bluuebunny/crossref_metadata_2025_split huggingface dataset:
The association between Internet use and health outcomes in the population of older adults
Authors: Szulc K , Duplaga M 
Published: October 2020

Abstract

Background
The Internet has become one of the primary sources of health-related information. Less is known about the impact of Internet access and use on health-related outcomes in the older population, which frequently suffer from a digital divide. The main objective of this study was the assessment of the associations between Internet use and variables reflecting health status, the use of health services and health behaviours in the population at least 50 years old.

Methods
The analysis was carried out on the data set from the telephone-based survey in a sample of 1000 respondents representative for targeted age strata of Polish society. The effects of Internet use were assessed with logistic regression models after adjusting for key socioeconomic variables.

Results
Mean age (standard deviation) of respondents was 64.2 (9.6). In the study group, 51.1% respondents were Internet users, 19.4% - persons with disabilities, 21.2% were hospitalised at least once, and 51.0% visited health care facilities at least six times in preceding 12 months. The respondents being Internet users less frequently reported chronic diseases (OR, 95%CI: 0.21, 0.16-0.30), disability status (0.52, 0.37-0.72) and higher self-assessed health status (1.64, 1.24-2.16). They also less often used health services in the preceding 12 months (0.77, 0.60-0.99. Internet use was not associated with hospital admission in the preceding year (1.04, 0.76-1.41) and most of the health behaviours (smoking: 1.06, 0.77-1.45, physical activity: 0.85, 0.63-1.15, the consumption of fruits and vegetables: 0.73, 0.50-1.07). Interestingly, Internet users drunk more alcohol (1.52, 1.14-2.02).

Conclusions
In the population of older adults, the use of the Internet is associated with variables reflecting health status and the utilisation of health services. Higher health status and lower prevalence of chronic conditions among Internet users were found after adjusting for age and other socioeconomic factors.

Key messages
It was shown that Internet use may be related with more favourable health outcomes. The reported association should trigger further research on the impact of Internet in elderly persons.
Developing a national framework for community involvement in health promotion in Tajikistan
Authors: Prytherch H , Karimova G , Schueth T , Egamberdiev M , Fischer O , Sadonshoeva G , Djamalova M , Shabalina G , Mukhtarova P , Aminov O 
Published: October 2020

Abstract

Background
In rural Tajikistan, various approaches have been taken to involve communities in health promotion, but many of them survived only as long as there was outside donor support.

Methods
In 2017, these approaches were examined and conceptualized, leading to the development of a “Guideline on Partnership with Communities on Health Issues” that was put into practice in 11 rural districts of the country.

Results
The Guideline sees Primary Health Care (PHC) staff trained as facilitators so as to conduct Participatory Reflection and Action (PRA) sessions with their local communities. Based on health priorities identified through these PRA sessions, and on national health priorities, the Health Promotion Institute chooses annual community activities facilitating behavioral change. Community Health Teams (CHTs) are formed, and the facilitators train them in disease prevention activities, and in how to plan initiatives to promote better health and well-being at village level. In the 5 initial districts, CHTs successfully mobilized community members to take part in activities related to identified health priorities e.g. health actions on Hypertension and Diabetes including free screenings. Furthermore, CHTs started to address determinants of health e.g. by supporting disabled people in their communities, organizing weekly waste removals, and initiating womens' walking groups.

Conclusions
Engaging communities by forming and capacitating teams, leads them to become a partner to the PHC system, and empowers them to tackle local determinants of health through their own initiatives. The capacity built in the local primary health care and health promotion structures hold potential for an expansion of this community-based approach to health promotion throughout the country. So what? By encouraging a government-recognized approach to community involvement in health, capacity and ownership of local institutions and stakeholders has increased, providing promise for long term sustainability.

Key messages
Community involvement in health remains central to primary health care. A government-recognised approach provides promise for sustainability.
Effectiveness of protective measures on dental care utilization: analysis from linked database
Authors: Berete F , Van der Heyden J , Demarest S , Charafeddine R , Van Oyen H , Bruyère O 
Published: October 2020

Abstract

Background
Financial accessibility to healthcare is a cornerstone in the Belgian health care system. A whole range of financial protectives measures are applied to ensure accessibility to all residents by minimizing the medical costs including a higher reimbursement for vulnerable population groups and protective measures for people with high health expenses due to chronic diseases. This study examines the effectiveness of such protective measures on the use of dental care among a representative sample of Belgian adults.

