bluuebunny/crossref_metadata_2025_split huggingface dataset:
Expansion of activity-based hospital payment in Israel: evaluation of effects on inpatient activity
Authors: Waitzberg R , Quentin W , Maoz-Breuer R , Busse R , Greenberg D 
Published: November 2019

Abstract

Background
In 2013-14, Israel stepped up the replacement of per-diem payments by Procedure-Related Group (PRG) based hospital payments, a local version of Diagnosis-Related groups (DRGs). PRGs were created for selected procedures in urology, general surgery, gynecology and ophthalmology. We analyzed how did this change affect inpatient activities, measured by the number of discharges, average length of stay (ALoS), and the case-severity Charlson Comorbidity Index (CCI).

Methods
We investigated the impacts of the PRG-payment reform on 15 procedures. Observations covered groups of inpatients, by age and gender, who underwent these procedures in 2005-2016 at all non-profit hospitals. We examined the effect of the payment change on the number of discharges, ALoS and CCI using a multivariable analysis of Ordinary Least Squares controlling for patients, hospital characteristics, and year fixed-effects.

Results
Data on 89,533 patients were examined. During the study period, the ALoS decreased except for one procedure, the number of inpatients increased for most procedures, and case severity remained stable. The multivariable analysis suggests that the transition to PRG-payments contributed to changes in ALoS or case severity for only 3 out of 15 procedures examined. The PRG-reform contributed to changes of 10%-45% in the number of patients, but there was no clear trend: it increased in 9, and decreased in 5. The changes did not follow a clear pattern according to procedures’ price changes after the reform.

Conclusions
Factors that may have hampered the effects of the PRG-reform are conflicting incentives created by other co-existing hospital-payment components, such as revenue caps and retrospective subsidies, and the lack of resources to increase productivity.

Key messages
Provider payment reforms should carefully coordinate the entire payment system, otherwise the incentives may be blurred. Uncoordinated reforms may miss their goals.
The effect of breast cancer on work participation in different sectors. A Danish registry based study
Authors: Jensen L , Bøggild H , Overgaard C , Fonager K 
Published: November 2019

Abstract

Background
A breast cancer diagnosis affects an individual’s affiliation to the labor market, but whether the effect of breast cancer variates in different sectors in a Danish setting has not been examined. The present study investigated the effect of stage IA breast cancer (tumor&lt;20 mm and no lymph nodes involved in six sectors among Danish women being part of the work force. Stage IA breast cancer has a good prognosis, and it would be assumed that the majority have returned to work after 1 year.

Methods
This registry-based cohort study was based on data from linked Danish nationwide registries. We identified 5,543 women (aged 25-63 years) diagnosed with breast cancer (BC) stage IA (exposed) and 65.889 women without breast cancer (unexposed) and included women from the different sectors. We calculated a yearly Work Participation Score (WPS), defined as the proportion of weeks being self-supported during a year. We compared the means of WPS for exposed and unexposed women in six different sectors: 1) teaching, 2) childcare, 3) eldercare, 4) cleaning, 5) administration and 6) hospitality industry.

Results
BC had a negative effect on being self-supporting for women in all six sectors in all three years, although the effect declined. In the first year, the difference in WPS varied between 0.38 and 0.54. During the second year all BC patients had still significantly lower WPS with the largest difference in hospitality industry (0.65 (95% CI 0.50-0.80) for exposed women and 0.86 (95% CI 0.83-0.88) for unexposed women). In the third year, the effect further declined although WPS was still significantly lower for most sectors with the biggest difference in the cleaning sector.

Conclusions
A stage IA BC diagnosis had a negative effect on being self-supportive after 2 and 3 years among women in all six sectors, although the difference was largest among cleaning workers. This may indicate, that individual follow-up in relation to work participation is necessary.

Key messages
Although breast cancer stage IA has a good prognosis, it still affects being self-supporting after three years. A diagnosis of breast cancer affects the affiliation to the labour market, but the effect differs according to different sectors.
We’re making individuals more “health literate” but what about communities?
Authors: Kendir D r , Breton D r 
Published: November 2019

