bluuebunny/crossref_metadata_2025_split huggingface dataset:
Depression screening program tailored to the primary health care settings
Authors: Strkic D , Niskanovic J 
Published: October 2020

Abstract

Issue
Depression is the leading cause of disability worldwide. People with mental health problems often do not feel comfortable to seek help from mental health professionals. Depression is often 'covered' with physical symptoms and patients first seek help from family medicine doctors.

Description of the Problem
Primary health care organized through mental health centers and family medicine service was base for planning of depression screening program. Program is supported by the Ministry of Health and Social Welfare in the Government of Republic of Srpska and the Mental Health Project in BiH (implemented by Association XY with support of the Government of Switzerland). Methodology and promotional materials were developed in the Public Health Institute. Outcome was improved health of the adult population at increased risk of depression. Program was implemented from June 2018 till December 2019 in ten primary health care centers. Mental health centers (MHC) sensitized and trained family medicine teams (FMT) for screening. FMT used Patient Health Questionnaire 9 (PHQ 9), MHC used the Hamilton scale for confirmation. Confirmed cases were measured for quality of life with the Q-LES-Q-SF. Both of questionnaires were used for control measurement after three months of treatment.

Results
Screening of 1037 patients resulted in 445 of them were referred, of which 310 patients came to the MHC, where depression was confirmed in 289 patients. In control measuring, 30% of the patients showed the absence of depression, with a significant improvement in the self assessment of the overall quality of life.

Lessons
Clear methodological guidelines and program adjusted to the organization of health care services, along with monitoring and evaluation, was crucial, and appreciated from health professionals involved. Regular communication of mental health centers and family medicine services was important in overcoming obstacles to get patients in the program, and maintain them.

Key messages
Stigma still prevents patients who need help to get to the mental health services. Sensitized and trained family medicine doctors, as first contact with patients, are crucial in early detection of depression and convincing patients to accept help and stick to treatment.
Non-communicable disease risk factors among a cohort of mine workers in Mongolia
Authors: McCarthy A , Damiran N 
Published: October 2020

Abstract

Background
Prevalence of non-communicable diseases (NCD) are growing among working populations globally. The World Health Organization (WHO) estimates NCD are responsible for 80% of all premature deaths (Lancet, 2016). The purpose of this study is to determine baseline level of NCD and risk factors among mine workers and to identify intervention strategies based on results. The collected results will be compared with a NCD study on the general population of Mongolia.

Methods
A cross sectional design was used for this study. 684 employees were randomly recruited to the study. We utilised WHO questionnaire to collect anthropogenic measurements, health behaviours, alcohol consumption, smoking, NCD and work related information.. The study focused on four (4) key risk factors of hypertension, obesity, drinking habits and smoking habits. These factors are key contributors to NCD and decreased life expectancy.

Results
Results of the study showed prevalence's of hypertension 12.9%, obesity 64.1%, alcohol users 22.1% and smokers 38.8%. The general population prevalence's are 27.5%, 56.8%, 15.5% and 24.8% respectively. Differences between gender in the study cohort for smoking rate (men = 43.3%, women = 8.9%), alcohol consumption (men = 29.9%, women = 16.1%) and central obesity (men = 78.3%, women = 35.1%) were statistically significant (p &lt; 0.05).

Conclusions
Prevalence of arterial hypertension for the mine worker cohort was lower than general population, however, obesity, drinking and smoking rates were higher. The study findings allow us to target intervention strategies to mitigate the risk of NCD development in the future.

Key messages
Understand the risk factors and control measures available to mitigate the risk of the development of NCD. Comparison of the mine site cohort with the general population to understand similarities and differences.
Innovative prototypes for cervical cancer prevention in low-income primary care settings
Authors: Arrivillaga M , Bermúdez Jaramillo P C , García-Cifuentes J P 
Published: October 2020

Abstract

Issue
In 2018, the mortality due to cervical cancer rose by 6.9 compared to the previous year, with 311.365 deaths in total. By 2030, it is estimated that there will be a 21.3% increase in incidence and 26.7% in mortality. In Colombia, cervical cancer is the second cause of death by cancer in women.

