bluuebunny/crossref_metadata_2025_split huggingface dataset:
Equity impacts of interventions to increase physical activity: A health impact assessment
Authors: Schoenbach J-K , Bolte G , Czwikla G , Manz K , Mensing M , Muellmann S , Voelcker-Rehage6 C , Lhachimi S K 
Published: October 2020

Abstract

Background
Behavioural interventions may increase social inequalities in health. This study aimed to project the equity impact of physical activity interventions that have differential effectiveness across education groups on the long-term health inequalities among older adults in Germany.

Methods
We created six hypothetical intervention scenarios targeting adults aged 55 years and above: Scenarios #1 to #4 applied realistic intervention effects that varied by education. Under scenario #5, the lower and medium educated group adapted the physical activity pattern of the higher educated. Under scenario #6, all persons increased their physical activity level to the recommended 300 minutes weekly. The number of incident ischemic heart disease, stroke and diabetes cases as well as deaths from all causes was simulated under each of these six intervention scenarios for males and females over a 10-year projection period using the DYNAMO-HIA tool, and compared against a reference scenario with unchanged physical activity pattern.

Results
For males, the highest reduction of disease cases and deaths would be achieved under scenario #4 (most effective in higher educated persons), while increasing inequalities between education groups. For females, the highest reduction would be achieved under scenario #3 (most effective in lower educated persons), while decreasing inequalities between education groups. Scenarios #1 to #4 would prevent only a fraction of the disease cases and deaths that would be avoided under scenario #5 or scenario #6.

Conclusions
This modelling study shows how the overall population health impact varies, depending on how intervention-induced physical activity changes differ across education groups. For decision-makers, both the assessment of health impacts overall as well as within a population is relevant, as interventions with the greatest population health gain might be accompanied by an unintended increase in health inequalities.

Key messages
Health impact assessments with a focus on equity are essential for decision-makers. In order to correctly project population health effects, and choose between options of intervention types from a public health perspective, data on subgroup-specific intervention effects are needed.
The Expanded Immunization Program (EPI): On which exogenous factors does it depend its success?
Authors: Urquidi C , Valenzuela M T 
Published: October 2020

Abstract

Background
EPI is one of the successful public health programs for the control and prevention of infectious diseases worldwide. In Latin America and the Caribbean, EPI achieved high rates of vaccination and reached both the eradication of poliomyelitis (1994) and the elimination of the indigenous transmission on the measles virus (2016). Between 2006 and 2011, 174. 000 deaths were also avoided.

Objective
To identify exogenous conditions that were in place before the establishment of the EPI, which contributed to a better implementation of the program and increased vaccine coverage levels since 1980.

Methods
an exploratory mixed ecological study with information from twenty-five Latin American and the Caribbean countries were studied in 1980. The exogenous variables were: Number of nurses per 10.000 inhabitants (as a proxy level for the level of development of the health services), Infant mortality (progress of health conditions), Annual GDP (Economy growth in production), and Human Development Index (HDI). The primary outcome was vaccine coverage (measles and OPV3) from 1980 to 2013, and secondary outcomes were inter and intersectoral coordination of PNI. The effects were estimated through regression models.

Results
In the univariate models, there was a positive relationship between HDI and vaccination coverage, and an inverse effect of infant mortality; an obvious situation since it is expected that as vaccination coverage increased, infant mortality declines. The number of nurses had a positive relationship between inter and intersectoral coordination. In the multivariate model, three of the four exogenous variables explained 35.7% of the increase in coverage: number of nurses, HDI, and GDP.

Conclusions
Exogenous factors played an essential role in the improvement of the immunizations program in Latin America and the Caribbean countries, as well as could be for other public health interventions.

Key messages
Economy growth and Human Development are essential for the implementation of public health programs. The level of development of health services contributes to the success of a public health program.
Defining a standard set of outcomes for patients with psychosis
Authors: McKenzie E , Shokraneh F , Matkin L , Fialho L S , Gintner T , Ilesanmi C , Emelurumonye I N , Addington D 
Published: October 2020

Abstract

Background
A working group (WG) of researchers, clinicians, and service users was created to develop a Standard Set of Psychotic Disorder Outcomes. This study describes the ICHOM framework to create a minimum Standard Set of outcomes for Psychotic Disorders.

Methods
The WG defined the scope of the project to include adolescents and adults meeting DSM-5 criteria for schizophrenia spectrum disorders or bipolar I disorder. A systematic literature review was conducted to extract patient outcomes. The WG then selected outcomes for this minimum standard set using an online modified Delphi consensus technique, throughout a series of video-conference calls. Outcome measures were identified through additional literature searches using a Terwee filter. These were evaluated by inclusion criteria, namely psychometric properties, feasibility of implementation, licensing fees and available translations.

