bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychometric properties of the Danish version of the European Health Literacy Survey Questionnaire
Authors: Nielsen M G , Svendsen M T , Sørensen K , Grønborg T K , Torp-Pedersen C , Bøggild H 
Published: October 2020

Abstract

Background
Understanding and utilizing health information has become increasingly demanding whereby people's health literacy becomes important. European Health Literacy Survey Questionnaire (HLS-EU-Q16) measures health literacy (HL). We aimed to study the psychometric properties of the Danish version in the general population and a population with coronary artery disease.

Methods
A national, cross-sectional survey of individuals from the general Danish population and patients with Myocardial Infarction (MI) was conducted. The general population sample consisted of 7,653 individuals. The MI sample of 4,440 individuals had previously been hospitalized with MI. To assess the influence of large sample sizes, we examined five randomly drawn subsamples of 500 from each population. The Rasch analysis was conducted using RUMM-2030 consisting of inspection of unidimensionality, local dependency, Differential item Functioning (DIF), and item fit.

Results
The results are preliminary and analyses still ongoing. The HLS-EU-Q16 did not fit the Rasch model, neither for the total sample, subsamples, the general population sample, nor for the MI sample.
For the MI sample, there were signs of local dependence and item 6 had the largest item misfit. DIF was observed for item 6 and 7 (age and gender). The general population sample also showed signs of local dependence, and item 1 indicated the largest item misfit. DIF was observed for item 1 (age) and item 1, 7, 8, 13 and 16 (gender).

Conclusions
The Danish version of HLS-EU-Q16 did not fit the Rasch model neither in the general population sample nor for the MI sample. Our large population-based study indicated scalability problems of the HLS-EU-Q16. The validation procedure is a step on the path to ensure the use of valid measures of HL in both populations and patient groups to support the raising awareness of HL as a necessary element to ensure equity in our health system and thereby initiating an urgent public health activity.

Key messages
We studied the construct validity of the Danish version of the European Health Literacy Survey Questionnaire HLS-EU-Q16 with a Rasch model. Our large population-based study indicate problems with the psychometric properties of the current Danish version of the HLS-EU-Q16.
Exploring associated factors of subjective health literacy in school-aged children
Authors: Freţian A M , Bollweg T M , Okan O , Pinheiro P , Bauer U 
Published: October 2020

Abstract

Background
Health literacy (HL) has been acknowledged as a critical determinant of health. While HL and its potential determinants have been studied in adults, little research has been conducted with children. Therefore, this study investigates factors associated with children's subjective HL to explore potential entry points for the promotion of HL in childhood.

Methods
Cross-sectional data was collected from 4th-graders at German schools with a self-report questionnaire. Age, sex, family affluence, functional HL, self-efficacy, motivation to learn about health, and perceived parental health orientation were included as potential determinants, while the dependent variable subjective HL was assessed with a newly developed scale. We used hierarchical linear regression to explain variance in HL with different sets of predictors.

Results
n = 907 4th-graders (53.4% female) were surveyed. Subjective HL was high, with 82.2% reporting that it was “rather easy” or “very easy” for them to deal with health-related information. Age, sex, home language, and family affluence together were able to explain 2% of variance in subjective HL. In contrast, 19.3% of variance could be explained by all independent variables together, whereby family affluence, functional HL, self-efficacy, motivation, and perceived parental health orientation were significant predictors (p &lt; .01). Motivation was the most potent predictor (β = .24), followed by parental health orientation (β = .18) and self-efficacy (β = .11).

Conclusions
This study was able to identify potential predictors of HL among children. Our data indicate that the promotion of health-related motivation and self-efficacy, but also of certain parental attitudes might be particularly fruitful in order to support the development of HL early in the life course. However, intervention research will need to provide further evidence on the extent to which these factors can be modified and actually lead to increased HL.

Key messages
This study was able to identify potential predictors of children’s HL which might be used to inform interventions. Further longitudinal research is necessary to verify our findings.
Health literacy level among journalists and general population: a cross-sectional survey
Authors: Savatteri A , Gualano M R , Voglino G , Crocetta R , Lo Moro G , Catozzi D , Bert F , Siliquini R 
Published: October 2020

Abstract

Background
Recent studies have shown that low Health Literacy (HL) negatively influence people's health. In an era of fake news journalists are called to recognize reliable sources in order to provide trustworthy information, especially on health topics. The aim of the study was to evaluate the knowledge of health-related topics among health journalists and how it differs from general population.

