bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self-perception in health and quality of life: association with social determinants
Authors: Aguiar Lemos S M , Vasconcellos L J , Tavares R , Escarce A G , Melo E M 
Published: October 2020

Abstract

Objective
To investigate self-perceived health, quality of life and its association with social determinants in adults and the elderly.

Methods
Observational analytical cross-sectional study, with a probabilistic sample of 1,129 participants, adults and seniors, stratified by conglomerates, living in a municipality in Minas Gerais, Brazil. The response variables were the questions: 'How do you evaluate your health in the last two months?' and 'How do you evaluate your quality of life in the last two months?'. The explanatory variables were sociodemographic and technical-assistance data. For data analysis, a descriptive analysis of categorical and continuous variables and an association analysis (Chi-Square Pearson test) were performed, statistically significant those with a value of p0.05.

Results
The majority were female, classified the quality of life as good and presented positive self-perception of health. Most were aged between 30 and 39 years old, attended high school, were married, had formal work and family income of up to one minimum wage. The association between self-perceived health and quality of life with social determinants revealed that the interviewees who tended to present positive self-perception of health were female, had up to 39 years of age, studied until high school, received up to five minimum wages and had had between one and two medical consultations in the last 12 months. Regarding quality of life, the interviewees who reported there were good were female, between 30 and 39 years old, with high school, were married, had formal work, received up to two minimum wages and had between one and two medical consultations at last year. The univariate analysis revealed that respondents who said their health was positive also rated the quality of life as good.

Conclusions
In the sample studied, it was observed that positive self-perception of health is associated with good quality of life.

Key messages
Health public. Quality of life.
Youth leadership in peer-to-peer community sport: comparing programme rationales and peer delivery
Authors: Christensen J H , Nielsen G , Klinker C D , Heinze C , Kurtzhals M L , Elsborg P , Bentsen P 
Published: October 2020

Abstract

Background
Peer-to-peer approaches are widely used in health promotion. Peer leaders are suggested to increase credibility and identification through role modelling. We suggest that to meet the rationales of peer education, peer leaders should be able to interpret and rework their delivery, based on programme rationales. This entails a need for implementation studies to compare programme theory with the realities of implementation. The purpose of this study was therefore to conceptualise a youth-led programme and to explore how peer leaders engage with the peer leader education and subsequently implement activities.

Methods
The case of study was the Danish street sport organisation, GAME. GAME educates and supports youth peer leaders (age 16-25) in providing life skills-based community sports activities for younger peers (age 8-15) in less advantaged neighbourhoods. A theory of change was developed in partnership with professionals from GAME to conceptualise their programme and its rationales. To study implementation, we observed three two-day peer leader education camps and 49 peer-led GAME activities focusing on specific elements of the theory of change.

Results
We present a theory of change to illustrate the content, rationale, expected outcomes and key assumptions of a peer-led community sport programme. We compare this conceptualisation to the implementation of peer-led activities; i.e., GAME's operationalisation of the peer leader education and peer leaders' enactment of the programme in practice, focusing on role modelling, pedagogical approaches and interactions with participating children. As expected, implementation style varied considerably across settings and thereby the ways in which delivery corresponded with the intentions described in the theory of change.

Conclusions
The study provided insight into how youth peer leaders in community sport interpret their role and interact with peers of relevance to peer leadership research and practice.

Key messages
The rationales behind peer education call for programmes that allow youth peer leaders to interpret and adjust activity implementation with an ensuing need for implementation studies. Initiatives to educate and support peer leaders should be modified based on insights into peer leaders’ interpretation and implementation of peer-led activities.
Designing and implementing an interventional health-promotion program to prevent falls in elderly
Authors: Sakaretsanou A K , Bakola M , Kitsou K S , Bizirgianni V , Jelastopulu E 
Published: October 2020

Abstract

Background
A fall is defined as the unexpected event in which the participant is accidentally lying on the ground, on the floor, or at a lower level. It is often the reason why the elderly are admitted to hospitals or other care facilities, such as nursing homes. Health promotion programs are playing an essential role in raising awareness about how to prevent falls among older adults who are living away from their homes. Our aim was to inform and raise awareness about falls in this population group in an Elderly Care Unit in Patras, through a six month health promotion action program.

Methods
The program was implemented September 2018 to February 2019. The intervention group consisted of 16 seniors. Twelve meetings were held, which included hands-on exercises, discussions, collaboration with a social worker and physiotherapist, and leaflet sharing.

Results
A total of 16 seniors (10 women and 6 men), over 60 years old participated in the program. Twelve meetings were held, which included hands-on exercises, discussions, leaflet sharing and collaboration with a social worker and a physiotherapist. During each meeting every participant was excited and joyful with the knowledge and material provided. At the final evaluation, the majority remembered that they should look after in order not to fall, but they couldn't remember the simple, everyday exercises which were shown during the meetings and would improve their quality of life.

