bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of obesity on absenteeism among working adults in Portugal and its costs
Authors: Destri K , Alves J , Gregório M J , Dias S , Canhão H , Rodrigues A 
Published: October 2020

Abstract

Background
Obesity leeds to poor health and may afffect work productivity. We aim to investigate the association between obesity and absenteeism and its indirect costs.

Methods
Individuals employeed and actively working at baseline form the EpiDoC Cohort, a large portuguese population-based prospective study analized from 2011 to 2016. Body mass index was assessed during baseline appointment. Follow-up assessment was performed through a phone interview and self reported absenteeism defined by the question”did you have a sick leave in previous 12 months? yes/no”, followed by the number of days missed work due to sickness in the previous twelve months.(1) Negative Binomial Regression model estimated the association between obesity and absenteeism. Indirect costs were computed using the human-capital method.

Results
EpiDoC cohort had 4338 participants who were working adults at baseline. The prevalence of obesity among working adults was 15.2% and of absenteeism was 29.4%. Obesity was associated with an increase in absenteeism incidence rate ratio by 31% (p &lt; 0.01). Obese individual miss 3.9 days per year (95% CI 3.1-4.5). This number is higher in women, 4.6 days per year (95% CI 3.6-5.6) and according to the professional categories women with white collar professions were 82% (p &lt; 0.01) more likely to miss work than peers with their normal weight. Extrapolating for the entire working population, absenteeism due to obesity has an estimated cost of 236€ million per year.

Conclusions
Obesity is an independent risk factor for absenteeism among working adults wich leads to high societal burden in terms of costs. Food and nutrition policies are needed in order improve food patterns and reduce obesity levels among south european population.

Key messages
Obesity is an independent risk factor for absenteeism among working adults. Obesity increases absenteeism mainly in women and has a major impact on economies.
Quality of life of caregivers of cancer patients in home palliative care: a non-interventional study
Authors: Faggian E , Favero S , Gregori D , Martinato M 
Published: October 2020

Abstract

Background
caregivers of home-cared cancer patient during palliative phase are often under psychological and physical pressure. This can lead to a low level quality of life (QoL). This study assesses the QoL of this type of caregiver, more specifically it aims to outline which factors (age, type of palliative care, amount of time spent daily with the patient) affect positively or negatively the QoL score.

Methods
The AC-QoL questionnaire has been completed by 25 caregivers of oncological patients in home care in north-eastern Italy. The questionnaire is made of 40 items divided into 8 subjects: support in care, choice of care, stress, economic issues, personal growth, sense of value, care skills and personal satisfaction. It has been administered during a home visit or during a follow-up phone call.

Results
The average score obtained is 71/120, which means a medium level of QoL. The factors which worsen the QoL are the psychological and physical stress (average score 5/15) and restrictions on caregivers' private life (average score 6/15). No significant differences in the QoL of the caregivers are related to social and personal variables (such as age, working condition, relationship with the patient, type of palliative care, amount of time spent daily with the patient).

Conclusions
These caregivers play a fundamental role in the management of an appropriate continuity of care and their health and QoL are important. Stress and restrictions on private life are the factors which worsen QoL, that's why nurses should evaluate the caregivers' wellbeing during home-visits. Caregivers usually feel able to offer adequate assistance if they have been adequately trained to by healthcare professionals: nurses should provide every useful tool to aloud the caregiver to feel able of and comfortable providing assistance to his/her relative trough an “empowerment process”.