Methods
Data from the participants of the Belgian health interview survey (BHIS) 2013 aged 18 years and over were individually linked with data from the Belgian compulsory health insurance data (BCHI), (n = 8,668). Multivariate logistic regression was applied to assess the impact of the financial measures on the use of dental care.

Results
Five percent of the population reported having delayed dental care in the past 12 months due to financial barriers. Results from the multivariate model show that irrespective of gender, age, and educational level, individuals who have preferential reimbursement are more likely to postpone their dental care (OR = 3.32, 95% CI: 1.87-5.92), while those who can account on measures for high health expenses due to chronic diseases are less likely to do so (but not significantly).

Conclusions
Findings suggest that vulnerable people have more postponement despite the fact that they have a preferential reimbursement and, high expenses as a result of chronic diseases are not associated with more postponement of dental care. More targeted financial interventions should be necessary to reduce postponement of dental service utilization.

Key messages
Current health interventions are not yet effective for vulnerable people in dental care use. High expenses as a result of chronic diseases are not associated with more postponement of dental care.
The contribution of case mix, skill mix and care processes to the outcomes of community hospitals
Authors: Lenzi J , Adja K Y C , Pianori D , Reno C , Fantini M P 
Published: October 2020

Abstract

Background
The rapid increase in the proportion of older people underscores the need for new organizational models to face the unmet needs of frail patients with multiple conditions. Community hospitals (CHs) could be a solution to tackle these needs and foster integration between acute and primary care. The aim of this study was to investigate which patients' characteristics and which care processes affect clinical outcomes, in order to identify who could benefit the most from CH care and the best skill mix to deliver in this setting of care.

Methods
This study included all patients aged ≥65 and discharged in 2017 from the 16 CHs of Emilia-Romagna, northern Italy. Data sources were the regional CH informative system and hospital discharge records. CH skill mix and processes of care were collected with a survey; 3 non-respondent CHs were excluded. The study outcome was in-hospital variation of the Barthel index (BI) (≥10 vs. &lt;10). We performed a 2-level random-intercept logistic regression analysis, and used the variance partition coefficient (VPC) to quantify the proportion of BI improvement that lay at CH level.

Results
Of the 13 CHs, 7 admitted ≥150 patients, 8 had a general practitioner medical support model, and 6 had &gt;12 nurses' working hours/week/bed. Overall, 53% of the patients had a BI improvement ≥10 (4% to 71% across CHs). The patient case mix (i.e. baseline BI, female, older age, transfer from acute care) explained a portion of variability across CHs, as shown by the VPC that decreased from 0.32 to 0.26. Skill mix and processes of care were not associated with BI change, and the VPC resulting from controlling for these variables was virtually unchanged (0.28).

Conclusions
Patients' characteristics explained part of between-CH variation in BI improvement. Professional skill mix and processes of care, albeit fundamental to achieve appropriate care and respond to the unmet needs of the frail elderly, did not account for differences in CH-specific outcomes.

Key messages
A combination of quantitative and qualitative methods might better explain the outcome variability across intermediate care services. Multidisciplinary CH teams and services can be helpful to address the unmet needs of older people, but further studies are necessary.
Understanding corporate influence on science and the use of science - presentation of a new typology
Authors: Legg T , Hatchard J , Gilmore A 
Published: October 2020

Abstract
Corporations responsible for so-called 'industrial epidemics' go to great lengths to stifle policymaking concerning their products and practices, including through interactions with science. Here we present a newly-created typology which illustrates the ways in which industries attempt to influence science and the use of science.
Our analysis of the literature identified sectors of industry involved, strategies used by industries, and key relationships between these strategies. Eight sectors of industry attempted to influence science and the use of science: tobacco, alcohol, processed food and drink, pharmaceuticals and medical technologies, gambling, chemicals and manufacturing, fossil fuels, and the extractive industry. We identified five macro strategies widely used by industries: influence on conduct and publication of science, influence on interpretation of science, influence on reach of science, influence on the use of science in policymaking, and over-arching supporting strategies.
Across eight sectors of industry, strategies used in order to influence science are strikingly similar. When taken together, these appear to represent attempts to permeate and mould systems through which science is created, interpreted and used. This typology provides an accessible way to understand the strategies used by industry to influence science and the use of science. It can be used to pre-empt and counter future industry activity within contexts including academia, healthcare, and regulatory decision-making
10.D. Workshop: Health Impact assessment of climate change: monitoring and experiences
Authors:   Organised by: EUPHA Health impact assessment section, EUPHA Public health monitoring and reporting section, Public Health Wales,   Chair persons: Piedad Martin-Olmedo - Spain, Liz Green - UK
Published: October 2020

