bluuebunny/crossref_metadata_2025_split huggingface dataset:
Promoting equity through monitoring inequalities in the semi-rural region of Girona
Authors: Batlle Amat P , Lazaro-Lasheras L , Oliveras S , Perafita X , Tarrés A , Vilà A 
Published: October 2020

Abstract

Problem
Girona's region is a semi-rural territory with 750,000 h located in the northeast of Spain. There is no system to monitor health, well-being and health inequalities. This causes a lack of local public health equity policies.

Description
Design, implementation and results of participatory process, carried out over 6 months, to identify the information and data needs to be monitored locally for social determinants and health inequalities. Process has 4 phases: Selection of technical and political profiles representing coastal and inland, rural and urban municipalities linked to the fields of social determinants of health.Diagnosis: 2.1. Systematic collection of information through: i) Self-administered online questionnaire, sent to 250 policy makers and 580 technicians. ii) 6 focus groups 2.2. Data analysis to prioritize data and information needs.Evaluation and conclusions.Dissemination of results and transfer of knowledge.

Results
Involve actors in the identification of health information needs and their determinants permit to build a shared model of indicators. Spread the model of social determinants and their effects on health and well-being, increasing awareness of inequalities and health strategy in all policies. Identify the need to adjust some state and international indicators locally to be useful in local proximity policies.

Lessons
Involving local stakeholders has enabled the Girona's Observatory of Social Determinants of Health and Well-being to respond more efficiently to the information needs of technical and political decision makers. Indicators for monitoring health and inequality at the state and international levels need to be lowered at the local level so that they can be heard in the decision-making process of actors at the local level.

Key messages
It is necessary to adjust international health indicators to territorial realities in order to adjust local health and wellness policies. Local policies need health and wellness monitoring indicators to guide their policies.
Assessment of access to water, sanitation and hygiene in rural schools of Central Kazakhstan
Authors: Bolatova Z , Toleubekov B , Kulov D , Sukhanberdiyev K , Tussupova K 
Published: October 2020

Abstract

Background
The Sustainable Development Goals (SDGs) call for universal coverage and access to drinking water, sanitation and hygiene (WASH) for all by 2030. Access to WASH in schools is one of the priority areas, considering Joint Monitoring Program is lacking the data from many developing countries, particularly, rural areas including Kazakhstan. The aim of the paper is to assess the access to WASH at schools in rural regions of central Kazakhstan.

Methods
The study was conducted in three rural schools using focus group discussion with school heads, the observation of drinking water and sanitation units, and a questionnaire survey among 166 pupils. All tools cover the set of questions about the availability and the privacy of WASH facilities, accessibility, acceptability to pupils, functionality.

Results
Results of the study show that the main water source of Algabas and Kerney schools is a centralized piped water supply provided into the school building and 85,91% of pupils from these schools report the uninterrupted availability of water from this source. However, Sartau has its well, and only 51,72% of pupils from this school indicate that water from the main source is continuously available. All toilets are flushing toilets inside of schools and not connected to the centralized sewage system. The maximum number of the toilet is 6 in the Kerney school; however, this amount of toilets is not enough for the number of pupils by the national norms. Majority of pupils (89,15%) report that the school toilets are always available. Nevertheless, 34,87% of pupils indicate no toilet paper as a reason for not using the school toilet. Handwashing facilities are located near the toilets and in classrooms. Only 53,02% have soap available and 42,77% have access to hand drying facilities after handwashing.

Conclusions
The current study shows rural schools of Central Kazakhstan are not provided with sufficient materials for pupils to manage personal hygiene appropriately.

Key messages
The study is essential for mapping the situation of WASH in schools. This study provides the baseline data for JMP; consequently, it is crucial to plan the UN SDGs in Kazakhstan.
Trajectories of adherence to adjuvant endocrine therapy for 5 years in women with breast cancer
Authors: Memoli V , Lailler G , Le-Bihan C , Bendiane M K , Lauzier S , Mancini J , Bousquet P J , Bouhnik AD 
Published: October 2020

Abstract

Background
Adjuvant endocrine therapy (AET) is a daily oral medication prescribed for women with hormone-sensitive breast cancer (BC) to reduce recurrence and mortality risks. However, many women do not take AET daily or do not persist with AET for the recommended duration of at least 5 years. Our aims were to identify: 1) trajectories of AET adherence for the 5 years; 2) factors associated with these trajectories.

Methods
The French Cancer Cohort includes data on hospitalizations, ambulatory care and drug claims for all cancers diagnosed in France (SNDS database). Women diagnosed with a 1st non-metastatic BC in 2011 who had ≥ 1 AET claim within 12 months of surgery were included. For each woman, we estimated the monthly proportion of days covered (PDC) by an AET for 5 years after the first AET. Monthly PDCs were used to model AET adherence trajectories using group-based trajectory modeling. Statistical criteria were used to assess the suitability of the selected model. The factors associated with the trajectories were identified using multinomial logistic regressions.