Key messages
Caregiver of cancer patient in charge of home palliative care is fundamental for an appropriate continuity of care and his health and quality of life (QoL) are important to provide good assistance. Psycho-physical stress and restrictions on private life worsen QoL. Caregiver’s wellbeing should be assessed and useful tools should be provided by home care nurses to ease caregivers’ job.
Availability of family planning supplies in the Brazilian Primary Health Care Units
Authors: Fassa A , Ruivo A C O , Wachs L , Tomasi E , Facchini L A 
Published: October 2020

Abstract

Background
The availability of contraceptive methods is a main determinant of their use and diversification is necessary to meet the reproductive health needs of women at different stages of life, in a universal and equitable way. The study aims to evaluate the availability of family planning supplies in Primary Care Units (PCU) in Brazil that adhered to the Program for Improvement of Access and Quality of Primary Care (PMAQ-AB) in three evaluation cycles (2012, 2014, 2018), as well as, its distribution according to the Human Development Index (HDI), population size, Family Health Strategy (FHS) coverage and geographic region.

Methods
A descriptive cross-sectional study, of the more than 10.000 UBS included in the external evaluation of the PMAQ-AB. Availability was assessed by the physical presence of the following supplies: ethinyl estradiol + levonorgestrel, norethisterone, norethisterone + estradiol, levonorgestrel, medroxyprogesterone, male and female condom, IUD and rapid pregnancy test. The availability of all supplies at the PCU was considered adequate availability.

Results
The availability of supplies increased in the evaluated period. The lowest availabilities were IUD, 34.4% and rapid pregnancy test, 41.8%; the greatest were male condoms, 96.9%, and ethinyl estradiol + levonorgestrel, 85.2%. In Cycle III, adequate availability was 10.9%. The North had the worst results, followed by the Midwest region. HDI had little effect and population size had no effect on adequate availability, while FHS coverage was associated with greater availability. The PCUs of municipalities with a lower HDI had the largest increases in adequate availability. Adequate availability was greater in the PCUs that participated in all PMAQ-AB cycles.

Conclusions
Policies aimed at strengthening PHC increased the availability of supplies evaluated with equity promotion, however, regional inequities remain. The availability of a rapid pregnancy test and an IUD should be increased.

Key messages
Policies aimed at strengthening PHC, focusing infrastructure, provision and training professionals and quality monitoring increased the availability of family planning supplies with equity promotion. Monitoring the availability family planning supplies is essential for detecting failures, as the low availability of rapid pregnancy test, an essential supply for the early start of prenatal care.
Primary prevention of cervical cancer in Bulgaria
Authors: Kostadinova P S , Kostadinov S D , Stoilova I Y , Georgieva S L , Kamburova M S , Atanasova G N , Ivanova S K 
Published: October 2020

Abstract

Background
The incidence and mortality rate of cervical cancer in Bulgaria are higher than in most European Union countries, with an upward trend in the last three decades. Bulgaria is one of the 98 countries that, since 2012, has implemented a nationally funded national program for the primary prevention of cervical cancer. The purpose of this study is to investigate how this program is implemented in Bulgaria and why it is ineffective in our country.

Methods
A documentary study and a direct individual survey were conducted among 161 GPs from the Pleven region. The questions concern the attitudes of GPs to carry out immunoprophylaxis and the causes of low coverage.

Results
The immunization coverage with a complete scheme of three intakes in 2013 was 23.83% and in 2014 - 19.6%. In 2015, it switched to a two-dose regimen and its scope dropped sharply below 10% in this and subsequent years. The survey found that 17% of GPs felt that vaccination was unnecessary. 26% have not immunized any of their patients and 32% have covered less than 10%. Only 22% of GPs report that they are actively seeking out patients. The main reasons for the low coverage that respondents include are: rejection by parents (74%) due to fear of complications (41%), do not believe in the benefit of the vaccine (19%), and consider the vaccines to be harmful (10%); poor awareness (43%); negative information on the Internet and media (38%).

Conclusions
It is too early to take into account the effect of Cervical Cancer Immunoprophylaxis, conducted in Bulgaria, but the low coverage of those subject is alarming. It is necessary to undertake active health education activities among the population and additional training of GPs.