Description of the Problem
We present the design process of innovative prototypes for cervical cancer prevention in primary care centers located in low-income settings in Cali, Colombia, using the Human-Centered Design (HCD) approach. The practice was developed in collaboration with a public healthcare network comprised of 38 urban and rural centers with women between the ages of 25 and 65 years, healthcare providers of the cancer program, healthcare managers. We conducted five HCD stages: research, need synthesis, ideation and co-design process, prototyping and in-context usability testing. We used observations, open-ended interviews and conversations, multi-stakeholder workshops, focus groups, systematic text condensation analyses and tests in real contexts.

Results
We designed four prototypes: (1) 'Encanto': An educational manicure service, (2) 'No le des la espalda a la citología': A media-based strategy, (3) An educational wireless queuing device in the waiting room, and (4) Citobot: A cervical cancer early detection device, system, and method.

Lessons
The tests carried out with each prototype showed their value, limitations and possibilities in terms of subsequent development and validation through public health research or clinical research. We recognize that a longer-term evaluation is required in order to determine whether the prototypes will be used regularly, integrated into cervical cancer screening services and effectively improve access to cytology as a screening test.

Key messages
HCD is a useful methodology for design-based prevention in the field of cervical cancer. Integration of HCD with public health practice would allow the generation of evidence prior to the formulation of policies and programs as well as optimize existing interventions.
Non-communicable diseases and use of medication among Syrian refugees: a prospective cohort study
Authors: Strømme E M , Haj-Younes J , Hasha W , Fadnes L T , Kumar B , Diaz E 
Published: October 2020

Abstract

Background
Conflict-driven disruption in continuity of care for non-communicable diseases (NCDs) is likely to have adverse public health impact. Yet, data on the prevalence and treatment coverage of NCDs among refugees is scarce. In this study we aim to assess the changes in prevalence of NCDs and use of relevant medication among Syrian refugees from a near-conflict phase in Lebanon to a resettlement phase in Norway.

Methods
This is a prospective cohort study. Survey data were collected during 2017-2018 among adult Syrian refugees in Lebanon selected for quota resettlement and at follow-up approximately one year after resettlement in Norway. Our primary outcomes were changes in NCDs as defined by the WHO and use of relevant medication. We calculated prevalence proportions with confidence intervals and assessed changes in prevalence over time using generalized estimating equations.

Results
Altogether 353 Syrians participated. The median age was 34 years and 51 percent were women. The overall prevalence of NCDs was 12 (9-16) percent at baseline and 9 (6-12) percent at follow-up. The odds ratio for reporting any NCD at follow-up compared to baseline was 0.68 (0.46, 1.00). Among those reporting NCDs, the prevalence of using either antithrombotic or cholesterol lowering medication, antihypertensives, antidiabetics, or drugs for asthma or chronic obstructive pulmonary disease was 55 (39-70) percent at baseline and 63 (44-80) percent at follow-up. The odds ratio for using relevant medication at follow-up compared to baseline was 1.01 (0.63, 2.05).

Conclusions
In our study around one tenth of the refugees reported at least one NCD. Nearly half of those reporting NCDs in a conflict-near setting did not seem to receive relevant medication, while the same was true for more than one third of respondents after resettlement. We call for innovative public health approaches and interventions to protect continuity of care for NCDs in settings of conflict-driven exodus.

Key messages
A high share of Syrian refugees reporting NCDs do not seem to receive relevant medication. The management of NCDs among refugees needs attention in order to avoid negative health effects.
Motivational Interviewing for the control of type 2 diabetes mellitus and arterial hypertension
Authors: Leites de Souza Steffen P , Demétrio Faustino da Silva D , Schilling Mendonça C , Meyer E 
Published: October 2020

Abstract

Background
Motivational Interviewing (MI) has been effective in promoting positive changes in various health-related behaviors, including chronic disease management. The main goal of this study was evaluating the effectiveness of this care technology in individual nursing consultations for the control of type 2 Diabetes Mellitus (2DM) and Arterial Hypertension (AH) in primary healthcare.