Conclusions
Having in mind that there are seniors who are unable to remember discussions and advices given on a regular basis, a risk assessment should be done by health professionals in order to establish fall risk reduction policies and correct the endogenous and environmental factors that cause the falls.

Key message
Assistance in reducing fall risk through assessments, analyses, and provision of recommendations regarding home environments is of great importance.
Smoking and gut microbiota: a cross sectional study involving students
Authors: Cattaruzza M S , Valeriani F , Sindoni A , Castrechini M , Antinozzi M , Romano Spica V , Liguori G , Galle F 
Published: October 2020

Abstract

Background
Cigarette smoking is associated with oncological and non-oncological diseases. Tobacco smoking causes more than 7 million deaths per year worldwide. Cigarette smoking could impact not only on human tissues and organs, but also on the gut microbiota, i.e. the community of microorganisms in the gastrointestinal tract. The aim of this study is to evaluate the composition of gut microbiota among smoker and non-smoker university students.

Methods
Students from Sapienza University of Rome were asked to fill a questionnaire about smoking attitude and to provide a fecal sample. Students undergoing therapy which could affect gut microbiota were excluded. Differences in microbial composition and variability between smokers and non-smokers were assessed.

Results
A total of 107 students (43.9% males, mean age 21.96±2.52 years, 30,0% smokers) were enrolled so far. As for microbial composition, Firmicutes/Bacteroidetes ratios (F/B ratio) differed between smokers and non-smokers (5.34±16.66 vs 2.47±2.28). As for variability measures, smokers had lower Shannon index (3.43±0.26 vs 3.46±0.29). At Genus level, Prevotella was significantly more abundant in smokers (10.97±15.87 vs 4.86±10.86; p = 0.027) in comparison to non-smokers.

Conclusions
Our preliminary results seem to suggest that smoking habit affects gut microbiota. Smokers had higher Firmicutes/Bacteroidetes ratio and Prevotella Genus, while lower Shannon index. These preliminary data suggest that smoking habit may cause changes in gut microbiota pattern, but further research is needed.

Key messages
Smoking may cause changes in gut microbiota pattern. Smoking seems increases F/B ratio and Prevotella, while reduces gut microbiota variability.
Focus Group: Experience of a Brazilian implementation study on a low resource setting
Authors: Resende R E , Barbabela T , Silva L B , Pinto T L , Oliveira J A Q , Ribeiro A L P , Marcolino M S 
Published: October 2020

Abstract

Background
Developing strategies for health promotion is essential, mainly in remote areas. The Telehealth Network of Minas Gerais, Brazil, developed an implementation study to improve management of patients with hypertension and diabetes - Control of Hypertension and Diabetes in Minas Gerais (CHARMING) Project. Assessing needs and barriers or enablers perceived by local health professionals is of utmost importance to enhance the implementation strategy.

Aim
To evaluate the perception of health professionals about current health strategies for patients with chronic diseases in primary care settings.

Methods
Qualitative study: 3 focal groups were conducted, with 18 healthcare professionals from 8 cities from the CHARMING Project, divided according to professional categories: local coordinators, nurses and doctors. Each group, conducted by 2 mediators and observers, lasted 90 minutes. There was a script to guide discussion concerning continued education, and educational and physical activity patient groups.

Results
Overall, healthcare professionals reported patients have low adherence to health education and physical activity groups. Living in rural and remote areas was perceived as the main barrier. Organizing groups in rural areas and acquiring proper gymnastique items could engage the population. Also, education materials should be adequate for a low-literate population, with interactive tools. Quarrels within the health teams and lack of medications were seen as limitations for properly managing chronic diseases. Concerning professional qualification, nurses reported to prefer short web lectures, physicians preferred studying online books and pre-appraised summaries, while local coordinators preferred presencial lectures.

Conclusions
Local health professionals were participative and willing to share their experiences within focal groups. They pointed out limitations and made suggestions that were not previously noticed and that will improve our health strategy.

Key messages
Listening to local health professionals is essential for developing more effective health strategies, mainly on low resource settings. Focal Groups are an effective qualitative method of research and should be implemented.
Health Literacy in Diabetes management: A priority in health care
Authors: do Ó D , Raposo J , Goes A , Loureiro I 
Published: October 2020

Abstract

Background
Glycemic control and self-management of diabetes are influenced by a range of factors, including health literacy - the ability to access, understand, appraise, and use health information. This study explored associations between domains of health literacy (HL), glycemic control and perceived general health in people with diabetes.

Methodology
Cross-sectional study, with 453 people with diabetes,attending the Portuguese Diabetes Association (APDP). We collected information on HL, demographics, glycemic control and self-perception of health. HL was assessed using the Health Literacy Questionnaire. Descriptive and correlational analysis were performed.

