bluuebunny/crossref_metadata_2025_split huggingface dataset:
Building a regional database of experiential knowledge on health promotion and digital tools, France
Authors: Sagni A , Villeval M , Hamant C , Cornibert A C 
Published: October 2020

Abstract

Issue
Digital technology has become an increasingly important aspect of our lives. This growth also creates a lot of concerns among professionals and families. In France, health promotion (HP) actors are more and more being called on to discuss and analyse the issue of health and digital technology, but knowledge on this subject is not always shared. Furthermore, there is no inventory about experiential knowledge which could explain how the interventions in this particular field are designed. The Good Ideas and Promising Practices (BIPP) approach has been elaborated by the Regional Health Promotion and Education Association in Auvergne Rhône Alpes (FRANCE) to fill this gap.

Description
The BIPP approach aims to identify interventions perceived as promising to inspire HP actors who support the digital practice of young people, as well as their parents and the educational community. The BIPP inventory process is based on 7 steps and relies on local partnership to identify innovative interventions. Collected actions are classified by major areas of intervention and offer HP actors a selection of what has been put in place in terms of digital tools. The most promising practices are selected to build a database of experiential knowledge.

Results
90 interventions were identified. 60 interventions were selected according to the validated criteria: sustainable, iterative interventions, empowering people and affecting vulnerable groups. A process of experience capitalisation, based on the adjusted method developed by a national multidisciplinary committee, has been carried out for the most notably promising interventions, and videos have been made to enhance knowledge transfer in HP and digital tools.

Lessons
The BIPP approach has produced a lot of contents that HP actors can draw inspiration from. The process shared within a partner network can easily be replicated in other settings and countries.

Key messages
In addition to scientific knowledge, experiential knowledge on digital tools interventions is useful and must be shared in HP community to enhance the quality of interventions. Promising practices in health promotion can be formalised by the BIPP replicable inventory process to build up and share knowledge to support other interventions, decisions and advocacy.
Integrating sustainability in professionals’ training in the field of health promotion and prevention
Authors: Lutz A , Pasche M , Zürcher K 
Published: October 2020

Abstract

Background
Climate change poses a number of threats and challenges to our societies and has direct impacts on human health. Raising awareness and training health professionals to sustainable development represents a major strategy in order to respond to climate challenges. This article describes a teaching experience conducted in the context of a Certificate of Advanced Studies (CAS) in public health at the University of Lausanne, where students have been trained to sustainable development, through theoretical lessons and practical exercises.

Objectives
The integration of the topic of sustainable development in the teaching of health promotion and prevention to the students of the CAS in public health aimed to foster students' knowledge and competences in relation to this emerging topic. The main objective was to transmit concepts, methods and practical resources allowing them to incorporate sustainability into everyday health promotion and prevention practices.

Results
Health promotion and sustainable development share common goals and methodologies. The experience of teaching sustainability to public health students shows that these two topics can be easily integrated within a public health training, if teachers provide students with a clear theoretical and methodological framework, allowing them to make the appropriate connections between the two fields. Social determinants of health, intersectorial action and multilevel governance represent key topics that teachers can address with students in order to show the connections between public health and sustainability.

Conclusions
As stated in the 2019 Lancet Countdown on health and climate change, climate change is both a threat and an opportunity for our societies. While it puts health systems and professionals under considerable pressure, it also represents an opportunity to innovate and transform professional training and practices, and generate new knowledge and know-how.

Key messages
Training health professionals to sustainable development represents a major strategy to respond to climate change and its health impacts. In order to integrate sustainable development in public health training, teachers should provide students with a clear theoretical and methodological framework.
Associations between labour market policies and work stressors
Authors: Lunau T , Rigó M 
Published: October 2020

Abstract

Background
Many studies have shown that psychosocial work stressors have a negative impact on health. It is therefore important to understand how psychosocial work stressors can be reduced. First cross-sectional studies have shown that working conditions are influenced at the political level. With this study, we want to extend the existing studies by specifically looking at the longitudinal dimension and test if changing labour market policies are related to changes in psychosocial work stressors.

