bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mediterranean diet and risk of first hospitalization for heart failure and atrial fibrillation
Authors: Bonaccio M , Di Castelnuovo A , Costanzo S , Ruggiero E , Persichillo M , De Curtis A , Cerletti C , Donati M B , de Gaetano G , Iacoviello L 
Published: November 2019

Abstract

Background
We aimed to explore the association of a traditional Mediterranean diet (MD) with risk of first hospitalization for heart failure (HF) or atrial fibrillation (AF) in a population-based cohort from a southern Italian region.

Methods
Longitudinal analysis on 20,598 men and women (aged≥35 y) free from HF, AF and cardiovascular disease recruited in the Moli-sani Study (2005-2010). First hospital admissions for HF or AF were recorded by direct linkage with hospital discharge form registry. Dietary data were collected by the EPIC food frequency questionnaire, adherence to MD was appraised by the Greek Mediterranean diet score (MDS ranging 0-9). Hazard ratios (HR) with 95% confidence interval (95%CI) were calculated by multivariable Cox-regression.

Results
Over a median follow up of 8.2 y, we ascertained 661 HF events and 337 AF cases. A 2-point increase in the MDS was associated with a downward trend in the risk of developing HF (HR = 0.94;0.85-1.04) after adjustment for potential confounders, while no association was found with risk of AF (HR = 1.07;0.94-1.21). Analyses run separately by gender revealed that higher adherence to an MD was associated with lower risk of HF among women (HF = 0.83;0.72-0.95 for 2-point increase in the MDS) but not in men (HR = 1.07;0.93-1.22; p for interaction=0.011). No gender-related difference was observed for AF risk (p for interaction=0.62). Among women, higher intake of monounsaturated over saturated fats was associated with 38% (20% to 52%) lower risk of HF, while in men moderate alcohol intake was likely to reduce HF risk (HR = 0.87;0.70-1.08).

Conclusions
Closer adherence to a traditional MD is associated with lower risk of first hospitalization for HF among women but not in men. No association was found with risk of AF.

Key messages
A traditional MD reduces the risk of HF in women but not in men. Minor dietary changes inspired to a traditional MD could be valuable primary prevention measures for risk of HF.
Building bridges takes time: Views of healthcare professionals on health literacy and migration
Authors: Baumeister A , Aldin A , Chakraverty D , Seven ÜS , Anapa G , Jakob T , Skoetz N , Kalbe E , Woopen C 
Published: November 2019

Abstract

Background
Health literacy is an output of individual resources and capabilities, situational factors, environmental conditions, and the requirements of the health care system. As migration continues to increase globally, successful interaction between healthcare professionals and migrants can be important for a sustainable and resource-oriented promotion of health literacy. This study aims to explore challenges, needs and applied solutions of healthcare professionals in the interaction with migrants in Germany.

Methods
Five focus group discussions were conducted in Cologne, Germany. Participants were healthcare professionals (n = 30), including general practitioners, medical specialists in inpatient and outpatient care, and nurses. Discussions were audio recorded, transcribed verbatim and analysed by qualitative content analysis.

Preliminary results
Participants reported a lack of time and general uncertainty in dealing with the health literacy-related needs of the target population. Assumptions on discrimination through the health system and restrictive gender roles on the patients’ side were additional key challenges for a successful interaction. To bridge these barriers, some participants reported to invest time even beyond systemic conditions; most wished for professional interpreters or cultural mediators. Participants who themselves were migrants found this helpful for communicating information to patients and improving patients’ confidence in the recommended treatment. Using clinical staff as lay interpreters outside their own treatment situation was rated critical, as it can be associated with a considerable burden due to a further time restriction for their actual tasks.

Conclusions
Preliminary findings reveal that general problems in the health care setting (e.g. time pressure, ensuring patients’ compliance) can occur more intensively in migrant patients. Health professionals require support through the provision of state-funded professional interpreters.

Key messages
Health literacy related challenges become more visible in the context of migration and reveal general issues in the German health system that need to be solved for the benefit of the entire population. Research on health literacy in the context of migration is important in order to ensure the promotion and maintenance of health equally and effectively across populations.
Digital health literacy of health care profession students
Authors: Dratva J , Juvalta S , Gemperle M , Händler-Schuster D , Scheermesser M , Klamroth-Marganska V 
Published: November 2019

Abstract

Background
Digital transformation in health and health systems is a chance and a challenge for health professionals irrespective of their field. To maximize the benefit for patients high digital health literacy is required. A requirement not represented in health professions’ curricula in Switzerland. Little is known on the digital health competencies of students, on their utilization and views of digital media in the context of health, thus a cross-sectional survey was performed at a School of Health Professsions in Switzerland.