Results
In total, 7074 studies were screened for outcome extraction. Outcomes were extracted from the 239 of these which passed eligibility criteria. The WG voted to include 17 outcomes, grouped into 7 domains (symptoms, treatment, recovery, functioning, quality of life, physical health and safety). A further 24 outcomes were identified for bipolar disorder, grouped within the same domains.

Conclusions
The outcomes recommended by the working group enable meaningful and standardized assessment of psychotic disorders worldwide. Adoption of the ICHOM framework can facilitate informed decision-making by healthcare providers, long term monitoring and improved global treatment outcomes in the long term.

Key messages
Standard set provides a valid and easy tool for healthcare workers for measuring outcomes. Value based health care and outcomes measures could globally improve healthcare and at the same time reduce healthcare cost.
Epidemiological panorama of dengue in the 2019 season of the HCG Juan I. Menchaca
Authors: Gonzalez Valadez J , Castillo Velez F E , Paredes Casillas P 
Published: October 2020

Abstract

Introduction
Dengue fever is a viral infection transmitted by female mosquitoes of the Aedes aegypti and Aedes albopictus species. vector-borne diseases represent an impact on public health in Mexico and the world, so it has tried to contain and mitigate them.

Objectives
Analyze the epidemiological panorama of dengue in the 2019 season of the Guadalajara Civil Hospital 'Juan I. Menchaca'.

Material and Methods
A cross-sectional, analytical study was designed. The data search was carried out through the platform of the National Epidemiological Surveillance System (SINAVE), of all the cases notified as arbovirosis during the year 2019. The analysis was carried out with the EPI Info 7 statistical package, frequency measures were calculated and association.

Results
1496 probable cases of dengue were reported, of which: non-serious dengue 108 (7.22%), dengue with alarm signs 197 (13.17%) and severe dengue 183 (14.9%), positivity of 488 cases (70%). Municipality of residence: Guadalajara 287 (58.81%), Tonalá 73 (14.95%), Tlaquepaque 60 (12.29%). Housewife represented 39.96% (OR 1.40, 95% CI 0.99-1.97, p 0.053), age (mean 30.78), male 60.83% (OR 0.77, 95% CI 0.54-1.09, p 0.14). Liver enzymes in patients with dengue fever: ALT 830.42 (mean difference 795.08, 95% CI 683.00-907.17, p &lt; 0.0001), AST (mean difference 2368.83, 95% CI 1980.65-2757.01, p &lt; 0.0001).

Conclusions
The high positivity reflects a high incidence of the disease during the 2019 season. Home occupation was highly prevalent, although it was not possible to demonstrate statistical significance as a risk factor for the disease, however, it opens the possibility of future research. Our study highlights the importance of including liver function tests as an initial evaluation since it was an important predictor of mortality.

Key messages
Dengue. Fever.
Geographical Information System for Health Impact Assessment and urban planning
Authors: Smida J , Loosova J 
Published: October 2020

Abstract
The use of methods of geographic information systems and cartography is common in the processes of spatial planning and Health Impact Assessment. As part of the research team of the Technical University of Liberec (Czech Republic) and in cooperation with the Liberec City Hall and the Regional Hygiene Authority of the Liberec Region, we propose a procedure for the implementation of HIA in spatial planning.
The project aims to propose and verify the methodological procedure of comprehensive assessment of health determinants in the area following the method of HIA in the territory of Liberec and the municipalities of the Liberec region. The main area of research and the applicability of results is in spatial and urban planning and public health protection, where the methodology will contribute to the identification of the main impacts on the health of the population, health inequalities and the proposed measures to eliminate or reduce negative or strengthen positive impacts. Multicriterial analysis with outputs in GIS will be used to define impacts. Project activities: the design of the concept of the data model, data analysis, evaluation of the methodology and proposal of measures supporting health.
The project includes the design of the concept and logical structure of the data model of health determinants. This is the basis for multicriterial analyzes of health determinants. Its proposal will use methods of health impact assessment (HIA, especially scoping) and qualitative research methods. GIScience and geoinformatics methods will be used to solve the model structure.
Last but not least, the methodology for analytical processing is elaborated: the activity will focus on the design and testing of multi-criteria analysis of health determinants.

