bluuebunny/crossref_metadata_2025_split huggingface dataset:
The applicability of methods for assessing comorbidities: The Cumulative Illness Rating Scale (CIRS)
Authors: Napolitani M , Kundisova L , Messina G , Nante N 
Published: November 2019

Abstract

Introduction
It is essential to compare the results of medical care in patients suffering from multiple, and complex diseases. CIRS is a risk adjustment tool useful for assessing patients’ comorbidities although it needs to be used with precision following guidelines. The aim of this research is to assess whether organised seminars, planned to motivate the clinicians for correct data compilation, have an effect on the concordance of scores on the CIRS scores.

Methods
A prospective, pilot study started in November 2018 on a sample of 49 patients admitted to a private clinic between December 2018 and February 2019. In the context of a seminar, an Resident Physician in Public Health (RP), distributed and explained the CIRS guidelines to the clinicians. CIRS scores were then calculated by the ward physicians and compared with those of the RP who successively analysed the same medical records. The inter-rater agreement was calculated through Cohen’s kappa coefficient (κ), using Stata 14.2.

Results
Concordance was excellent or almost perfect or substantial for 8 out of 14 categories: heart disease (k = 0.82), genitourinary disease (k = 0.90) blood pressure category (p = 0.72), sense organs (k = 0.75), upper gastrointestinal system (k = 0.70), lower gastrointestinal system (k = 0.76), musculoskeletal system and skin (k = 0.66), central nervous system (k = 0.69), endocrine system and breast (k = 0.63) and psychiatric diseases (k = 0.63). The agreement was moderate for the respiratory system (k = 0.48) and for the liver (k = 0.57), and was fair for Severity Index, Comorbidity Index and the vascular system (k = 0.24, k = 0.38 and k = 0.28 respectively).No Concordance in renal diseases (k = 0.00).

Conclusions
Overall, the agreement of the scores between RP and clinicians was good, and it was possible to analyse the main weaknesses and difficulties of the clinicians. Subsequent seminars will be done to increase over time the concordance of the surveys.

Key messages
Organized seminars, planned to motivate clinicians to correctly compile the CIRS scores, were effective. The inter-rater agreement was good. Subsequent seminars will be done to increase over time the concordance of the surveys.
Assessment of the e-health system in the Kaunas City Outpatient Clinic
Authors: Kaseliene S , Blazeviciute L , Mesceriakova-Veliuliene O 
Published: November 2019

Abstract

Background
The Lithuanian National Electronic Health (e-health) System was only launched in 2015. The aim of this study is to evaluate the e-health system in the Kaunas City Outpatient Clinic using a system of balanced performance indicators.

Methodology
The survey was carried out from October until December, 2018, at the Kaunas City Outpatient Clinic (Lithuania). The study included 264 medical staff members and 384 patients.

Results
62% of the patients and 100% medical staff of the clinic used various e-health system services. The most often used services by the patients were SMS reminder (75.5%), online registration (70.8%) and electronic prescription (59.3%). The physicians took the most advantage of assigning electronic prescriptions (88.2%), filling the sickness certificates (78.9%), booking laboratory tests and receiving their results electronically (63.9%). Majority of the medical staff and patients stated that the e-health services are of high quality (77.6 and 89.5%, respectively), reliable (86 and 90.8%) and have a wide spectrum of services (75.3 and 93.7%). The most common problems that patients faced when using the e-health system services were the malfunctions and failures of the system (68.9%) or missing health data of the patient (59.7%). According to the medical staff, e-health system technologies do not cover the needs of employees in full extent (95.1%), also, the e-health system is still not completely reliable (97.7%). Only 56.7% specialists stated, that they have enough skills to work with the e-health system, 77.7% would like to improve their professional qualifications in this field. The Clinic used the funds of the institution, municipality or EU structural funds to develop the e-health system, update the computer equipment and software, and acquire licenses.

