bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unsatisfactory effectiveness of preventive programs for oncogynecological diseases in Bulgaria
Authors: Georgieva S , Stefanova P , Kamburova M 
Published: November 2019

Abstract

Background
Incidence rate and mortality of breast cancer and cancer of the cervix uteri in Bulgaria are higher in comparison with most countries of European Union (EU). Moreover, during the last three decades they have been increasing, even doubled for cervix cancer, although in developed countries there are proven effective prevention programs. The aim of the study is to explore how these programs are being implemented in Bulgaria and what caused their unsatisfactory results.

Methods
Data were collected by documents review and direct individual self-administered questionnaire among 186 women aged 30-69 concerning types and regularity of preventive activities.

Results
National Health Insurance Fund in Bulgaria defines as mandatory and finances a regular check-up annually for health insured people over 18 years of age. Mammography, as a screening of a breast cancer, was included in regular check-up package from the year 2011, once at every two years, for women aged 50-69. Papanicolau test for cancer of the cervix uteri wasn’t provided in the preventive package until the year 2017 when it was included only for women who complete 30 years of age in the current calendar year with intended regularity once at every two years. Women from other age groups currently are not covered with preventive examination for cervical cancer or they should pay for it which restricts accessibility and affordability of prevention activities. Study results indicates that every fifth of the investigated women have never had a prophylactic examination for breast cancer and cervical cancer. In addition, 69.4% of those who have such examination did not comply with the recommended regularity.

Conclusions
Screening programs against breast cancer and cancer of the cervix uteri are consistent with the recommendations of the oncology research societies but they being applied relatively soon in Bulgaria and some age groups are out of their coverage which decreases their effectiveness.

Key messages
Incidence rate and mortality of breast cancer and cancer of the cervix uteri in Bulgaria are higher than in most countries of European Union although there are proven effective prevention programs. Screening programs against breast cancer and cervical cancer are not effective because of their low accessibility and affordability and because they don’t comply with the recommended regularity.
Maternal perceptions of paediatric cancer and diabetes in Cameroon
Authors: Wamba A , Matchika Mégaptché M , Mambou Nouemssi J-P , Koki Ndombo P , Pondy Ongotsoyi A-H 
Published: November 2019

Abstract

Background
Maternal perceptions of paediatric cancer and diabetes are still poorly studied in Cameroon, while they are considered as an inevitable part of the chronic diseases. Little is known to what maternal representations of paediatric cancer or diabetes refer to. Their contents remain unknown; and they are rarely taken into account in training programs for health care providers and educators. Yet, when ignored, they can have consequences impacting the relational dimension of care, prevention of relapses, disease complications, health education and behaviour change.

Methods
Based on a critique of the psychosocial conceptual models used in prevention, this study combines a qualitative approach aimed at identifying and describing mothers’ perceptions about paediatric cancer and diabetes, transforming them into educational content that can be reused for the training of health care providers and educators; and a quantitative component, obtaining their impact on the therapeutic relationship and therapeutic compliance.

Results
The results show that caregivers (healers, physicians), children, mothers and their close family are involved in the relational component of care; the Cameroonian mother expects that the therapist consulted should be a psycho-oncologist or a psycho-diabetologist, who can (power) and knows (knowdlege). Maternal perceptions determine the techno-therapeutic dimension, and may, if ignored, threaten therapeutic adherence, leading to abandonment.

Conclusions
This study suggests integrating maternal perceptions of cancer and diabetes with the messages used to elaborate languages for health education and caregiver training, to associate the healers to the early screening of cancer and diabetes, and to their educational, preventive and therapeutic care. Also suggested by this research is consideration of the relational dimension as a care service, and maternal perceptions as an illness that will need to be treated like cancer and diabetes.

