were developed focusing on mental health, chronic disease management and oral health. Refugees and migrants tend to have a higher prevalence of mental distress compared to non-refugees. For the challenge of lack of recording mental health of migrants/refugees, improving the collaboration between ‘migrant-specific’ organizations is needed. Health care systems in Europe will have to accommodate the high demand for health care services for chronic conditions among migrants/refugees in the coming years. Implications such as the impact of poverty, level of health literacy and/or the cultural adaption of the measures need to be considered when planning to address future trends related to non-communicable diseases including diabetes among migrants/refugees. The provision of oral care presents great variability across the European countries, but in most cases, it is characterized by high cost and restricted range of services if offered within the state health systems. Migrants /refugees will not be able to meet the high cost of private dental care. Local community interventions have been proven very effective.
The equity impact of a universal child health promotion programme
Authors: Pulkki-Brännström A M , Lindkvist M , Eurenius E , Häggström J , Ivarsson A , Sampaio F , Feldman I 
Published: November 2019

Abstract

Background
We aimed to evaluate whether the Salut Programme, a universal child health promotion intervention, aimed to strengthen healthy lifestyles in northern Sweden, had any effect on income-related inequalities in positive birth outcomes for children and on healthcare use for children and their mothers.

Methods
Mother’s residence and child’s date of birth determined whether the child and the mother belonged to the control group (areas that received care-as-usual) or the intervention group (areas with the intervention implemented from 2005), during the pre-measure period (children born 2002-2004) and the post-measure period (children born 2006-2008). The sum of parents’ taxable income was used for socioeconomic ranking. We computed the standard concentration index for six binary indicators of positive birth outcomes, and for inpatient and day patient care for children and mothers during the two years after delivery. Using a difference-in-difference approach, we assessed whether the extent of inequality changed over time between areas.

Results
Income-related inequalities in child health status at birth and in child healthcare use were absent, except that full-term pregnancies were concentrated among the poor at pre-measure in the intervention group. However, mothers’ healthcare use was significantly pro-poor in the control group. The extent of inequality changed between pre- and post-measure periods for two outcomes: the pro-poor concentration of full-term pregnancies in the intervention group at pre-measure disappeared at post-measure; and an increase in pro-poor concentration of normal birth weight in the control group was not matched by a similar increase in the intervention group. Inequalities in healthcare use did not change significantly.

Conclusions
Birth outcomes and child healthcare use seemed to be equitably distributed. However, the results raise concerns whether the intervention may have reduced the pro-poor concentration of positive birth outcomes.

Key messages
There are concerns that participation in universal health promotion programmes differs by socioeconomic status, although few public health interventions have been evaluated from an equity perspective. Birth outcomes and child healthcare use in Northern Sweden seemed to be equitably distributed across different socioeconomic groups.
Prevalence of non-adequate health literacy in Europe: a systematic review and meta-analysis
Authors: Baccolini V , Di Paolo C , Salerno C , Rosso A , Prencipe G P , Isonne C , Marzuillo C , De Vito C , Villari P , Romano F 
Published: November 2019

Abstract

Background
Many studies show that a low level of health literacy (HL) is associated with several adverse outcomes. The aim of this systematic review was to estimate the prevalence of non-adequate HL (NAHL) in European countries and outline the main needs for interventions.

Methods
The systematic search was performed in April 2019 and updated in June 2019. PubMed, Embase and Scopus were searched. Articles were considered eligible if they were cross-sectional studies published in English after 2000 and estimating the NAHL prevalence in European countries. Globally, 15490 articles were retrieved. Adapted Newcastle-Ottawa Scale was applied for the quality assessment. Several stratified meta-analyses were carried out. We also performed a meta-regression analysis to test the association between variables and NAHL.

Results
In total, 59 articles of heterogeneous quality were included, providing data for 98 studies to include in the proportion meta-analysis. Overall, quantitative analysis yielded a pooled NAHL prevalence of 40% (95%CI, 36%-43%). Despite the prevalence varied considerably by country, it seemed to follow a geographic gradient, with the northern countries clearly having a lower prevalence than the other European counterparts. The pooled prevalence estimates (PEs) varied significantly according to the different type of HL assessment method applied. Also, high study quality was found to be significantly associated with a reduction of NAHL in the PEs. Grouping the sample in general population, oncology patients, chronic disease patients and refugees, the meta-regression analysis showed a significantly lower prevalence of NAHL in oncology patients.

Conclusions
Although the PEs varied in relation to several factors (e.g. either among population groups, or depending on the HL assessment method), this study shows that more than one in every three surveyed participants had NAHL. Targeted strategies and coordinated policies aiming at improving HL in the Region are needed.

