bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health coach online - health benefits on the citizens terms
Authors: Kuitunen M , Cavrak A 
Published: November 2019

Abstract

In Sweden, we know that half of the women and two thirds of the men have one or more unhealthy lifestyle habits. We also know that 90% of all diabetes type 2, 80% of all heart attacks and 30% of all cancer can be prevented, if one has a healthy lifestyle. Consultative conversations have been proved very helpful while changing ones habits. The lifestyle habits of Swedes are similar to those of other countries in Europe, and by making our research available and the concept known to other countries, the overall health in Europe can improve.
In August 2017 an online practice opened in a county in south west of Sweden, were we performed lifestyle interventions with people who applied and needed it. The practice specialized in eating habits, physical exercise, alcohol and tobacco use. We have 4-6 consultative meetings during 3 to 4 months, where we help our clients set realistic goals to reach, that work in their day to day life. While using coaching techniques and motivational interviewing, we have met over 200 people, and helped improve their lifestyle.
We have seen that in regarding to self-assessed health (1-10), our clients score is higher after both completed health coaching and a year after completed coaching than at start. Calculating QALY, we can see that the impact the coach makes on our clients is cost effective and one person being coached saves the amount in hospital costs that we can use to coach 30 more.
We have learned that online meetings are more cost effective and practical for this type of concept. Our clients feel more relaxed and open to the process at a location of their choosing and it saves time for them, time they might not have taken otherwise - therefore, we can help more people. Meetings online enables us to reach all over the Västra Götaland region, and not only the close proximity where the coaches are located.

Key messages
Online health coaching supports our health care and helps the citizens to improve their lifestyle habits and their overall health. The online method is cost effective and it saves money for both health care and society.
Contexts between mental health of fledged people and compassion competence in the care
Authors: Steiner S 
Published: November 2019

Abstract

The aim of this doctoral thesis is to investigate the extent to which the competence compassion has a positive influence on the mental health of refugees. The research question was raised in a first step by means of a questionnaire by Mohr & Müller, ‘Depression tendencies in the non-clinical context’. Eighty asylum seekers were questioned in a total of seventeen lodgings. In addition, a survey was conducted with employees and volunteers in refugee care. This survey included 102 people who were assessed using the standardized BOSS1 Burnout Screening Scale. With the help of the Santa Clara Briefing Scale, the differences in the population between people who are not volunteering and those who volunteer in refugee care are being investigated through an online survey. There were 818 people attending. The evaluation of the data showed that the competency compassion lowers the depressive tendencies among the refugees and they have a more positive sense of integration and hope for a better life. The competency of compassion reduces burnout factors and people who have committed themselves voluntarily have significantly higher values in compassion competency. Thus compassion can be confirmed as a valuable competence in refugee care, not only among the refugees, but also among employees and volunteers.

Key messages
The present study has shown that empathy skills reduce depressive tendencies in people who have escaped. Associations of compassion and low burnout factors confirmed by the study showed that persons with high compassion skills have low burnout scores.
An automatic platform to monitor Web 2.0 presence of Healthcare Providers in Italy
Authors: D’ambrosio A , Barbara A , Kakaa O , Falvo R , Parente P , Gualano M R , Silenzi A , Siliquini R 
Published: November 2019

Abstract

Background
Healthcare providers (HP) need to involve the population to spread correct and useful health information and to gather feedback on the perceived quality of the service. Web 2.0, based on the use of Social Networks (SN), allows direct communication between the HP and the population. We built an automatic platform which monitors Web 2.0 usage by Italian public and private HP.

Methods
For each HP the platform finds the relative website using Google searches and extracts the links to SN. For Facebook and Twitter, it retrieves one year of content and identifies common topics via natural language processing. Finally, it compares the Web 2.0 usage patterns and topics with the type of HP and geographical position.

Results
In 2017, on 540 HP screened 97.8% had a website (309 unique sites, many HP have a common site). 37.5% of the websites had links to SN in the homepage: Youtube (YT) was the most common (74.1%), then Facebook (FB, 72.4%) and Twitter (TW, 51.7%). The presence of SN was lower in the south (OR: 0.63; p &lt; 0.001) while is higher for research centers (OR: 5.12; p &lt; 0.001) and private hospitals (OR: 2.12; p = 0.004). Local Health Trusts were the most active on FB (1.86 more posts, p = 0.004) but research centers had more fans RR: 5.32; p = 0.003) and likes per post (RR: 4.95; p &lt; 0.001). On TW private hospitals had the most followers (RR: 3.35; p = 0.002) and likes per tweet (RR: 3.95; p &lt; 0.001). The most posted topics were on healthy behaviors and organizational changes, while a lower number of posts were on healthy food and vaccines. Posts on specific pathologies information and healthy behaviors received more likes.