Methods
We used comparative longitudinal survey data from the European Working Conditions Survey (27 countries; years 2005, 2010, 2015). The measure of psychosocial work stressors is based on two established work stress models: job strain and effort-reward imbalance. To measure labour market policies we used information on active (ALMP) and passive labour market policies (PLMP). 64659 participants were eligible for the ERI analysis and 67114 participants for the analyses on job strain. Estimation results are provided by three-level multilevel regressions.

Results
An increase in ALMP investments lead to a decrease of ERI and therefore to an improvement in psychosocial working conditions. The analyses for the subcomponents showed that these results are mainly driven by reward: an increase in ALMP investments lead to an increase in rewards. We didn't find significant associations between ALMP and job strain and between a change in PLMP measures and the observed work stressors.

Discussion
The study extends current knowledge with longitudinal information by showing that an increase in ALMP lead to an increase in rewards and a decrease of ERI. These longitudinal analyses are more closely related to a causal interpretation than previous cross-country analyses. The findings of this study may have important policy implications. Our main result suggests that investments into ALMP can improve certain working conditions and therefore improve workers' health.

Key messages
Psychosocial work stressors have a negative impact on health. Investments into active labour market policies can improve psychosocial working conditions.
Efficacy of an intervention based on workplace exercises regarding burnout and musculoskeletal pain
Authors: Amaral A P , Santos G , Pocinho M 
Published: October 2020

Abstract

Background
Work stress is associated with a wide range of mental and physical symptoms and presents a challenge in public health. In this study, we highlighted burnout syndrome and musculoskeletal pain. The main goal was to test the efficacy of an intervention based on compensatory workplace exercises in the reduction of burnout levels and musculoskeletal pain. The questions were: 1) How high are the levels of burnout and musculoskeletal pain before the intervention? 2) Does the intervention contribute to reduce the levels of burnout and musculoskeletal pain?

Methods
This study was conducted in a hospital and employed a pre pos-test design using the following measures: Maslach Burnout Inventory - General Survey and the Nordic Musculoskeletal Questionnaire. The participants are 49 administrative employees, 61.2% females with a mean age of 38.3 years (SD = 11.6). The intervention program consisted of 18 sessions of compensatory workplace exercises, held for five weeks, with a frequency of three sessions per week.

Results
In relation to burnout, the results obtained before the intervention (mean values) suggest moderate Exhaustion (2.50±0.94), higher Cynicism (3.27±0.92) and lower Professional Efficacy (1.81±0.41). Concerning musculoskeletal pain, it was more prevalent in the shoulders (69.4%) and back (upper 67.3% and lower 65.3%), followed by the thighs and neck (both 61.2%). After intervention, the results showed a significant (p &lt; 0.05) decrease of burnout and all musculoskeletal symptoms evaluated.

Conclusions
The results support the effectiveness of the compensatory workplace exercises in the reduction of burnout and musculoskeletal symptoms contributing to mental and physical health of the workers involved. This study was innovative due to the studied link between burnout and compensatory workplace exercises. Moreover, this study led to changes in the hospital, which implemented better practices for a healthier life of the workers.

Key messages
The intervention based on compensatory workplace exercises reduced burnout and musculoskeletal pain in a sample of administrative employees and had impact in the health policies of the hospital. The implemented intervention promoted workers' physical and mental health and led to better health practices in the hospital.
Social relations and self-rated health in a multi-ethnic social housing area undergoing demolition
Authors: Kvorning M F , Srivarathan A , Nygaard S , Lund R 
Published: October 2020

Abstract

Background
During the coming years, selected social housing areas in Denmark will undergo large structural changes as part of a political agenda. Previous studies on the effects of such interventions are inconclusive. Residential areas are important for the development of social relations and health. The aim of this study was to explore the associations between social relations and self-rated health (SRH) and the interaction with country of origin in an ethnically diverse social housing area undergoing demolition, and compare results with the municipality.

