bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contacts with health services during the year prior to suicide death in France (2013-2015)
Authors: Laanani M , Imbaud C , Tuppin P , Poulalhon C , Jollant F , Coste J , Rey G 
Published: October 2020

Abstract

Background
This study was designed to describe contacts with health services during the year before suicide death in France, and to compare the prevalent mental and physical conditions in these people to those of the general population.

Methods
Data were extracted from the French National Health Data System (SNDS), which comprises comprehensive claims data for inpatient and outpatient care linked to the national causes-of-death registry. Individuals, national health insurance general scheme beneficiaries (i.e. 76% of the population living in France), aged 15 years or older, who died from suicide in France in 2013-2015 were included. Medical consultations, emergency room visits, and hospitalisations during the year preceding death were collected. Conditions were identified, and standardised prevalence ratios (SPRs) were estimated to compare prevalence rates in suicide decedents with those of the general population.

Results
The study included 19,144 suicide decedents. Overall, 8.5% of suicide decedents consulted a physician or attended an emergency room on the day of death, 34.1% during the week before death, 60.9% during the month before death. Most contacts involved a general practitioner or an emergency room (46.2% of suicide decedents consulted a general practitioner during the month before death, 16.7% attended an emergency room). During the month preceding suicide, 24.4% of individuals were hospitalised at least once. Mental conditions (36.8% of cases) were 7.9-fold (SPR 95% CI: 7.7-8.1) more prevalent in suicide decedents than in the general population. The highest SPRs among physical conditions were for liver/pancreatic diseases (SPR=3.3, 95% CI: 3.1-3.6) and epilepsy (SPR=2.7, 95% CI: 2.4-3.0).

Conclusions
General practitioners and emergency departments have frequent contacts with suicide decedents during the last weeks before death and are at the forefront of suicide risk identification and prevention in individuals with mental, but also physical conditions.

Key messages
Mental and physical conditions are more common among suicide decedents than in the general population, and contacts with primary care services are frequent in the last weeks prior to suicide. Primary care services (general practitioners and emergency rooms) should be targeted for suicide preventive interventions.
The lead up to tobacco plain packaging policy in Turkey
Authors: Selamoğlu M , Fawkes S , Önal A E , Gleeson D 
Published: October 2020

Abstract

Background
Research shows tobacco plain packaging (TPP) is effective in reducing the attractiveness of tobacco products, effectiveness of tobacco packaging and increases the impact of health warnings. Since Australia introduced TPP in 2012, several other countries have adopted similar legislation, and more have begun preparations for introducing it. Turkey first announced its intention to proceed with TPP in 2011, however prior to the eventual passage of legislation in December 2018 there were many false starts and delays. This study (conducted in 2018 before TPP legislation was passed in Turkey) explored the barriers and facilitators to introducing legislation.

Methods
A qualitative study design was employed using a single case study approach. Publicly available documents relevant to TPP in Turkey were analysed and interviews with key informants from academics, bureaucrats in government ministries and non-government organisations (NGOs) were conducted in 2018.

Results
Barriers such as changes to the government, tobacco industry opposition and the economic crisis appeared to contribute most to the delays in introducing TPP. Despite the barriers Turkey had faced, TPP legislation managed to reach the political agenda primarily through the collaborative advocacy efforts of NGOs, academics and the leadership of particular tobacco control advocates.

Conclusions
TPP legislation was approved by the Turkish government on the 5th December 2018 and has been in force since the 5th January 2020. Implications for the wider uptake of TPP include the importance of building effective coalitions and raising public awareness.

Key messages
The tobacco industry opposition can be defeated by tobacco control advocates working together. Turkey’s experience should be considered by other countries who are willing to implement TPP.
Digital health information seeking of migrant populations – a scoping review
Authors: Dratva J , Zysset A 
Published: October 2020

Abstract

Background
As societies and health systems are increasingly digitally transformed, many health information are provided digitally. Digital health information may reduce barriers to health systems known to be more common in persons with a migrant than native origin. We performed a scoping literature to evaluate evidence on digital information seeking by migrant populations.