Conclusions
More efficient and effective e-health services and developing the capacity of the e-health usage are required to promote high-quality health care in Lithuania.

Key messages
Although majority of the patients and medical staff members use various e-health system services and are satisfied with their quality, there still are problems with the operation of the system. Specialists feel the lack of skills to work with the e-health system.
Training on health communication and social media: European public health residents’ perceptions
Authors: de Nard F , De Vita E , Quattrone F , Thomas R , de la Torre L 
Published: November 2019

Abstract

Background
Theoretical knowledge about health communication (HC) and expertise in planning, implementation and evaluation of HC interventions are essential tools for Public Health (PH) specialists. In the social media (SM) era, specific abilities and digital communication skills are gaining importance.

Objective
Our aim is to describe European PH residents’ perceptions regarding their training in the HC field, with a focus on SM. We piloted a survey using Google Forms during the European Network of Medical Residents in PH (EuroNet MRPH) meeting in Turin, April 2019. We then spread the survey to other PH residents across Europe in July 2019. The survey consists of 25 questions (Likert scales from 1=strongly disagree to 5=strongly agree, or multiple-choices) divided in 5 thematic sections (HC theory, public speaking, traditional media based HC, SM based HC, HC impact evaluation). Questions aim to map HC topics covered in residency educational programs, learning methods, and the perceived importance of HC skills.

Results
The study included 114 residents from 10 countries (37% Italy, 23% Portugal, 10% UK, 9% Spain, 8% France, 13% other). Participants perceived they receive the best training in the areas of public speaking, impact assessment and HC theory (median 3, IQR 2-4). Conversely, for traditional and SM based HC, training was perceived as unsatisfactory (median 2, IQR 1-4 and 1-3 respectively) with self-education as main learning method (51%). Public speaking and traditional HC were identified as the most important HC skills for PH specialists (median 5, IQR 5-5), while less importance was attributed to SM based HC (median 3,5, IQR 3,25-5).

Conclusions
Despite SM are playing a crucial role in public HC, specific training seems to be scarce in this sample. Although residents perceive SM based HC skills as important, they consider them less important than other HC skills. Further analysis is needed in order to explore the perceived relevance of SM in PH residents training.

Key messages
Training on health communication via social media is scarce among European public health residencies. Common training programs across European residencies in PH should address this educational need. European public health residents perceive social media based health communication skills as important, but not as important as traditional media based health communication skills.
Social network and grief: a text mining analysis
Authors: Corvo E , De Caro W 
Published: November 2019

Abstract

Introduction
Grief represents a multifaceted response to loss. Several dimension such as physical, cognitive, social, spiritual and philosophical are involved while an individual is experiencing loss. Often bereavement and grief are used interchangeably, however they are two very different concepts, bereavement refers to the state of loss while grief is the reaction to that loss. Each individual experiences loss differently, this is often connected to the culture of the individual in terms of culture per se or religion. Furthermore loss pertains not only to the individual who is directly involved and to its family but the entire environment of the person, in terms of community for instance. How individuals live and communicate death, loss and grief on online social network seems to have a role in coping and managing the loss itself.

Methods
Text mining analysis was performed using web tools and Taltac 2.11. A text analysis of posts and discussion on open online social network was carried out in order to better detect which kind of coping activity was developed by participants. Specifically 149 losses post and more than 10.000 comments were analyzed.

Results
Loss, bereavement and grief represent one of the most relevant topics on social network. Two main themes were identified. The first is focused on religion and spiritual support in faith, while the second on emotional support and affective-type closeness in which friends (virtual or not) support other individual having previously experienced the same losses. Analysis suggests that individuals are able to support peers in a wide range of way, furthermore virtual support is easier and more straight forward with respect to traditional and face to face relationship.

Conclusions
This study display that individuals recognized a new way to be supported through social network. Individuals feel to be with close friends and at the same time to have the opportunity to live the loss by themselves without a face to face relationship.