Key messages
Associate the healers to the early screening of cancer and diabetes, and to their educational, preventive and therapeutic care. Considering relational dimension as a care service, and maternal perceptions as an illness that will need to be treated like cancer and diabetes.
Network of Vascular Centers in the Russian as a way to reducing mortality in the working population
Authors: Zubko A , Sabgayda T , Shelekhov P , Zaporozhchenk V , Zemlyanova E 
Published: November 2019

Abstract

Over the entire period of the state program aimed at reducing mortality from circulatory system diseases initiated in 2008 the number of Vascular Centers has increased from 85 to 140. According to the federal statistical observation form, the rate of Vascular Centers per 100 000 population increased 1.5 times from 0.066 to 0.095 in 2008 and 2017 respectively. As a result, the number of treated patients increased 6.3 times - from 53.1 to 327.3 per 100 000 population. During the analyzed period, the mortality rate of patients of Vascular Centers decreased from the average of 9.3% for all Vascular Centers in 2009 to 7.6% in 2017 (χ2 = 248.6, p &lt; 0.0001) reflecting accumulation of experience of care delivery within the framework of the state program.
The majority of patients with myocardial infarction and cerebrovascular diseases received treatment in the Vascular Centers. In 2017, 76.6% of all patients were admitted to Vascular Centers. From 2008 to 2017, the mortality from circulatory diseases in urban males of working age decreased by 36.1% (from 354.6 to 226.6 per 100 000 population), while cardiovascular mortality in rural males decreased to a greater extent - by 41.0% (from 394.2 to 232.0). Female mortality from circulatory system diseases (the level of which was initially five times lower) decreased to a lesser extent: from 67.0 to 44.5 per 100 000 urban females of working age (1.5 times - by 33.6%), and was even more pronounced in rural females - from 90.8 to 55.4 (by 39.0%).
Therefore, along with the increase in the number of Vascular Centers the volume of specialized care including high-tech, increases while mortality decreases, reflected by the decreased mortality from myocardial infarction and other forms of acute ischemic heart disease. However, the activity of Vascular Centers did not affect the rate of mortality from cerebrovascular diseases in the Russian population.

Key messages
Through the activity of regional vascular centers since 2008 substantial reducing of patients’ mortality was registered from myocardial infarctions and other acute forms of ischaemic heart disease. Mortality from myocardial infarction has decreased in the last decade faster than in the period up to 2009.
Clustering & trajectories of multimorbidity across the lifecourse: a 70 year birth cohort study
Authors: Khanolkar A R , Patalay P 
Published: November 2019

Abstract

Background
Multimorbidity (≥2 chronic diseases) is increasingly prevalent in ageing populations and presents a public health challenge in successful disease management. Most evidence for multimorbidity at different ages comes from cross-sectional data, hindering understanding the extent and types of multimorbidity across the lifecourse, how they develop and associated risk factors. The aim of this study is to investigate the clustering and patterning of multimorbidity over the lifecourse using one of the longest running national birth cohort studies.

Methods
This ongoing study is based on the National Survey of Health & Development (NSHD), a birth cohort study following 5,362 individuals born in 1946 with detailed sociodemographic and clinical data collected from 22 waves across the lifecourse till date. This study will investigate the trajectories and clustering of 24 diseases (physical and mental health) and potential differences by sex and socioeconomic status using mixed-effects linear spline modelling.

Results
Preliminary analyses indicate that as expected, the rates of many conditions increase with age (e.g. 13% obese at age 43 to 31% at age 69), increasing the likelihood of individuals suffering from multiple conditions with age. At age 63, 73% with diabetes had hypertension, increasing to 85% with hypertension at age 69. We will estimate longitudinal trajectories of multimorbidity for individuals and whether the age of onset and rate of accumulation vary by sex, life-period and SES. Given the longitudinal nature of the data, we will investigate the extent to which multimorbidity earlier in the lifecourse predicts the rate of further multimorbidity later in the lifecourse.

Conclusions
Understanding patterning and trajectories of multimorbidity over the lifecourse and associated inequalities will better inform health care provision planning including appropriate window periods for intervention, specifically for the disadvantaged at higher risk of high multimorbidity.

