bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adopting healthy habits through the collaboration of health, education and culture systems
Authors: Puljak A , Bajs M Maric , Sostar Z 
Published: November 2019

Abstract

Background
The ’Adopt healthy habits’ program is a health promotion program that links the health system, education system and the City of Zagreb library. It is based on the association of mental, physical and emotional health factors. It is done through work in smaller groups, using educational interactive materials and methods with selected books in accordance with the topic of the workshop and with the practice of applying the adopted knowledge.

Methods of work
The methodological basis of the programs are health workshops conducted in the libraries of the City of Zagreb in cooperation with the primary schools. They imply working with students by acting on risk factors: obesity, physical inactivity, smoking and low self-esteem. The skills used are promoting health, cognitive-behavioral methods, health education, kinesiology, nutrition and bibliotherapy.

Objectives
Educating students about the importance and ways of adopting healthy habits and gaining self-esteem and reducing the occurrence of risky behaviors. Long-term objectives are improvement of the psychophysical development of students, increase of the population of the City of Zagreb with balanced dietary habits and regular physical activity and normal body mass index and reduction of the occurrence of chronic non-communicable diseases in adulthood.

Results
In the period from 2015 to 2018, a total of 141 workshops were conducted through which 3,106 pupils were educated. The workshops were conducted in 12 primary schools of the City of Zagreb and 5 of the related city libraries.

Conclusions
Interactive approaches in the creative environment proved to be the most appropriate in educative work with children. It is necessary to continue to implement this form of primary prevention on a wider population.

Key messages
Adopting healthy habits in childhood is the basis for primary prevention of chronic non-communicable diseases. Multidisciplinary approach to health education in youth assures a more permanent adoption of positive health behavior.
An ordinary life with chronic condition as a goal for medicine
Authors: Gaille M s , Camus M s 
Published: November 2019

Abstract

Background
Social sciences and humanities have developed a significant interest about chronic condition since the 1960, examining the “biographical disruptions” it seems to entail and the coping capacities of individuals. The present study, funded by IreSP, aims at developing a new conceptual and normative perspective: to explore the idea of “normal” life with chronic condition. This perspective allows for taking into account the expression of the wish for a “normal life” actually expressed by persons with chronic condition. On the basis of this research perspective, the present study aims at assessing the possibility to live such a life with chronic condition as a goal for the health care systems. As it may have substantial implications in terms of health care organisation and orientation, this research is important to ground public health policies.

Methods
1.Review of literature (philosophy of the forms of life and of ordinary life, social sciences’ critical assessment of the “injunction to normality”, ethnographic works on the expression of the whish for a normal life)
2.Analysis of the theoretical and ethical resources of the philosophical works by G. Canguilhem and K. Goldstein

Results
-Elaboration of a philosophical conceptual and normative frame based on the notion of “ordinary life” and of a “reinvented normality”
-Attention paid to the “milieu” of life of the person and its adjustment to her capacities.
-Identification of the technological tools and care practices contributing to such a reinvention.

Conclusions
The study presents the conceptual and normative results of a philosophical analysis careful of the challenge raised by the wish for a “normal life” expressed by people with chronic condition. It proposes some conceptual and normative tools to answer this challenge. It formulates this challenge as an issue for the health care systems and the organisation of medical care, its places (institutions of various types and/or home) and its goals.

Key messages
The wish for a “normal life”, “a life like everyone’s life expressed by persons with chronic condition should by taken into account by the health care system. Philosophy offers some conceptual and normative tools to medical care to answer this wish.
Economic burden of diabetes in France between 2012 and 2017 based on French national claim database
Authors: Denis P , Aguadé A , Lesuffleur T , Pestel L , Nicolas M , Rachas A , Gastaldi-Menager C 
Published: November 2019

Abstract

Background
The aim of this study is to assess the economic burden of diabetes in France based on a top-down allocation of health care expenditure, and to analyze structure and trends of expenditure between 2012 and 2017.