Methods
In January 2020 we conducted a literature search (Web of Science, MEDLINE, CINAHL) using terms and synonyms for migrants, health, digital media and information seeking, limited to publications in English. Two researchers independently rated first titles and then abstracts for suitability, obtaining consensus at each step. Primary target group, health topic and related life phase, country, and primary study question were extracted from remaining manuscripts. Data on digital health information seeking will be extracted from full texts.

Results
After title and abstract screening 41 from 315 articles remained. 25 articles focused primarily on migrant populations, 16 ran analyses by migrant status or ethnicity. Dominant populations were Latinos, Hispanics and Asians. Studies were performed in North America (n = 32), Europe, Asia and Australia (each n = 3). Seven papers were on maternal and child health, four on child and adolescent and 30 on adult health. Use of digital technologies is very frequent in most migrant populations. Impact of digital health information vs. traditional information was seldom investigated. In Adults general health, HIV and Cancer were most frequent topics. Further data on impact, preferences, barriers, and context will be presented.

Conclusions
Studies indicate frequent use of digital health information both on general health and specific health topics. The many North American studies indicate an advanced digital transformation of health promotion and care. Full texts will further reveal potential and limitations of digital information seeking and services for migrants.

Key messages
Digital health information seeking is common in migrant populations. Data on digital health information seeking is as heterogenous as migrant populations themselves, current evidence is limited to allow recommendations on design and implementation of such services.
Traffic-borne pollution as a risk factor for acute vascular events: a population study in Milan
Authors: Magnoni P , Murtas R , Russo A G 
Published: October 2020

Abstract

Background
Traffic-borne noise and air pollution have both been associated with cardiovascular and cerebrovascular diseases, albeit with inconsistent findings and issues of collinearity/mutual confounding. The present study aims at evaluating the role of long-term exposure to traffic-borne pollution as a risk factor for acute vascular events in a highly urbanized setting.

Methods
This is a population-based retrospective dynamic cohort study including all residents aged &gt;35 years in the municipality of Milan over the years 2011-2018 (N = 1087110). A noise predictive model and a NO2 land-use regression model were used to assign mean values of traffic noise at the day-evening-night level (Lden, dB) and NO2 concentration (µg/m3) to the residential address of each subject. Cox proportional hazards models were performed to assess the incidence of acute vascular events, with adjustment for potential confounders (age, sex, nationality, a socio-economic deprivation index) and sub-analyses for different outcomes (acute myocardial infarction, ischemic stroke, hemorrhagic stroke).

Results
A total of 27282 subjects (2.5%) had an acute vascular event. Models using NO2 yielded inconsistent results. When using Lden as a proxy of traffic intensity, there was a positive trend in risk with increasing levels of exposure, with an optimal cut-off for dichotomization set at 70 dB (HR 1.025, 95% C.I. 1.000-1.050). The association was observed specifically for ischemic stroke (HR 1.043, 95% C.I. 1.003-1.085) and hemorrhagic stroke (HR 1.036, 95% C.I. 0.969-1.107). When stratifying by age group and sex, a remarkable effect was found for hemorrhagic stroke in men aged &lt;60 (HR 1.439, 95% C.I. 1.156-1.792).

Conclusions
Living close to high-traffic roads was found to exert a small but tangible effect on the risk of stroke. The varying effects observed for specific outcomes and in different age and sex groups are likely due to different pathogenetic mechanisms at play, which warrant further investigation.

Key messages
Residential proximity to roads with high traffic intensity (mean traffic noise level over 70 dB) is a risk factor for stroke, especially for hemorrhagic stroke in middle-aged men. Further interventions aimed at reducing traffic intensity in highly urbanized cities may be justified in order to reduce morbidity and mortality from stroke.
Prevalence, awareness and control of hypertension among Tunisian adults, 2016
Authors: Cherif I , Ben Mansour N , Rejaibi S , Zoghlami N , Saidi O , Skhiri A , Ben Slama F , Ben Romthane H , Turki Z , Aounallah-Skhiri H 
Published: October 2020

Abstract

Background
Hypertension is becoming increasingly frequent mainly in low and middle income countries. We aimed to assess the prevalence, awareness and control of hypertension among Tunisian adults and identify associated factors with hypertension control.