Key messages
Despite several variations, a significant proportion of European population has non-adequate health literacy. Targeted public health strategies of intervention are crucial to address this deficit.
Transitional care models for chronic patients: preliminary results from an umbrella review
Authors: Riccardi M T , Cicconi M , Ricciardi W , Gianino M M , Damiani G 
Published: November 2019

Abstract

Worldwide, chronic diseases are burdening and the health systems need to be rethought to better manage this epidemiologic shift. One of the critical points in the care pathway of chronic patients is the transition from one care setting to another. Aim of this study is to provide an overview of the current evidence on the impact of transitional care programs on health and economic outcomes for chronic patients
Medline, Web of Science and EMBASE were queried for relevant reviews using the Population-Intervention-Context-Outcome (PICO) model. The quality of the included articles was determined using A MeaSurement Tool to Assess systematic Reviews (AMSTAR 2). Data were analyzed using descriptive statistic, and comparison among studies carried out in European Union (EU) versus non-EU was performed (Chi-square test was used and a p &lt; 0.05 was deemed as statistically significant)
124 reviews were assessed for eligibility and 14 were eventually included (for a total of 167 primary articles). Quality appraisal was critically low in 60% of the reviews. Both hospital readmission rate and Emergency Department (ED) visit rate were lower than those in usual care group, but this difference was significant in 40% of articles. In EU studies readmission rate was lower in 65% of cases while in non-EU ones the percentage was 51.0%, but the difference was not significant (p = 0.23). Six reviews (43%) investigated the economic impact of the transitional care: most reported an initial increase in cost due to investment in staff training and creation of organizational networks, followed by a sharp decrease in costs due to a better utilization of health services, thus leading to a reduction in overall costs.
Compared with usual care, transitional care shows an overall cost reduction, even if with limited effects on re-hospitalization or ED visit rates. These findings should encourage decision makers to invest in the development of this kind of programs in order to identify models that best perform.

Key messages
The patient transfer supervision from one care setting to another is necessary for continuity of care, but there is no robust evidence about the better performance of transitional care models. Systematically reviewed transitional care models has been shown be more cost saving, with a moderate impact on hospital readmission or emergency department visits rates.
Clinicians’ decision making about Parkinson’s treatment plans using self-report vs digital data
Authors: Timotijevic L , Rusconi P , Hodgkins C , Egan B M , Banks A 
Published: November 2019

Abstract

Background
An mHealth-based support systems promise to deliver objective data about the patient’s healthcare status to the clinician in a timely manner but at the same time, risks increasing ‘technical uncertainty”, by increasing the amount of available information, but not necessarily its utility in making medical decisions.The study aim was to investigate clinicians’ decision making about treatment and care plans based on the relative utility of subjective (reported by a person with Parkinson’s Disease, PwP) or objective (digital health) information.

Methodology
Clinicians completed an online questionnaire with 15 vignettes describing patient cases of PwP where information type (subjective, objective, subjective and objective) and symptoms / signs were manipulated whilst disease stage, duration and patient demographics were kept constant. Dependent variables were the likelihood of changing the care plan and the confidence in the decision. We also recorded the willingness to rely on subjective or objective information.

Results
Clinicians were equally likely to change the care plan and were equally confident in their decision when receiving information from self-reports or the digital health devices’ outcomes. The likelihood for change increased when both information sources provided consistent information. However, inconsistent information from both sources did lead to more conservative decision making, that is, clinicians were more reluctant to change the care plan.

Conclusions
Clinicians consider digital health information equally as useful and trustworthy as patients’ self-reports for their care plan decisions. This finding corroborates the potential utility of wearable technology and mobile devices for symptoms’ monitoring. Facilitating clinician’s feedback on situations where subjective and objective sources provide conflicting information is an important consideration for the development and improvement of clinical decision support systems (DSS).

Key messages
It would be important to identify conditions and mechanisms that could give rise to this conflicting information and the impact that that could have on patient care. Guidelines (e.g., more frequent appointments to monitor the situation) could then be put in place to deal with these situations.
A Developmentally Appropriate Patient Education during Transition
Authors: Gagnayre R G , Lombrail P L 
Published: November 2019

Abstract

Introduction
Patient education is recommended to improve transition from pediatric to adult care for young people living with chronic conditions. But a consensus has not been reached regarding a particular model. Our study aims to understand how to implement a Developmentally Appropriate Patient Education during Transition (DAPET), which would revolve around the young people’s psychosocial development.

Methods
Three focus groups were organized with healthcare providers and two focus groups took place with the parents of young people with chronic conditions. We relied on Activity Theory to explore practices and to identify obstacles, as well as recognize which resources were available to implement a DAPET.

Results
Six themes were identitified via the thematic analysis. In summary, healthcare providers agreed on the need to engage in an educational approach centered on the psychosocial development of young people during transition. They did, however, highlight a lack of competencies in adolescent and young adult medicine and a lack of available resources to meet these goals. The parents wanted to redefine their role with healthcare providers in order to apprehend transition to adult care and to allow their children to develop self-management skills.

Conclusions
Healthcare providers and parents considered the implementation of a DAPET to be acceptable and even advisable. However, this program’s feasibility was questioned due to the perceived shortfalls of the hospital system as it currently stands and the ways in which an educational approach would be applied. An enabling environment is therefore required to facilitate the educational initiatives of healthcare providers and to encourage the participation of parents. The means and modalities for achieving this are discussed.

Key messages
Patient Education during transition from pediatric to adult care need to be developmentally appropriate. Healthcare providers need en enabling environment to carry on a developmentally appropriate approach during transition.