Results
85.4% consider Feeling understood and supported by healthcare providers but only 54.1% have the Ability to actively engage with healthcare providers and 27.8% feel the Ability to find good health information,66.5% consider Having sufficient information to manage my health but only 38.7% are Understanding health information well enough to know what to do and 28.5% refer the Ability to find good health information. Higher HL scores were associated with better glycemic control and more positive perception of general health(GH) across the following domains: Having sufficient information to manage my health, Appraisal of health information, Ability to find good health information, Actively managing my health and social support for health. The domains Ability to actively engage with healthcare providers and Navigating the healthcare system were also associated with more positive perception of GH. Associations achieved either p &lt; 0.001 or p &lt; 0.05. Considering HL levels, a statistically significant negative association was found with the levels of HbA1c and positive association with perceived general health, even for functional HL.

Conclusions
The results emphasize the importance of improving the level of HL of people with diabetes in order to improve glycemic control and the perceive General Health

Key messages
Health literacy is critical for diabetes self-management. People with diabetes need to understand and use health information to promote well-being and diabetes control.
Health needs: a temporary analysis of the social representations of the concept
Authors: Winckler M , Zioni F , Johson G 
Published: October 2020

Abstract

Background
This study aims to analyse the social representations of health needs in a Brazilian municipality, questioning the capacity that public policies developed and implemented by the Brazilian Health System (SUS) had to meet these needs.

Methods
Qualitative case study in which the data were analysed by: 1) the Health Needs Taxonomy (Matsumoto, 1999), as an instrument for assessing health needs, formatting the interview guide and organizing the empirical data; 2) the Theory of Social Representations (Jovchelovitch, 2000), to capture health needs; 3) Content Analysis (Bardin, 2004), as an instrument of analysis and comparison of perceived needs. The methodological path used was the same in the two moments in which this research is based (2009 and 2016). The entire municipal territory was analyzed and 26 representatives of civil society organizations were interviewed.

Results
Based on the results given, we state that health is a permanent and timeless need, but the mediations for its satisfaction have changed historically. The interface between quantitative indicators and subjectivity in assessing needs reveals the authoritarian architecture of its decision-making process, which has ruined the necessary democracy for prioritising and meeting those needs. The asymmetrical relationships present in the Brazilian society have both undermined the collective character of health needs and promoted the distance between who care and who are cared for. Most of the priorities listed by the interviewees in 2009 remain composing the social context of the municipality in 2016.

Conclusions
The challenges for comprehensive health care remain critical given both the decrease in popular political participation and in institutional spaces, which leads to the annulment of the right to a universal health. Interdisciplinary and participatory diagnostics remain essential to understand the complexity of social changes and the challenges for the consolidation of meeting health needs.

Key messages
The capacity that public policies developed and implemented by the Brazilian Health System (SUS) had to meet these needs. The challenges for meeting health needs remain critical given both the decrease in political participation and in institutional spaces, which leads to the annulment of the right to a universal health.
From ICD10 to ORPHAcodes: paving the way towards improved identification systems for rare diseases
Authors: Cavero-Carbonell C , Rico J , Echevarría-González de Garibay L J , García-López M , Guardiola-Vilarroig S , Maceda-Roldán L A , Zurriaga O 
Published: October 2020

Abstract

Background
The International Classification of Diseases 10th revision (ICD10) and its clinical modification (ICD10CM) are commonly used for the identification of diseases occurrence worldwide. In Spain, diagnoses are coded with its Spanish version (ICD10ES) since 2016 regardless of the prevalence of diseases. Rare diseases (RDs) are scrambled among common diseases in ICD10 and its derivatives and many RDs dońt have a specific ICD10 code, delaying a proper identification. Orphanet developed a classification system specific for RDs called ORPHAcode. This study aims to characterize whether ICD10ES mapping to ORPHAcodes improves RDs identification and which kind of disorders would benefit the most.

Methods
95% of the disorder level ORPHAcodes indexed at Orphanet was mapped to codes from 20 ICD10ES chapters by comparing the descriptors associated in both classifications. ORPHAcodes were then clustered based on their assigned ICD10ES chapter and the redundancy of each individual ICD10ES code was calculated by counting the ORPHAcodes they mapped to. 3 groups were established: Group 1 (1 ORPHAcode per ICD10ES), Group 2 (between 2-49 ORPHAcodes per ICD10ES) and Group 3 (≥50 ORPHAcodes per ICD10ES).

Results
5588 ORPHAcodes were correlated to 1677 ICD10ES codes. 1051 were group 1, 3261 group 2 (615 ICD10ES) and 1276 group 3 (11 ICD10ES). Most of the Orphacodes correlated to “Q” (&gt;40%), “G” (&gt;14%) and “E” (&gt;12%) chapters of ICD10ES. Regarding specificity, “G” and “Q” were also the only chapters including group 3 ORPHAcodes, while less than 10% of the ORPHAcodes linked to these chapters were in group 1.