Key messages
Geographic information systems enable efficient creation, analysis and communication of data model of health determinants. Spatial planning is a concrete tool for the implementation of health impact assessment objectives into practice.
Barriers against safer sex as predictors of condom negotiation self-efficacy among Mozambican Women
Authors: Patrão A L , McIntyre T 
Published: October 2020

Abstract

Background
Negotiation self-efficacy is one of the main predictors of effective condom use. Therefore, it is essential to identify the factors that influence condom use negotiation self-efficacy in vulnerable women. The aim of this paper is to examine whether socio-demographic and marital factors, and perceived barriers against safer sex are associated with condom use negotiation self-efficacy among Mozambican women at sexual risk.

Methods
173 women, patients at a Mozambican public Hospital and at risk for HIV infection, completed measures of sociodemographic and marital characteristics, perceived barriers against safer sex, and condom use negotiation self-efficacy. Measures included the Mozambican version of the “Women's Health Study Questionnaire”, which presented good psychometric properties in this sample.

Results
Demographic variables (age and education) explained 20% of the variance (ΔF(2, 170)=20.92, p&lt;.001) in condom use negotiation self-efficacy, and the marital variables, “marital status” and “talking about AIDS with partner”, explained 30% of the variance in the outcome (ΔF(2, 168)=50.06, p&lt;.001). Barriers against safer sex explained 6.5% of unique variance in condom use negotiation self-efficacy (ΔF(1, 167)= 24.68, p&lt;.001). The overall model explained 55% of the variance in condom use negotiation self-efficacy.

Conclusions
These results support an exploratory predictive model of condom use negotiation self-efficacy that can inform interventions directed at behavioral change among Mozambican women at sexual risk.

Key messages
Women who were younger, had a higher level of education, were single, and talked about AIDS, had higher levels of condom use negotiation self-efficacy. Women who had lower levels of perceived barriers, had higher levels of condom use negotiation self-efficacy.
Fatigue and sleepiness in night workers: preliminary results of an educational program
Authors: Amaral A P , Câmara L T , Nunes L S , Gomes A A 
Published: October 2020

Abstract

Background
Night work has negative effects on sleep, sleepiness and fatigue with repercussions in performance, safety and health. Therefore, implementing sleep hygiene educational intervention seems of tremendous importance to industries. The questions underlying this study were: 1) To what extent do shift workers experience risk levels of fatigue and sleepiness?; 2) May a sleep hygiene program be associated with improvements on fatigue and sleepiness?

Methods
The study was conducted in industry and employed a pre pos-test design using the Epworth's Sleepiness Scale and Chalder's Fatigue Scale. From 471 night workers assessed 45 participants at risk for fatigue and sleepiness (93.3% males), mean age of 31 years (SD = 7.3), were selected for the intervention, composed of four sessions along five months, delivered by the occupational medical doctor. The first three sessions, in small groups, focused in sleep literacy and sleep hygiene; the last one, individual, focused in clinical issues (personalized intervention plan).

Results
Results suggested that 9.6% (N = 45) of the night workers were at high risk (higher levels of fatigue and sleepiness). After intervention, paired T tests revealed significant decreases (p&lt;.001) on mean values for fatigue from T0 (M = 6.67; SD = 2.23) to T1 (M = 4.78; SD = 3.02), and for sleepiness from T0 (M = 15.49; SD = 4.39) to T1 (M = 11.8; SD = 5.95). Along the intervention, participants pointed out family-related routines as an obstacle to daytime sleeping period.

Conclusions
Results support the importance of this educational program focused on sleep hygiene, in reducing sleepiness and fatigue. The program is now part of the occupational health procedures of the company but qualitative results also suggest the importance of including the family in the program, as an innovative procedure. In summary, education of night workers and their families is needed regarding sleep habits in order to promote safety and health in workplace.

Key messages
The sleep hygiene program implemented in permanent night workers allowed to reduce fatigue and sleepiness. Fatigue and sleepiness management improvements might contribute to reduce the risk of accidents in the workplace and increase the workers’ health condition.
Effect of a school-based intervention in eating habits among school children:quasi experimental study
Authors: Ben Cheikh A , Maatoug J , Ghammam R , Chouikha F , Mallat A , Ghannem H 
Published: October 2020

Abstract

Background
Childhood obesity has become a public health problem. Worldwide, the prevalence of overweight and obesity in children has increased dramatically especially in developing countries. The present study aimed to assess whether six months intervention program with parents' implication in primary schools is able to decrease morning snack consumption among children aged 6 to 12 years.

Methods
We carried out a quasi experimental study with two groups of schoolchildren in the region of Sousse (Tunisia) from 2015 to 2016. One primary school in each group was selected. In each school, we randomly selected a sample size of schoolchildren and their parents. The intervention was based on healthy eating habits promotion.