Abstract
Most scientific communities and governments accept that a global warming process is occurring, and are concerned about its alarming potential environmental and health consequences. The extreme conditions associated to climate change such as severe storms, floods and prolonged heatwaves and droughts, are expected to increase considerably the burden of climate-sensitive diseases (e.g. heat-related illness, new and emerging infectious diseases, respiratory diseases or threats to food security). Poor countries are most at risk, but developed economies can also be strongly affected as illustrated by the large number of deaths associated to the European heat wave of 2003.
Conducting health impact assessment of climate change (HIA-CCh) requires the analyses of complex interactions between humans and natural ecosystems, demanding an interdisciplinary approach and a wide range of tools and techniques. Those analyses should be simultaneously context specific and extend over time to track not only the full dimension of health impacts but also the efforts needed to adapt and build resilience. Standard indicators for climate-sensitive health outcomes alone will not adequately capture the changing risks typically related to climate change. In addition to them, indicators of vulnerability and exposure, adaptation planning and resilience for health, and learning and knowledge management are required.
The present workshop aims at analysing and sharing expertise on how to conduct an HIA-CCh, with the following elements for discussion: Definition of the scope (both temporal and spatial) and the interdisciplinary team to be involved in the processSelection of indicators that will allow not only characterization of health impacts but also promoting and tracking adaptation activities at national and local health departmentsForesight climate change scenarios and how this can be incorporated into the decision-making processVulnerability risk in relation to impact assessment and health / health equity in the context of climate changeHow the proper HIA-CCh can have an impact on learning and changes in management frameworks

Key messages
Increasing public health’s adaptive capacity to face climate-sensitive threats is needed. Conducting HIA-CCh requires innovative management strategies and proper selection of indicators.
Understanding vulnerability in the context of climate change – a Health impact Assessment Framework
Authors: Haigh F , Harris-Roxas B , de Leeuw E 
Published: October 2020

Abstract
The climate emergency is resulting in differential exposures to health risks across populations. Where the 'standard' determinants of (ill) health are already socio-economically distributed, the impacts of a changing climate will have even greater effects on the most vulnerable in society and further exacerbate health equity gaps. Building on a conceptualisation of health inequity as 'the unfair and avoidable differences in health between groups in the population' we argue that phenomena like high temperatures, extreme weather and rising sea levels do not affect everyone equally; and that policies and interventions need to be cognisant of distributed and differential patterns of health risk exposure and responses.
Vulnerability can be conceptualised across three dimensions. Firstly, some populations are vulnerable because they have higher levels of exposure. Secondly, some populations have higher levels of vulnerability because they are more sensitive. The final type of vulnerability is particularly important and relates to health equity adaptive capacity - people's ability to prepare for and respond to health threats. For example, people who are economically less well-off are: more likely to live in poor quality housing and in areas with relatively less access to resources; less likely to know how to respond (health literacy), or if they do know, less likely to be able to acquire and afford mitigation measures; have less capacity to advocate; and are less likely to be listened to. These vulnerabilities tend to cluster and accumulate, reinforcing and exacerbating health inequities. These same communities also have capacities and assets that can support recovery and resilience.
We can utilise Health Impact Assessments to understand context specific climate emergency vulnerabilities and to develop strategies to respond. In this presentation a climate vulnerability framework and associated tools for HIA will be described and discussed.
Sarphati Amsterdam: a dynamic research infrastructure
Authors: Ujcic-Voortman J K , Hall J T , Johannes M , Seidell J C , Verhoeff A P 
Published: October 2020