Key messages
Social network 4 grief. Virtual friend give support.
The professional experience of a public health intern: How to promote health through a comic strip
Authors: Leuci L 
Published: November 2019

Abstract

Issue/problem
Public health is a complex discipline often misunderstood by medical students. The way these future professionals get to grips with this subject may impact their career.

Description of the problem
Starting in November 2018, a young public health intern, who also happens to be an illustrator, shares with us her medical journey through a comic broadcasted online. This innovative approach aims to demystify public health to medical students and could potentially raise their interest in the profession. The author started her residency training at the French Regional Authority of Health Promotion and Education (Instance Régionale d’Éducation et Promotion de la Santé - IREPS).

Results
She recounts some of her professional anecdotes: an empowerment project for struggling young people, a survey on environmental health… The chapters of her comic are periodically shared on social media to professional members and public health interns in Dijon. The French organization of Public Health Interns (Collège de Liaison des Internes de Santé Publique de France - CLISP) has been contacted to publish the comic nationally. An English translation has been considered as well. A printed edition will be distributed to medical students of the region during an introductory course in public health.

Lessons
This experiential comic strip enables the intern to conduct a self-analysis of her work. The short format of each chapter obliges the author to focus on some understandable key messages. The comic strip receives a warm welcome as well as by the professional members of IREPS, and the young and skilled co-interns who all appreciate this discipline being presented under a new light.

Key messages
The comics strip represents a great tool to transfer knowledge in public health as it is attractive and ludic. It is essential to provide a better understanding of public health.
Empowerment: a key to promote the health of people with disabilities
Authors: Lafitte S , Ferron C , Mussillier L , Poli S , L’Horset C , Masrouby M , Bidaux L , Alias F 
Published: November 2019

Abstract

In France, health public policies for people with disabilities are based on specific laws, recommendations and systems of reference. This population is under the responsibility of the medico-social sector, which governs specialized institutions and services. These services favor a medical approach to health focused on access to care. Their main missions are to take care of disabled people with kindness on a daily basis and to adapt the care to each person’s special needs, whatever the disability. They create links with families, organize the services offered and the living environments, administer their staff and collaborate with health professionals. As they ensure safety and health at all levels, from every individual project to collective life, they have a real opportunity to act on a set of health determinants.
The Ottawa Charter for Health Promotion refers to the empowerment and participation of the population as fundamental principles; this is also true as far as people with disabilities are concerned. With the principal stakeholders on a national level, we wrote a handbook in order to support the implementation of these principles in medico-social institutions and services: ’Promoting health and well-being in the medico-social field in cooperation with people with disabilities” and their families.
In this presentation, based on concrete examples, we will outline how the five intervention strategies of the Ottawa Charter can apply to people with disabilities, their families and their communities, especially inside specialized institutions and services. We will pay particular attention to the intervention methods and pedagogical tools which can be used to initiate or to improve the participation of disabled people in decisions, through the valuing of their experiential expertise, the development of their social skills, the strengthening of their health literacy, family-professional co-education, and cooperative strategies.

Key messages
Specialized institutions and services can promote the health of the people with disabilities they care for, by acting on the determinants of their health and by mobilizing participatory strategies. To strengthen disabled people’s participation, using their experiential expertise, developing their social skills and health literacy, and mobilizing co-education, are the best strategies.
Sick leave and disability pension before and after breast cancer diagnosis: a Swedish cohort study
Authors: Chen L C , Alexanderson K A 
Published: November 2019

Abstract

Background
Most working-aged women are, after diagnosed with breast cancer (BC), on some sickness absence and/or disability pension (SADP). We aimed to explore possible trajectories of their previous and subsequent SADP days and risk factors for consistently high levels of future SADP.

Methods
In a longitudinal cohort study of all 3536 women in Sweden aged 19-64 with a first BC diagnosis in 2010, we calculated their annual SADP net days from two years before to three years after BC diagnosis date. A group-based trajectory model was applied to depict SADP patterns. Logistic regressions were used to calculate odds ratios (OR) with 95% confidence intervals (CI) for having &gt;90 or &gt; 180 SADP days/year in the three postdiagnostic years.