Conclusions
We propose an automatic platform that monitors the internet presence of HP in Italy, helping to define the best strategies for effective health communication. We found that in the south and in the public sector the importance of this tool is less perceived, with a lower SN presence and a gap between posted topics and those appreciated by the public.

Key messages
We propose an automatic platform that reports and monitors the web 2.0 presence and usage by HP in Italy, helping to define the best strategies to spread effective health communication. In Italy the presence of SN among HP is lower in the south and in the public, while is higher for research centers. HP have to engage the population maximizing the potentiality of web 2.0.
Short-term and long-term effectiveness of an e-coaching application; the INHERIT project
Authors: Spelt H , Karnaki P , Tsiampalis T , Kouvari M , Petralias A , Zota D , Westerink J , Linos A 
Published: November 2019

Abstract

Background
Lifestyle e-coaching applications have the potential to be successful in changing people’s lifestyles although it is unclear whether such support would indeed help people with lower socioeconomic status (SES). The aim of the present study, conducted within the INHERIT EU project, was to investigate the effectiveness of a lifestyle e-coaching application in increasing physical activity (PA) in lower SES groups and whether such an increase is sustained after its prolonged use.

Methods
A two-site (Greece: N = 105, Netherlands: N = 89), two arm [Greece: 50 (experimental) and 55 (control), Netherlands: 45 (experimental) and 44 (control)], parallel group, randomized controlled trial proceeded in three phases over 19 weeks, comparing PA (as measured by the IPAQ questionnaire) of participants using a lifestyle e-coaching application with participants not using any such application. Inclusion criteria involved participants to be in low SES, have an age of 18-65 years and an estimated level of physical activity of less than 210 minutes/week, while they needed to possess a smartphone, willing to install the application and being fluent in Dutch or Greek.

Results
Results showed that the use of the app significantly improved participants’ PA in both countries, at 6 (Greece: p = 0.015, Netherlands: p = 0.003) and 19 weeks (Greece: p = 0.002, Netherlands: p &lt; 0.001), while the effect was even higher for low physically active participants as measured at baseline, after both time periods. Compared to the control group, after adjusting for several characteristics, the experimental group achieved a better improvement of PA at 19 weeks compared to baseline (p = 0.006) and week 6 (p = 0.007).

Conclusions
Positive effects on participants’ PA after 19 weeks were observed, with the findings suggesting that the longer the application is used, the greater the improvement of PA, while the effect was more obvious among those following a sedentary lifestyle as measured at baseline.

Key messages
E-coaching applications could be useful in promoting physical activity among people from low SES. E-coaching applications are cost effective and environmentally friendly methods of promoting physical activity. Uptake by national health systems should be examined further.
Adverse pregnancy outcomes and long-term risk of maternal renal disease: a systematic review
Authors: Barrett P , McCarthy F P , Kublickiene K , Cormican S , Judge C , Evans M , Kublickas M , Perry I J , Stenvinkel P , Khashan A S 
Published: November 2019

Abstract

Background
Little is known about the long-term risk of renal disease following adverse pregnancy outcomes, such as hypertensive disorders of pregnancy (HDP), gestational diabetes (GDM) or preterm delivery. We aimed to investigate associations between adverse pregnancy outcomes and maternal chronic kidney disease (CKD) and end-stage kidney disease (ESKD), by synthesising results of relevant studies.

Methods
A systematic search of PubMed, EMBASE and Web of Science was done up to July 2018. Case-control and cohort studies were eligible for inclusion if they provided original effect estimates for associations between adverse pregnancy outcomes (HDP, GDM, preterm) and maternal renal disease (primary outcomes: CKD, ESKD; secondary outcomes: renal hospitalisation, renal mortality). Two independent reviewers extracted data and assessed risk of bias. Random effects meta-analyses were conducted to determine pooled adjusted odds ratio (AOR) and 95% confidence interval (95%CI) for each association.

Results
Of 5,120 studies retrieved, 21 studies met inclusion criteria (4,483,847 participants). HDP was associated with increased odds of ESKD (AOR 6.58, 95%CI 4.06-10.65), CKD (AOR 2.08, 95%CI 1.06-4.10), renal hospitalisation (AOR 2.29, 95%CI 1.42-3.71). The magnitude of association was dependent on HDP subtype: AOR for preeclampsia and ESKD was 4.87 (95%CI 3.01-7.87); gestational hypertension and ESKD was 3.65 (95%CI 2.34-5.67); other HDP (including chronic hypertension) and ESKD was 14.67 (95%CI 3.21-66.97). Preterm delivery was associated with increased odds of ESKD (AOR 2.16, 95%CI 1.64-2.85). GDM was associated with increased odds of CKD among black women (AOR 1.78, 95%CI 1.18-2.70), but not Caucasian women (AOR 0.81, 95%CI 0.58-1.13)

Conclusions
Women who experience adverse pregnancy outcomes have increased odds of renal disease, especially after HDP. Risk stratification and preventive interventions may be needed to reduce the risk of clinically significant renal disease in mothers.