Methods
All BSc. students (N = 1200; nursing, midwifery, occupational health, physiotherapy and health promotion) received an online questionnaire covering utilization of various information resources, views on digital health & media and the German eHealth Literacy Scale (eHEALS, score 0 - 40). Descriptive and group analyses were performed, further adjusted analyses will be run.

Results
453 students responded (female N = 368, male N = 26). Participation was 38% and highest in 1st students. Personal health information resources used most were: internet 82%, familiy&friends 70%, health professionals 66%, textbooks 40%. A majority rated digital media as important (66%) or rather important (30%) for their future professional activities. The overall eHeals-score was 28.6 (sd 4.93); critical evaluation and confidence in applying information scored lowest. Preliminary group analyses show significant increase by study year (1st 28.0, 2nd 28.9, 3rd 29.7, p = 0.01), while scores by gender or health profession were non-significantly different.

Conclusions
Almost all students in health professions use digital media for their own health information needs and consider digital media as highly relevant for their future career. Critical evaluation skills need to be strenghtend. Digital Health Literacy is only slightly higher in 3rd year students. Longitudinal data are needed to differentiate cohort from learning effects.

Key messages
Digital media are increasingly important in health systems, a view shared by future health professionals. Data indicate only a small increase of digital health literacy across three years of study. Curricula should include digital health competencies to ensure a highly digitally skilled health work force.
1.O. Workshop: Building bridges between environmental and Public Mental health
Authors:   Organised by: EUPHA (PMH), EUPHA (ENV) Chair persons: Jutta Lindert - EUPHA (PMH), Marija Jevtic - EUPHA (ENV)
Published: November 2019

Abstract

Scope and extent as well as duration of mental health and mental disorders are influenced by various factors, such as environmental factors. Environmental factors relate to physical, chemical and built environment. We aim to build knowledge by providing 1) a case study on perception of climate change and possibilities and limitations of adaptation, 2) a review on mental and neuropsychiatric disorders in the light of the SDGs framework and 3) give an overview of research methods both, in environmental epidemiology and in neuropsychiatric epidemiology. By bringing together the two fields of expertise and the members of the section of Environment and Health and of Public Mental health we will not only build bridges between individuals but between disciplines which might lead to a joint research agenda.

Key messages
The scope of mental health changes with changes in the environment. Knowledge provides a strong bridge to link the environment with mental disorders.
“Brave men” and “emotional women”: A literature review on gendered norms towards patients with pain
Authors: Samulowitz A , Gremyr I , Eriksson E , Hensing G 
Published: November 2019

Abstract

Background
More women than men report chronic pain but despite the large body of research on sex differences there is a lack of knowledge on the influence of social and cultural gender. As gender norms can lead to gender bias in health care it is important to raise awareness about them. The purpose of this study was to illustrate gendered norms about men and women with chronic pain in scientific journals, and to analyze how societal norms are reproduced in health care.

Methods
A literature search of the databases PsycINFO, CINAHL and PubMed was conducted, January 2000 to April 2015, with the search term chronic pain combined with femininity, masculinity, gender bias, gender stereotypes and gender roles. A total of 77 articles met the inclusion criteria and were analyzed qualitatively. The integrative approach enabled a review of articles from both social and medical sciences, and to include qualitative and quantitative research. The material was sorted into theoretical categories and further coded into substantive categories.

Results
The included articles showed a variety of gendered norms about men’s and women’s experience and expression of pain, their identity, lifestyle and coping style. Women were described as emotional and hysterical, constantly dealing with mistrust from health care. Men were pictured as brave, stoic and struggling with their sense of masculinity. Prevailing societal norms are consolidated in health care, positioning the masculine man as the ideal patient.

Conclusions
Gender stereotypes are reproduced in healthcare, which can lead to gender bias in the treatment of patients with pain. The findings were used to develop a tool, “the pain cube”, aimed to improve health care providers’ consciousness about gendered norms.

Key messages
Men and women with chronic pain are depicted in a stereotypical way in scientific articles. Increased awareness about gendered norms can support health care professionals in providing equitable care.
Do financial difficulties affect health? A study among older adults in Switzerland
Authors: Dumontet M , Santos-Eggimann B 
Published: November 2019

Abstract

Background
In perspective of health promotion strategies among older adults, it is particularly important to identify socioeconomic determinants associated with the dynamic of health. In this study, we want to assess the role of financial difficulties on health among older adults.