Key messages
This is the first study to investigate trajectories of multimorbidity with data from birth to old age. Understanding how early life factors predict later life multimorbidity will better inform healthcare planning.
Validation of a national algorithm for diabetes screening
Authors: Lavranos G , Chrysostomou C , Leonidou M , Prodromou M 
Published: November 2019

Abstract

Background
The continuing upward trend in diabetes diagnosis across the world has led governments to adopt new treatment programs. According to the International Federation for Diabetes (2017) Europe and in its Member States spent from 10% to 20% of healthcare costs, for diabetes. The purpose of this study is to assess the feasibility of an algorithm to identify both the regulatory needs of diabetic individuals and to screen for undiagnosed individuals in the community.

Methods
The population sample consisted of 2100 people. The survey was conducted in two phases over the period 2017-2018. In the first phase we identified the 188 already diagnosed people with diabetes who were asked to answer a questionnaire comparing their current standard of care to NICE indicators. In the second phase, the remaining 1912 non-diabetic patients were asked to answer the Findrisk questionnaire. Those who were classified as high risk and very high risk were selected and referred to a clinical laboratory where they were subjected to a glucose curve to detect any diagnosis.

Results
The diabetes prevalence at the onset of the study was 9% (188/2100 people). Fifty-two new incidents were diagnosed. Thirty-six new cases were diagnosed by randomized glucose values after triple check and symptomatic diabetes symptoms consistent with the World Health Organization’s recommendations on diabetes diagnosis. Sixteen new cases were diagnosed via OGTT. The prevalence of diabetes at the end of the survey reached 11.4% (240/2,100 people)..

Conclusions
It has been found that one person in every forty in the general population suffers from diabetes without been yet diagnosed. Deviations from international diabetes standards have been observed. A new diabetes strategy should be implemented in the future, allowing the catholic implementation of the Findrisk Diabetes Prevention tool every ten years.

Key messages
Despite existing guidelines and recommendations, very few diabetic patients fulfill NICE follow up criteria. FINDRISK and OGTT can be used as part of a cost-effective national diabetes screening algorithm.
Current and future burden of prostate cancer in Tunisia projections to 2030
Authors: Cherif A , Dhaouadi S , Osman M , Hsairi M 
Published: November 2019

Abstract

Introduction
Prostate Cancer is the second most common cancer among men worldwide. Current and future estimates on the burden of cancer are needed. The aim of this study was to assess prostate cancer burden in Tunisia in terms of disability adjusted life years (DALY) in 2017 and to perform projections by 2030.

Methods
DALYs for cancer are the sum of years of potential life lost due to premature mortality (Years Life Lost YLL) and the years lived with disability (YLD). Estimated data related to Burden of disease (Incidence rate, death rate, DALY, YLL and YLD)are obtained by the Institute for Health Metrics and Evaluation (IHME). Demographic data were provided by the National institute of statistics. The projection of DALYs for prostate cancer through 2030 was performed by a Poisson Regression analysis with Age -Period -Cohort (APC) using SPSS software, while using IHME estimated data for the period 1990-2017.

Results
In 2017, prostate cancer incidence rate and mortality rates among males in Tunisia were 24.17/100000 persons years and 7.08/100000 persons years respectively. Prostate cancer DALY values were 6548 (114 /100000). The number of YLLs was 5712 with a higher contribution of YLL in DALYS (87.2%). Without effective interventions, the number of DALYs due to prostate cancer would reach 10105 in 2030 with a standardized rate of 113/100000 persons years (IC 95% = [110/100000 to 116/100000].

Conclusions
The burden of prostate cancer in Tunisia in 2017 is relatively high and will still rising until 2030. This highlights the urgent need to focus resources on disease prevention and in the improvement of treatment.

