bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pre-participation screening of the athletes in Turkey: approach of primary care physicians
Authors: Dursun M , Bilir E , Kaymaz K , Sakarya S 
Published: November 2019

Abstract

Background
The pre-participation screening is crucial as the risk of sudden death for competitive athletes is higher than that of non-athletes. In Turkey, screening could be performed at the primary health care setting both by family medicine specialists (FMSs) and by general practitioners (GPs). Although there is a guideline, there is no legal regulation for the process. The aim of this study is to evaluate the approach of primary care physicians in pre-participation screening.

Methods
An online questionnaire based on the Turkish Medical Association (TMA) guideline, and the 14-item Screening Guideline of the American Heart Association (AHA) was delivered to primary care physicians. Knowledge, experience and approach of the physicians were assessed. Self-confidence, application of AHA criteria, accurate referral ratios and further test requests were taken as outcome measures. Descriptive and inferential analyzes were performed and p &lt; 0.05 was considered significant.

Results
Of 214 participants, 39.3% were women, the average age was 44.9 years, the average work experience was 7.9 years. 89.7% of the participants were aware of their authorization, 90.2% had previously given this report, but only 6.5% feels confident. Only 13.1% knows the presence of TMA guideline, and only 23.8% states being educated on the subject at any part of their career. More than 60% of the participants consider further testing necessary in addition to medical history and physical examination. Blood and urine test requests were significantly more for GPs compared to FMSs (p = 0.026, p = 0.011). Accurate referral decision ratio was only 59.3% with no difference between FMSs and GPs (p = 0.216). Work experience had no effect on any of the outcomes.

Conclusions
As the legal regulations and awareness of the guideline are insufficient, pre-participation screening is not standardized, and this increases tendency for further testing or referral.

Key messages
The pre-participation screening of athletes in Turkey is not standardized among primary care physicians. Further testing request ratio is high and accurate referral ratio is low.
Evaluation of medical students to interest in the health research in Kazakhstan at 2018
Authors: Akanov A , Koikov V , Abduazhitova A , Aubakirova A , Otargalieva D 
Published: November 2019

Abstract

Background
Since medical education is significantly different from other conditions of higher education, it is necessary to analyze the influence of the health research component on the quality of training a future health specialist.

Methods
A quantitative analysis based on the survey. 2 types of original questionnaires were based on the AGREE method: a) to analyze the involvement of medical students, and b) to analyze the teachers of medical universities to integrate health research into the educational process. The survey involved 1,439 medical students.

Results
85±1.02% of medical students agree that the triangle of science, education and practice is the main principle of doctors. 63±2.76% of students indicate a discussion with the teacher about the latest advances in medical science. 77±3.24% of surveyed students believe that health research is conducted at a good level. 78±5.8% of students confirm a good health research infrastructure at the University. The continuity of the scientific school and the discussion of the health research results was confirmed by 74±1.24% of students.
Evaluation of the participation of teachers in the study showed that 32±3.41% of respondents do health research at the time of the survey. 63±7.1% of teachers agree that the “science-education-practice” triangle is the main principle of doctors. 70±5.17% of teachers indicated the use of Case-based learning, Project-based learning and Research-based learning in their teaching practice.

Conclusions
The analysis showed a lack of involvement of medical students in health research and a lack of commitment of educational organizations to the principle of the triunity of science, education and practice.

Key messages
Medical students who are engaged in research have professional competencies related to the practical use of their knowledge and skills than their peers who are not involved in research. Involving medical students in research provides benefits for Universities, medical students and stakeholders.
Who has access and who participates in parkrun? - implications for selecting future event locations
Authors: Schneider P P , Smith R , Bullas A , Haake S , Brennan A , Goyder E 
Published: November 2019

Abstract

Background
parkrun is an international organisation which hosts free, weekly volunteer-led, running events. More than 300,000 people participate across 21 countries each week. The present study investigates how access to, and participation in, parkrun events varies across England. We go on to make policy recommendations for new parkrun event locations, in order to maximise geographical access and participation whilst taking account of the impact on inequalities.