Abstract

Health literacy (HL) is increasingly hailed as a strategy to improve the control individuals have over their health. So much so that HL is now ranked as a determinant of population health. A central critic of HL intervention is its over emphasis on individual level factors something recognised in the 2008 report of the Commission of Social Determinants of Health (SDoH) that recommended expanding the scope of HL to cover the SDoH.
Our objective of our study was to assess the extent to which recent progress on HL captures the need for collective action on the SDoH.
We conducted a scoping review on PubMed looking for review papers, published between 2013-2018 in English and French. The reference lists of the papers were also searched to find other relevant articles. The WHO website was also consulted. The most cited definitions were analysed against two main dimensions (i.e. locus of change of HL strategies and foreseen outcome of HL improvements).
We identified 419 articles. Despite a number of authors calling for more research on HL interventions at the community level and an expansion of the definition to cover the SDoH, we found that the recommendation of the Commission has yet to be implemented. Even when the definitions include the capacities of individuals on distal determinants, both the locus of change and outcomes of HL improvement stayed focused on intra individual factors. It is noteworthy that communities were either framed as a setting outside of health care services or as an aggregate of individuals. We found no instance of HL intervention regarding communities as complex systems of actors sharing a common space and dynamic.
We conclude by drawing attention on the research gap in addressing the upstream SDoH through HL actions. We propose some elements of definition of HL reflecting the need for interventions to build capacities for collective action on the SDoH and develop measurements at the community level.

Key messages
Research and practice have yet to embrace the contribution of HL in addressing the upstream SDoH. There is a large research gap on how HL can build collective capacities on addressing the SDoH.
The association between screen time and psychological distress in Norwegian adolescents
Authors: Kleppang A L , Steigen A M , Finbråten H S 
Published: November 2019

Abstract

Background
The use of screens, especially mobile devices like tablets and smartphones have increased over the last years, and have become an integrated part of modern life. Adolescents today spend a lot of their time using screens both at school and outside school. The concerns about the impact of screens on adolescents are growing, and some expert groups have suggested controlling screen time for children and young adults. Because research is limited and screen-based utilization technologies and their patterns are changing rapidly, it is important to examine their impacts on mental health. This can help to guide public health policy on consequences of, and potential limits on screen time. The purpose of this study is to study the association between screen time and psychological distress among adolescents.

Methods
This study is based on self-reported cross-sectional data from the Ungdata survey conducted in 2018. The target group comprised 6777 adolescents from secondary schools in Norway. Ten items on depression and anxiety symptoms were used to create a composite measure of psychological distress. Binomial logistic regression was used to analyse the association between screen time and psychological distress.

Results
Preliminary results showed that the odds for psychological distress were higher for those who used screens more than 2 hours per day after school (OR: 1.83, 95% CI: 1.60-2.09), compared to those who used screens 2 hours and less per day. Further, the odds of having psychological distress were higher in girls compared to boys (OR: 3.49, 95% CI: 3.14-3.87), and in upper secondary school compared to lower secondary school (OR: 1.41, 95% CI: 1.25-1.58).

Conclusions
Two hours or more used on screens per day was associated with significantly higher odds for psychological distress. Hence, public health policy and practice should pay attention to consequences of screen time use in adolescence. Additional research is needed to further explore these associations.

Key messages
Public health policy and practice should pay attention to screen time in adolescence and its association with psychological distress. This knowledge is important to enhance mental health in adolescence.
Participatory research for developing health promotion campaigns for migrants and host community in Berlin, Germany
Authors: Schouler-Ocak M , Kirkgöze N 
Published: November 2019

Abstract

Background
During the current refugee crisis, hundreds of refugees left their homes and fled to Europe. The country that received the highest rates of refugees was Germany, which above all presented a challenge to the healthcare system. This study aimed to inform the development of a pilot intervention to improve migrants healthcare access in Berlin, Germany.

Methods
A Metaplan© qualitative technique was applied to ensure the community participation, with three sessions with refugee and asylum seeking women and youth in Arabic, Somali and German languages, and one with professionals. With each group, participants identified issues in migrants’ healthcare, then suggested solutions to address these issues and prioritized these solutions.

Results
The migrants (n = 30) were mainly from Syria (n = 4), Somalia (n = 14) and other African countries, mainly females (17-53 yrs) and youth (16-18yrs). The professionals’ group (n = 13) included an interdisciplinary team of a psychiatric day clinic. All groups prioritized language barriers as a crucial problem and suggested to work with interpreters to facilitate the communication. Professionals are additionally confronted with cultural differences in the treatment of refugees. Somali women prioritized raising the awareness about Female Genital Mutilation in the healthcare system and also in their community. Other suggestions included supervisors for unaccompanied minors, multilingual forms, increased intercultural competence of health care providers and reducing waiting time for an appointment.

Conclusions
Future interventions should focus on intercultural competences for professionals and health-promoting information in the specific sociocultural context of migrant communities. This would include the dissemination of multi-lingual doctors’ brochures, interactive training for health care providers as well as informational workshops for migrants to increase their health literacy and promote health-enhancing behaviors.
Could machine learning aid the production of evidence reviews? A retrospective test of RobotAnalyst
Authors: Hookway A , Price S , Knight T 
Published: November 2019

Abstract

Background
The Observatory Evidence Service (OES) at Public Health Wales supports evidence informed decision making by conducting evidence reviews, which follow systematic review methodology, on complex public health topics. Machine-learning technologies have the potential to aid in screening studies for inclusion in reviews, and the OES have undertaken testing of one such system, RobotAnalyst, to assess its accuracy and to determine if it would increase the efficiency of the review process.