Key messages
Bulgaria has introduced a national program for primary prevention of cervical cancer, funded by the country. There is a very low coverage of subordinates due to insufficient awareness of the population, negative attitudes and insufficient commitment of GPs to implement the program.
Who is at risk for measles in Italy? Continued measles outbreaks in 2019 and barriers to elimination
Authors: Filia A , Bella A , Del Manso M , Baggieri M , Magurano F , Iannazzo S , Sabbatucci M , Nicoletti L , Rota M C 
Published: October 2020

Abstract

Background
Measles is a highly contagious vaccine preventable disease that can lead to serious complications, including death. All five regions of the World Health Organization have set targets to eliminate measles. In Italy, measles vaccination was introduced in 1976, with sustained low uptake in the 1980s and 1990s. Uptake improved in subsequent years but never reached 95% coverage required for elimination. Two doses of measles-mumps-rubella (MMR) vaccine are recommended (at 12-15 months and 5-6 years respectively). Since July 2017, MMR vaccine has become mandatory for all children up to 16 years of age. Large outbreaks continue to occur, with over 8.000 cases reported in 2017-2018.

Methods
We analysed measles cases reported to the national integrated measles and rubella surveillance system during January 1 - December 31, 2019.

Results
From 1 January to 31 December 2019, 1,627 cases (87% laboratory-confirmed), were reported from all 21 administrative regions. National incidence was 27 cases/million. Overall, 86% of cases were unvaccinated. Median age was 30 years but the highest incidence was in infants below one year of age. Ninety-six cases were reported amongst healthcare workers and transmission in the healthcare setting was frequent. Overall, 31% of cases reported complications, including three cases of encephalitis (in two adults and one child) and one death in an adult patient. Complications were more frequent in cases ≥20 years of age compared to younger patients. Forty-six percent of cases were hospitalised.

Conclusions
The median age of cases has increased further in 2019 compared to 2017 (27 years) and 2018 (28 years). The proportions of complicated and hospitalised cases are high, this may be due to the high median age of cases but also to underreporting from general practitioners who are likely to see milder cases. Wide immunity gaps among adults (including healthcare workers) and nosocomial transmission are major challenges to measles elimination in Italy.

Key messages
Measles is still endemic in Italy and large outbreaks continue to occur, with a significant public health impact. Wide immunity gaps among adults (including healthcare workers) and nosocomial transmission are major challenges to measles elimination in Italy.
Measles and young adults: the case of the Local Health Authority of Bologna over the last decade
Authors: Montalti M , Gori D , Dallolio L , Catalani F , Resi D , Fantini M P 
Published: October 2020

Abstract

Background
Measles is increasing globally, with a 300% increase in the first three months of 2019 in the WHO European Region. Measles cases recorded annually over the last decade in Italy have been cyclical with the last peak in 2017 with 84 cases per million inhabitants. In the same year, national coercive vaccination measures were introduced for access to educational services. Although the country is again achieving adequate vaccination coverage (VC) for the second dose of MRR (93.2% in 2018), outbreaks can still occur in communities with low VCs.

Methods
The aim of this study was to analyze measles epidemiology in Bologna Local Health Authority (LHA) from 2010 to 2018, focusing on age groups at higher risk of spread. Aggregate data on measles incidence were provided by Bologna HLA and VCs in residents were provided by the Emilia-Romagna Region (RER).

Results
The number of cases in the period of reference was 261 cases, 240 of which were laboratory confirmed (92%). The overall average age was 28.5 years (standard deviation, ds: ±14.73 years). The age group with the highest average incidence rate was 20-24 years (93 per 1.000.000 inhabitants), followed by 25-29 years (88) and 30-34 years (75). With regard to occupation at highest risk of prevalence, students represented the largest group with 22.6% of cases. VC data in residents in RER showed that in the age group 19-35 the fraction of the population not vaccinated with two doses of vaccine decreased significantly in the birth cohorts of the 1990s with a coverage of 6.9% for the 1984 birth cohort. None of the cohorts taken into consideration achieved a VC of 95% for the second dose.