Methods
We combined location data of census areas, parkrun events and public parks in England. For the census areas, access was defined as the distance of the area’s centroid to the nearest parkrun event, and parkrun UK provided information on 2018 participation rates per area. Linear regression was used to investigate the effect of deprivation on access, and the effect of deprivation and access on utilisation. We propose a flexible algorithm for identifying optimal new parkrun event locations and provide two sample sets of recommendations.

Results
The median distance to the nearest parkrun event was 3.4 km, but the distribution was heavily skewed: for approximately 10% of the population, the nearest event was more than 10 km away.
Despite statistical significance, the relationship between deprivation and access was very weak. However, access and deprivation had a considerable effect on participation: less deprived areas, and areas with good access had higher participation rates. The best locations for new events are contingent on what parkrun aims to maximise. We demonstrate that optimal locations for maximising equitable geographic access differ from locations for maximising participation.

Conclusions
Access to parkrun is generally good and is similar across socioeconomic groups, but participation is markedly higher in less deprived areas. Our algorithm can be used by parkrun to further improve access for deprived communities. However, better access alone is unlikely to reduce inequities in participation.

Key messages
In England, access to parkrun is generally good, and our algorithm can be used to further optimise it. However, better access alone is unlikely significantly increase participation from deprived areas.
Exploration of perceptions of health of low SES citizens in the Netherlands
Authors: de Jong M A J G , Wagemakers A E 
Published: November 2019

Abstract

Background
Health promotion programs (HPPs) have not yet succeeded in substantially reducing the health gap between higher and lower socioeconomic groups. It is thus a challenge to develop more effective strategies, based on an ecological perspective. To develop such strategies and activate citizens, this study explores citizens’ perceptions of health and what they need to improve it.

Methods
Setting Community HPP Voorstad on the Move (VoM) (July 2016-Jan 2020) in a district (+-11,000 inhabitants) in Deventer. Inhabitants’ socioeconomic status (SES), perceived health status and lifestyle are low relative to other city districts.
Study design: A qualitative study of 11 community groups (n = 89) participating in two focus groups. Concept mapping was used to cluster and prioritize health perceptions. Social Practice Theory (SPT) guided the analysis of needs to change health-related behavior.

Results
“We don’t assume that everyone has the same idea about health, do we?” (citizen)
Participants differed in age (16-82), cultural background (17% non-Dutch origin) and type of group activity. High-ranking dimensions of health are social relations, physical activity, a positive life attitude, healthy eating and empowerment. To improve health, social support from family and friends and self-confidence were the main needs. Physical impediments, (chronic) illness and financial aspects were also mentioned as barriers. The focus groups contributed to new activities as part of the VoM program facilitated by a health broker: e.g. a swimming group, biking buddies, social meetings.

Conclusions
Citizens perceive health as multidimensional, encompassing the physical and social environment, lifestyle behaviors, positive attitudes and being in control. Using SPT to unravel these needs in terms of meanings and competences helped to facilitate citizens’ active involvement in health-promoting activities.

Key messages
Low SES citizens perceive social relations, physical activity and a positive life attitude as important dimensions of health. Insight into citizens’ meanings and competences about health behaviors facilitates the development of health-promoting activities.
The relationship between sleep quality and nutrition of medical school students in a city of Turkey
Authors: Pehlivan E , Yalcin E , Firinci B 
Published: November 2019

Abstract

Background
Students need quality sleep and regular feeding during an intensive training proces. The aim of this study was to determine the sleep quality of Faculty of Medicine students and whether there is a relationship between sleep quality and eating attitudes and habits.

