bluuebunny/crossref_metadata_2025_split huggingface dataset:
Strengthening core competences and skills of medical and public health students for digital health
Authors: Petráková A , Príkazský V , Hlavinka A , Holý O 
Published: October 2020

Abstract

Background
Innovations and use of modern IT approaches are important for new generation of health professionals, in particular for strengthening their core competences on health protection, public health emergencies, preparedness and response. Faculty of Medicine & Dentistry, Palacký University Olomouc (UPOL), Czech Republic, one of the full ASPHER members, implemented in medical as well as public health curricula new topics focused on digital health in general, in particular on provision of health services in the time of health emergencies.

Objectives
To strengthen competences and skills of medical students in the area of digital health with a special focus on health protection. To train students in using modern IT approaches. To strengthen methodology for retrospective evaluation of surveillance data with an emphasis on updating crisis management for human health within the system of epidemiological alertness.

Results
New module on digital health was developed and successfully tested in all education programmes at the Faculty of Medicine & Dentistry, Palacký University Olomouc, Czech Republic: General Medicine (Czech and English programmes), Dentistry (Czech and English programmes) and Public Health (Czech programme). New module has blended learning structure based on combination of face-to-face seminars and exercises with e-learning parts, including self-assessment. New module will be presented in details.

Conclusions
This new education module fully supports international recommendations to strengthen digital health competences and skills of medical as well as public health students. This new approach is an integral part of the pilot project on further development and implementation of digital health in the Czech health system, managed by the University Hospital Olomouc. COVID-19 pandemic confirms how important this new approach is for all health professionals.

Key messages
Improving competences and skills of medical as well as public health students in digital health is crucial. Using digital health in the area of health protection, preparedness and response is important for prediction and its use in epidemiological alertness.
Communication breakdown in Italy’s vaccination governance
Authors: Attwell K , Harper T , Rizzi M , Taylor J , Casigliani V , Quattrone F , Lopalco P L 
Published: October 2020

Abstract

Background
In 2017, Italy rebooted its mandatory vaccination regime, following a series of unfavourable court decisions placing vaccination in disrepute. Vaccination rates had steadily declined for half a decade, culminating in a measles epidemic. Existing studies demonstrate the role of vaccine hesitancy, but none have explored the role of government in the years prior to the new mandate. This study analyses the drivers of failures to address sliding vaccine confidence in Italy.

Methods
We engaged in qualitative analysis of primary sources, Italian and international scholarship, and semi-structured interviews with key informants. These were analysed using the coding software NVivo 12. We developed an empirically and theoretically informed schema to make sense of governance failures in knowledge and action.

Results
The resort to mandates in 2017 was triggered by a series of unfortunate events, further thwarted by governance capacity gaps. During 2012-2017, Italy's vaccination governance included no online campaigns to address concerns. Public health officials lacked crucial knowledge regarding the population, including strategies to address hesitancy. They were preoccupied with other significant changes to Italy's vaccination governance, notably the vaccination schedule. Limited financial resources from the political class constrained officials' capacity in a context of austerity. A credibility gap ensued, which officials sought to plug by constructing Italians as in need of firm instruction by mandatory vaccination.

Conclusions
When voluntary vaccination failed in Italy, the new mandates improved coverage rates. However, the vaccine confidence work explored in this study should not be neglected. The future governance of vaccine confidence requires that effective communications to address vaccine confidence be implemented Italy and other jurisdictions facing vaccine hesitancy and refusal problems.