Methods
Using information about 57 millions of individuals from the general scheme insurance database (87% of the French population), we applied algorithms based on ICD-10 diagnoses, long-term diseases, and specific treatments. All reimbursed expenditure (drugs, medical visit and other ambulatory care, hospitalization, disability/sickness benefits) were extracted for each individual. A top-down method was used to allocate expenditure to diabetes. To analyze trends, we applied the same methodology from 2012 through 2017.

Results
In 2016 (results for 2017 will be available for the conference), among the 137 billion euros reimbursed, 6.8 billion (5%) were attributed to diabetes and 3.2 million people were concerned (5.5% of the population). Drugs represented the main expenditure item (31% of the average annual expenditure per patient related to diabetes), followed by nursing (18%) and medical devices (17.5%). From 2012 to 2016, the number of people with diabetes increased by 11.4% (+322 700) with an increase by 2.7%/year, the expenditure attributed to diabetes increased by 2.3%/year. The average expenditure per patient in 2016 was about €2150, slightly decreasing from 2012, mainly due to price controls on antidiabetics drugs which permits to limit expenditure growth.

Conclusions
Our study shows the high economic burden of diabetes in France with a detailed analysis of expenditures and their main drivers. With the arrival of innovation and predicted increase of the number of patients partly related to ageing process, control of expenditure must be a priority. The developed tool will help decision makers to monitor the burden of diabetes but also to provide stakeholders with a better understanding of trends and regulating actions.

Key messages
Diabetes represents a high proportion of healthcare expenditure in France. With the arrival of innovation and predicted increase of the number of patients partly related to ageing process, control of expenditure must be a priority.
Tuberculosis screening for foreign students change: good saving and bad idea?
Authors: Gerbaud L , Chabanas B , Perrève A , de l’ADSSU Bureau 
Published: November 2019

Abstract

Issue
There was a mandatory screening of tuberculosis (TB) for the 60.000 foreign students (out of European Union) annually newcomer in France. It was organized by screening centers of the Office of Immigration and Integration, a State agency. There was a link with university students’ health services (USHS) by systematic exchange of data, and sometimes the USHS was in charge of this screening and financed for that. In March 2016, a law, applied since January 2017, stopped this obligation, and transferred the responsibility of a “preventive survey” to USHS, without any means and financing.

Problem
As the decision was made without any data, thanks to the national network of UHSH, we made a brief national survey showing a 2,7 to 7,9/1.000 incidence, from year to year, 40% being active. About 50% of the cases came from North Africa and China. These data did not changed the decision, and we present its consequences in one French University, which was a previous TBI screening center. We computed all the cases of TB known in our USHS, since 2010, completed by the data form health authorities.

Results
Since screening is not anymore mandatory we faced a global refusal from Chinese and Moroccan students arguing that there was no TB in their country. Number of foreign students and their origin were approximately stable from 2010 to 2016, and mean TB incidence was 1,97/1.000. Students from China and North Africa represented half of the cases and 40% were latent TB. Since January 2017, TB incidence lowers to 1,51/1.000. Latent TB represent less than ¼, and there was no more cases screened from North Africa and China, while there was no change in foreign students origins, showing a significant degradation of screening effectiveness.

Lessons
The main reason for screening cessation was to save public money. Due to important lack of knowledge among French state authorities, we couldn’t change a decision which threatens the TB epidemic control.

Key messages
Cost saving policy reduced the effectiveness of tuberculosis screening. Health policy decisions may not take into account epidemiologic objectives.
Healthcare workers and measles outbreaks in Italy: is it time to act? A systematic review
Authors: Baccolini V , Sindoni A , Adamo G , Rosso A , Massimi A , Pitini E , De Vito C , Marzuillo C , Villari P 
Published: November 2019

Abstract

Background
Despite healthcare workers (HCWs) vaccination against measles is strongly recommended in Europe, many studies showed their low vaccination coverage and a significant involvement in hospital and community outbreaks. The aim of this systematic review was to analyze the available evidence on HCW role in measles outbreaks and identify the epidemiological characteristics of the transmission patterns related to HCW infection.