Methods
Double-blind, controlled, parallel randomized clinical trial conducted in Porto Alegre, Rio Grande do Sul - Brazil, from June 2018 to July 2019. The study subjects suffered from 2DM with associated diagnosis of AH and were randomized individually to the Test/MI Group and Control Group. The Test Group was subjected to an MI-based nursing consultation intervention with a professional who had been trained for 20 hours, while the Control Group received conventional nursing consultation. The variables were collected in order to measure the main glycated hemoglobin and blood pressure outcomes, and for the secondary adherence outcome.

Results
After an average follow-up of 6 months, 175 patients completed the study. There was a significant difference between the groups with improvement in the Test/MI group for the outcomes Systolic Blood Pressure - SBP (p &lt; 0.01), Diastolic Blood Pressure - DBP (p &lt; 0.01), Total Adherence Score in Martín-Bayarre-Grau Questionnaire (p = 0.011) and their dimensions 'Treatment compliance' and 'Personal implication' (p = 0.033; p = 0.031). The blood pressure levels of the patients who received the Motivational Interviewing Intervention showed a significant mean reduction of 15.2 mmHg in SBP and 6.4 mmHg in DBP, compared to the control group. The Test group also showed a significant average intragroup reduction of 0.5% in HbA1c at the completion of the study (p &lt; 0.01).

Conclusions
It is concluded that the MI-based nursing consultation was effective in improving clinical control and adherence in diabetic and hypertensive patients in primary healthcare.

Key messages
MI-based nursing consultation is effective in reducing pressure and glycemic levels in primary healthcare. The MI improves adherence levels in diabetic and hypertensive patients.
Raised blood pressure in Italy: results of the CUORE Project-health examination survey 2018-2019
Authors: Donfrancesco C , Di Lonardo A , Minutoli D , Lo Noce C , Buttari B , Profumo E , Bellisario P , Giampaoli S , Galletti F , Palmieri L 
Published: October 2020

Abstract

Background
The WHO Global Action Plan for the Prevention of Non-Communicable Disease (WHO-NCD) recommends a 25% relative reduction in the prevalence of raised blood pressure (RBP) by 2025. Prevalence of RBP and mean blood pressure in the Italian general adult population measured in the 2018 CUORE Project-Health Examination Survey are presented to investigate if Italy can reach this target.

Methods
Within the health examination survey conducted in 2018-2019, representative random samples of resident population, aged 35-74 years, stratified by age and sex (822 men and 869 women) were examined in 8 Italian Regions from the Northern, Central and Southern Italy. Blood pressure was measured by automated oscillometric device using standardized procedures and methods; mean level of two measurements are here considered. RBP is defined as systolic and/or diastolic blood pressure equal or greater than 140/90 mmHg or being under specific drug treatment. The survey is funded by the Italian Ministry of Health-CCM.

Results
Preliminary analysis shows that prevalence of RBP is 43% (95% C.I. 40-47) in men and 32% (29-36) in women. Prevalence of persons with raised blood pressure and not receiving pharmacological treatment is 19% (15-22) in men and 9% (5-12) in women. In men and women prevalence of raised blood pressure is significantly higher in the Southern Regions. Mean value of systolic blood pressure is 131 mmHg (130-132) in men and 122 mmHg (121-123) in women. Mean value of diastolic blood pressure is 77 mmHg (76-78) in men and 73 mmHg (72-74) in women.

Conclusions
Preliminary data underline that RBP is commonly observed in the Italian adult population. However, in comparison to data measured within the CUORE Project 10 years earlier, prevalence of RBP and mean blood pressure are declining, facilitating the meeting of WHO-NCDs target.