Results
The consumption of morning snacks the day before data collection, reported by children, decreased significantly in post-intervention in both intervention and control groups. The decrease of consumption of morning snacks was significantly higher in intervention group (p = 0.009). According to parents, the proportion of children who had the habit of eating morning snack decreased significantly from pre to post-intervention in intervention group (p &lt; 0.001).

Conclusions
A healthy environment should be created through effective school policies to prevent obesity.

Key messages
The consumption of morning snacks reported by children, decreased significantly in post-intervention. A healthy environment should be created through effective school policies to prevent obesity.
Health Literacy level and related factors of students in a health vocational high school
Authors: Yalcin E , Cavuslu I C , Firinci B , Yalcinkaya N , Pehlivan E 
Published: October 2020

Abstract

Background
Health literacy (HL) is defined as the capacity to acquire, interpret and understand basic health information and services in a way to improve person's health. Population health literacy level was found to be inadequate or limited with 64,4% Ä°n Turkey Health Literacy Research (2015). The aim of this study is to determine the HL levels of students attending health vocational high schools and the related factors.

Methods
The population of this cross-sectional study was students who attended to the vocational school in the center of Malatya. The sample size was determined as 337 by using the power analysis based on Turkish data. Official permission was obtained for the research. In May and June 2019, Turkish Health Literacy Questionnaire-32 (THLQ) developed by the Ministry of Health was applied to the accepting students in this study.The score obtained from the scale is considered to be insufficient of 25 and below, limited to &gt; 25-33 points and a score of &lt; 33 and above is sufficient or excellent. In the analysis of the data, Kolmogorov Smirnov, Mann Whitney U and Kruskal Wallis tests were used and p &lt; 0.05 was chosen as the level of error.

Results
68% of the students is female and 32% is male. The average age of the research group is 16.6 ± 1.1 (min. 14, max. 20). 18.3% of male students stated that 6.6% of female students smoke. The THLQ score of the study group was found to be 33.7 ± 8.9. 53.7% of male students and 39.5% of female students had insufficient or limited HL different from each other significantly (p &lt; 0,025). 56.4% of students in 9th and 10th grades and 37.4% of 11th and 12th grade students were found to have insufficient or limited HL significantly (p &lt; 0,0001). There was no difference between HLL scores and other socio-demographic characteristics(p &gt; 0,05).

Conclusions
The frequency of adequate or excellent HL in the study group is higher among females (60.5%) than males (46.3%). It can be said that female students value health more.

Key messages
The limited level of health literacy of health vocational high school students indicates the insufficiency of health education in schools. Health topic campaigns should be organized frequently for awareness on health education during school education.
Communication on complementary feeding: attitudes of parents versus pediatricians in France
Authors: De Rosso S , Nicklaus S , Ducrot P , Schwartz C 
Published: October 2020

Abstract

Background
Appropriate complementary feeding (CF) can be seen as a promising strategy to prevent childhood obesity. Children's eating behavior is influenced by multiple factors, but parents play a key role in modelling eating habits of their children. For this reason, parents must be informed and guided properly through the CF process. Pediatricians (PED) interact with parents before and at the onset of the CF transition, they can thus positively influence related parental decisions. With the release of new recommendations in France in 2019, the aim of this study was to inform the communication strategy accounting for the needs of parents and PED.

Methods
Two online surveys were prepared, completion was anonymous and on voluntary basis. PED members of AFPA, the French Association of Ambulatory Pediatrics, (n = 1402), were asked on their attitudes and practices in counselling parents on CF. A representative national sample of 1001 parents, with at least one child under 4 years, was interviewed to investigate their sources and expectations regarding information on CF.

Results
Answers from 301 PED and 826 parents showed that the importance of CF for the healthy growth of the child was well recognized by all. PED considered as their responsibility counselling parents on CF and parents acknowledged them as the most influential source of advice. However, PED neglected the fact that parents gave almost the same level of trust to their social network when looking for advice on CF. Internet was a well-recognized source of information according to all whatever their status. Apps were also rated as an appropriate communication tool but no such official app exist so far. Diverging from what PED consider useful, parents were interested in practical advice to implement CF, such as recipes' examples.

Conclusions
This study highlights common expectations but also points of divergence between PED's and parents' needs with regards to communication on CF.

Key messages
PED are an important and reliable source of information on CF for parents, but the influence of parents’ social network is underestimated by PED and must be taken into account. In developing the communication strategy for CF guidelines, both paper and digital tools should be considered. These tools should tackle topics for which parents lack information.