Methods
In this cross-sectional study; a face-to-face questionnaire was administered to 352 students who attending Inonu University Medical Faculty between January and March of 2019. The sample group is stratified according to class sizes (total 1665 students. The sleep quality and eating behaviors of students were questioned. For purpose, Pittsburgh Sleep Quality Index (PUKI, developed by Buysse et al,1989), and Eating Attitude Test (EAT,developed by Garner et al 1982) was used to assess quality and disorders. Kolmogorov Smirnov normal distribution test, Mann Whitney U and Kruskal Wallis test were used in analysis of the data.

Results
The mean age of the students was 21.5 ± 2.5 and 54.3% were female and 45.7% were male and 25.0% smoked cigarette. 64.4% of the study group had normal body mass index. The median value of the PUKI (cut of point is 5.0 and under 5 is good) score by gender is similar with 6.0 (1.0-15.0). The median value of the PUKI score was 6.0 (1.0-16.0) in social media / internet users and 5.0 (1.0-13.0) in non-users. According to Internet / social media users before going to sleep, the difference is significant (p: 0.016). The difference between cigarette smoking and median value of PUKI was significant (p: 0.029). there was a difference between classes in favor of upper classes in terms of EAT values (p = 0,046). 12.2% of the students are at risk of Blumia and 10.8% are at risk of Anorexia. There was no significant but positive correlation between the PUKI and EAT (p = 0.074, r = 0.096).

Conclusions
In general, the students’ sleep quality and eating attitudes and habits were found close to the cut-off points accepted by the tests. But blumia and anorexia is significant. This study was supported by the Research Fund of the Inonu University (No. 1792)

Key messages
Social media / internet usage of students before going to sleep affects sleep quality significantly. Although 64.4% of the students have normal body mass index, eating disorders (bulumia and anorexia) risk are noteable.
Misconceptions, not evidence guide occupational physicians’ decisions on legionellosis prevention
Authors: Riccò M , Balzarini F , Mezzoiuso A G , Colucci M E , Catellani W , Veronesi L , Corradi M 
Published: November 2019

Abstract

Introduction
Legionnaire’s diseases (LD) is a significant cause of community-acquired pneumonia. An increasing number of cases has been linked with occupational exposures. The aim of this study was understanding knowledge, attitudes and practices of occupational physicians (OPh) towards LD.

Methods
A questionnaire-based cross-sectional study (April 2019), collecting a convenience sample of OPh operating in the Parma Province. Knowledge status (KS), Risk Perception (RP), and actual participation to the LD risk assessment were assessed. Multivariate odds ratios (mOR) for factors associated with participation to the LD risk assessment were calculated by means of a binary logistic regression analysis.

Results
80 OPh participated to the survey (76.9% participation rate; mean age 48.2±11.2 years): even though the majority of them assisted at least one enterprise at potentially high risk for LD (i.e. 41.4% retirement houses, 27.1% water treatment plants including spas and pools, 25.7% hospitals) only 42.9% had participated to the LD risk assessment. The majority of OPh did not acknowledge diabetes (52.9%), cancer (65.7%), alcoholism (77.1%) as risk factors for LD, while a large share of OPh did not recognize hospital (50.0%), retirement houses (48.6%), swimming pools (48.6%) and spas (35.7%) as high risk environments. Moreover, participants underestimated both actual frequency (&gt;1000 cases/year) and severity (lethality 10-15%) of LD in Italy, and occupational RP was not coincidentally low (43.2%±20.3). Participants reporting better KS were more likely to participate to the risk assessment (mOR 4.82 95%CI 1.06-21.94), while RP was eventually unrelated with preventive practices.

Conclusions
OPhs were diffusely affected by significant knowledge gaps on the actual risk factors for LD. Their misperceptions have the potential to negatively influence daily practice, impairing prevention of LD on the workplaces, and should be specifically targeted by information campaigns.