Methods
Retrospective testing was undertaken using three previously completed evidence reviews. For each test, references were uploaded into RobotAnalyst and the decisions made by the original reviewers were input in blocks of 25 to form a training set. The “update predictions” function generated a predicted inclusion decision for the remaining references at each test point and these were compared to the original review decisions.
We calculated RobotAnalysts sensitivity, specificity, positive predictive value, false include and exclude rate and the proportion of missed references.

Results
Mixed levels of performance were observed. An overall increase in sensitivity as more studies were added to the training set was detected for two of the three reference sets when screened at title stage, but only in one case did RobotAnalyst produce relatively high levels of sensitivity (over 90%). This was observed in reference test set one (n = 500 references), where sensitivity increased from 51% at the start of testing to 91% after 250 references had been manually marked on the system. Although performance tended to be higher as more studies were added to the training sets, the increases were not always linear.

Conclusions
There may be some promise in using RobotAnalyst as a second screener, especially on larger reference sets when the human resource demands of duplicate screening are considerable. We are continuing to test RobotAnalyst both retrospectively and prospectively.

Key messages
Retrospective testing of RobotAnalyst observed mixed levels of performance. RobotAnalyst could potentially be utilised as a second screener for evidence review.
MS-Diet, a tailored nutrition counselling web-application based on mathematical diet optimization
Authors: Gazan R , Darmon N D , Vieux F V , Maillot M M 
Published: November 2019

Abstract

Background
By definition, messages in tailored approaches are built to reach a given person, based on her/his specific characteristics and needs. Tailored dietary behavior change interventions have a small but significant effect on dietary behavior change. The majority of these interventions target a few food groups or nutrients, without evaluating the overall diet. Diet optimization is a powerful mathematical method to translate nutrient recommendations into individual-specific food choices. This method is increasingly used in nutrition research, in the fields of public health and diet sustainability. Objective: The aim was to combine tailored approaches and diet optimization in a web application of tailored nutrition counselling.

Method and results
The web application, called MS-Diet, was developed based on behavior changes techniques, such as: self-monitoring, self-regulatory, tailored feedback and engaging communication techniques. In a first feature, based on user’s data collected online (including answers to a food frequency questionnaire), the user can obtain a picture of the nutritional quality of her/his diet, the diet cost and the level of physical activity. In a second feature, MS-Diet suggests to the user a list of tailored dietary advices to get a healthier diet (i.e., a nutritionally adequate diet), adapted to her/his specific needs and food preferences. With the application, the user is actor in her/his own dietary changes: she/he specifies her/his food preferences and; chooses dietary suggestions that she/he considers achievable.

Conclusions
This prototype could be a future online health promotion tool which could help individuals to improve their diet or serve as a decision-support tool for health professionals. The evaluation of the tool (e.g. whether the use of the tool results in changes of dietary habits) is warranted before use on health promotion.

Key messages
MS-Diet demonstrates how diet optimization can be used to design dietary advice adapted to user’s needs and food preferences. MS-Diet is a promising tool to help individuals improving their diet but requires qualitative and quantitative evaluation for further improvements.
Telepathology and second opinion for cancer diagnosis in sub-Saharan French-speaking countries
Authors: Petit L , Ilunga J , Foërster F , Traore C , Anani L , Lebwaze B , N’Kegoum B , Hurwitz N , Raphaël M , Gagnepain-Lacheteau A 
Published: November 2019

Abstract

Many healthcare disparities can be described to explain cancer prevalence differences between developed and developing countries. Telepathology, telemedicine declination consisting in the transmission of digital images from a classical optical microscope combined with a digital camera linked to a computer, could offer a healthcare solution by enabling efficient communication between physicians and reinforcing multidisciplinary approaches. This study evaluated a pilot telepathology project using the ‘i-Path’ platform in Sub-Saharan French-speaking countries. This is a descriptive retrospective study. This study was made in two steps: (1) quantitative description of the platform’s use by the pathologists group and (2) qualitative evaluation of the users’ perception of the pilot project. From October 2009 to March 2018, 226 cases were submitted; 86·3% of them (n = 195) were analyzable. More than 30 experts in surgical pathology of 12 different countries were involved in the network. The average turnaround-time was less than one day. The main highlighted obstacles were the lack of time to submit cases and internet connection problems. Discussions on i-Path lead to a useful second opinion for 67·7% (n = 132) of the cases. The major part of second opinion was in favor of lymphoma (32·6%). Regarding children, lymphoma represent half of the second opinion (50·7%). The inter-observers agreement between first interpretation and second opinion was κ = 0·36, and κ = 0·58 after excluding non-diagnosed cases at submission. Even if some improvements can be made, we concluded that the project was satisfying and workable and it could be extended to other applications.