Conclusions
Our results confirm the high proportion of measles cases among young adults. This highlights the need to consider catch-up actions and awareness campaign. For example, by focusing on students without previous documented vaccinations, considering that Bologna is home to tens of thousands of University students every year.

Key messages
The measles epidemiology analysis in the Local Health Authority of Bologna (Italy) over the last decade showed that the young adults (aged 20-35) have the highest average incidence rate of measles. Considering the need to focus on young adults in order to contain new cases of measles; checks on previous vaccinations, catch-up actions and improved awareness campaign are essential.
Differences in consumption of sugar and sweeteners in two neighbor countries: Lithuania and Poland
Authors: Austys D , Stukas R , Dobrovolskij V , Arlauskas R 
Published: October 2020

Abstract

Background
In connection with attempts to reduce consumption of added sugar, consumption of non-nutritive (or low caloric) sweeteners (NNS) is likely to increse in many countries. In addition to variety of NNS, limited evidence on public health effects related to NNS exist. Thus, it remains important to monitor consumption of added sugar and sweeteners in our societies. As Lithuania and Poland are neighbor countries with similar culture and nutritional habits, the objective of this study was to compare consumption of sweeteners among adults in Lithuania and Poland.

Methods
A representative sample of Lithuanian population of adults aged 18 to 75 years was formed. A total number of 1008 residents from Lithuania participated. Distribution of them by answers about consumption of added sugar and sweeteners was assessed with respect to results of the survey conducted in central part of Poland where a group of 2000 adult respondents was investigated.

Results
Majority of respondents in both countries declared consumption of added sugar: 79.3% and 87.4% of Lithuanian and Polish respondents, respectively (p-value less than 0.05). Apart from sugar, majority of the respondents in Lithuania declared consumption of honey or fructose (respectively, 78.1% and 43.4%), consumption of other sweeteners such as saccharin, stevia, corn syrup, aspartame and sucralose were less prevalent (respectively, 30.9%, 18.2%, 9.5%, 9.0%, 3.4%). In Poland, 41.8% of respondents declared consumption of products containing stevia. Distribution of Poles by answers to the question which sweetener they used most often was 26.6%, 23.6%, 15.6%, 12.3% for stevia, xylitol, aspartame and fructose, respectively. Honey, acesulfame K, thaumatin and other substances were used by a lower percentage of Polish respondents.

Conclusions
Despite cultural similarities consumption of added sugar and sweeteners among adults differed significantly in two neighbor counties: Lithuania and Poland.

Key messages
In comparison to Lithuania, consumption of added sugar, xylitol and natural non-nutritive but intense sweetener stevia was more prevalent in Poland. In comparison to Poland, consumption of added sugar was less prevalent, but non-intense and high in calories sweeteners were more prevalent in Lithuania.
Socio-economically deprived families’ routes to family-based addiction prevention services
Authors: Pfister A , Wyss S , Koschmieder N 
Published: October 2020

Abstract

Background
Families living in poor socio-economic circumstances, already confronted with social and health inequalities, are often not reached by family-based addiction prevention programmes. Besides quantitative models and health literacy approaches, qualitative research is lacking that could shed light on the exact circumstances and processes that lead to hindered addiction prevention service uptake by these families. Drawing on the concept of 'candidacy', we aimed to reconstruct how socio-economically deprived parents and their (pre-)adolescent children in German-speaking Switzerland identify their candidacy for family-based addiction prevention services.

Methods
Following grounded theory, we collected and analysed data in an iterative-cyclical manner using theoretical sampling and theoretical coding techniques. Sixteen families with children aged 10-14 years were interviewed in depth (parent/s and one child separately). All but one family lived below the at-risk-of poverty threshold.

Results
Families' modes of recognising and handling problems in everyday life were found to be core phenomena that structure the process towards (non-)identification of candidacy for family-based addiction prevention services. Further, thematic relevance of addiction prevention, past experience with offers, integration in systems of assistance (social welfare, etc.), strategies to protect the family, and parents' search movements for support were important for families' identification of candidacy.