Methods
Data were obtained from the 2016 Tunisian Health Examination Survey, a household survey stratified at three degrees. Adults (age≥18 years old) were interviewed using an individual questionnaire, then three blood pressure measurement were performed. Participants were considered hypertensive if they were previously diagnosed or had a systolic blood pressure (SBP) ≥140mmhg and/or a diastolic blood pressure (DBP) ≥ 90mmhg during the survey. Were considered under control, treated persons with SBP&lt;140 mmhg and a DBP&lt;90 mmhg. A weighted binary logistic regression was used to assess associated factors with hypertension control. Input model variables were: sociodemographic variables, comorbidities and lifestyle factors.

Results
In this study, 8908 adults were enrolled with a mean age of 42.8±0.2 years old and a sex ratio (M/F) equal to 0.96. Among respondents, 29.3% (95% CI: 28.2-30.5) had hypertension, 60.7% (95% CI: 58.7-62.6) of them were unaware of their disease and only (29.5%, 95% CI: 28.2-30.5) of treated patients had a controlled hypertension. In multivariate analysis, eating more than five fruits and vegetables per day was independently associated with a better hypertension control (AOR=1.7, 95% CI: 1.1-2.5). In addition, participants living in northern Tunisia were more likely to have a controlled hypertension than those living in the south (AOR=1.9, 95% CI: 1.2-2.9).

Conclusions
Almost third of Tunisian adults were hypertensive. Low level of awareness and control of hypertension were found in this study. This highlights the urge to reinforce hypertension screening interventions and to strengthen educational programs on this disease with a focus on blood pressure monitoring and healthy lifestyle measures.

Key messages
Tunisian adults had a low level of awareness and control of hypertension. Reinforcing hypertension screening interventions and increasing awareness about healthy lifestyle measures are recommended.
Puberty problems among ART children born 1985-2015 in the Nordic countries – CoNARTaS cohort data
Authors: Klemetti R , Perry B , Aaris Henningsen A K , Pinborg A , Opdahl S , Romundstad L V , Bergh C , Wennerholm U B , Tiitinen A , Gissler M 
Published: October 2020

Abstract

Background
Children born after ART (Assisted reproductive technology) are known to be at increased risk for adverse outcomes, but there are little data on health of older children. The aim of this study is to examine puberty related outcomes of ART children as available in existing health care registers, using Nordic data.

Methods
The CoNARTaS cohort contains data on 121 746 ART children and 6 538 411 naturally conceived children born in Denmark (1994-2014), Finland (1990-2014), Norway (2002-2015) and Sweden (1985-2015). All data were obtained from national health registries, disease-specific quality registries and other nationwide databases. Puberty problems were defined by using ICD-10 codes and classified as any problems, late and early puberty and unspecified problems. Cox regression adjusted for maternal age, parity, plurality, maternal diabetes and maternal smoking were made, separately for girls and boys.

Results
36 508 children had diagnoses related to puberty problems, of which 591 were ART-children including IVF (in vitro fertilization) and ICSI (intra cytoplasmic sperm injection). In total, ART children had increased risks for any pubertal problems (adjusted HR 1.60, 95% CI: 1.47-1.74), late puberty (1.57, 95% CI: 1.31-1.89) and early puberty (1.63, 95% CI: 1.46-1.82). The effect was similar for girls (1.61, 95% CI: 1.46-1.78) and boys (1.55, 95% CI: 1.33-1.81), but girls had more diagnoses related to early puberty (66.2%) and boys with late puberty (48.8%). ICSI was associated with higher risk (2.01, 95% CI 1.74-2.31) than IVF (1.46, 95% CI: 1.30-1.65), but the difference between fresh and frozen embryo transfer remained statistically insignificant.

