bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lower predicted probabilities of attained Lifés Simple 7 factors in the presence of sleep problems
Authors: Felisbino-Mendes M , Andrade F , Dias Moreira A , Hernandez R , Vieira M A , Velasquez-Melendez G 
Published: October 2020

Abstract

Background
Given that sleep disturbances seem to be increasing in Brazil, this may have serious implications on Cardiovascular Health and mortality.

Objective
To examine the predicted probabilities of attained Lifés Simple 7 factors (LS7) in the presence of sleep problems among Brazilian adults.

Methods
We used data from the 2013 Brazilian National Health Survey (PNS), a nationally representative cross-sectional household survey of adults in Brazil. Cardiovascular Health was assessed by the sum of Lifés Simple 7 factors (LS7), which includes four behaviors (smoking, physical activity, body mass index and diet) and three biological factors (hypercholesterolemia, hypertension and diabetes). We analyzed self-reported data from 36,480 Brazilian adults aged 18 and over, including the sleep problems. We estimated predicted probabilities after multivariate Poisson regression.

Results
Mean CVH scores was higher among those who did not report sleep disturbances [4.2 (95% CI: 4.1; 4.2)], than those with sleep disturbances [3.8 (95% CI: 3.7; 3.8)]. Predicted probabilities of attained LS7 and CVH score was lower in the presence of sleep complaints, with a dose response for blood pressure, glucose, smoking and CVH score in both unadjusted and adjusted analyses, for age, sex, schooling, depression and night work shift.

Conclusions
Brazilian adults with sleep disturbances are less likely to achieve LS7 and consequently ideal cardiovascular health. Given that sleep disturbances seem to be increasingly more common in Brazil, recent gains in CVH mortality may be affected.

Key messages
Sleep disturbances may potentially affect metabolic outcomes and modifiable lifestyles behaviors as decreased physical activity and smoking. Sleep disturbances is novel risk factor for metabolic diseases.
Risk Management in nursing homes: an Italian experience in 2019
Authors: Furmenti M F , Bert F , Rucci M , Fiandra U , Scarmozzino A , Guerrieri A , Ripa F , Siliquini R 
Published: October 2020

Abstract

Background
The ageing of the European population leads to an increasing demand for Long-Term Care services. The security and well-being of the elderly population hosted in nursing homes (NHs) needs an effective Risk Management policy, officially sanctioned in Italy by the so-called “Legge Gelli” n.24 (March 8th, 2017) and the Directive 2011/24/EU on the application of patients' rights in cross-border healthcare. In order to verify the effective application of common “best practices” in terms of Risk Management in NHs, a tool useful to analyse risk management attitudes in Northern Italy was conceived and applied in a sample of NHs.

Methods
The tool, developed in collaboration with the health insurance company SHAM Italia, is composed of 124 items (with a dichotomous answer -YES/NO) on topics related to various Risk Management practices. This tool was submitted in a face-to-face interview to several Directors (Health Directors or Nursing Coordinators) of NHs in the Piedmont Region. A list of randomly-chosen NHs was contacted: 4 of them were selected for the pilot study and compiled the questionnaire. Answers were gathered and analyzed through Microsoft Excel.

Results
Only the 25% of NHs has a Risk Management plan with objectives and indicators of effectiveness and uses Risk Analysis instruments for a pre- and post-” risk detection. Only one has employees working mainly on Risk Management alone. The 75% of the reported events were “Adverse Events”, and all the NHs (100%) have a protocol for a patient voluntary departure or for fall prevention or for bedsores prevention; while 50% have a protocol for prevention of aggressions towards operators or for patients' suicide prevention.

Conclusions
This work provides a starting point to face new challenges that are looming on the European Health-care Systems: the care for the elderlies needs to be perfected to reduce inefficiencies, cut useless costs and improve safety of patients in the NHs setting.

Key messages
Despite safety of older patients in nursing homes is not only important but mandatory in Italy, risk management tools for this setting are lacking in literature. A new tool applied in Italian nursing homes showed that risk management needs to be implemented in practice and these results can be extended to European context.
Smoking prevalence, nicotine dependence, and intention to quit among cigarettes smokers
Authors: Algabbani A , BinDhim N 
Published: October 2020

Abstract

Introduction
Tobacco consumption remains a challenging issue to the global and public health that requires close monitoring of the spread of this epidemic and its impact. This study aims to assess the national prevalence and determinates of cigarette smoking and nicotine dependence in Saudi Arabia.

Methods
A cross-sectional national survey of a sample of 5148 of Saudi residents' ages 18 years or older was conducted through web-based-computer assisted telephone interviews. The two main measurements were current cigarette smoking status and nicotine dependence assessed using the Fagerstrom Test for Nicotine Dependence. Data was weighted by age, gender, and region to account for the different probabilities of selection. Descriptive and logistic regression analyses were used to assess cigarette smoking and nicotine dependence determinants.