Key messages
The burden of prostate cancer is high in Tunisia in 2017. Need to focus ressources on disease prevention and in the improvement of treatment.
Lung Cancer burden of disease in The Northern Tunisia
Authors: Cherif A , Dhaouadi S , Osman M , Hsairi M 
Published: November 2019

Abstract

Introduction
Lung Cancer is one of the leading cancers and major causes of death among men worldwide. Current estimates on the burden of cancer are needed to plan and evaluate cancer control policies. This study aimed to estimate the lung cancer burden in Northern Tunisia in terms of disability adjusted life years (DALY) from 2007 to 2009.

Methods
DALYs for cancer are the sum of years of potential life lost due to premature mortality (YLL) and the years of productive life lost due to disability (YLD).We calculated YLL by multiplying the number of deaths by the standard life expectancy at that age using the mortality data of the Global Cancer statistics 2012 (Globocan 2012) and the population data provided by the National institute of Statistics. We used the model life-table West with a life expectancy at birth of 82.5years for women and 80 years for men.YLD were computed by multiplying the number of new cases by the average duration of the disease calculated with the DiSMoDII software. The disability weight employed was 0.917 for lung cancer; a discounting rate of 0.03 was applied. The Incidence data were obtained from the Cancer Registry of the North region of Tunisia 2007-2009.

Results
The incidence rate of lung cancer in the northern region of Tunisia between 2007 and 2009 was 28.8/100000 persons years for males and 3.1/100000 persons years for females. Lung cancer death rate was 27.8/100000 persons for males and 1.65/100000 persons for females. Lung cancer DALY values were 10404 for males (410/100000) and1251 for females (50/100000). The percentage of YLL in DALYS was 93.3% for males and 51.7 % for females. The highest proportion of YLL was observed for the age group 60-69years for both sexes.

Conclusions
The burden of lung cancer especially among males is very important. This highlights the importance of promoting the preventive measures such as the Tobacco control including tobacco cessation.

Key messages
Burden of lung cancer among male is very high in Tunisia. Importance of promoting preventive measures such as tobacco control.
Identifying barriers to organizational health literacy in public health departments in Germany
Authors: Mehlis A , Hornberg C 
Published: November 2019

Abstract

Background
To master challenges to their environmental health, people have to have health literacy (HL). At a national and communal level, focus is shifting from individual HL to health care organizations. They have to raise their organizational health literacy (OHL) to help their users to access information and services. In Germany, public health departments are responsible for environmental health at a population level while the environmental administration is responsible for health-related environmental protection. To date, there is no research on the OHL of public health departments in Germany. Which are the barriers that keep public health organizations from raising their OHL as well as from making better use of possible synergies with the environmental administration?

Methods
The study consisted of interviews with experts from public health (n = 7) and environmental departments (n = 5) at communal (n = 8) up to federal state level (n = 4). Experts were asked for their insight on barriers for OHL as well as for cross-sector collaboration. They were selected for a wide range in socioeconomic factors and administrative levels. The interviews were recorded between 10/2018-04/2019. After transcription the anonymized interviews underwent qualitative content analysis.

Results
In twelve interviews 10.4 h of audio were recorded. Content analysis revealed 13 barriers for OHL. Several of those had been described for hospitals before while others, like low responsiveness to the needs of the public, were unknown so far. Preliminary results also indicated several barriers for cross-sectoral cooperation as well as recommendations to overcome said barriers.

Conclusions
Interviews with public health and environmental administrative organizations turned up 13 barriers that keep them from raising their OHL. Implementing preliminary recommendations could result in better cooperation, in higher OHL, higher environmental health and therefore contribute to public health in the general population.