Conclusions
Both girls and boys born after ART had the increased risk for pubertal problems. However, we could not adjust for all possible confounders such as infertility diagnoses or drugs used in ART. More studies are needed to confirm the findings and to find out reasons for the increased risks.

Key messages
Both girls and boys born after ART had the increased risk for pubertal problems. More studies are needed to confirm the findings and to find out reasons for the increased risks.
Public reporting of performance measures in long-term care in Canada: does it make a difference?
Authors: Poldrugovac M , Amuah J E , Wei-Randall H , Sidhom P , Morris K , Allin S , Klazinga N S , Kringos D S 
Published: October 2020

Abstract

Background
Evidence of the impact of public reporting of healthcare performance on quality improvement is not yet sufficient to draw conclusions with certainty, despite the important policy implications. This study explored the impact of implementing public reporting of performance indicators of long-term care facilities in Canada. The objective was to analyse whether improvements can be observed in performance measures after publication.

Methods
We considered 16 performance indicators in long-term care in Canada, 8 of which are publicly reported at a facility level, while the other 8 are privately reported. We analysed data from the Continuing Care Reporting System managed by the Canadian Institute for Health Information and based on information collection with RAI-MDS 2.0 © between the fiscal years 2011 and 2018. A multilevel model was developed to analyse time trends, before and after publication, which started in 2015. The analysis was also stratified by key sample characteristics, such as the facilities' jurisdiction, size, urban or rural location and performance prior to publication.

Results
Data from 1087 long-term care facilities were included. Among the 8 publicly reported indicators, the trend in the period after publication did not change significantly in 5 cases, improved in 2 cases and worsened in 1 case. Among the 8 privately reported indicators, no change was observed in 7, and worsening in 1 indicator. The stratification of the data suggests that for those indicators that were already improving prior to public reporting, there was either no change in trend or there was a decrease in the rate of improvement after publication. For those indicators that showed a worsening trend prior to public reporting, the contrary was observed.

Conclusions
Our findings suggest public reporting of performance data can support change. The trends of performance indicators prior to publication appear to have an impact on whether further change will occur after publication.

Key messages
Public reporting is likely one of the factors affecting change in performance in long-term care facilities. Public reporting of performance measures in long-term care facilities may support improvements in particular in cases where improvement was not observed before publication.
A systematic review on the barriers and enablers to shared cancer follow-up care
Authors: Sandell T , Schütze H 
Published: October 2020

Abstract

Background
The digital information revolution empowers individuals to lead and control their healthcare. The increasing incidence of cancer, coupled with improved survivorship, has increased demand for cancer follow-up care, and the need to find alternative models of care. The aim of this review was to identify the barriers and enablers to shared cancer follow-up care, and to inform a shared model of care.

Methods
Systematic review. Seven electronic databases MEDLINE, Science Citation Index, Academic Search Complete, CINAHL, APA Psychinfo, Health Source: Nursing/Academic edition and Psychology and Behavioural Sciences Collection were searched for published papers between 1999 to 2019. Papers were included if they were available in full-text, English, peer-reviewed, and had a focus on cancer follow-up care. 31 Papers were included in the final review.

Results
Role clarification, communication, and technology were identified as important to shared cancer follow-up care. The lack of effective exchange of information in real-time between oncologists and general practitioners hinders the implementation of feasible and acceptable shared care.

Conclusions
While patients may prefer the oncologist-led model, their acceptance to have their general practitioner play a greater role in their follow-up care increases if their oncologist can oversee the care. Bridging the digital communication exchange between oncologists and general practitioners can support shared cancer follow-up care, whilst providing safe, patient-centred, long-term care.