Key messages
We analyse the Italian government’s response to the crisis of vaccine confidence prior to the introduction of mandates, in order to provide lessons for other governments. We identify and explain the gaps in governance capacity that prevented the addressing of sliding coverage rates.
Social values and public procurement in health: can ‘smart’ procurement enhance justice in health?
Authors: Mezeiova V 
Published: October 2020

Abstract
Governments spend 29% of total expenditure on procurement while the second largest area is health. However, the important question is what the impact of these expenditures on health is. Can one buy health justice through procurement? In order to answer this issue, the study firstly analyses theory of global health governance to substantiate whether procurement is a health governance tool whose efficiency and effectiveness determines health outcomes. Secondly, health as a social aspect is scrutinised because its governance and procurement have to be driven by a normative value. Within the study, health justice is justified to be such a value as it is a significant public health factor in practice. Following this normative claim, the study uses analysis of legislation, case law and examples from procurement practice to show whether procurement law can enhance health justice.
In terms of methodology, the study establishes a normative framework of governance in health, health justice and procurement. On that basis, it distinguishes procurement categories (procurement of health, and procurement for health) and concludes what it is in procurement that health justice is transformed into. In order to answer the core research question, the study analyses harmonised transnational EU legislation, policy, case law of the CJEU, and examples from practice through stages of supply framework - at input, output and outcome.
The study leads to a conclusion that procurement serves as a tool of governance in health. In order to reach effectiveness and efficiency of procurement in health, it is submitted that procurement needs to reflect on the argument of ethics and economics of health. Health inequalities are an operationalized factor to reach this. The EU procurement law enables to consider health justice. However, it is restricted by the requirement of proportionality. Therefore, health justice is perceived as distortion, rather than a goal of competition to be enhanced.

Key messages
In order to reach effectiveness and efficiency of procurement in health, it is submitted that procurement needs to reflect on argument of ethics and economics of health. The EU procurement law enables to consider health justice. However, it is rather perceived as distortion, than a goal of competition to be enhanced.
Association between legal status regularization and self-rated health among undocumented migrants
Authors: Fakhoury J , Duvoisin A , Jackson Y L , Burton-Jeangros C , Consoli L , Guessous I 
Published: October 2020

Abstract

Background
Little is known about the social determinants of undocumented migrants' health. The canton of Geneva, which hosts 10-15'000 undocumented migrants, implemented a selective regularization policy in 2017-2018. We sought to assess whether the regularization of the residence status was associated with self-rated health.

Methods
Analyses were based on the first-wave data of the Parchemins Project, a prospective multidisciplinary study evaluating the impact of regularization on undocumented migrants' health and wellbeing. We included 444 undocumented or recently (&lt;3 months) regularized migrants living in Geneva for at least 3 years recruited in the community and healthcare settings. We used multivariate logistic regression to estimate odds of excellent or very good versus good, fair or bad self-rated health. Explanatory variables included measures of integration, financial situation and social support. Models were adjusted for health variables.

Results
Of the 444 undocumented migrants included, 204 (46%) had recently obtained a residence permit. These regularized migrants reported excellent or very good health more frequently than those undocumented (44.6% vs. 29.2% respectively, p-value &lt; 0.01). However, this difference was not explained by the residence permit (OR = 1.14 [0.70, 1.85]), but rather by the ability to overcome financial hardships (OR = 1.66 [1.02, 2.71]) and better social support (OR = 1.67 [1.07, 2.62]). Adjustment for health variables did not alter these associations.

Conclusions
Policies aiming at promoting better health among undocumented migrants should include measures strengthening financial security and social resources. Further evidence is needed to assess the impact of residence status regularization on self-rated health in the longer term.

Key messages
Studies assessing the impact of the regularization of the legal status on health are generally scarce and evidence in the European context is lacking. This study contributes to fill these gaps. The relationships between the regularization of the residence status, socioeconomic conditions and social participation are of central interest to better understand undocumented migrants’ health.
Theoretical prediction of life expectancy using lifestyle factors in the EPIC-Heidelberg cohort
Authors: Srour B , Hüsing A , Gonzales Maldonado S , Kühn T , Kaaks R 
Published: October 2020

Abstract

Background
The past few decades have witnessed a substantial increase in life expectancy in Western countries, leading to an increase in the prevalence of age-related chronic diseases. Several lifestyle risk factors (i.e. smoking, adiposity, unhealthy diet, heavy alcohol drinking and lack of physical activity) have been responsible for a large proportion of premature deaths, as they can affect the incidence of age-related chronic diseases. Our objective was to predict the loss of residual life expectancy (RLE) associated with these lifestyle factors, using data from the EPIC-Heidelberg cohort, linked to an up-to-date mortality registry.