Methods
Data include multilingual interviewer driven surveys with residents aged 45+ years before demolition began in 2018 (N = 209) and during the demolition in 2019 (N = 132), and a health survey on municipality level (N = 1638). Information on social relations include contact frequency with and support from family, friends and neighbors. SRH was dichotomized into high/low. Descriptive and multivariate logistic regression analyses adjusted for age, sex and Western/non-Western origin are presented.

Results
In cross-sectional analyses from 2018, low contact frequency and low support increased the risk of low SRH, OR = 1.44 (0.63-3.29) and OR = 1.23 (0.62-2.48), especially when also having non-Western origin compared to having high contact frequency or support and Western origin, OR = 6.27 (1.80-21.84) and OR = 4.43 (1.68-11.69), respectively. The same association was seen in 2019 and on municipality level.
Low contact frequency in 2018 was associated with higher risk of developing or maintaining low SRH in 2019 compared to the group with high contact frequency in 2018 in longitudinal analyses, OR = 3.04 (0.91-10.91).

Conclusions
Poor social relations increased the risk of low SRH, especially when also having non-Western origin. Having poor social relations before the demolition was associated with an increased risk of developing or maintaining low SRH during the demolition in an ethnically diverse social housing area.

Key messages
Having low contact frequency before area demolition in a social housing area in Denmark increased the risk of developing or maintaining low self-rated health after demolition had begun. Having poor social relations and non-Western origin is associated with a strong increased risk of low self-rated health in a deprived ethnic diverse social housing area in Denmark.
Can Home Palliative Care services reduce Emergency Department visits? Piedmont Experience, 2013-2018
Authors: Scacchi A , Berchialla P , Dalmasso M , Gianino M M 
Published: October 2020

Abstract

Background
Home-based Palliative Care (HPC) ensures multi-disciplinary medical, nursing, rehabilitation and psychological assistance for people with severe disabilities or with progressive end-stage disorders like cancer, promoting the continuity of care in home setting. Emergency Department (ED) visits in palliative care patients are considered an indicator of poor quality in home care services, since ED visits in these patients are not essential and potentially avoidable. There is still no agreement in literature about the efficacy of HPC in reducing the use of ED. However, recent studies demonstrated that HPC increases patient satisfaction while reducing use of medical services like ED, symptom burden and medical costs. The objective of this study was to evaluate if patients assisted by HPC have a reduction of ED visits compared to the 90-day period before HPC admission.

Methods
A retrospective study using the administrative regional database of Piedmont (Italy) was conducted on the cohort of 4433 patients admitted to HPC from 2013 to 2018. ED visits during period A (90-days before HPC) and period B (during HPC) were compared for each patient, taking into account avoidable or unavoidable visits based on triage examination.

Results
During period A, patients had 2880 ED visits, 1934 were considered avoidable (67%). During period B, 2050 ED visits were recorded, 994 were considered avoidable (48%). Patients receiving HPC had a reduction of overall ED visits (IRR 0.87, IC 95% 0.82-0.92) as well as avoidable ED visits (IRR 0.63, IC 95% 0.58-0.67). Unavoidable ED visits increased during HPC (IRR 1.36, IC 95% 1.24-1.49), as a consequence of disease progression.

Conclusions
Home-based Palliative Care is associated with a significant reduction of the use of overall Emergency Department visits (-13%) and ED avoidable visits (-37%). Since it reduces medical care costs and burden of patients and caregivers at the end of life, Home-based Palliative Care delivery should be increased.