Results
33,260 women were included. A 6-trajectory model was selected: 1) Stop of AET in the 1st year (6.6%), 2) Adherence for 1 year and stop (5.7%), 3) Adherence for 2.5y and stop (6.3%), 4) High adherence for 4.5y and stop (8.3%), 5) Sub-optimal adherence for 5y (4.3%), 6) Very high adherence for 5y (68.8%). Factors associated with non-adherence trajectories are mainly extreme age (&gt;70y) and switch in AET.

Conclusions
About 70% of women had an optimal adherence for 5 years. Our results showed that women who changed AET during the treatment course were at higher risk of non-adherence. Among non-adherent women, the switch in AET is frequent and probably often related to the management of side effects. Interventions to detect and manage these side effects may help to support women with AET use. Effective management of these effects during all the 5 years could be needed to maintain adherence.

Key messages
About 70% of women had an optimal adherence for 5 years. Women who changed AET during the treatment course were at higher risk of non-adherence.
Spatial distribution of children used Ritalin at the neuropediatrics clinic in Maringá (PR), Brazil
Authors: De Lima C H , Paiola G C , Massuda E M , Maier A M R R 
Published: October 2020

Abstract

Blackground
Brazil is the second largest consumer of methylphenidate in the world. Considering the social determinants on the health of people and communities, the objective of the research is to evaluate the influence of social and economic factors on the prescription of methylphenidate for school-age children.

Methods
Quantitative exploratory study with primary data collected from the electronic medical records of school-aged children, 6 to 11 years old, in a neuropediatric clinic at a Basic Health Unit of the Unified Health System (SUS) in a city located in the southern region of Brazil, with the date of the last withdrawal of methylphenidate between the period of March 2017 to November 2019.

Results
104 patients who used methylphenidate were evaluated, 85 male and 19 female, with an average age of 8.26 years at the outpatient clinic and 9.19 years currently, the youngest being 6 years old and the largest 11 years old, with deviation 1.47 standard. Preliminary results indicate that 50.96% of prescriptions were aimed at children from places of greatest social vulnerability.

Conclusions
It was found that the majority of school-age children prescribed ritalin at the clinic are from poor neighborhoods. Building this panorama based on socioeconomic determinants suggests the need to understand the influence of how environments with higher levels of violence can influence the health-disease process, both for integrality to diagnosis and for longitudinality to treatment. New studies are suggested that consider children who have not been treated in the public health service.

Key messages
Impact of the evaluation of socioeconomic determinants on the prescription of methylphenidate for school-age children. Integral and longitudinal treatment with methylphenidate for children from poor areas.
Qualitative study on Bhutanese patients’ perceptions of modern, Sowa Rigpa, and local medicine
Authors: Hosoda M 
Published: October 2020

Abstract
Modern society has seen a rapid shift toward biomedicalization. However, there is now an increasing trend of using complementary and alternative medicine for holistic treatment. Bhutan promotes the physical, mental, and spiritual well-being of its citizens through its universal healthcare system, production of herbal medicines, Buddhist practices, and governmental policy of Gross National Happiness. Patients can choose one or a combination of modern, traditional (Sowa Rigpa), and local healing practices for treatment. For this study, in-depth, semi-structured interviews were conducted among randomly-selected patients (N = 20). Interviewees were categorized based on demographics, past medical experiences, upbringings, and expectations for medical care providers. All participants were found to rely on modern medicine (n = 20), many used traditional medicine (n = 13), and some had experienced local medicine (n = 9). Only a fraction had solely relied on modern medicine (n = 5) and a select number relied on all three practices for treatment (n = 7). In addition to determining patients' reliance on one or a combination of healing practices, this study identified their perceptions of the strengths and limitations of each method. To this end, the participants' reasonings for relying on certain practices over others for particular ailments were investigated. A key finding was that patients believe the flexibility in the reliance of one or multiple treatment types optimize their health and facilitate access to medical resources. Further collaborations between modern medical practitioners and complementary and alternative medical care providers are necessary to advance the integration of these three practices and ensure patient well-being.

Key messages
Bhutan provides universal health coverage to access basic public health services in both modern and traditional medicine, giving patients the freedom to choose their own modes of treatment. Referrals and communication between modern medical practitioners and complementary and alternative medical care providers are necessary to ensure patient health and well-being.
Portrait of young Italian university smoker student
Authors: Gori F , Vonci N , Quercioli C , Rossi S 
Published: October 2020

Abstract

Background
Smoking is a widespread problem in all age and social groups. Number of smokers is increasing among students and the years of university are those in which it is most common to start smoking.
The aim of this study is to outline the profile of the smoker university student.