Results
The national prevalence of cigarette smoking was 16.18% (95% CI:14.59-17.77) with 14.12% (95% CI:12.64-15.59) current daily smoking prevalence. Almost 72% of smokers started smoking before the age of 22 and 27% of smokers were highly dependent on nicotine. Having a smoker parent (AOR=1.84[95%CI:1.31-2.58], P &lt; 0.001) or a smoker close friend (AOR=6.49[95%CI:3.89-10.81], P &lt; 0.001) were significantly associated with being a smoker. Higher nicotine dependence level was significantly associated with early onset of regular smoking (ages&lt;18) (AOR=2.71 [95%CI:1.38-5.34],P&lt;0.001) and lower attempting to quit (AOR=0.51[95% CI:0.32-0.83],P&lt;0.01).

Conclusions
Cigarettes smoking and nicotine dependence are prevalent in Saudi Arabia. The study found the majority of smokers started regular smoking before the age of 22 and the early onset of smoking was associated with a higher nicotine dependence level. Restrict access to tobacco products to those below the age of 22 will help reduce smoking prevalence and lifetime addiction to nicotine.

Key messages
Majority of smokers initiated smoking by the age of 21 and early regular smoking initiation was associated with higher nicotine dependence. Strategies to prevent initiation before the age of 21 will help prevent addiction to nicotine.
Self-efficacy among nursing assistants in Denmark after dementia specific education
Authors: Rasmussen B M , Waldorff F B , Berg-Beckhoff G , Andersen P T 
Published: October 2020

Abstract

Background
The care needs for people with dementia (PWD) constantly needs adjustment which makes it difficult for nursing assistants (NA) to accommodate optimal care to PWD. Dementia education to NAs may increase staff skills, self-efficacy and care quality. The study aims to investigate NA's experience of self-efficacy and how it changes during dementia education.

Methods
NAs received dementia-specific education focusing on behavior management through a person-centered approach. A phenomenological hermeneutic study using semi-structured interviews with 18 NA from two municipalities in Southern Denmark. Interviews lasted approx. one hour and were conducted at worksites. Analyses were made with a phenomenological hermeneutic approach. Concept maps were constructed during the process to follow changes in understanding.

Results
Dementia education increases the feeling of self-efficacy for NAs through acknowledgement, trial-and-error and social inspiration by peers and educators. NAs experience dementia education differently depending on whether NAs have a structural or citizen-centered focus to their work. NAs with a citizen-centered focus experience greater impact and that higher self-efficacy increases motivation for action and providing good care. They also more frequently experience successful situations due to a more analytic approach to daily challenges. NAs with structural-centered focus identified several structural barriers to establish new routines and therefore did not experience the same increase in self-efficacy.

Conclusions
Higher feeling of self-efficacy among NAs after dementia education seems to produce more motivation and engagement in daily care. NAs with a citizen-centered focus in their work, experience a higher level of self-efficacy and are frequently confirmed in this belief.

Key messages
Increasing needs for continuing dementia education. Nursing assistants with citizen-centered focus experience greater impact of dementia education.
Violence against disabled persons: Brazilian’s Health Service’s Notifications, 2011 to 2017
Authors: Freitas de Mello N , Pereira V O M , Pereira E L , Santos L M P 
Published: October 2020

Abstract

Background
Violence has important consequences for the people who experience it, for families and for societies. It becomes an even greater challenge for disabled persons (DP), who face various kinds of barriers and suffer all kinds of discrimination, prejudice, stigma and oppression. This work aimed to analyze the panorama of violence against DP from the characterization of cases of violence reported in the Ministry of Health's Violence and Accident Surveillance System (Viva) by Brazilian's health services. The profile of the DP in violence's situation, the type of violence perpetrated against this people and the profile of the probable perpetrators of violence allow us to understand the context of vulnerability and exclusion to which the DP are immersed.

Methods
It conducted a descriptive epidemiological analysis of violence reported against DP between 2011 and 2017. To this end, it used the Pearson chi-square test, with a 95% confidence interval, to assess differences between proportions by sex.

Results
It showed that, in most of the reported cases, the victim is female (67%), white (50.7%; p &lt; 0,001), adults (61.6%; p &lt; 0,001) and mentally disabled (58.1%; p &lt; 0,001). It highlighted the notification of physical violence (51.6%; p = 0,107), psychological/moral violence (23,0%; p &lt; 0,001), neglect / abandonment (15,0%; p &lt; 0,001) and sexual violence (12.2%; p &lt; 0.001). The probable perpetrators are predominantly family and close partners (58,0%; p &lt; 0.001).