Abstract
Sarphati Amsterdam is a collaboration between the city of Amsterdam and four Amsterdam research institutions, focusing on innovative multidisciplinary research beneficial to preventing non-communicable diseases effectively and sustainably. With the Sarphati Cohort, Sarphati Amsterdam has established a dynamic cohort study that systematically monitors growth and its determinants from birth until adulthood, in order to 1) identify causes of overweight and 2) evaluate interventions to combat overweight.
Data collection is linked to routine Youth Health Care consultations with all ∼150,000 Amsterdam children (0-18y). Thus, making selected care data on growth and development available for research. After informed parental consent, anonymised data can be used to systematically monitor children. Additional data is collected through age-specific questionnaires. The sub-cohort structure facilitates more extensive data collection in subpopulations, including interviews, observations, and biosamples.
Up until March 2020 over 5,130 children enrolled. The continuous inclusion of new-borns gives the Sarphati Cohort its dynamic character. This enables the incorporation of innovative research designs to evaluate interventions.With over 170 different nationalities Amsterdam has a highly diverse population, both in terms of cultural and socio-economic background. The data collection strategies and tailored tools are developed to meet the level of adaptability this design requires.
Embedding research in this manner enriches it way beyond clinical settings and provides an unparalleled depth and breadth of data. With the Sarphati Cohort, Sarphati Amsterdam facilitates innovative research in the field of obesity that will contribute to the ambitious policy objectives of the city of Amsterdam to promote healthy behaviour and improve the quality of life of young people.
Examples of lived experiences assessed by participative research
Authors: van Houtum L , Concincion S , Fernald F 
Published: October 2020

Abstract
Wicked problems and system thinking require solutions that are about changing the system dynamics in favourable ways. Randomized controlled trials (RCT), which traditionally have been seen as the 'gold standard' in evaluation research, are not the solution for this type of problem, as they are merely suited to evaluate single and multi-component interventions in a controlled setting. With system thinking, we recognize the complexity of the problem with multiple, interacting factors that are adaptive and dynamic over time. Crucial is participation of the target population.
Participatory action research (PAR) is an approach to research in communities that emphasizes participation and action of the target group. PAR increases feasibility and validity of research, and eventually the chance of designing successful interventions, as they are more likely to meet the target population specific needs and to change local practices. In addition, it contributes to personal development and self-efficacy among the stakeholders by prompting them to reflect on their lives and take shared action.
We will present three examples of lived experiences assessed by PAR, with a focus on childhood obesity. In the first project, we aim to develop, implement and evaluate an integrated action programme for 10-14-year-old adolescents in Amsterdam at the level of family, school, neighbourhood, health care and city, based upon a detailed insight into the characteristics of the population at stake (LIKE). The second project (Food4Smiles) aims to give children in their first 1000 days a good start in life regarding food, exercise, sleep and overall wellbeing. In this project, we work together with parents, grandparents and healthcare providers. The third project focuses on the healthcare for children with obesity. Goal is to understand which factors contribute to successful self-management behavior in children with obesity and their family and how youth nurses can empower and support this behavior.
Time trends in the geographical distribution of physicians, nurses and midwives in Europe
Authors: Winkelmann J , Maier C B 
Published: October 2020

Abstract

Background
Data on the supply of health professionals show large variations in the health workforce density among European countries based on national-level data. However, little attention has been paid to the comparison of health professional density at the regional level. This study aimed to analyse the density of physicians, nurses and midwives at regional level, using a cross-country comparative design and examine time trends.

Methods
Descriptive analysis of Eurostat data on the rate of health professionals per population at national and regional levels (NUTS 2 regions) for 2017 and time trends (2005-2017) and comparison to population density. To improve the cross-country comparability of data a set of criteria was applied, resulting in 15 European countries covered on physicians and eight for nurses and midwives. Changes over time in the regional distribution were analysed, using percentage change and compound annual growth rate (CAGR).

Results
We found a 2.4-fold difference in the physician density between the highest and lowest density countries (Austria: 513, Poland 241.6 per 100.000) and a 3.5-fold difference among nurses (Denmark: 1702.5, Bulgaria: 483). Differences by regions across Europe were higher and varied up to 4.5-fold both for physicians and nurses/midwives and did not improve over time. Results show that in all countries physician density levels are highest in densely populated regions, with capitals and/or major cities, while density of nurses and midwives tends to be higher in less populated areas. Overall, physician rates grew at a faster rate than the density levels of nurses and midwives.

Conclusions
International data should not only cover supply indicators at national level, but routinely collect regional data on the number of health professionals to demonstrate regional differences in workforce supply and to improve monitoring and workforce planning at regional levels.

Key messages
Despite increases in the density levels of physicians, nurses and midwives, time trends over a ten-year period showed no improvement in the geographical distribution within countries. The study is the first of its kind to descriptively analyse geographical density levels and time trends among health professionals across a selection of European countries using Eurostat data.