Key messages
Occupational Physicians were affected by significant knowledge gaps, particularly on individual and occupational risk factors for legionnaire disease. In order to better address the increasing threat of Legionnaire Disease, Occupational Physicians should be specifically targeted by information campaings.
Clear proceedings as workplace health promotion. Supervision and management tools in rural Uganda
Authors: Piccinni G , Putoto G 
Published: November 2019

Abstract

Health centres and supervision teams in rural/poor settings in developing countries are affected by limited resources, uneasy reporting to higher level of power and unclear proceedings to filling the gaps. Inconsistency in supervising visits lead to mistrust. Supervisees react with resistance or indifference. Supervisors react behaving as policemen. In Uganda, Oyam Health District, february-august 2018, actions were taken in order to solve conflicts, sustain quality, improve interactions. Sharing the concept and the implementing process could inspire colleagues engaged in workplace health promotion.
Key points were informed by direct observations, talks with staffs, literature review, ugandan Ministry of Health official directives and tools, NGO’s adaptations. Selected issues were discussed during two workshops held in april ’18 involving all the concerned staff: 100 people. Agreement reached, based on a 3 (gap-act-resp) 5 (0-4 grading) algorithm, re-designed tools were able to reduce aléa during inspections, grade the gaps, guide actions and to address the appropriate level of responsability. User friendly reporting formats, database and unicode for linkage were designed ex novo. Information flow was agreed with the Health District Authorities.
After the learning period, staffs felt empowered about resolving gaps and less stressed advocating higher authorities. Conflicts lost harshness. Satisfaction was captured by a self-filled anonymous questionnaire in june 2018 (n = 80, 12 core questions, 0-4 likert scale, mean &gt;3, SD &lt; 1, median= 4, open sentences positives). Quality improvements of health care services were measured by the Ugandan Ministry of Health independently.
Unclear targets, shortage of means, ineffective communication flows reduce quality and trigger frustration. Sustaining transparency, organizing communication flows and proceedings, sourcing staff’s experience could enhance success both in reaching targets and promoting relational health at workplace.

Key messages
Transparency, shared decisions, clear communication, awareness of the aims and mastership are able to reduce conflicts and misunderstandings, sustaining a healthier workplace relational environment. People spend 60 to 80% of their active time at workplace. Well designed tools, policies and information flows, could be effective health enhancer as well. Work style is a lifestyle.
The association between eating vegetables at start of meal and dental caries among Japanese children
Authors: Ito K , Isumi A , Doi S , Ochi M , Fujiwara T 
Published: November 2019

Abstract

Background
Dental caries is still serious problem among Japanese children. Previous studies suggested that higher consumption of vegetables prevent dental caries. Eating order habit, such as eating vegetables at start of meal, called “Vege-first”, may increase the amount of vegetable consumption, and in turn, prevent dental caries. However, no published studies have examined the impact of “Vege-first” habit on dental caries. The aim of this study to investigate the association between “Vege-first” and dental caries among Japanese children.

Methods
We used the 2015 cross-sectional data from the Adachi Child Health Impact of Living Difficulty (A-CHILD) study, a population-based study of all first-grade students in Adachi City, Tokyo, Japan. The number of DMFT (decayed, missed due to decay, and filled teeth) was used as an outcome. Poisson regression analyses were applied to determine the independent association between “Vege-first” habit and the number of DMFT after controlling for the effects from child’s sex, parents’ marital status, socioeconomic status, and frequency of tooth brushing, drinking sweet beverages, and snacking.

Results
Of 3,689 valid Japanese children participants, 38.2% had DMFT and 11.6% were having the “Vege-first” habit. The number of DMFT decreased linearly with “Vege-first” habit (p &lt; 0.001). After controlled for covariates, the number of DMFT was still significantly and independently decreased with “Vege-first” habit (prevalence ratio=0.89 (95% confidential interval [0.81-0.98])).

Conclusions
This study showed that having the “Vege-first” habit was associated with dental caries even accounting for socioeconomic status, dental health behavior, and dietary habits. Health policy introducing “Vege-first” habit may be effective to prevent pediatric dental caries.