Methods
A cross-sectional survey was made by administering an online 28-item questionnaire. The questionnaire was constructed by joining an introductive part assessing socio-demographic characteristics with three tests: Single Item Literacy Screener (SILS), Medical Data Interpretation Test (MDIT) and IMETER, the Italian version of Medical Term Recognition Test (METER).

Results
A total of 589 valid surveys were obtained. Regarding this sample, 130 participants were journalists, 142 were healthcare workers and 317 belonged to general population. Journalists dealing with health-related topics (p = 0.016) and writing for online newspapers (p = 0.035) were found to have a higher HL, as well as those having a postgraduate qualification compared to colleagues with lower educational qualifications (p = 0.012). Instead, low HL was found among those journalists considering insufficient their economic status (p = 0.031) and among those who had never or only occasionally written about health-related issues (p &lt; 0.001). Among general population HL level was lower for females (p &lt; 0.001), while it was higher for participants with higher educational status (p = 0.038).

Conclusions
These results suggest that education is a key factor for an adequate health literacy. Given the importance, writing about medical and healthcare topics should be prerogative of journalists specifically formed in those fields.

Key messages
An adequate education strongly influences health literacy. It is of great importance to have specialized journalists write about medical and health-related topics.
Universal Design assessment tool to promote well-being and inclusion in healthcare environment
Authors: Mosca E I , Steinfeld E , Capolongo S 
Published: October 2020

Abstract

Background
Universal Design is a design process that enables people of all ability levels by improving human performance, wellness and social participation. The research aims at developing a performance-based assessment tool adopting Universal Design to enhance users' benefits and positive outcomes such as usability, well-being and social inclusion focusing on healthcare environment.

Methods
The evaluation framework resulted by different methodologies: a systematic literature review on existing Universal Design tools; workshops with both users and experts and the analysis of hospital case studies. Multi-criteria analysis is adopted as methodology to develop a hierarchical framework able to compare quantitative and qualitative aspects of the same project. A rating system based on a checklist is used to evaluate performance.

Results
The tool structure is based on a hierarchical framework composed by 3 Categories (Physical/spatial quality; Sensorial/cognitive quality and Social quality); 8 Criteria (Usability, Functionality, Safety and Security, Wayfinding, Understanding, Environmental factors, Well-being and Social Inclusion); 20 Indicators and a plurality of requirements. Since the needs of users (patients, visitors, staff) change in relation to the space setting, the tool assess the quality considering different areas of the hospital: Outdoor Spaces, Entrance, Interior Circulation, Support Spaces (waiting areas, bathrooms, food services), Work Spaces (exam rooms, offices) and Overall Service.

Conclusions
The proposed tool can foster public health supporting the management of healthcare environment in taking decisions on universal usability and multisensory quality perception through a performance-based approach. The tool has been validated in a hospital of the State of New York, focusing on public areas and outpatient department. Further applications in various healthcare facilities of the Italian context are aimed to implement the tool.

Key messages
The assessment tool aims to support designers and healthcare management from the beginning of the design project to ensure public health and inclusive design through a performance-based approach. The tool based on Universal Design allows to evaluate spatial, sensory and social quality considering the relation between hospital areas and users’ needs that influence people’s well-being.
Subsidies for improving diet and population health in Russian Federation
Authors: Mukaneeva D , Kontsevaya A , Myrzamatova A , Khudyakov M , Drapkina O 
Published: October 2020

Abstract

Background
The insufficient consumption of fruit and vegetable (F&V) is important contributors to main non-communicable diseases (NCDs). Russia lags behind many countries in the world in per capita consumption of F&V. A growing number of countries have implemented subsidies to address the growing burden of dietary-related diseases. The purpose of the study is to assess the potential social and economic impact on mortality and morbidity due to main NCDs of policy to subsidies F&V in Russia.

Methods
Using a population model of dietary-related diseases and health care costs, we simulated the effect of 10% subsidy on F&V, over the 15 years of the Russian population. We estimated cardiovascular diseases (CVD), diabetes and cancers cases prevented, health-related costs, and incremental cost-effectiveness ratios. Baseline prevalence of the risk factor was derived from the Russian epidemiology survey.

Results
Subsidies aimed at reducing the price of F&V by 10% can lead to an increase in the consumption of F&V by about 14%, and thereby prevent 37 064 deaths, the projected economic effect due to the prevented deaths will amount to 10.7 billion rubles over 15 years. The number of prevented cases of CVD will be 28 881, type 2 diabetes - 580 cases, cancer - 4025 cases. When calculating the economic effect for the analyzed period, the prevented medical costs for CVD will amount to 147.9 million rubles, for cancer - 86.6 million rubles, for type 2 diabetes - 3 million rubles. The implementation of this measure in the Russian population will allow to “save” 221.6 million rubles related to the payment of disability benefits from the main NCDs and 1.2 billion rubles due to the prevented loss of GDP from disability over 15 years. Thus, the cumulative forecasted effect of this measure in the Russia over 15 years will amount to 11.2 billion rubles.