Key messages
Home-based Palliative Care is associated with a reduction of the use of overall Emergency Department visits and avoidable ED visits, reducing medical care costs and burden of patients and caregivers. Home-based Palliative Care delivery should be encouraged and increased, aiming to an early enrolment as well as an increase of the patients.
Setting indicators for oncological clinical pathways: a 2-round Delphi method and face-to-face meeting
Authors: Acampora A , Fauci A J , Cadeddu C , Angioletti C , De Belvis A G , Iannone P 
Published: October 2020

Abstract

Background
An ongoing project, promoted by “Gruppo Italiano di Reti Oncologiche” (GIRO) network and coordinated by the “Istituto Superiore di Sanità”, aims to apply Value Based Healthcare (VBH) for evaluating the performance of oncological healthcare providers. In this framework, the aim of this study was to define a set of indicators for assessing the overall clinical pathway for patients with colorectal cancer receiving healthcare in one of the seven GIRO referral centers.

Methods
A 2-round Delphi study was conducted involving experts from GIRO centers. A list of preliminary indicators, identified from national and international agencies, was firstly evaluated according to four criteria (relevance, evidence-based, measurability, actionability) using a 5-point Likert scale. Indicators receiving ≥50% of judgements ≥3 in 3/4 criteria went to selection process of the second round. The second survey firstly asked whether the indicator was to be included in the final set and, if yes, it was then evaluated on a balancing criterion. Indicators receiving ≥75% of agreement for inclusion and ≥50% of judgements ≥3 for balancing were confirmed for the final set. During the face-to-face meeting, a subset of indicators was prioritized for a pilot collection.

Results
After 1st-round consultation, all the 34 indicators in the preliminary list passed to the 2nd-round and 32 (94%) of these were included in the final set (16 colon;16 rectum). During the face-to face meeting, critical issues highlighted during the process (e.g. events occurring outside the referral center) were discussed and 16 (50%) indicators were prioritized for the pilot collection (8 colon;8 rectum).

Conclusions
Evaluating the overall clinical pathway for oncological patients is very important for achieving high-quality healthcare. Enhancing collaboration and networking among oncological referral centers is a main tool for the continuous improvement of healthcare outcomes in a VBH perspective.

Key messages
Evaluating the overall clinical pathway for oncological patients is very important for achieving high-quality healthcare. Enhancing collaboration and networking among oncological referral centers is a main tool for the continuous improvement of healthcare outcomes in a VBH perspective.
Multi-Morbidity and Mediterranean Diet in the Cypriot population
Authors: Kyprianidou M , Panagiotakos D , Kambanaros M , Makris K C , Christophi C A 
Published: October 2020

Abstract

Introduction
Knowledge about factors associated with multi-morbidity in a given population has important implications for prevention, diagnosis, treatment, and prognosis strategies.

Objectives
To examine the association of Mediterranean diet with multi-morbidity in the adult general population of Cyprus.

Methods
A representative sample of n = 1142 Cypriots over 18 years old was recruited during 2018-2019. Multi-morbidity was assessed using a validated questionnaire and diseases were classified according to the International Classification of Diseases, 11th Revision (ICD-11). Mediterranean diet was evaluated using the MedDiet score tool which included the weekly consumption of non-refined cereals, fruit, vegetables, legumes, potatoes, fish, meat and meat products, poultry, full fat dairy products, as well as olive oil and alcohol intake.

Results
The average Mediterranean diet score was 15.5 ± 4.0 with males adhering more to the Mediterranean diet compared to females (p &lt; 0.001). Being in the higher tertile of adherence to the Mediterranean diet was associated with lower odds of multi-morbidity at α = 0.10, even after adjusting for age, gender, educational status, smoking habits, and physical activity (OR = 0.72, 95% CI: 0.49, 1.06, p = 0.09), compared to the lower tertile.

Conclusions
To the best to our knowledge, this is the first study which provides evidence of an association between Mediterranean diet and multi-morbidity. Adherence to Mediterranean diet was associated with lower risk of multi-morbidity. Future prevention programs and practice guidelines in Cyprus and elsewhere should take into account the beneficial effects of a Mediterranean diet on multi-morbidity.