Methods
Between October 2018 and January 2019, a sample of 150 smoking students of Siena University were randomly selected. We administered the structured Fagerstrom test. This test contained six items to evaluate the dependence and the quantity of cigarettes consumption. We conducted a descriptive analysis and a linear regression using software Stata.

Results
The sample was composed of 75 males (50%) and 75 females (50%), with a mean age of 24.6 years (sd 3.1). About 45% of the participants smoked between 11 and 20 cigarettes a day. Fifty per cent of the respondents lighted the first cigarette after 1 hour since they woke up, indeed only about the 25% preferred to smoke just woke up and would hardly give up the first cigarette. About the 80% did not show difficulty to avoid smoking in forbidden places or when they were ill. The mean degree of dependence of cigarettes was 2.7 (sd 2.3), considered as medium-low level of dependence. The degree of dependence (0 -10) was correlated with every items of the test, resulting: time to lighted the first cigarette (r = 0.71, p &lt; 0.005), difficulty to refrain from smoking in places where is forbidden (r = 0.41, p &lt; 0.005), cigarette hate to give up (r = 0.32, p &lt; 0.005), number of cigarettes smoked a day (r = 0.69, p &lt; 0.005), smoking more frequently in the morning (r = 0.26, p &lt; 0.005), smoking even if being sick (r = 0.27, p &lt; 0.005). The gender did not show correlation with any variables.

Conclusions
The our sample showed a medium-low level of dependence from nicotine (11-20 cigarettes a day) with the time to light up the first cigarette after 60 minutes; as resulted from the linear regression analysis. The gender did not have correlation with the dependence from cigarettes.

Key messages
Outline the profile of the joung smoker university student. Smoking is a widespread problem in all age and social groups.
Translation and validation of a brief Health Literacy instrument for children into Danish
Authors: Bonde A H , Stjernqvist N W , Klinker C D , Maindal H T , Paakkari O , Elsborg P 
Published: October 2020

Abstract

Background
Evidence for health literacy (HL) as an important determinant of health and health behaviour is increasing. Brief and generic tools for measuring HL in children are few. One such tool is the Health Literacy for School-Aged Children (HLSAC) instrument, which is a 10-item theory-based tool developed in Finland for measuring HL in children aged 13-15. The aim of this study was to translate and validate the HLSAC-instrument among Danish children aged 12-14.

Methods
The instrument was translated into Danish by a recommended standardized forward-backward translation process, and then pre-tested for face validity with 61 pupils from four schools. Thereafter, the instrument was tested among 805 pupils from 15 schools. Structural validity was analysed with confirmatory factor analysis (CFA), predictive validity with regression analysis, and internal consistency with Cronbach's alpha.

Results
When HL was modelled as one latent factor with all 10 items loading on this factor, CFA showed standardized factor loadings from 0.52 to 0.75 (p &lt; 0.001) and an excellent model fit (comparative fit index &gt;0.95, Tucker-Lewis Index &gt;0.95, standardized root mean square residual &lt;0.08, and root mean square error of approximation &lt;0.06). The predictive validity regarding food intake was good (p &lt; 0.001, r2=0.027) and the internal consistency was high (Cronbach's alpha=0.86).

Conclusions
A valid and reliable version of the HLSAC-instrument is now available in Danish for measuring HL among children aged 12-14. This instrument is considered useful for future surveys to inform and guide public health policy, health promotion strategies and health education targeting children.

Key messages
A validated brief Health Literacy instrument for school-aged children is now available in Danish. The Health Literacy instrument’s ability to predict healthy food intake is promising for the utility.
Dietary guidelines made useful in migrant networks
Authors: Magnusson M , Bertolino C , Landmér R , Lustig E 
Published: October 2020

Abstract
Globally, many deaths and DALY:s are attributed to unhealthy diets. Short education, low income and migration are risk factors. Healthy food cost more and is less available while unhealthy food is cheaper and heavily advertised. Health guides (HG) speak Swedish and at least one more language and have networks among migrants. Their work draw on the Right to health framework - availability, accessibility, acceptability and quality for all (AAAQ). HG transfer viewpoints from their groups to health care and contribute to culturally accessible and acceptable information and support.
Public Health Unit of a local hospital initiated a project with the aim to develop a method to make information about healthy food accessible for a wider range of people. How to make food based dietary guidelines useful for recent migrants? How to avoid that official guidelines, when transferred by laymen, become distorted by personal experiences rather than being enriched by them? Systematic collection of viewpoints from inhabitants, helped of HG, implied that “shop walks” have potential to increase health equity. During a shop walk the guide shows healthy alternatives and transfers knowledge on different options. The intervention was developed during 2019. The first shop walks were conducted in February 2020.
Dietary guidelines were made useful by a process including cooperation between HG, nutritionally skilled staff and the communication department. A detailed manuscript and a participant folder were developed together with a mandatory education including theory and practice. 14 HG speaking six languages were included. During the first three weeks six shop walks were conducted. Qualitative evaluation implies that shop walks are functional arenas for strengthening AAAQ.
By structured shop walks HG can contribute to making dietary guidelines relevant for recent migrants. AAAQ is supported by participation of stakeholders in the population in collaboration with professional expertise.