Methods
A total of 23,324 German adults, aged 40 years and above were included (1994-1998) and followed until June 2019. A multi-adjusted parametric proportional hazard model (Gompertz hazard distribution), used to predict survival probabilities, followed by a life table approach was used.

Results
At age 40, being a heavy smoker (&gt; 10 cigarettes/day) was associated with 10.5 y loss of RLE in men and 8.3 in women. Low body mass index (&lt; 22.5 kg/m2) was associated with a RLE loss of 3.7 y in men and 1.4 y in women, while obesity was associated with 4.4 y in men and 3.8 y in women. Heavy alcohol drinking (&gt; 4 drinks/day) was associated with a loss of 4.5 y in men, and high red/processed meat consumption (≥ 120 g/day) was associated with a loss of 1.1y in men and 2.1 y in women. Compared with an overall healthy lifestyle, combined unhealthy behaviors were associated with a loss of RLE of 21.4 y in men and 15.5 y in women.

Conclusions
Prevention strategies encouraging the adoption of an overall healthy lifestyle, particularly by avoiding smoking, heavy alcohol drinking, excess body fatness and reducing red/processed meat consumption, help reducing premature deaths. An extension of this project using blood biomarkers measures is ongoing.

Key messages
Adopting a healthy lifestyle by avoiding or reducing the exposure to risk factors might contribute to a longer life expectancy. Tobacco use, adiposity, and alcohol are probably the main modifiable lifestyle factors affecting life expectancy.
Prevalence and predictors of stress, suicidal thoughts and depression in Italian university students
Authors: Boietti E , Bert F , Savatteri A , Scattaglia M , Ferrara M , Langiano E , De Vito E , Lo Moro G , Gualano M R , Siliquini R 
Published: October 2020

Abstract

Background
Depression is a major public health issue in Europe. The prevalence of depressive symptoms (DS) in university students (US) is considerably higher than in the general population.
Since few data on DS among Italian US exist, this study aimed to estimate perceived stress (PS) and DS prevalence and assess associated factors in Italian US.

Methods
A cross-sectional study was performed in the Social Sciences and Educational Sciences degree courses at University of Cassino through self-administered questionnaires including socio-demographic items, Beck Depression Inventory-II (BDI-II) scale and Perceived Stress Scale. Primary outcomes were DS presence (BDI-II score≥14), suicidal thoughts (ST) and PS. Multivariable analysis and linear logistic regressions were performed.

Results
Globally, 203 questionnaires were collected (23 BDI-II missing). DS and ST prevalence was 30.6% and 11.3 %. PS median score was 20 (IQR=11) and 87.7% reported moderate/severe PS. Family history of psychiatric disorders and not being a freshman (attending first years of courses) were significantly (p &lt; 0.05) related to DS, while not thinking that University hinders carrying out personal activities was protective. High PS and having a chronic disease were significantly associated with ST, while family cohesion appears to be protective. High PS was significantly associated with: female gender, family history of psychiatric disorders, thinking that University hinders resting and relaxing, being under psychiatric/psychological care and having chosen university for Intellectual curiosity. Having no worries about future was linked to a lower PS.

Conclusions
This study found an alarmingly high prevalence of DS and ST in Italian US. Further longitudinal studies need to define risk factors for depression and stress in US. Public health actions such as offering preventive treatment interventions could improve health in European US.