Key messages
This study provides the first evidence of an association between Mediterranean diet and multi-morbidity. health benefits in terms of multiple chronic diseases in an individual can be gained from Mediterranean diet pattern.
Comparison between indirect calorimetry and Harris-Benedickt formula
Authors: Comba M 
Published: October 2020

Abstract

Background
The benefits of providing optimal nutrition for recovery from illness and chronic health management are well documented. The measure of energy expenditure by indirect calorimetry or by predictive equations are two methods to assess energy needs. This abstract provides an overview of indirect calorimetry use in the outpatient setting. The study aims is to compare the results obtained with indirect calorimetry, with those obtained through the theoretical calculation with the Harris-Benedickt formula, by using t-student test.

Methods
This observational study was conducted from January 2019 to February 2020. The selected population is made up equally of men and women in the general population, from 18 to 65 years of age, without a specific disease, after having given informed consent. Our study was conducted in outpatient setting by using the fitmate pro to do the indirect calorimetry.

Results
A total of 50 patients were evaluated. The t-student test was used to evaluate whether there was a statistically significant difference in the population analyzed between the basal metabolic rate calculated with the Harris-Benedickt formula and the one measured by indirect calorimetry. The variables evaluated were gender, age (greater than or less than 38 years) BMI (greater than or less than 25).

Conclusions
A statistically significant results were found (with t-student less than 0.05) for patients over the age of 38 (0.006) and women (0.044). Not statistically significant results were found for the variables: male (0.64), under 38 years of age (0.98), BMI (0.15). Our study shows there are data in favor of the use of indirect calorimetry as a better method for assessing basal metabolic rate instead of Harris-Benedickt for a more targeted approach to the patient. Further studies may support results obtained in this study; furthermore, direct research is necessary in order to increase a personalized approach of the doctor towards the patient.

Key messages
Our study shows that there are data in favor of the use of indirect calorimetry as a patient-oriented approach to assessing basal metabolic rate. The study aims is to compare the results obtained with indirect calorimetry with those obtained through the theoretical calculation with the Harris-Benedickt formula.
Gender equality and inequalities in self-reported health in 27 European countries (2004 to 2016)
Authors: Roxo L , Bambra C , Perelman J 
Published: October 2020

Abstract

Background
Across Europe, women tend to report worse health than men, probably due to women's lower position in society. Although societal gender inequalities have decreased, differences persist regarding employment, income and use of time. This study aims to assess the evolution of gender-based inequalities in 27 European countries between 2004 and 2016, and to analyze the impact of societal gender equality in this evolution.

Methods
We used data from the Survey on Income and Living Conditions (EU-SILC), from subjects between 25 and 64 years old (N = 2,931,081) from 27 European countries. Logistic regressions were performed with bad self-reported health as dependent variable, first adjusted for age, country and year, and later also for education and employment. Interactions between gender and year were added to the models to assess changes over time. Countries were clustered according to their societal gender equality, based on their Gender Equality Index of 2005 and 2015 (GEI). Analyzes were stratified by education, employment and cluster of GEI.

Results
Women were 17% (OR = 1.17, 95%CI=1.15-1.19) more likely than men to report bad health. Considering education and employment, women were 3% less likely to report bad health (OR = 0.97, 95%CI=0.96-0.99). Gender-based inequalities were larger among the cluster with higher GEI (OR = 1.37, 95%CI=1.26-1.48) and those with lower education (OR = 1.21, 95%CI=1.18-1.24). Although the gender gap reduced from 26% (OR = 1.26, 95%CI=1.18-1.34) in 2004 to 16% (OR = 1.16, 95%CI=1.08-1.24) in 2016, the decrease was not significant. Differences between years were not significant when analyses were stratified for education, employment or cluster of GEI.

Conclusions
Gender-based inequalities persisted between 2014 and 2016 and were strongly related to differences in education and employment. The gender gap was larger among countries with greater societal gender equality.

Key messages
Women’s disadvantage in self-reported health persisted in 2016 and was connected to socioeconomic differences. The gender gap is not smaller in countries with greater societal gender equality.