Key messages
Eating habit which vegetables at start of meal called “Vege-first” may increase the amount of vegetable consumption and possibly reduce dental caries. The habituation of Vege-first was likely to reduce child’s dental caries even accounting for socioeconomic status, dental health behavior and dietary habits.
Important factors to ensure wellbeing in a whole-school setting – a photovoice study
Authors: Ese J , Flobakk J , Castellan C , Ihlebaek C 
Published: November 2019

Abstract

Background
The whole-school approach focuses on promoting health and wellbeing for pupils, employees, and parents. In Norway, several schools are now developing such an approach and opening the school premises for community activities. The aim of this study was to investigate what pupils, employees and parents themselves experience as important factors to ensure wellbeing in a whole-school setting. More knowledge about such factors as perceived by the users could give important information in order to ensure health promotion in other schools wanting to implement a whole-school approach.

Methods
The participatory method Photovoice was used. Seven pupils, six employees, and four parents at Alvimhaugen Primary School, Norway photographed what they perceived as factors generating wellbeing at the school premises. The school is located in an area with challenges related to living conditions. The pictures were used as basis for six focus group discussions by the participants. All interviews were audiotaped, transcribed and analysed using Malterud’s Systematic Text Condensation and Drew & Guillemins framework for image analysis. The results were discussed within the framework of Sense of Coherence (SOC).

Results
The factors that emerged as important for wellbeing among all stakeholders were interconnected. Important factors were the built and natural environment, activities before/during/after school hours, and organisational characteristics. Further, these factors were associated with a sense of security, belonging, social support and manageability expressed by the stakeholders.

Conclusions
The factors identified are all known to be central in strengthening SOC. These factors are therefore important for promoting health, not only in pupils but also in employees and parents. The whole-school approach could contribute to address complex public health issues and wellbeing, and might be especially important in schools in deprived areas.

Key messages
The built and natural environment, activities before/during/after school hours, and organisational characteristics are all important aspects to ensure wellbeing in a whole-school approach. The whole-school approach could contribute to promote wellbeing, and might be especially important in schools in deprived areas.
Is medical ionizing radiation negligible or neglected? How to interact with patients?
Authors: Nicoulet I 
Published: November 2019

Abstract

Issue
Medical exposure is in France, the first source of artificial exposure of populations to ionizing radiation (IR). The use of ionizing radiation in diagnosis, (CT scan) is steadily increasing. With IR, nothing is visible, nothing is lost, everything is cumulative and transformed. How to explain it to patients and how to answer their questions? How, in this area, can patients become empowered?
The radiologists have already produced information materials for patients. Explaining the different types of exams is easy, explaining the dose is more complex; doses are not expressed with the same units. In addition, since the organs do not all have the same sensitivity to ionizing radiation, the addition of doses delivered does not always make sense. The comparison of doses delivered with the natural exposure to ionizing radiation makes it understandable. Specific awareness campaigns such as ’for lumbago radio, this is not always the right scenario’ were launched.
One of the main rule of radioprotection is the justification of the act in relation to the expected benefit. Both general practitioners and patients can influence the decision by asking simple questions. An awareness campaign on this theme is planned by HERCA (European HEad of Radiation protection Competent Authorities) in Europe in November 2019.
It aims to reduce inappropriate exams by breaking habits. It is aimed mainly to general practitioners.

Results
The French Nuclear Safety Authority will decline this campaign for both general practitioners and patients. This campaign is based on the most common questions such as: If I have already made a diagnosis, what is the added value of a radiological examination?Why should I have another radiological examination?Why refer my patient for an X-ray or CT if another examination can be done that does not use ionizing radiation?Why is it important to ask if pregnancy is a possibility?

Lessons
Illustrative documents will be presented at the congress

Key messages
Risks related to medical exposure to ionizing radiation are not sufficiently explained. A European campaign of recognized authorities and the involvement of patients should help reinforce the messages of the French campaign.