Conclusions
New and improved ICD10ES codes are required because just 20% of all ORPHAcodes studied were into group 1. Especial care should be put on the two majoritarian chapters, “Q:Congenital Anomalies” and “G:Nervous System”, that show the lowest specificity for RDs. Complementary use of ORPHAcodes would improve the identification and registry of RDs either.
Funded: Project RD-CODE

Key messages
The lack of a specific chapter for Rare Diseases in the InternationaI Classification of Diseases hinders their identification and therefore their study. Direct mapping between ICD10 and ORPHAcodes or the use of ORPHAcodes for diagnoses codification of Rare Diseases would enable better detection and epidemiological analysis.
Factors affecting readmission and post discharge consult at the Philippine General Hospital
Authors: Malijan G , Cerrado J , Tamondong-Lachica D 
Published: October 2020

Abstract

Background
In a resource limited setting such as the Philippines determining which patients are at high risk for readmission and the factors affecting their ability to adhere to post-hospitalization outpatient consult are key to ensuring efficient and safe healthcare delivery.

Methods
This was a prospective cohort study including patients of the General Medicine service in the Philippine General Hospital. Patient demographics, hospitalization details, and HOSPITAL score were collected prior to discharge. Succeeding patient encounters were classified as readmission, outpatient consult and lost to follow-up; data was collected using a researcher-guided questionnaire. Patients lost to follow up 30 days from discharge were traced. Factors associated with readmission and adherence to post hospitalization consult were extracted; readmission rate, outpatient follow up rate and time to follow up were summarized.

Results
Of the 619 patients included, outpatient follow up rate was 36.3% with a time to follow up of 15.6 +/- 6.8 days. Readmission rate was 16% with time to readmission of 12.4 +/- 7.8 days. Strongest risk factors for readmission were HOSPITAL score of High [RR 2.94 (2.09-4.13)] and prior admission in the last 30 days [RR 2.53 (1.71-3.74)]. Lastly, lost to follow up rate was 47%, and the most frequent reasons preventing outpatient consult were related to health condition (37.3%) and socioeconomic reasons (31.2%).

Conclusions
Patients identified as high risk for readmission and had recent admission had an increased risk of further readmission. Half of patients discharged were eventually lost to follow up, most commonly due to worsening health conditions and socioeconomic limitations, while majority of the patients who were able to follow up were deemed of low to intermediate risk of readmission. These findings highlight the importance of risk stratifying patients prior to discharge and identifying potential factors to improve outcomes at an institutional level.

Key messages
In a resource limited setting stratifying patient’s risk for preventable readmission and targeting identified risk factors are key to reduce negative patient outcomes and unnecessary health spending. The current health condition and socioeconomic factors strongly affect the patient’s ability to adhere to prescribed post-hospitalization outpatient consult.
Assessing patient safety culture and its associated factors in 12 emergencies across Tunisia
Authors: Aouicha W , Tlili M , Dhiab M B e n , Mtiraoui A , Chelbi S , Zedini C , Ajmi T , Said Latiri H , Ben Rejeb M , Mallouli M 
Published: October 2020

Abstract

Background
Although the emergency departments (EDs) are the front line of the public health system, they are considered high-risk environments because of the shocking frequency of adverse events, within. Developing safety culture among EDs professionals, as a strategic focus, remains a priority. The purpose of this study is to measure safety culture in EDs and to determine its associated factors.

Methods
This is a cross-sectional and multicenter study, conducted among professionals from all the EDs of public and private healthcare institutions in central Tunisia. It was conducted from June to September 2017. The instrument tool used was the self-administered Hospital Survey On Patient Safety Culture questionnaire translated and validated by the CCECQA. Data entry and analysis were performed using SPSS 20.0 and Epi info 6. Also, ethical considerations were taken into account.

Results
In total, the study included 442 participants from 12 ED, with a participation rate of 80.35%. All the ten dimensions of safety culture were all to be improved. As for 'teamwork within units', it scored the highest with 46%, however, the lowest scores were attributed to 'the frequency of reported adverse events' (19.6%) followed by 'the non-punitive response to error' (19.8%). Private EDs have shown significantly higher scores regarding nine safety culture dimensions. Also, the size of the hospital was significantly associated with all dimensions of the safety culture.

Conclusions
This study has shown that the level of safety culture needs to be improved in public and private EDs and also underlines the importance of developing the safety culture and the implementation of safety and quality management systems.

Key messages
Patient safety culture is to be improved in Tunisian emergencies, although it is significantly more developed in private settings. A punitive culture still reigns in Tunisian healthcare context.