Key messages
This is the first study to summarise the long-term risk of renal disease among women who experience a range of adverse pregnancy outcomes. Women who experience hypertensive disorders in pregnancy, preterm delivery, or gestational diabetes are at increased odds of renal disease.
Peer support for socially vulnerable citizens with diabetes: Bridging the gap to the health system
Authors: Christensen U , Garn SD , Glumer C 
Published: November 2019

Abstract

Problem
Despite free universal healthcare, Copenhagen is challenged by inequality in the prevalence and implications of type 2-diabetes (T2D). To address the problem, the Municipality of Copenhagen has initiated a city action plan including a peer support program for socially vulnerable citizens with T2D. Such programs have shown to be an essential supplement to the established health system to reach groups, who have limited contact with the health system. However, research on the implementation of the programs is generally limited.

Description of the problem
This 6-months peer support program is based on an initial analysis, showing social vulnerability to be associated with co-morbidity, low level of education, unemployment, living in a disadvantaged district and living alone. The peers are matched with a volunteer peer supporter with T2D, who helps out every 14. day with social-, practical- or bridging activities to health services or the municipality.
We aim to evaluate the implementation with focus on contextual factors. We conduct in-depth qualitative interviews with peers (N = 12), peer supporters (N = 12), and relevant stakeholders (N = 6). Further, surveys with the peers and peer supporters (N = 45).

Results
Our preliminary results indicate how the peer supporters can bridge the gap between socially vulnerable citizens with T2D and the health system. However, contextual factors regarding the recruitment of peers have challenged the implementation process as the municipality has difficulty reaching them.

Lessons
To ensure a successful implementation, it is important to prioritize resources to ensure good collaboration with local stakeholders, who can be gatekeepers in the recruitment and get in contact with this group of citizens.

Key messages
The program has potential to bridge the gap between socially vulnerable citizens and the health system. The group is hard to reach without collaboration with local stakeholders.
Trends by gender and predictors of diabetes-related amputations: an Italian regional analysis
Authors: Scampoli P , Di Giovanni P , Meo F , Cedrone F , Di Martino G , Staniscia T 
Published: November 2019

Abstract

Background
Lower extremity amputations (LEAs) are common among people with diabetes, resulting in high disability and mortality. Understanding trends in diabetes-related LEAs is important for assessing the quality of care. Aim of this study was to evaluate predictors and time trends in LEAs in a region of Southern Italy, focusing on gender difference.

Methods
Hospital discharge records were used to identify all diabetic adult patients hospitalized for LEAs between 2006 and 2015. For each year, gender- and age-adjusted standardized hospitalization rates for major and minor amputations were calculated and time trends were analyzed by gender. Predictors of LEAs were estimated by a multivariable regression model.

Results
In the study period, 579 major and 1345 minor amputations were performed in Abruzzo. Gender- and age-adjusted standardized admission rates decreased for minor amputations among both males (-29.96%) and females (-5.33%), whereas major amputations rates decreased only for males (-44.73%). Males were at higher risk of undergoing major (Rate Ratio [RR] 1.41, 95%CI 1.19-1.67) and minor (RR 1.62, 95%CI 1.45-1.82) amputations, but the male-to-female rate ratio decreased for major and minor amputations. Peripheral vascular disease was the main predictor of major (adjOR 4.09, 95%CI 3.31-5.06) and minor amputations (adjOR 12.90, 95%CI 11.00-15.12). Age over 85 (adjOR 9.07, 95%CI 1.84-44.71) and more than 3 comorbidities (adjOR 2.51, 95%CI 1.75-3.60) were parameters associated only with major amputations.

Conclusions
Reducing the number of LEAs represents a healthcare priority. This study emphasizes the existence of gender disparities in LEAs, highlighting a significant reduction of LEAs for males and a lack of improvement for females. Thus, it is worthwhile to investigate potential clinical, behavioral and healthcare-related causes of this difference, in order to plan health system changes aimed at improving care and facilitating access to health care for women.

Key messages
Time trends in LEAs showed a substantial improvement only for males, highlighting the existence of gender difference. Understanding the underlying causes is essential to improve the quality of care.
Trends in diabetes prevalence, awareness, treatment, control in Yangon, Myanmar between 2004-2014
Authors: Aung W P , Bjertness E , Stigum H , Htet A S , Kjøllesdal M K 
Published: November 2019

Abstract

Background
In 2004, a survey in Yangon Region was conducted as the first STEP survey in Myanmar, which was repeated in 2014, assessing diabetes prevalence. Whether there have been any changes over time in the awareness, treatment and control status of diabetes is not known. The study aimed to assess changes in the prevalence, awareness, treatment and control of diabetes from 2004 to 2014, among adults in Yangon region.