Key messages
Dialogue between expert in multiple LMIC is feasible with telepathology network and, as 1st diagnosis assessment is not always sure, telepathology help for 2nd opinion. Centers’ use of the telepathology system are different but the discussion between experts still provide a 2nd opinion in favor of a precise diagnosis.
Digital media: How to adapt digital media to promote health of young people?
Authors: Durand D , Vassieux L , Dodet J-F , Millot I 
Published: November 2019

Abstract

A priority of the French government health section is to promote strategies to develop teenager and young adult abilities to manage their own health. Interventions must be based on digital tools on how to improve it. The Pass’santé Jeunes (PSJ) is a regional measure based on a global, positive, community approaches, and on peers interventions. Managed by the Agence Régionale de Santé since 2013, and lead by the Instance Regional d’Education et de Promotion pour la Santé, this program consists of the provision of two portals: Pass’santé Jeunes and Pass’santé pro.
This project aims to renew prevention approaches with youths, and to develop a common culture around efficient intervention strategies with professionals for linkage in digital practices. This initiative has been developed and collaborated with the targeted public, parents, and professionals. We queried the opinions of a youth panel, and requested advice of experts to assure relevance and veracity of the information. Websites were then created for professionals to locate information to support their missions.
Analysis of the actual uses of the PSJ were conducted by the University of Burgundy in 2016. Results showed much of the research leaning toward the creation of a prevention tool. For alignment with internet use by youths, we adapted the variety of media (quizzes, videos, apps...). In 2018, the average monthly audience of both sites increased significantly.Greater utilization of these resources is explained by increased awareness by professionals and prevention missions of health students.
In the health sector, challenges exist in understanding digital practices of youth and professionals, therefore it is important to play a key liaison role. First identified as an informational medium, these devices are now real resources for meeting and circulating knowledge.Prospects for 2020 are to redirect these tools to the 0-8 years age group, adapt them to situations of disability, and expand to the pregnancy period.

Key messages
In line with digital practices of youth, the PSJ relies on innovative communication supports, available in different formats (videos, quizzes, games, apps...). Beyond an informational tool for the young, the PSJ turns out to be a tool of knowledge brockering. It facilitates networking, implementation of activities, and improving health practices.
Children and digital devices: a survey on risk perception and use
Authors: Covolo L , Roncali J , Zaniboni D , Mapelli V , Ceretti E , Gelatti U 
Published: November 2019

Abstract

Background
Paediatrics associations in different international contexts recommended avoiding the use of screen media in children ages 0-2 years and limiting the use to one hour per day for children ages 2-5 years. In the light of these guidelines, the aim of this study was to investigate risk perception in the general population and use of digital devices (DD) in preschool children.

Methods
We carried out a cross-sectional study on 3115 Italian subjects including parents and non-parents, using an online survey. Parents answered questions about their children’s DD use. We used multiple linear regression analysis to assess the potential predictors of devices’ use in preschool children.

Results
Overall 74% of sample think that the use of DD by preschool children is a risk for health. They perceive risks, such as having eye irritation (83%), having sleep disorders (65%) more than benefits, e.g. communicating with distant relatives (47%), and learning new words (40%). Parents of preschool children represent the 74% of all parents (N = 1869). The 56% of parents with only 0-2 years children think that is not correct the use of DDs in toddlers, however the 25% of them allow their children to use them. The mean time use reported is 63±57 minutes. Among parents who have also children from 2 to 5 years, the 89% think it is correct the use of DD up to a maximum of one hour a day for children aged 2-5 years. However, the 58% of them allow their children to use it more than one hour. The mean time use reported is 61±52 minutes. Parents without a job, having low education level, with more than one child and having children ages 3 and older, are more prone to allow the use of DD to their children.

Conclusions
There is a discrepancy between risk perception and real attitude on DD use in children by parents. Public health actions must aim to increase awareness about a conscious use of DD in children considering the spread of DD in the society and younger people.

Key messages
The discrepancy between risk perception and actual behaviour means an underestimation of health impact of digital devices use in children. Health professionals are very concerned about the health risk of digital devices use in children. Considering the large use of digital devices, public health actors must pay attention to this matter.