Key messages
Raised blood pressure is commonly observed in the Italian general adult population. If confirmed, in the last ten years prevalence of raised blood pressure and mean blood pressure are declining in the Italian general adult population.
From 'to cure' to 'to care' in Oncology Toward shared Evidence based practice
Authors: Rubba F , Paparo E , Capuano F , Montella E , Continisio I G , Iervolino A , Magri P , De Angelis C , De Placido S , Triassi M 
Published: October 2020

Abstract

Aims
Oncological disease need a system of care involving hospital staff and informal caregivers. Care-givers are subjected to stressful factors (burden) with repercussions on psycho-physical balance. The project, carried out together with the ONLUS Travel Companions Association and the Multidisciplinary Oncological Groups (GOM) of Brain and Breast Cancers, intends to offer supportive training experiences for care-givers and health workers, offering emotional and practical preparation for the treatments that they will find themselves providing the cancer relative by helping to improve the quality of care and the relationship between the subjects. The professionals participating in the project (doctors, nurses) take part in a training held by professionals from the Association. The care givers, divided into groups, carry out a CBI test (Caregiver Burden Inventory) and training meetings on medical, psychological and social assistance issues. After 3 months from the end of the course, the care-giver carries out the interview with the psychologist and recompiles the CBI. Furthermore, on 30 selected patients of Breast Cancers, GOM, an emotional evaluation questionnaire of their life experience was administered with respect to the stages of the disease pathway.

Results
The answers were then analyzed by the word cloud method and summarized in a synthetic map for each question. The most used words to describe the mood during the illness are 'anger, pain, anguish and worry'; while waiting before the visit they are 'long, exhausting, anxious'; towards the doctor 'availability, humanity, kindness, friendliness, professionalism'; with regard to 'excellent, availability' assistance; about social life during the 'unchanged, serene' illness; towards the return home 'joy'.

Conclusions
The project is a starting point towards a continuous and progressive humanization of the integrated pathways from 'to cure' to 'to care' in oncology.

Key messages
Patients are positively affected from shared initiatives. Word cloud may resume patients moods and thei main issues concerninthe path.
Health and Gender Medicine Clinic: 2 years of multidisclipinary team experience
Authors: Pasqualini P , Rizzo L , Facchi E , Culicchi V , Lenzi L , Mucci D , Erba F , Moscatelli C , Pagliara C , Doretti V 
Published: October 2020

Abstract

Background
Cardiovascular disease (CVD) is the leading cause of mortality in western countries and the first cause of mortality in women.

Purpose
Women generally do not concern about CVD and that represents the main risk for them.

Methods
Misericordia Hospital, Grosseto, started a Clinic of Health and Gender Medicine on 2017. On the first and third Monday of every month, we evaluate &lt; 60 years patients who are at risk for traditional CVD, depression, early menopause, polycystic ovary, autoimmune and rheumatic disease. On the first visit, medical history, arterial pressure, electrocardiogram, body mass index, waist circumference and lipid profile, were collected. We also supply questionnaires to evaluate diabetes and depression risk by Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-9) and food diary. Two weeks later, a multidisciplinary team (cardiologist-diabetologist-nutritionist-gynecologist-psychiatrist and a nurse) evaluates the patients defining the personal risk profile.

Results
From 2017 to December 2019, 74 females and 7 males belonging to the target population were examined. Age group: &lt;45(61%), 46-50(26%), 51-60(48%), &gt;60(19%). Clinical characteristics: Hypertension: 64%; Obesity 5%; Unknown dyslipidemia 44%; Risk of diabetes: 39%; Gestational diabetes: 5%; Gestational hypertension: 5% CVD risk: 42%; Depression: 33% Autoimmune disease: 30%. From them 60.5% have needed further investigation. Follow-up is going on.

Conclusions
according with the literature, more than 50% of the cohort was unconsciously at high risk of CVD. So a multidisciplinary approach is needed in order to frame a complex health status. Thus we established collaboration with patients to improve lifestyles as CVD-prevention's tool.