Methods
The study was conducted in urban and rural areas of Yangon region, Myanmar, using two cross-sectional household based studies, in accordance with World Health Organization STEPS methodology. Men and women aged 25-74 years old participated in the studies (n = 4448 in 2004) and (n = 1372 in 2014). Logistic and linear regression were performed and outcome variables were diabetes and fasting plasma glucose.

Results
The overall age-standardized prevalence of diabetes were 8.3% (95% CI 6.5-10.6) in 2004 and 10.2% (7.6-13.6) in 2014 (p = 0.296). The diabetes prevalence increased from 2004 to 2014 only among participants aged ≥60 years, from 14.6% (11.7-18.1) to 31.9% (21.1-45.0) (p = 0.009). Awareness of having diabetes increased between 2004 and 2014 (44.3% (39.2, 49.6) to 69.4% (62.9-75.2)) (p &lt; 0.001). Among participants who were aware of having diabetes, the proportion under treatment had increased between 2004 and 2014 from 55.1% (46.8-63.1) to 68.6% (61.5-74.8) (p = 0.015). There were no increase between 2004 and 2014 in the proportion of participants with controlled diabetes. After adjustments for age, sex and education, mean fasting plasma glucose levels in 2014 was 0.56 mmol/l (0.26-0.84) higher than in 2004.

Conclusions
The studies to monitor the development of diabetes prevalence in Myanmar are needed. Preventive measures to halt increases prevalence, to increase the detection rate of undiagnosed DM also treatment rate and to help people with diabetes to control their situation are needed.

Key messages
Mean plasma glucose levels were higher in 2014 than in 2004, but an increase in DM prevalence during this period was seen only among the oldest participants. The proportion of women being aware of having DM, as well as the proportion under treatment for most groups, had increased, however not the proportion under control.
Understanding quality of care and analyzing different strategies to assure and improve it
Authors: Busse R , Panteli D , Quentin W 
Published: November 2019

Abstract
Assessing and improving quality of care presupposes an understanding of what it does and does not entail. Different definitions often specify relatively long lists of various attributes that they recognize as part of quality. Effectiveness, patient safety, and responsiveness/patient-centeredness seem to have become universally accepted as core dimensions of quality of care. The inclusion of a list of additional elements is confusing and often blurs the line between quality of care and overall health system performance. This presentation provides an in-depth look at this interplay, recognizing that the definition of quality changes depending on the level at which it is assessed. At the level of health services, there seems to be an emerging consensus that quality of care is the degree to which health services for individuals and populations are effective, safe, and people-centered. On the other hand, a health care system as a whole is of high quality when it achieves the overall goals of improved health, responsiveness, financial protection, and efficiency; here, there seems to be an international trend towards using the term health system performance.
The workshop looks at different strategies to assure or improve the quality of health care. To understand, analyze, compare and ultimately prioritize or align different quality strategies, this presentation will introduce a comprehensive framework, which includes the following lenses: i) the three core dimensions of quality: safety, effectiveness, and patient-centeredness; ii) the four functions of health care: primary prevention, acute care, chronic care, and palliative care; iii) the three main activities of quality strategies: setting standards, monitoring, and assuring improvements; iv) Donabedian’s triad: structures, processes, and outcomes; v) the five main targets of quality strategies: health professionals, technologies, provider organizations, patients, and payers.
External institutional strategies for health care organizations as a quality strategy
Authors: Berger E , Groene O , Shaw C 
Published: November 2019

Abstract
Accreditation, certification and supervision are quality strategies that intend to encourage the compliance of health care organizations with published standards through external assessment. The idea is that health care organizations will increase compliance with standards in advance of a planned external inspection. Despite several common characteristics of the three strategies, their origins and initial objectives differ. This presentation aims to disambiguate these concepts, inform on their utilization in European countries and discuss the evidence on their effectiveness, cost-effectiveness and implementation.
External assessment strategies have been widely implemented in Europe. Most countries make use of several strategies, including basic supervision as part of the licensing process for healthcare providers, coupled with certification or accreditation strategies to ensure and improve the quality of care. The scope of these strategies and their regulation differs substantially between countries. Despite this widespread uptake, there is little robust evidence to support their effectiveness and there is a complete absence of evidence on cost-effectiveness. Furthermore, due to the broad purpose range of external assessments and the lack of consensus in the use of terminology, implementation strategies are sparse or missing. However, this presentation highlights several facilitators and barriers that may affect the implementation of external assessment strategies in health care organizations as well as relevant insights for policy-makers.