Methods
We use cohort data coming from the Lausanne cohort 65+. Participants were community-dwelling older adults representative of the general population aged 65 to 70 years in 2004 and living in Lausanne (Switzerland). This cohort is a longitudinal survey and was designed as an annual survey where same individuals (N = 1564) are re-interviewed in successive waves. Wave 1 and wave 2 are considered as baselines. We perform our analysis on the 2006-2016 period (11 waves). We consider the health dynamic by estimating system GMM estimators. Our main explanatory variable is a proxy of financial difficulties: “Have you been confronted to financial difficulties in the last 12 months?”. We study the effect of this variable on several health indicators (self-rated health, number of medical conditions, depression, difficulties in activities in daily living) and evaluate if this effect is similar for these different dimensions of health.

Results
Our econometric analysis underlines the importance of using dynamic approach: health lag variables have significant effects (p &lt; 0.01) and to control for endogeneity bias. We find no evidence of a causal link from having financial difficulties to health. The effect was non-significant for all health variables.

Conclusions
In terms of public policy, our results provide insight that policies allowing to limit short term financial difficulties are not essential to protect elderly against health deterioration.

Key messages
There is no evidence of a causal link from having financial difficulties to health. Policies allowing to limit short term financial difficulties are not essential to protect older adults against health deterioration.
E-health for healthcare system users & social and geographic health inequalities, literature review
Authors: Ramel V 
Published: November 2019

Abstract

Objective
EHealth has been taking a growing part in public health policies and seems to make it possible to break space and time barriers currently impacting health and well-being (by improving care coordination, prevention, decision support and helping care delivery). However, there is a growing literature on eHealth-related digital divides. We therefore need to understand better the interface between social and geographic vulnerabilities and eHealth services. Previous reviews of the literature started exploring it but lacked a sufficient framework that would be useful for health professionals to adapt to their practice.

Methods
We carried out a scoping literature review of these relationships in scientific literature since 2000 in Western countries in Scopus, PubMed, PsycArticles, SocIndex, PBSC.

Results
The links between eHealth oriented towards healthcare system users and social and geographic health inequalities (SGHI) can be observed at three levels: access to digital technologies, understanding of digital technologies and of the information provided (eHealth literacy) and adoption of these technologies to help improve one’s health. People’s vulnerabilities can become real inequalities regarding eHealth, in a cumulative way. Several types of vulnerabilities are analysed.

Conclusions
EHealth is more easily accessed by people who need it the least. These unintended consequences have to be taken into account while developing eHealth and more research needs to highlight them. This review contributes insights about eHealth and health inequalities descriptors thus describing better SGHI and of digital technologies fields. It presents a thorough description of this field which has not been sufficiently described in the literature. It is a large scoping review offering a knowledge cartography which purposely addresses the whole spectrum of these links. In the future, it will be interesting to perform further in-depth systematic analyses on specific sub-issues.

Key messages
EHealth is more easily accessed by people who need it the least. These unintended consequences have to be taken into account while developing eHealth and more research needs to highlight them. This review contributes insights about eHealth & health inequalities descriptors. It offers a knowledge cartography and a strong basis for further in-depth systematic analyses on specific sub-issues.
National survey on telemedicine education and training among medical students and residents in France
Authors: Ohannessian R , Yaghobian S , Iampetro T , Riom I , Salles N , Matthieu-Frtiz A , Moulin T 
Published: November 2019

Abstract

Telemedicine was defined in France in 2009 and until 2017 integrated into the official medical school and residency programs. A national survey among medical school deans indicated a lack of implementation of telemedicine education and training despite positive attitudes towards it. In September 2018, teleconsultation started to be reimbursed for all doctors and patients by the National Health Insurance.
The objective was to describe the knowledge, attitudes, and practices of medical students and residents in France on telemedicine. A national voluntary online questionnaire-based survey was conducted from December 15th, 2018 to March 3rd, 2019. The survey was shared by the French Society of Telemedicine (SFTelemed), the National Association of French Medical Students (ANEMF), and the National Union of Medical Residents (ISNI).
There were 3329 answers, with 67.5% of participants being women and 69.8% being medical students and 30.2% residents. In total, 82.8% declared telemedicine was relevant to improve access to care. 84.8% did not know telemedicine regulations at all. 86.9% declared they knew the definition of teleconsultation and only 40.3% for tele-expertise. 14.4% received telemedicine theoretical education, and 97.9% stated they were not trained enough. 7% practised telemedicine during their medical school education and 30% during residency. Among them 60.2% practiced telemedicine less than 5 occasions. Among those who did not practise telemedicine during their education, 82.6% answered that they would want to practice telemedicine before the end of their studies.
Medical students and residents in France have a positive attitude towards telemedicine, however, were limited to its practice. Majority of participants declared they want to be educated and trained for telemedicine during their studies. This is the first national scale study in the world and should be applied in France for other healthcare professionals and other countries.