Key messages
Interviews with experts from public health and environmental administrative organizations in Germany turned up barriers that keep them from raising both their OHL and cross-sectoral cooperation. Implementing preliminary recommendations could result in higher OHL of public health departments and higher environmental health of the general public and thus contribute greatly to public health.
Assessing the use and understanding of the Portuguese Heat–Health Warning System (ÍCARO)
Authors: Leite A , Santos A J , Silva S , Nunes B , Mexia R , Rodrigues A P 
Published: November 2019

Abstract

Background
Heatwaves can lead to increased mortality. Portugal has a Heat-Health Warning System (HHWS) in place (ÍCARO system). Researchers at the Instituto Ricardo Jorge send a daily report with heat-related mortality forecasts to key stakeholders (e.g. Heat-Health Action Plans (HHAP) staff). HHAP practitioners issue warnings and implement measures to prevent heatwaves-related mortality. ICARO is amongst the recommended data sources to assess risk and issue warnings but its use and understanding is unknown. Therefore, we aimed to assess ÍCARO’s use and understanding by key HHAP practitioners.

Methods
We conducted semi-structured interviews with national and regional HHAP practitioners. Interviews were recorded, transcribed, and analysed using thematic content analysis. Intercoder reliability was applied to a sample of segments from 5 of 6 interviews.

Results
We conducted 6 interviews with 9 professionals (mean time 52 minutes). We identified 4 categories: Report’s content and presentation, Report’s reception and communication, ÍCARO and risk assessment, Other issues. Practitioners use ÍCARO and perceived it as very relevant tool. However, they mentioned several questions on its interpretation. Practitioners also felt their questions were not fully answered, given researchers’ use of statistical terms. Finally, practitioners referred the need to assess risk at the local level, information not currently provided. We also identified the need for improved communication and report’s clarity.

Conclusions
Our study stresses the need for an integrated collaboration between experts within HHWS and HHAP. Despite ICARO’s understanding being challenging, practitioners consider it a relevant tool. Researchers should use less statistical language and clarify ÍCARO interpretation. Practitioners’ needs should be considered when developing or revising tools. We are currently implementing some of these recommendations in an attempt to close the gap between researchers and practitioners.

Key messages
Portuguese Heat–Health Action Plans practitioners use heat-related mortality forecasts (ICARO) and perceived it as very relevant instrument. However there find ICARO’s interpretation challenging. Portuguese Heat/Health Action Plans Practitioners’ needs should be considered when revising or developing tools, and notes should be added to clarify statistical/technical concepts.
Environmental health risks perceptions: results from cross-sectional surveys in Southeastern France
Authors: Bocquier A , Cortaredona S , Andrieu-Semmel M , Dagnet L , Pouget V , Urban-Boudjelab S , Verger P 
Published: November 2019

Abstract

Background
In accordance with commitments made as part as the European conferences on environment and health in the 90s, France has adopted national environmental health plans since 2004. These plans include regional offshoots to take local specificities into account. To guide stakeholders in defining this plan in Southeastern France, studies were carried out to document general population environmental health risks perceptions and practices.

Methods
Data come from the Southeastern Baromètre santé environment, random cross-sectional telephone surveys carried out in 2007 and 2017 among the population aged 18-75 years (n = 1415 and 1960 respectively). They focused on people perceptions’ about environmental health risks (e.g., air pollution) and actions to reduce them, trust in sources of information, and their practices. We performed descriptive analyses of the 2017 data, and logistic regression models adjusted for sociodemographic variables to test time evolutions.

Results
In 2017, the main environmental health risks perceived were pesticides, carbon monoxide, and air pollution (over 90% of the participants thought they carry high health risks). As in 2007, over 90 % thought the air quality had been worsening. The most efficient ways to reduce air pollution were the improvement of public transportation, of bike paths and the development of car sharing. Between 2007 and 2017, self-reported use of soft mobility and/or car sharing increased from 54% to 66%; and consumption of organic food increased from 40% to 69%. Participants perceived physicians as the most trustful source of information about environmental health.

Conclusions
Habitants from Southeastern France are highly concerned by environmental health risks, especially pesticides and air pollution. They call stakeholders to take actions to reduce these risks, but appear to have changed some of their own practices too. These results helped stakeholders to define priorities of the current regional environmental health plan.

Key messages
The general population was highly concerned by environmental health risks (especially pesticides and air pollution), and has become aware of the necessity of changing its own practices. Such results about the regional population main concerns have been used to define regional priorities for actions.