Conclusions
It is concluded that there are enormous challenges related to the confrontation of violence against DP in Brazil, such as the dissemination of information on the subject. Thus, this work is intended to subsidize public policies to combat violence against DP from the knowledge of its panorama, in addition to supporting awareness raising actions among society, health professionals and public managers.

Key messages
The reported cases of violence against DP indicate predominantly female, white, adult and mentally disabled victims, occurrence of physical violence and by aggressor family members or close partners. The analysis of the panorama of violence against people with disabilities allows subsidizing actions and public policies to combat this type of violence.
The Pathway Study: Commonalities Across New Food Bank Users in Rural, Suburban and Urban Areas
Authors: Roncarolo F , Mercille G , O'Loughlin J , Riva M , Sylvestre M P , Perez E J , Potvin L 
Published: October 2020

Abstract

Background
Few studies investigate long-term effects of food donation programs on food insecurity, diet, social integration or health. We describe household food insecurity (HFI), health, social integration and sociodemographic characteristics of 1003 new food banks users in rural, suburban and urban areas in Quebec, Canada.

Methods
Adults requesting food aid for the first time in the past 6 months were recruited in 117 food aid organizations (32 in rural, 35 in suburban, 50 in urban areas) using a nested sampling technique. Baseline data were collected from Sept 2018 to Jan 2020 in computer-assisted face-to-face interviews. Participants will be followed biennially. HFI was assessed with the 18-item Household Food Security Survey Module. Perceived physical and mental health scores were assessed with the SF12V2 module. Psychological distress and social integration were assessed with the Kessler scale K6+ and a modified version of MSPSS Scale. Differences across groups were tested with Chi square, ANOVA and post-hoc tests.

Results
Most participants reported high levels of materiel deprivation, with some variability across settings. Severe HFI was more prevalent in rural (51%) and urban (47%) areas than in suburbs (38%). More urban participants reported &lt;20000 CAN$/yr (79% vs 74% in suburbs and 69% in rural) although low education level was more prevalent in rural areas (82% reported &lt;12th grade education vs. 67% in suburban and 64% in urban areas). Psychological distress was higher in the suburbs (28%) compared to urban (21%) or rural areas (22%). No differences were detected across settings in social integration or physical or mental health scores.

Conclusions
New users of food banks report markedly high levels of material, social and health-related deprivation. In-depth analyses will permit more meaningful interpretation of these differences. The Pathways Study will permit better understanding of the life experience of persons requesting food assistance.

Key messages
People demanding food aid for the first time reported high levels of materiel deprivation, with some variability across settings. Severe housefold insecurity is around 50% among new food aid demanders in rural and urban settings.
Lung cancer survival trend in Umbria, Italy, 1994-2016: preliminary results
Authors: Ostorero A , Gili A , Violi S , Stracci F 
Published: October 2020

Abstract

Background
Lung cancer is the second most common cancer worldwide and the leading cause of death for cancer (18.4%). During the last 30 years, lung cancer incidence and mortality increased in women and decreased in men, because of tobacco smoking exposure. Population survival trend reflects both the influence of disease severity at diagnosis and treatment effectiveness. Some studies reported an increase in global lung cancer survival and linked it to new treatment options. However, change in the overall survival may also reflect a shift towards morphologies with more favorable prognosis. We analyzed overall and morphology specific survival trends for lung cancer to gain insight on the role of new treatments and changing exposures.

Methods
We analyzed lung cancer 1 y-survival and 3 y-survival after diagnosis in Umbria (890'000 inhabitants) in the period 1994-2016. Population-based data were obtained from the Umbrian Cancer Registry (RTUP), Italy. We estimated relative net survival (Pohar-Perme approach) stratified both for sex and histotype (NSCLC, SCLC, NOS), considering six diagnostic periods from 1994 to 2016 (4 years for period, except 3 in the last one) for 5'268 lung cancer cases (26% women).

Results
Overall survival by gender resulted 40,5% (1y) and 16.5% (3y) in men, 47,3% (1y) and 23,2% (3y) in women. NSCLC survival increased in women during the period 1994-2016 from 41% to 53% (1y) and from 23% to 33% (3y), and remained unchanged in men. SCLC 3 year-survival did not change significantly neither in women nor in men.

Conclusions
We did not observe a significant increase in lung cancer survival over a 25 years period. We observed a significant increase in survival probabilities for NSCLC among women only. Thus, our data don't confirm a major role of new treatments in improving lung cancer control. We will provide further analyses for adenocarcinoma and a comparison of incidence and mortality trends to understand the influence of exposures and treatments on survival.