Results
Three trajectories of SADP days/month over the five years were identified: “high” (30% of all)”, “increase only around diagnosis” (61%), and ’constant very high’ (9%). Across the study period, the risk factors associated with constantly high levels of SADP days (&gt;90 or &gt; 180 days/year) were similar. Particularly, factors significantly associated with having annual SADP &gt;90 days during all the three postdiagnostic years were: stage II cancer (OR = 4.59; 95% CI 2.98-7.07), stage III+IV (OR = 26.57; 13.52-52.22), prediagnosis SA 1-30 days (OR = 2.73; 1.30-5.70), prediagnosis SA &gt; 90 days (OR = 24.52; 12.25-49.08), and prediagnosis DP (OR = 659.97; 292.52-&gt;999.99).

Conclusions
When diagnosed with BC, SADP increased significantly postdiagnosis, however, decreased with time and the absolute majority had no SADP the third year after BC diagnosis. Advanced cancer stage and previous high SADP were the highest risk factors for later SADP.

Key messages
Most breast cancer survivors’ work capacity (sickness absence (SA) and disability pension (DP) is only affected shortly post-diagnosis. Prior SADP and high cancer stage were strongest risk factors. Register-based information on breast cancer patients and their sickness absence and disability pension before and after diagnosis are useful to identify different types of return-to-work patterns.
Work disability before and after incident myocardial infarction and subsequent common mental disorder
Authors: Bokenberger K , Rahman S , Wang M , Vaez M , Dorner T E , Helgesson M , Ivert T , Mittendorfer-Rutz E 
Published: November 2019

Abstract

Background
This study investigated the extent to which work-disability patterns including sickness absence and disability pension (SA/DP) before and after acute myocardial infarction (AMI) were associated with subsequent common mental disorders (CMDs) such as depression and anxiety in AMI patients without previous CMD.

Methods
A cohort of 11,493 patients aged 26-64 years without previous CMD with incident AMI during 2008-2010 were followed up for CMD measured as antidepressant prescription through 2013. Four SA/DP trajectory groups during the 3 years pre-AMI and 1 year post-AMI were identified. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated in Cox models.

Results
Higher pre-AMI SA/DP levels (&gt;1-12 months/year), compared to the majority of patients (78%) following low increasing annual levels (increasing up to 1 month/year) of pre-AMI SA/DP, were associated with a 40-60% increased CMD rate. Regarding post-AMI findings, constant high (∼25-30 days/month) and steeply decreasing SA/DP levels within the first 3 months were associated with a 76% and 35% higher CMD rate, respectively, compared to constant low (&lt;1 days/month) levels. Conversely, a gradually decreasing pattern of post-AMI SA/DP over a 12-month period suggested protective influences for CMD (HR = 0.80), even after adjusting for sociodemographic and medical factors.

Conclusions
This is the first study to demonstrate that pre- and post-AMI work disability patterns are associated with subsequent CMD risk in AMI patients. Work disability patterns should be considered in clinical practice as an indicator of AMI prognosis in terms of CMD risk.

Key messages
Increasing and high persistent levels of pre-AMI work disability are associated with higher risk of subsequent CMD, while gradually decreasing post-AMI work disability has a favourable CMD prognosis. Pre- and post-AMI patterns of work disability (sickness absence and disability pension) can be a useful marker in terms of CMD prognosis.
Gender and psychological distress: contribution of work-family balance
Authors: Viertiö S , Kiviruusu O , Piirtola M , Kaprio J , Korhonen T , Marttunen M , Suvisaari J 
Published: November 2019

Abstract

Background
Women suffer from psychological distress more often than men. Our aim was to investigate the potential contribution of work-family balance to this gender difference.