Methods
PubMed, Scopus and ISI Web of Science were searched to detect the measles outbreaks occurred in Italy and involving at least one HCW. English or Italian records were considered eligible. The quality assessment was performed using the ORION checklist. We also analyzed national or regional measles reports and the Measles outbreaks reporting forms that are annually submitted to the World Health Organization (WHO) of the period 2014-2018.

Results
Twenty-one articles were identified in the literature search and were in general of good quality. Of these, six were regional or Italian reports, two referred to one city, 13 were single outbreak reports. The national data showed that the number of infected HCWs increases with the rise of the total number of cases. A total of 72 descriptions of measles outbreaks were retrieved from the WHO reports. The vast majority was confined to the hospital or started at the hospital and spread in the community. The index cases were mainly patients seeking care for measles-related symptoms but, in the last years, a growing number of infected HCWs was identified as infection source. Similarly, the number of outbreaks with more than one infected HCW recorded a small increase over time.

Conclusions
HCWs play a critical role in measles transmission especially in hospital outbreaks, which are significantly costly and disruptive for the healthcare delivery quality and safety. Vaccination policy aiming at increasing their immunization rate is crucial to limit the virus spread and the economic impact on the institutions.

Key messages
In spite of the remarkable progress, measles elimination in Italy is far from being met and the virus transmission in healthcare settings is increasingly notified. Vaccination policies aiming at increasing HCW immunization coverages are essential.
Overview of three-year trends of antimicrobial consumption and resistance in Sicilian hospitals
Authors: Barchitta M , Quattrocchi A , Maugeri A , La Rosa M C , La Mastra C , Sessa L , Cananzi P , Oteri A , Murolo G , Agodi A 
Published: November 2019

Abstract

Background
Antimicrobial resistance (AMR) is one of the ten threats identified by the WHO in 2019. In order to face this issue and in the framework of the National Action Plan on Antimicrobial Resistance (PNCAR) 2017-2020, the Sicilian Health Authority has implemented a surveillance system of antibiotic consumption in the hospital sector and in the community and of antibiotic resistance in the Sicilian hospitals. The aim of the present work is to report the results of three-year surveillance.

Methods
From 2015 to 2017, data on antibiotic consumption have been collected from pharmacies of participating hospitals. AMR data on seven bacterial pathogens isolated in blood and cerebrospinal fluid have been collected from hospital laboratories, using routine clinical antimicrobial susceptibility tests. Antibiotic consumption was expressed as Defined Daily Dose (DDD) per 100 patient-days. Antibiotic resistance rates (RRs) were calculated as the number of non-susceptible isolates divided by the total number of isolates multiplied by 100.

Results
The most commonly consumed antibiotics in participating hospitals were fluoroquinolones in 2015, penicillins in 2016, and beta-lactams in 2017, respectively. RRs of Klebsiella pneumoniae significantly increased for all antimicrobial classes (p &lt; 0.001), but carbapenems. By contrast, RRs of Escherichia coli resistant to third-generation cephalosporins and carbapenems showed significant decreasing trends (p &lt; 0.001).

Conclusions
The implementation of the Sicilian surveillance system provides Sicilian reference data to monitor trends and target interventions and policies for reducing the threat of AMR. Recently, using toolkits of the ECDC-EAAD initiative adapted with regional surveillance data, an educational campaign “Obiettivo Antibiotico” - https://www.obiettivoantibiotico.it/ - was designed and launched to raise awareness of prudent use of antibiotics in the general public and in healthcare professionals in Sicily.