Key messages
Depressive symptoms can be widespread up to 30% of university students and European policies should afford this issue with a strong commitment in order to reduce harmful consequences. Predictors of depressive symptoms, such as university workload and family cohesion, are recognizable and can be a target for European strategies aimed to improve university students’ mental health.
The importance of reliable social media information during the COVID-19 pandemic
Authors: Bernardino M , Bacelar Nicolau L 
Published: October 2020

Abstract
On December 2019, in Wuhan-China, SARS-Cov2 coronavirus emerged, causing the COVID-19 pandemic, responsible by June 29 2020, for 10.112.754 cases, and 501.562 deaths, in over 213 countries. Our research aims to study the impact of COVID-19 on Facebook and Instagram posting activity, regarding publications with word ‘Coronavirus', their total interaction and source, as well as an analysis of possible fake news
A sample of 4.000 posts (3.025 Facebook and 975 Instagram posts) was extracted through a web-based social media analytics tool, over two periods: January 10-February 27 (P1) and 01 May-June 28 (P2). Data were analysed using Microsoft tools. The 2.000 P1 posts generated 77.654.161 interactions - 70% likes, 4% comments and 27% shares. However, the 2.000 P2 posts prompted more than four times engagement, with 330.930.859 interactions - 92% likes, 2% comments and 6% shares. From January to February, likes increased 59%, but comments and shares decreased by 27% and 57%, respectively: users are generally more engaged but at a less profound level. From May to June, likes, comments and shares decreased 41%, 43% and 51%, as users gradually come out of confinement.
Certain events boosted engagement: on January 21, as the first case in the United States was announced, 767.280 interactions were reported, a 21-fold increase from the previous day; February 16 was the day with more monthly engagement when the first case in France was announced. January 25, CNN posted the Facebook post with more interactions of the month (2.510.695). On February, the post with most interactions was from Real Madrid Football Club. On P2, the two most popular posts were from The United Nations International Children's Fund Facebook page (May post had 4.153.981 interactions). Social media is nowadays the most used source of information in the world. In a health crisis like the Covid-19 pandemic, quality information is necessary to keep the population calm and informed on the correct steps to take.

Key messages
Study the impact of the COVID-19 on Facebook and Instagram, regarding the evolution of publications related to word “Coronavirus”. The importance of Social Media during a Health Crisis.
Factors related to sleep behavior in adolescents: a focus group study
Authors: Vandendriessche A , Deforche B , Verloigne M 
Published: October 2020

Abstract

Background
Adolescents' sleep behavior has deteriorated over the last decades. However, little research has been conducted into possible psychosocial factors related to this behavior, which is an important prerequisite to develop effective sleep behavior interventions. In addition, previous research showed that actively involving adolescents in the development of interventions increases the chance of effectivity and sustainability. This study examined psychosocial factors related to sleep behavior in adolescents and investigated adolescents' willingness to participate in the development of a sleep behavior intervention.

Methods
Nine focus group interviews were conducted with seventy-two students (63,9% girls, 14.8 (±1.0) years) using a standardized interview guide. Interviews were audio-recorded and thematic content analysis was performed using Nvivo 11.

Results
Adolescents had adequate knowledge of sleep hygiene and short-term consequences of sleep deficiency, but limited knowledge of sleep norms and long-term consequences. Positive attitudes towards sleep were outweighed by positive attitudes towards other behaviours such as screen time. Leisure activities, smartphones, television, schoolwork, early school time and worrying were mentioned as barriers for healthy sleep. Adolescents showed low self-efficacy towards changing their sleep behaviors and perceived a negative social norm towards sleep. Although some adolescents indicated parental rules to have a positive influence on their sleep, others indicated these sometimes provoked frustration. Finally, adolescents emphasized the importance of their participation in the development of a sleep behavior intervention at school, although adult guiding would be needed.

Conclusions
Future interventions promoting heathy sleep in adolescents could focus on psychosocial factors such as knowledge, attitudes, barriers, self-efficacy and social perceived norm and could involve adolescents in intervention development.