Key messages
Telemedicine education and training should be provided to medical students and resident during their curriculum. Medical schools and residency programs need to integrate and apply telemedicine in their programs.
Which are the communication styles of anti-tobacco spots that most impress adolescents?
Authors: Mannocci A , D’Egidio V , Guerra F , De Marco Y , Gualano M R , Firenze A , Giordano D , Boccia G , Siliquini R , La Torre G 
Published: November 2019

Abstract

Objectives
To evaluate emotions and opinions of Italian adolescents aged 13-18 years old about different anti-tobacco spots delivered by the mass media campaigns over the world.

Methods
A multicenter cross-sectional study was conducted. Italian students from different regions were enrolled. A video that collected 7 anti-tobacco spots from all over the world. The spots describe the tobacco dependence, the health damages and the tobacco components using different communication styles (funny, scientific, dramatic, comedians, shocking, and sad). Information on age, gender, smoking status of family and peers were gathered. Descriptive and univariate analysis of emotional and cognitive reactions to spots were performed with respect to gender, smoking status of adolescents, their peers and parents.

Results
495 students were enrolled. 14% of them were current smokers. Two spots resulted to have most impressed the students: Sponge (29%) and Icons (18%). In the first spot the sponges represent human lungs, a pair of hands squeeze the tar from the sponge, revealing the cancer-producing tar that goes into the lungs of a pack-a-day smoker every year. The second one contrasts tobacco industry images such as a cowboy, a hip-hop DJ with a more accurate depiction of the repercussions of smoking: a dying man in a wheelchair who warns, ‘The reality is you can end up looking like this’. The reactions on these videos are disgust, reflection and sadness, respectively: Sponge 79%, 44% and 15%; Icons 60%, 3% and 20%. Univariate analysis showed differences by smoking status about video considered most impressive (p = 0.02) and by gender about the choice of spot in the role of the Minister of Health (p &lt; 0.001).

Conclusions
The spot media campaigns that gave a clear and scientific message or that changed the “icon” of the smoker were preferred by adolescents. Further research is needed to study adolescents’ responses and smoking outcomes obtained by different anti-tobacco mass media campaigns.

Key messages
The study demonstrates the preference of adolescents for spot giving clear scientific messages or using strategies that fight manipulation of the tobacco industry and aimed at changing smoker’s icon. The present study underlines that it is necessary to monitor the effect of a multimedia campaign and to examine its longitudinal impact, especially its impact on smoking behavior.
Social network characteristics and alcohol use among young Swedes with different ethnic backgrounds
Authors: Miething A , Gustafsson N K , Rostila M , Rydgren J 
Published: November 2019

Abstract

Background
The study explores how social network determinants relate to the prevalence and frequency of alcohol use of members of social networks. In a so-called dyadic design we study how similar alcohol habits co-exist among individuals (egos) and their peers (alters), when variables such as ethnic background, network composition, and other socio-cultural aspects are considered.

Methods
The data were derived from a Swedish survey entitled “Social Capital and Labor Market Integration: A Cohort Study.” The study participants (egos; n = 1989) were around age 23 at the time of the interview. A so-called dyadic design was applied, which means that all components of the analysis refer to ego-alter pairs (n = 7828).
The outcome variable considered how alcohol prevalence and frequency of binge-drinking co-exist between egos and their alters. The independent variables also measured mutual attributes and behaviors - whether egos and alters were at the same age and sex, had same ethnic background, were relatives or friends, had similar religious affiliations, or intensely interacted with friends.

Results
The analysis revealed that ego-alter similarity in terms of age, sex and ethnic background predict ego-alter similarity in alcohol use and binge-drinking. For example, if egos and alters shared a similar ethnic background, their risk of alcohol use was at least 30 percent higher as compared to those with different ethnic backgrounds. Relative to ego-alter pairs with mixed ethnic backgrounds, the odds of binge-drinking were highest for ego-alters pairs with Yugoslavian background (OR 1.76; 95% CI 1.27-2.42), followed by those with Iranian (OR 1.57; 1.04-2.35) and Swedish background (OR 1.28; 0.84-1.95).

Conclusions
We conclude that network similarity (i.e., homophily) is an important explanation for the co-existence of alcohol use among members of peer networks. Alcohol use is more common in homogeneous peer dyads representing population groups with higher use.

Key messages
Peer similarity predicts alcohol use and binge drinking. Ethnic similarity of peers is associated with increased alcohol use and binge drinking.