Methods
Questionnaire data from the nationally representative 2013 Finnish Regional Health and Well-being Study (target population all adults aged 20 years or over, n = 88 377, response rate 53%), was restricted in the current analysis to those who were working and who had minor children (n = 26 442). Psychological distress was assessed using the Mental Health Index (MHI-5, cut off value &lt; =52). Participants answered six questions on balancing work and family demands (yes/no). We used logistic regression adjusted for age, education and marital status.

Results
Women reported more distress than men (12.4% and 10.2% respectively, p = 0.000). We found statistically significant interactions between gender and two work-family demands (both p = 0.010): “I sometimes neglect my family when I am wholly absorbed in my work” was associated with distress in women (OR = 1.29, 95%CI 1.11-1.49), but not in men (OR = 0.95, 95%CI 0.79-1.14). “I feel inadequacy as a parent” had stronger association with distress in men (OR = 3.07, 95%CI 2.56-3.69) than in women (OR = 2.31, 95%CI 2.00-2.65). Both men and women had less psychological distress if they reported stopping thinking about their work at home or having more energy to be with the children when they also went to work. Correspondingly, they had more psychological distress if they felt they were neglecting home issues because of work or found hard to concentrate on work because of home issues. Common-law marriage was associated with psychological distress in women (OR = 1.43, 95%CI 1.22-1.68), but not in men (OR = 1.11, 95%CI 0.91-1.36).

Conclusions
Women felt distress about neglecting family due to being absorbed in their work while men did not. Feelings of inadequacy as a parent were associated with distress more in men.

Key messages
Both women and men struggle to coordinate work and family, but expectations how job is divided may differ by gender. Actions to improve coordination between working life and family life are needed, both within families and by political decisions.
Preterm delivery is associated with long-term risk of maternal renal disease
Authors: Barrett P , McCarthy F P , Evans M , Kublickas M , Perry I J , Stenvinkel P , Kublickiene K , Khashan A S 
Published: November 2019

Abstract

Background
Preterm delivery is an independent risk factor for maternal cardiovascular disease. Little is known about the association between preterm delivery and maternal renal function, and whether any association is independent of preeclampsia or intra-uterine growth restriction. This study aimed to examine the association between gestational age and long-term maternal chronic kidney disease (CKD) and end-stage kidney disease (ESKD).

Methods
Using data from the Swedish Medical Birth Register, singleton live births from 1973-2012 were identified and linked to data from the Swedish Renal Register and National Patient Register (up to 2013). Women with pre-pregnancy CKD/ESKD, cardiovascular disease, diabetes, hypertension, systemic lupus erythematosus were excluded. Gestational age at delivery was the main exposure, treated as a time-dependent variable. Primary outcomes were maternal CKD or ESKD. Cox regression was used, adjusting for maternal age, year of delivery, country of origin, education, parity, interpregnancy interval, smoking, BMI, gestational diabetes. Models were stratified by exposure to preeclampsia or small for gestational age (SGA).

Results
There were 3,847,694 pregnancies among 1,990,273 unique women. Nine percent of women (n = 172,915) had at least one preterm delivery (&lt;37 weeks). Exposure to preterm delivery was associated with higher risk of CKD (aHR 1.48, 95%CI 1.41-1.54) and ESKD (aHR 2.52, 95%CI 2.17-2.92). Earlier gestational age at delivery was associated with increasing risk of CKD and ESKD. Women with spontaneous preterm delivery were at higher risk of CKD (vs. normal term, aHR 1.33, 95% CI 1.26-1.40) and ESKD (aHR 2.02, 95%CI 1.69-2.40) independently of preeclampsia/SGA. Associations persisted after excluding women who developed postpartum cardiovascular disease, hypertension or diabetes.

Conclusions
Women who gave birth at earlier gestation were at higher risk of later CKD and ESKD. This association persisted independently of preeclampsia and SGA.

Key messages
Preterm delivery is an independent predictor of long-term maternal renal disease. Obstetric history should be considered as part of overall risk stratification for chronic kidney disease in women.