Key messages
Inappropriate antimicrobial consumption observed in Sicilian hospitals contributes to the emergence and selection of AMR. Surveillance system of antimicrobial consumption and AMR can help identify strategies for preventing spread of multi-drug resistant microorganisms.
A digitalized methodology to strengthen health equity: control, influence and participation
Authors: Magnusson M , Bertolino C , Hallmyr M 
Published: November 2019

Abstract

Problem
Angered Hospital is situated in the northeast of Gothenburg, Sweden, serving municipalities with high prevalence of ill health. Dedicated to increase health equity, the hospital has established a Public Health Unit (PHU) to support residents to healthier lives. PHU found that lack of transparency concerning strategies, reflections and results hindered knowledge-exchange between public health practitioners. Also, information from the execution of public health interventions and programs needed to be more accessible for policy-makers and researchers.

Description
PHU developed a digitalized methodology for systematic steering. It draws on control, influence and participation, using Social Cognitive Theory to plan for strategies. The evaluation build on norm-critical reflections of structured reports. Themes include: How to improve efforts on the structural level? What measures do we plan for and conduct to enhance participation from residents? Quantitative goals were set.

Results
222 activity reports were launched and discussed by team members, leading to professional development. Strategies to support self-efficacy were used throughout. The strategy “reciprocal determinism” was planned for more than used, due to giving floor to participants to raise their issues. Methods that draw on transparency, sound evidence and continous collaboration allow for residents to rethink their lifestyle and strive for change. Issues for future development included the importance og giving time for trust and shared values to emerge. Quantitive goals were reached.

Lessons
Quality assurance of public health work enables formative and summative evaluation, increases potential to close the health gap, provides policy-makers with valuable knowledge and opens for research. Trust and shared values are vital at all levels. The methodology allows for organizations to develop their health literacy in order to include and give voice to people in underserved areas.

Key messages
Public health units aiming at health equity should use tailored evidence based methods, including norm-critical reflections. Digitalizing a methodological instrument increases accessability and transparency which enables common knowledge development.
Sickness absence trajectories following labour market participation patterns in Catalonia, 2012-2014
Authors: Hernando-Rodriguez J C , Serra-Saurina L , Benavides F G , Ubalde-Lopez M 
Published: November 2019

Abstract

Background
Working life is characterized by transitions between different employment status which could affect future health status. Previous studies on sickness absence (SA) have focused on risk factors in the workplace; however, there is scarce evidence regarding labour market participation (LMP) patterns. The aim of this study is to examine the association between prior LMP patterns and the course of SA.

Methods
Cohort study based on a sample of 11,968 salaried workers affiliated with the Spanish Social Security system, living in Catalonia, who accumulated more than 15 days on SA at least in one quarter during 2012-2014, from three working life cohorts according to the working life stage in 2002: early (18-25 years), middle (26-35 years) and late (36-45 years). Sequence analysis was used to identify LMP patterns (2002-2011). Latent class growth analysis was applied to identify SA trajectories (2012-2014). Finally, crude and adjusted odds ratios (aOR) were estimated using multinomial logistic regression models.

Results
Overall, four SA trajectories were identified: low stable (83%-88% of the workers), decreasing (5%-9%), increasing (5%-11%) and high stable (7%-16%) accumulated days on SA, for men and women. Similarly, seven LMP patterns were obtained: stable employment (63%-81%), increasing employment (5%-22%), delayed employment (7%-8%), decreasing employment (4%-10%), varying employment (13%-14%), steeply decreasing employment (9%), and steeply labour market exit (8%). No significant associations were observed among LMP patterns and SA trajectories, except for young men, where an increasing employment pattern was significantly associated with a lower risk to increase days on SA over time (aOR: 0.21 [95% CI: 0.04-0.96]).

Conclusions
A prior 10 years of LMP pattern does not seem to show an effect on the course of SA. A closer working life to the SA course could be considered to assess this relationship.
Funding: Grants FIS PI17/00220 and PI14/00057

Key messages
A longitudinally approach is warranted to evaluate the relationship between working life and sickness absence. Extended prior working lives are not related to the course of future sickness absence.
Age-group differences in associations of working hour characteristics and short sickness absences
Authors: Ropponen A , Koskinen A , Puttonen S , Härmä M 
Published: November 2019

Abstract

Background
Working-hour characteristics are linked to disturbed sleep, but little is known about their association with short sickness absences (SA). We investigated the association between working hour characteristics in shift work and the incidence of short (1-3 days) SA in three age groups.