Conclusions
The modelling illustrates the potentially large social and economic benefits of subsidies on F&V for improving population health.

Key messages
The insufficient consumption of fruit and vegetable (F&V) is important contributors to main non-communicable diseases (NCDs). The modelling illustrates the potentially large social and economic benefits of subsidies on F&V for improving population health.
Emergency room services for people affected by sexualized and/or intimate partner violence in Berlin
Authors: Tezcan-Güntekin H , Rasch L , Plamp L 
Published: October 2020

Abstract

Background
People affected by intimate partner violence (IPV) and/or sexualized violence (especially women, children and LGBTIQ*) have long-term health consequences (WHO 2016: 6). The WHO Guideline (2013) and the Istanbul Convention (2016) demand systematic and structurally anchored services at the level of care, education, training of health professions and public health research. The aim of this study was to evaluate the service provided at emergency rooms (ERs) in hospitals in Berlin, Germany.

Methods
A questionnaire with quantitative and qualitative questions including dimensions of existing interventions, available resources of trained staff and institutional frameworks was sent to the management of the 37 hospitals with ERs in Berlin. Descriptive-statistical methods were used to analyze the current state of care provided. (Response rate: 76 percent (n = 28))

Results
The care often depends on individual decisions of staff members of the ER: 5 ERs report the existence of a Standard Operating Procedure (SOP) for IPV, 6 for sexualised violence. Awareness of demographic characteristics of diversity varies widely across ERs; no staff specifically trained to serve for the needs of LGBTIQ* is available; 25% offer a gender-specific choice of doctors; 11 ERs co-hospitalize children affected by IPV.

Conclusions
The institutional framework and the awareness of demographic characteristics of diversity in ERs influence the services provided on a regular basis to people affected by IPV and/or sexualized violence. Development of SOP, qualification of health care professionals (HCP) and systematic collection and evaluation of related data are needed in order to implement the WHO guidelines and the provisions of the Istanbul Convention.

Key messages
Public health research regarding the care provided for people affected by IPV or sexualized violence by ERs in Berlin demonstrate the demand for guiding standard procedures and qualification of HCP. The systematic collection and evaluation of relevant data should be implemented in all countries that have signed the Istanbul Convention.
Management of bio-psycho-social frailty to reduce hospital use and improve survival of older adults
Authors: Liotta G , Accarino N , Orlando S , Gentili S , Terracciano E , Scarcella P , Palombi L , Marazzi M C 
Published: October 2020

Abstract

Background
Ageing of population is associated to the increase of care demand. Many health systems are still centered on hospital care, that sometime is not appropriate. The shift from hospital to community care requires a new model of service delivery. Aim of this paper is to assess the impact of a community service based on the assessment of frailty, on mortality and use of hospital care by older adults.

Methods
A cohort made up by 8,592 over-75 subjects (67.1% female, mean age 84.5; SD ± 5.29) has been assessed once a year for bio-psycho-social frailty by the administration of the Short Functional Geriatric Evaluation questionnaire. The enrolled subjects were involved in a Community-based pro-Active Monitoring Program which provides interventions aimed at reducing social isolation. Mortality, use of hospital care and use of residential long-term care have been recorded during the follow up and separate and cumulative incidence rate was measured.

Results
The sample was stratified in Robust (37.5%), Pre-frail (24.0%), Frail, (29.5%) and Very Frail (9.1%) individuals. Mortality, Hospital admission rate and Residential LTC admission rate were higher in the very frails than among the other groups. However, according to social isolation, the integrated subjects at the baseline assessment, showed the highest incidence of negative events: 29.5%, 20.8%, 21.0%, .and 20.8% for integrated, mild isolated, moderate isolated and severely isolated individuals respectively (p &lt; 0.001). The logistic regression analysis, adjusted for age, gender and level of frailty, confirmed the protective role of reducing social isolation among isolated individuals compared with integrated ones (OR: 0.729; CL95% 0.673-0.720).

Conclusions
The assessment of bio-psycho-social frailty could be the starting point for effective intervention at community level, like the program mentioned above. Management of frailty may lead to an improvement of public health outcomes.