Key messages
Cancer survivorship requires long-term follow-up care. Improved utilisation of digital health is imperative to develop shared-care models of care between oncologists and general practitioners. Health services need to work collaboratively to provide person centred care and to improve health outcomes.
Quick and collaborative response to teenage pregnancies in a poor semi-rural area of Belgium
Authors: Déom V , Ben Abdelhafidh L , Annez N , Glorie C , Roland M 
Published: October 2020

Abstract
Early pregnancies are often linked to precarious situations. Even if Belgium has seen a decrease in teenage pregnancies, in the former mining region of the Hainaut there are still twice as many births to young women under 20 compared to the national rate.
Colfontaine is one of the poorest cities in Belgium. Last year, one of the local high schools counted 10 pregnant teenagers out of 450 students. Médecins du Monde was already present in the city at the time with a mobile health clinic called the Médibus. In response, we carried out a mapping of the local sexual and reproductive health actors. The lack of accessibility to social and health structures capable of welcoming teenagers anonymously and free of charge quickly emerged as a problem, the nearest family planning center being located 30 minutes away by bus.
In September 2019, in partnership with 5 local health actors, we decided to reshape the Médibus into the Adobus in order to offer family planning consultations, health promotion and harm reduction activities at the high school once a week.
In addition to offering health information services, we also aim to detect teenagers experiencing vulnerable situations such as addiction, violence, gender issues and refer them to appropriate services. Halfway through the project, we met 430 teenagers in 14 afternoons. The most common reasons for consultation (N = 310) were questions related to contraception for 29% and to sexually transmitted infections for 24,5%. 70,9% of teenagers received condoms and 13 girls were tested for pregnancy. One girl received a morning-after pill. 3 teenagers with addiction problems and 17 victims of violence were detected. The teams referred 18 teenagers to other services.
The success of this outreach project confirms the need for information regarding sexual and reproductive health for teenagers living in precarious situations as well as the need to develop reachable and affordable sexual and reproductive health services in semi-rural areas.

Key messages
Outreach is an efficient approach to respond to teenagers’ needs in poor semi-rural areas. Outreach facilitated the detection of early pregnancies, addiction and violence issues among teenagers.
Development and validation of the dental vulnerability scale in the primary health care setting
Authors: Palacio D , Mafra A C C N , Bonfim D , Rebustini F , de Oliveira D B , Martins A C F , de Mendonça J M T , Miraglia J L , Pereira A C 
Published: October 2020

Abstract

Background
Offering equitable access to dental care remains a challenge and methods to risk-stratify individuals to prioritize care could help to attain that goal. The interaction of multiple risk factors associated with oral disease vulnerability can outweigh protective factors conferring resilience and resistance to individuals and their communities; however, there is no validated instrument for measuring oral disease vulnerability. Hence, the objective of this study was to develop a Dental Vulnerability Scale (EVO) for primary health care (PHC) and evaluate its content validity and internal structure.

Methods
This was a psychometric study conducted in São Paulo, Brazil, in 2019. During content validation, 172 items were evaluated by a panel of 40 judges with diverse background and with the application of the Content Validity Ratio (CVR), considering a critical CVR value&gt; 0.26. During the internal structure evaluation, the EVO was applied to a sample of 1227 individuals in the PHC setting and the results were analyzed using Exploratory and Confirmatory Factor Analysis, in addition to the application of 3 reliability indicators (Cronbach's alpha, McDonald's Omega and Greatest Lower Bound).

Results
The CVR was 0.33 for relevance and 0.39 for clarity, resulting in 41 items. The final EVO was composed of 4 dimensions (general health, oral health, infrastructure and health services) with a total of 15 items. Factor loadings ranged from 0.37 to 0.96, with R-squared values ranging from 0.14 to 0.91. The reliability indicators values were α = 0.64, ω = 0.99 and GLB=0.82. The Goodness of fit were NNFI = 0,95, CFI = 0,98, GFI = 0,96 and AGFI = 0,97. The EVO instrument was considered valid to be used among oral health professionals in the PHC setting.

Conclusions
The EVO showed satisfactory psychometric properties and could be employed by health professionals and managers to plan actions and*inform* policies related to oral health.

Key messages
The EVO could be used to risk-stratify individuals in the PHC setting. The EVO could help to inform oral health policies.