Conclusions
Socio-economically deprived families are not a homogeneous group. They differ in modes of problem construction and handling in everyday life; this differently opens up or closes routes to family-based addiction prevention services. Policy and practice should build on a bundle of diverse strategies for outreach to these vulnerable families.

Key messages
Our qualitative study adds scientific knowledge to a better understanding of socio-economically deprived families’ complex routes to family-based addiction prevention services. Results provide evidence that policy and practice should build on a bundle of diverse strategies to reach these vulnerable families. Equity in access to services can thus be improved.
Impact of ferric carboxymaltose in patient blood management in Portuguese hospitals
Authors: Lucas J , Sousa P , Sequeira R , Isoppo C , Quinaz Romana G , Carvalho D , Fernandes A Campos 
Published: October 2020

Abstract

Background
The use of transfusions leads to excessive blood consumption, implying risks such as infections and immunological reactions, so it should be used only when strictly necessary. Patient Blood Management (PBM) aims to minimize the use of allogeneic blood and improve clinical outcomes, with better cost-effectiveness, using three essential points: improving hematopoiesis, minimize blood loss in and optimize the hemoglobin reserves of each patient. The aim of this work is to assess the preoperative haemoglobin optimization using ferric carboxymaltose as part of PBM implementation, in elective orthopaedic, cardiac and colorectal surgery in Portuguese hospitals.

Methods
This is an observational study materialized in a retrospective and multicenter cohort with data collection from medical records. The population and sample will be patients over 18 years from elective orthopaedic, cardiac and colorectal surgeries, treated according with local standards before PBM implementation were assigned to the pre-PBM cohort and patients after PBM implementation with ferric carboxymaltose to preoperative haemoglobin optimization to the PBM cohort. The criteria for selecting hospitals will be the implementation of PBM during the study period.

Expected Results
Based on a previous review, it is expected that the results of the use of ferric carboxymaltose to correct iron deficiency anaemia for preoperative haemoglobin optimization will contribute positively to reducing the number of transfusions, the length of hospital stays and will have a direct impact on economic results.

Conclusions
The use of ferric carboxymaltose and other ferric compounds, as part of PBM program, has demonstrated a positive impact on patients' outcomes (morbility and mortality), adverse events and on economic results. This study might show that clinical guidelines and programs like PBM are a major contribution not just for hemovigilance and blood safety but also for patient safety and health quality.

Key messages
This work is focused on Portuguese hospitals and aims to assess the impact of ferric carboxymaltose and its benefit on PBM strategy. Specially this study intends to conduct the assessment on health outcomes and costs.
Age-appropriate healthy living - research examples from German and Italy
Authors: Mairhofer S , Teti A 
Published: October 2020

Abstract
Housing and social participation have a significant influence on the quality of life and independence of elderly people. The importance of the living situation increases with age, because spend more time in the immediate living environment. Age-appropriate housing and life situations are therefore a prerequisite for reducing social and health inequalities in older life. Two research projects in the field of healthy ageing will be presented and some of the joint results will be discussed.
The project HOME Housing Opportunities & Mobility in the Elderly (North Germany) examines willingness to move in favor of age-appropriate living environments versus Aging in Place. The majority of the respondents were stayers. Age, gender, education and income are predictors for the willingness to move. In data analisis movers show a lower health-related quality of life than stayers.
As a second project a participative research project with elderly people, the 'young old', in South Tyrol (North Italy) will be presented. Elderly people are often associated with need for help, which does not correspond to the current diversity, especially for the 'young old'. The research results show the necessity of sensitization for health promotion and health (in)equity and the importance of professional community work for healthy ageing. Participatory research with elderly people seems to be a promising approach to ensure sustainability, to increase the quality of research and to stimulate transformation in science, politics, practice and the population.

Key messages
Housing and social participation have a significant influence on healthy aging. Health promotion with the young old in rural areas should become more attention.