Key messages
Intervention dealing with social isolation are able to revert the increase of mortality related to the lack of social resources. Management of frailty may lead to an improvement of public health outcomes.
Educational trends, patterns of employment and selected health indicators among young refugees
Authors: Dunlavy A 
Published: October 2020

Abstract

Background
Although the health and integration of young refugees is a top policy priority within the Nordic region, refugees continue to experience health and social inequalities relative to other immigrants and native-origin majority populations. This project explores how such inequities develop during the formative years among refugees who migrated as children, and how they relate to migration and welfare policies in different Nordic contexts, which vary considerably in terms of their generosity.

Methods
National administrative registers were used to compare key indicators of education, labor market participation, and health among young refugees living Denmark, Finland, Norway, and Sweden. The primary study population consisted of refugee children who were granted residency in the Nordic region as children (0-17 years) between 1986 and 2005, and were followed up through 2015.

Results
Overall, refugees in Denmark and Finland had the poorest primary and secondary educational outcomes, even when country of origin and age of arrival were considered. In all countries, the gap in secondary educational attainment between refugees and the native-born majority population was of a much greater magnitude than the corresponding achievement gaps in higher education.
Refugees in Denmark had the lowest proportion of labor market participation and the highest proportion of NEET (not in employment or education) at age 30 relative to refugees in the other Nordic countries; yet this difference was greatly diminished when secondary educational attainment was considered. Results also showed higher rates of early retirement pension receipt at age 30 among refugees in Denmark than those observed among refugees in other Nordic contexts.

Conclusions
Policies that facilitate introduction into the educational system and secondary education attainment among refugees should be given greater priority in order to promote labor market integration and health in young adulthood.
13.C. Workshop: Epistemic and ethical innovations in public health research
Authors:   Organised by: Universidad Autónoma de Barcelona (Spain),   Chair persons: Angel Puyol - Spain
Published: October 2020

Abstract
About 90% of the biomedical data accessible to researchers was created in the last two years. These data have a very meaningful impact both in creating public policies on health, as well as public health research. This certainly implies complex technical problems on how to store, analyse and distribute data, but it also brings relevant epistemological issues. In this workshop we will present some of such problems and discuss how epistemic innovation is key in order to tackle ethical issues related to the use of big data in public health research. Databases implied in public health research are so huge that they rise relevant questions about how scientific method is applied, such as what counts as evidence of a hypothesis when data can not be directly apprehended by humans, how to distinguish correlation from causation, or in which cases the provider of a database can be considered co-author of a research paper. To consider such issues nowadays, current protocols do not hold, and we need innovation in methodological and epistemic procedures. At the same time, due to the fact that a relevant deal of such biomedical data is linked to individual people, and how medical data can be used to predict and transform human behavior, there are ethical questions difficult to solve as they imply new challenges. Some of them are related to communication issues, so patients and citizens understand these new ethical problems that didn't arise before the development of big data; others relate to the way in which public health researchers can and can't store, analyse and distribute information, and some others relate to the limits on which technologies are ethically, safe and which ones bring erosion of basic human rights. The four contributions in the workshop analyse these questions in some detail. During the workshop we will present a coherent understanding on what is epistemic innovation, some logical tools necessary for its development, and then we will discuss several cases on how epistemic innovation applies to different aspects of public health research, also commenting its relevance when tackling ethical problems that may arise.

Key messages
The workshop deepens the ethical and epistemological innovations involved in public health policies and research, specially related to big data. The workshop analyses novel aspects of public health ethics
Abductive reasoning on humans/AI interactions in medical contexts
Authors: Sans A 
Published: October 2020

Abstract
The proposal of this talk is to explain alternatives to obtain ethical reasoning in the humans/AI interactions in medical (especially public health) contexts. One of the ethical problems in AI is the alignment mechanisms between human values and machines automatisms. This research is based on obtaining a system capable to infer from rational human activity in a certain behavior, so it can be captured how a human moves and the way that human beings learn and teach ethical values. One way is mimetic alignment, which are values imitation processes based trough big data preferences analysis, linguistic expressions, etc. However, this approximation commits two mistakes. First, preferences are confused with values, and then the second problem is that naturalistic fallacy is committed. From this point of view, naturalistic fallacy occurs if the research is focused on alignment meaning instead of value one, and the subsequent answer is preference analysis based. Therefore, prescriptions are derivate from descriptions. The chain of reasoning that leads us to commit this fallacy begins with the confusion that values and preferences are equivalent. An alternative proposal is anchored values alignment, which is based on anchoring normative values processes of a machine that has a behavior to interact. Through abductive reasoning, this way of thinking tries to capture the idea that a value is not in any set of things, instead it is some action guiding. The relevance of abduction is its temptative value to project beyond descriptive reasoning as statically one, which it is currently used in works on medical diagnosis precisely for the characteristics that clinical eye needs.