Key messages
A general increase in lung cancer survival, as could be expected after the introduction of new highly effective treatments is not present in western countries. Reducing exposure to tobacco smoking and environmental pollution remain the main intervention to improve lung cancer control.
Audit methodology for the quality assessment of medical records in the emergency department
Authors: Chiappa F , Vigezzi G P , Salvati S , Scardoni A , Oradini Alacreu A , Zandalasini C , Sancini S , Odone A , Signorelli C 
Published: October 2020

Abstract

Issue
Filling out medical records properly in Emergency Departments (ED) can be challenging, due to the high number of daily admissions and the variety of involved health care professionals (HCP).

Description of the Problem
The ED of IRCCS San Raffaele Hospital (OSR), with a mean of 198 admissions per day in 2019, suffers of frequent overcrowding; patients are managed by multiple HCPs, based on specific care needs; coordination and handover between them are crucial to guarantee quality care. The OSR Healthcare Directorate, the ED's Staff and the School of Public Health of Vita-Salute San Raffaele University developed and validated a model of internal audit to identify ED medical records' quality issues and to implement corrective actions. The workflow included: developing a structured checklist, mapping critical processes and highlighting each figure's tasks. A group of auditors, made up by medical residents in Public Health, tested n = 300 medical charts, filled out during the first semester of 2019, picked up in order to provide a representative sample of the triage priority codes assigned to patients in this period.

Results
To assess completeness and quality of ED's medical records, a new checklist was developed, comprising 4 major sections, furtherly divided in 14 items, scored from 1 (poor adherence/completeness) to 5 (excellent), providing a total score for each record, ranging from 14 to 70. Specific comments to items could be added and an ultimate judgement was written by each auditor. This approach made medical records measurable and comparable.

Lessons
The new checklist and the audit process are useful instruments for the evaluation of medical records and the identification of corrective measures in the ED of our hospital. Next steps will be the extension of the sample, the implementation of corrective actions, and the institution of a stable working group for a regular evaluation.

Key messages
ED's medical records must be clear, understandable and complete. The developed checklist is a tool for preventing and correcting wrong behaviours in a continuous improvement perspective.
Advancing in the institutionalization of Evidence-Informed Policy in Brazil
Authors: Oliveira S , Bento A , Valdes G , Oliveira S , Souza A , Barreto J 
Published: October 2020

Abstract
EVIPNet Brazil was launched in 2007, coordinated by the Ministry of Health. Its expansion has promoted the institutionalization of a national knowledge translation platform, and has also been active at the local level. Local Health Evidence Labs were implemented to institucionalize working groups linked to EVIPNet. In this multiple case study, we discuss the advances in the institutionalization of Evidence-Informed Policy-making in Brazil, based on a mapping of the Health Evidence Labs' institutional capacity to acquire, evaluate, adapt and apply evidence and analyzed organizational arrangements and implementation barriers. The coordinators of 15 responded to a self-assessment questionnaire from the Canadian Health Services Research Foundation. The main products reported are evidence briefs and deliberative dialogues focused on regional problems, training activities and different kinds of rapid responses. Health Evidence Labs have the resources to acquire and evaluate research evidence, but have a low capacity to adapt and apply evidence, indicating that they do not have all the factors (skills, structures, processes, and organizational culture) to promote and use research results in decision-making. The lower capacity to 'adapt' and 'apply' evidence may be related to low development of exchange process with external experts. Governance is joined between managers of the departments with technical bodies; the service provision occurs to attend internal and external demands; financing is public or utilizing public research calls. The implementation barriers described are the staff turnover, inadequate funding arragements for develop knowledge translation products, paid access to evidence databases, lack of a repository for their production, and lack of monitoring and evaluation. Brazil has improved in the institutionalization of evidence-informed policy but still some important barriers to achieve a complete national knowledge translation platform.

Key messages
Brazil has institutionalized evidence-informed policy from the structuring of EVIPNet Brazil Network. To achieve the network sustainability, it is vital to consider the alignment of organizational elements with an emphasis on governance, financing, and its monitoring.
Theme cities for health: are they the superior Healthy Cities?
Authors: De Leeuw E , Forbat J , Simos J 
Published: October 2020

Abstract
Since the early 1980s we have witnessed a proliferation of 'Theme Cities' with the WHO 'Healthy Cities' networks a very early adopter, together with local government initiatives that focused on environmental health and sustainability. These days such networks range very broadly, from Citta Slow and Child-Friendly Cities to sustainable, resilient, festival, happy, garden, winter, safe, inclusive and many more theme-centered international networks of local governments and communities.
We undertook a political analysis of the extent to which these networks formally recognise and address the drivers of inequity in societies around the world, and to which extent they are ready to act truly glocally. We found that 'Sustainable Cities' rank highly, with WHO/EURO and PAHO style 'Healthy Cities' a close second. 'Transition Towns and Communities' are in a category of their own and can be considered a potentially important political voice for glocal health equity.

Key messages
Healthy Cities are Theme Cities - but not all do well to promote health equity. Sustainability and health (as per the SDGs) have enormous glocal health potential.