Key messages
Future interventions promoting heathy sleep in adolescents should in addition to knowledge, also focus on psychosocial factors such as attitudes, self-efficacy and perceived social norms. Adolescents emphasize the importance of their participation in the development of a sleep behavior intervention. This approach could be worth trying in future research.
Integrating health and social care in Brazil
Authors: Sempe L , Lloyd-Sherlock P 
Published: October 2020

Abstract
Integrating health and social care is now a high priority for public health policy in high-income countries. It has received much less attention in low and middle-income country (LMIC) settings. There is particular value in assessing the potential to integrate care services for older adults, given the speed of population ageing in LMICs.
The presentation provides findings of process and impact evaluations of novel local government initiatives to integrate care for older people in Brazil (drawing on a study co-funded by the UK MRC and CONFAP Brazil).
Programa Maior Cuidado (PMC) was established in the Brazilian city of Belo Horizonte in 2011. It is jointly managed by the departments of health and of social assistance and involves close community-level collaboration between health posts and neighbourhood social service centres. A key element of PMC is the provision of paid trained lay carers to support family care for dependent older people in socially vulnerable families. We will present findings on the implementation process and operation of PMC, as well as its effects on the following outcomes of interest: reduced unnecessary hospitalisations, enhanced health status for older people and reduced care burden for family carers.
Quasi-experimental analysis using spatial-based Propensity Score Matching shows promising results in terms of increasing planned attentions as well as access to rehabilitation services, which confirms the ability of the Program to improve interface with health services avoiding unplanned unnecessary attentions
We will examine the implementation of similar interventions in other Brazilian cities, including Fortaleza and Contagem, and will study the role of national and international processes in dissemination, knowledge sharing and agenda-setting.

Key messages
The presentation provides findings of process and impact evaluations of novel local government initiatives to integrate care for older people in Brazil. Programme under evaluation lead to interesting outcomes of interest: reduced unnecessary hospitalisations, enhanced health status for older people and reduced care burden for family carers.
How to scale up quality and safety program into home care: an accreditation tool proposal
Authors: Cristofori V , Brunelli L , Battistella C , Agnoletto A , Catelani A , De Sarno C , Odasmini B , Pauletto S , Tosetto C , Brusaferro S 
Published: October 2020

Abstract
Home care is managed with extreme heterogeneity among Italian regions by healthcare and social services. Standardization and self-assessment of these activities can improve their quality and outcomes. The goal of the study is to develop and validate an accreditation tool that provides minimum standards for home care. A multidisciplinary group of health and social care professionals developed a new tool according to the Deming cycle, including 26 items for a total of 144 standards grouped in 6 areas: Organization&governance (A1); Patient safety&clinical risk (A2); Job description, knowledge and skills (A3); Communication&information (A4); Integration tools in care processes (A5); Improvement&innovation (A6). Between April and November 2019, 40 experts from Italian primary care and social services of Friuli-Venezia Giulia (FVG) and Veneto Regions were asked by email to evaluate the tool using Delphi methodology. Experts were asked to score each standard according to relevance and feasibility (RF) on a 1 to 9 point scale. RF and agreement among experts were considered good respectively when mean score was &gt;7, and 70% of responses were greater than 7. A total of 21 experts' reviews were collected, with a response rate of 53%. Most responders came from the healthcare setting (71%) and FVG Region (86%). Globally, 101 standards (70%) were rated as good. RF mean and agreement resulted to be good for: A1 (7.6; 81%); A2 (7.4; 71%); A4 (7.5; 86%); A5 (8.0; 86%). More critical results were achieved concerning A3 (7.0; 52%) and A6 (6.5; 43%). Most standards were recognized as both relevant and feasible by experts, confirming the tool developed for home care accreditation. Agreement for Job description, knowledge and skills, and Improvement&innovation areas seems harder to be achieved. The evaluation of detailed experts' comments would further improve the tool, and a pilot study will be implemented in the next future to test its reliability.

Key messages
The implementation of the home care accreditation could reduce inequalities among contexts, while helping quality and patient safety improvement outside healthcare facilities. The existence of a unique home care accreditation tool can foster the integration between health and social care while reducing hospitalizations.