Key messages
Cardiovascular disease represent often an hidden health problem, especially in women. Multidisciplinary approach is needed to face CVD.
The prognostic role of micro-RNAs in Head and Neck Cancers: an umbrella review
Authors: Mariani M , Castagna C , Pastorino R , Boccia S 
Published: October 2020

Abstract
Head and neck cancer (HNC) represents the sixth most common cancer and the seventh cause of cancer-related deaths worldwide. Because of HNC high mortality and morbidity a support from the development of new biomarkers and personalized care for patients is needed. The role of micro-RNAs (miRs), as new epigenetic biomarkers, aimed at improving early diagnosis, predicting prognosis and establishing effective cancer therapies, has recently received considerable attention. The aim of this study was to conduct an umbrella review that synthetizes all the findings of systematic reviews already available in literature that investigate the prognostic role of miRs as potential biomarkers in the field of tertiary prevention of HNC.
We selected systematic reviews, published in English until December 2019, related to human HNC with meta-analysis of observational studies that reported quantitative prognostic measures, Hazard Ratios (HRs), of Overall Survival (OS) or Disease-Free Survival (DFS). The methodological quality of the included reviews was assessed using the Assessment of Multiple Systematic Reviews AMSTAR 2 tool.
Six systematic reviews were included in the umbrella review. The most reported miRNAs were: miR21; the Let7 family (c,d,g), miR17, 18 family, 20a, 29 family, 125b, 375. A total of 4 reviews assessed miR-21 expression in HNC patients, all showing its upregulation.
The most frequently studied miR was miR21 which was reported either in the OS and DFS statistical analyses. The OS analysis showed a significant lower prognosis when miR21 was upregulated.
It is involved in oncogenic and oncosuppressive cell signals pathways: the overexpression of miR21 was shown to be associated with cell proliferation, migration, invasion and survival. Recently the cumulative effects of sets of miRs has been increasingly studied and they might be stronger predictor of survival than single. The role of miRNAs as a prognostic biomarker specifically in HNC still need to be investigated.

Key messages
Some miRs were demonstrated to have as tumor-suppressing and oncogenic roles according to their level of regulation (up/down-regulation) in Head and Neck cancer patients. The role of miRs as prognostic biomarkers in HNC patients still need to be addressed by performing large scale to verify and enhance the power of evidence and clinical utility of these.
Return to work guidance within cardiac rehabilitation: content and costs of two settings compared
Authors: Drost R , Noben C , Paulus A , Smeets R , Kuijpers P , Evers S , de Rijk A 
Published: October 2020

Abstract

Background
Of those who survived a cardiac event and participated in cardiac rehabilitation (CR), many experience labor participation restrictions. The Dutch CR guideline includes return to work (RTW) guidance but no directives on where CR has to be offered. The aim was to compare rehabilitation centre and hospital based CR regarding 1) how RTW guidance was organised, 2) changes after CR in sickness absence and quality of life, 3) costs.

Methods
The study was designed as an exploratory cost-outcome description with naturalistic design. Care was assessed at the level of CR in a specialised rehabilitation centre and a hospital. The study population consisted of 116 employed cardiovascular patients (19-63 years of age) of one hospital referred to out-patient level II CR (for complex pathology), either at a rehabilitation centre (n = 53) or at the hospital (n = 63). Information on RTW guidance was obtained by interviews with the CR coordinators. Survey data from patients were collected at baseline, six and twelve months.

Results
At baseline, patient groups did not differ apart from sickness absence being higher in the rehabilitation centre group (76 versus 19 days in previous half year). RTW guidance within CR consisted of individual-based therapy including occupational therapy in the rehabilitation centre, and group-based therapy in the hospital. Costs of RTW guidance in the rehabilitation centre were estimated at €1,892.30, versus €296.82 in the hospital (net difference of €1,595.48). Sickness absence increased during CR for the hospital group, and decreased for both groups after twelve months (with 55 and 7 days, respectively); Quality of Life did not change.

Conclusions
Costs of CR at the rehabilitation centre were more than six times higher than in the hospital. Patients in the rehabilitation centre might have needed the more intensive RTW guidance. Cost-effectiveness research is needed to confirm if the guideline should include stricter targeting.

Key messages
Costs of return to work guidance within cardiac rehabilitation are higher at a rehabilitation centre than in a hospital. Further research on whether costs outweigh effects of return to work guidance at rehabilitation centres and hospitals is needed.