Methods
The data was from the hospitals’ electronic working time records. The final sample was restricted to the first incidence of short SA (1-3 days) from 2008 to 2015 and to shift working employees (n = 12156, 89% women). Age groups were &lt; 35 (n = 5652), 35-49 (n = 3592) and ≤ 50 years (n = 2545). Work shifts (morning, day, evening, and night), quick returns (&lt; 11 hours between two work shifts), length of work shift and weekly working time were calculated for case-crossover study design to compare the working hour characteristics of the 28 days preceding SA (exposure window) and those of the 28 days before the exposure window (control window). Conditional logistic regression models were run for odds ratios (OR) with 95% Confidence Intervals (95%CI).

Results
Working hour characteristics, especially length of working hours, played the clearest role among those &lt; 35 years of age. In this age group, exposure to &gt; 25% of &gt; 40 weekly working hours associated with an increased likelihood of short SA (OR 1.30, 95%CI 1.17-1.44), whereas weekly working hours had OR 1.02 (95%CI 1.02-1.03). Having only a few (≤ 4) quick returns decreased the likelihood of SA (ORs 0.31-0.54), whereas having ≥25 quick returns increased it (OR 2.75, 95%CI 2.44-3.11). The results showed mostly similar trends among those of 35-49 years of age whereas among older workers (≤ 50 years) only an association for quick returns was observed.

Conclusions
Long working hours increase the risk of short SA among those ≤ 49 years of age and several quick returns among all age groups. These working-hour characteristics should be avoided to minimize SA and increased costs for the employer, but also to maintain public health.

Key messages
Unhealthy working-hour characteristics should be paid special attention in shift scheduling to avoid sickness absence. Good shift scheduling could assist in maintaining workability and therefore public health.
The impact of psychosocial factors on breastfeeding duration in the BaBi cohort study, Germany
Authors: Grosser A , Doyle I-M , Löffler A , Breckenkamp J , Spallek J , Razum O , Miani C 
Published: November 2019

Abstract

Background
Breastfeeding is considered beneficial for both mother and child. In Germany, national guidelines recommend fully breastfeeding for at least 4 months, a goal reached by only 34% of mothers in 2012. The WHO’s recommendation of exclusively breastfeeding for six months was met by 19% only. Hardly modifiable factors such as socio-economic status and migration background have been associated with duration of breastfeeding but little is known about the impact of psychosocial factors such as personality traits and social support. We hypothesise that there are differences in the psychosocial profiles of mothers regarding the duration of breastfeeding.

Methods
We analyse baseline and follow-up data of the Bielefeld BaBi birth cohort (2013-16). They include detailed migration and socio-economic backgrounds, as well as three measures of psychological characteristics: the optimism scale, the Big Five inventory and the locus of control scales. We perform bivariate and multivariate analyses in order to identify psychosocial determinants of fully breastfeeding for four and six months.

Results
Out of 780 BaBi study participants, 548 fully breastfed for four months (70.3%), of which 279 continued until at least six months (35.8%). Logistic regression analyses show that fully breastfeeding for at least four or six months is independently associated with the intention to breastfeed and the attendance of antenatal class during this or previous pregnancies. Personality characteristics, social status and migration background show however no significant association with breastfeeding duration.

Conclusions
Our study results support the promotion of individuals’ breastfeeding intention and attendance to antenatal classes to increase breastfeeding duration. Since differences in breastfeeding practices have the potential to create inequalities in maternal and child health, more efforts are needed to intensify research on modifiable factors influencing breastfeeding duration.

Key messages
Neither psychosocial factors nor socioeconomic status were associated with breastfeeding duration. Two modifiable factors, breastfeeding intention and attending antenatal classes, were the main predictors of breastfeeding duration.