Key messages
If food based dietary guidelines are to be made useful outside the majority population, methods that allow those most concerned to participate in planning, execution and evaluation should be used. Availability, accessibility, acceptability and quality - The Right to health framework – should be used when developing public health interventions that aim at health equity.
The association of positive mental health indicators and normal body weight, Belgian HIS 2018
Authors: De Ridder K , Drieskens S , Demarest S 
Published: October 2020

Abstract

Background
An important health promotion goal is to maintain a normal body weight. However, knowledge about positive mental health indicators that might be associated with normal weight is scarce. The aim is to study positive mental health indicators and normal weight in a cross-sectional national representative population sample.

Methods
Study participants included adults aged ≥ 18 year (n = 6643) of the Belgian Health Interview Survey (HIS) 2018. Mental health indicators were having no psychological distress (GHQ-12&lt;2), no self-reported anxiety or depression (EQ_5D), medium to high vitality (SF-36 vitality scale) and high to medium level of life satisfaction. BMI was calculated on self-declared height and weight. The associations were assessed through logistic regression taking into account confounding and effect modification by age, gender, educational level, health status, physical activity, daily eating of fruit and vegetables and daily consuming sugared soft drinks or sweet/salty snacks.

Results
50.1% had a BMI≥25. In the crude models, all indicators were negatively associated with being obese, but there was no association between having a normal weight (versus overweight and obesity) and absence of psychological distress, absence of anxiety and depression, and medium to high vitality. Medium to high level of life satisfaction was associated with normal weight in the fully adjusted model (OR 1.3; 95%CI 1.0-1.6) but when stratified, medium to high life satisfaction was associated with normal weight only among high educated women (OR 1.8; 95%CI 1.1-2.9), but not among men and low educated women. Surprisingly, among low educated women, having no psychological distress was negatively associated with normal weight (OR 0.7; 95%CI 0.5-0.9).

Conclusions
These preliminary results showed a variable impact of gender and educational levels on the association between positive mental health indicators and normal weight. Trends and distribution in society should be further explored.

Key messages
Although unequivocal associations with obesity, positive mental health is not clearly associated with normal body weight in today’s obesogenic society. The effect of a shift towards a higher BMI in society on mental health needs to be further explored.
Does a work-stress intervention prevent sick leave? A randomized controlled trial in primary care
Authors: Hultqvist J , Bjerkeli P , Hensing G , Holmgren K 
Published: October 2020

Abstract

Background
Work-related stress (WRS) clearly presents a risk for sick-leave. A brief preventive intervention aiming to identify people at risk for WRS was tested in a RCT study in primary health-care centers (PHCC). At the 12-month follow-up there were differences regarding sick leave between the intervention and the control group, however they did not become statistically significant. Evaluating the intervention in a longer perspective is thus warranted.

Purpose
This study aims to evaluate whether a systematic early identification of work-related stress can prevent sickness absence over 18 to 24 months after the intervention.

Methods
The RCT-study had follow-ups at 18 and 24 months. The participants (N = 271) were employed, non-sick-listed women and men (18 to 64 years) seeking care at PHCCs for mental and physical health complaints. 132 patients were allocated to the intervention and 139 patients were allocated to treatment as usual. The preventive intervention included early identification of WRS by the Work Stress Questionnaire (WSQ), general practitioner (GP) awareness supported by a brief training session, patients' self-reflection by WSQ completion, GP giving the patient feedback at consultation, and identifying appropriate preventive measures. Sick leave data from the Swedish Social Insurance Agency register constituted the outcome comparing the preventive intervention by the GP versus treatment as usual.

Results
The preliminary results showed that there were differences in median sick days between the intervention group (68, 72) and the control group (80, 81) at 18 months and at 24 months, however these differences did not become statistically significant.

Conclusions
The WSQ brief intervention was not proven effective in preventing sick leave in the following 18 and 24 months compared to treatment as usual. The study may have been under-powered and the lack of statistical difference between the groups might be due to a type II error.

Key messages
Work-related stress is a predictor for sick-leave. Further research on how to identify those at high risk for sick-leave, give advice and treat this group in primary health care is needed. A study of the WSQ brief intervention with a larger sample seems warranted.