bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Investigation of Family Nutrition and Physical Activity and Affecting Factors in Primary Schools
Authors: Ekici E , Ikiişik H , Ankarali H , Kozan E H , Yetim M 
Published: November 2019

Abstract

Background
In this study, it was aimed to determine the family nutrition and physical activity status of primary school students and some affecting factors.

Methods
In this descriptive and correlation-seeking research, mixed sampling methods were used. The sample size was not calculated, it was aimed to reach all students in three primary schools with different socioeconomic status (high, medium, low) in Uskudar, Istanbul. Data from 727 subjects were collected through an introductory information form and The Family Nutrition and Physical Activity Screening Tool (FNPA).

Results
In the study, data from 294 (49.7%) girls and 297 (50.3%) boys from three primary schools who studied first grade (n = 321, 54.3%) and 4th grade (n = 270, 45.7%), a total of 591 children were used. The total FNPA score of students in schools with high or middle socioeconomic status was significantly higher than the socioeconomically low school (P &lt; 0.001). The mean score of the scale was significantly higher in those who doesn’t eat junkfood or snacks (P = 0.001), who had regular breakfast (P = 0.001) and people with regular meal time (P = 0.001). The mean BMI of children in the middle socioeconomic status school was found to be significantly higher than that of students in the low socioeconomic status school (P = 0.013). There was also a significant correlation between the mean BMI of mothers and the total FNPA score (P &lt; 0.001).

Conclusions
In the study, as the socioeconomic status of schools increased, FNPA total score increased as well. Although some studies suggest that family income and socioeconomic status are inversely related to childhood obesity, in this research the mean BMI of children in the socioeconomically middle school was significantly higher than the students in the socioeconomically low school.

Key messages
The evaluation of the nutritional and physical activity status of the family as an element of the obesogenic environment, may be effective on identifying the causes of childhood obesity. Studies to determine the nutritional and physical activity of the family in preventing childhood obesity are essential.
Determination of Orthorexia Nervosa Symptoms and Eating Attitudes in Medicine Students
Authors: Erol Ö , Özer A 
Published: November 2019

Abstract

Background
Orthorexia Nervosa (ON) is defined as obsession with healthy eating. It is known that the purity is more important than amount or energies of consumed food in people with ON.With this condition,ON results in restrictions on food intake in individuals.According to the literature, health professionals are in the risk group of ON. The aim of this study is to examine orthorexia nervosa symptoms and eating attitudes of medicine students.

Methods
This cross-sectional study was conducted on 298 students who educated Inonu University Faculty of Medicine in 2017.Data collection tools were General Information Form,ORTO-15,EAT-40.SPSS 22.0 and Pearson Exact,Fisher’s,Chi-Square tests were used for statistical analysis.

Results
%76.2 of students had orthorexia tendency, %11.1 of students had eating disorders. 24 aged students were found to less orthorexic than others and obese students tend to have less orthorexic than others. It was found that when reached true information about nutrition, individuals who changed their eating behavior always had more orthorexic than rarely. It was found that when reached true information about nutrition, individuals who changed their eating behavior always had more eating disorders rate (EDR) than others. It was found individuals who received information from book-scientific publications had EDR than others and individuals who received information from dietitians had higher EDR than those who did not (p &lt; 0.05). In addition, %12.3 of the individuals who tend to orthorexia and %7 of the individuals who tend to without orthorexia were found to have eating disorders.However,the difference between groups was not statistically significant (p &gt; 0.05).

Conclusions
According to our results, it is emphasized that question which “Is ON an eating disorder?”. In addition, we believe that our study will contribute to the literature because ON, eating attitudes and information sources of nutrition are examined together on medicine students.

Key messages
When individuals have access to nutritional information, behavior change states affect the tendency to orthorexia nervosa and eating disorders. Nutritional and psychotherapeutic interventions for behavioral regulation of individuals are thought to reduce the tendency of orthorexia nervosa and eating disorders.
Burden of disease attributable to exposure to aflatoxins in Portugal using Human biomonitoring data
Authors: Martins C , Vidal A , De Boevre M , De Saeger S , Nunes C , Torres D , Goios A , Lopes C , Alvito P , Assunção R 
Published: November 2019

Abstract

Human biomonitoring (HBM) is recognized as an important tool to assess the Human exposure to chemicals, contributing to describe trends and patterns of exposure over time and to identify population groups that could be under risk. Natural chemicals as mycotoxins, fungi metabolites that produce toxic effects in humans, are important compounds that could be found in foods usually consumed worldwide in a daily basis. Mycotoxins as aflatoxins (AFTs) are genotoxic, carcinogenic and immunosuppressive compounds. Hepatocellular carcinoma (HCC) is one of their main health toxic effects and is the third leading cause of cancer deaths worldwide. In Portugal, scarce data are available regarding exposure to AFTs and none previous study used HBM data to characterize comprehensively the burden associated to this exposure.
In the scope of the National Food, Nutrition, and Physical Activity Survey of the Portuguese General Population (2015-2016), 24h-urine samples from 94 participants were analyzed by liquid chromatography-mass spectrometry (LC-MS/MS) for the simultaneous determination of AFTs (B1, B2, G1, G2, M1). A model was developed to estimate the health impact of the exposure of Portuguese population to aflatoxins, estimating the number of cases of HCC and DALYs attributed to AFTs exposure.
AFTs were detected in 12.8% (AFB1), 16.0% (AFB2) and 19.1% (AFM1) of the 24h-urine samples. The estimated number of extra cases of HCC attributed to this exposure ranged from 17 to 65 cases/year; the associated DALYs for the Portuguese population ranged from 284 to 1802 years.
The present study generated, for the first time and within a HBM study, reliable data regarding the exposure of the Portuguese population to AFTs. These data were crucial to characterize the health impact associated to AFTs exposure and to support risk managers to establish preventive policy measures that contribute to ensure the public health protection.

Key messages
Portuguese population is exposed to aflatoxins, chemical food contaminants that may be harmful (carcinogenic, immunotoxic, mutagenic, teratogenic, hepatotoxic) to humans. Human biomonitoring studies provide realistic data on internal exposure at individual level, contributing to a more accurate estimation of the burden derived from this exposure.
Social validity for work ability assessments and official decisions – clients’ experiences
Authors: Karlsson E , Sandqvist J , Ståhl C 
Published: November 2019

Abstract

Background
Professionals need to be able to express what is at stake during the decision-making process and the discrepancy between formal rules and practical rationality need to be bridgeable and transparent for outsiders. Investigations of social validity for work ability assessments are rare. However, the concept can provide valuable information upon the acceptability and comprehensibility of procedures and how professionals can increase clients’ participation.
The purpose of this study was to investigate social validity for work ability evaluations within the sickness insurance system and the official decisions they lead to.

Methods
This was a longitudinal qualitative study using telephone interviews and files from the Swedish Social Insurance Agency. Clients (n = 30) were interviewed after their participation in a work ability evaluation as well as after receiving an official decision upon eligibility for sickness benefits. Data was analyzed using a deductive content analysis.

Results
Preliminary findings show that clients’ comprehensibility of the different tests and their composition were depending on whether the specific tests were perceived as clearly related to the clients’ difficulties and what information they had received. In order to receive a fair description of the client’s work ability, clients state that the work ability evaluation needs to be individually adapted and that the standardized structure is not relevant for all. What is acceptable and fair to one client could be unacceptable to another, depending on what arguments and information case-managers and evaluation professionals provided.

Conclusions
Authorities need to express and motivate the reasons for a diverse range of steps during clients sick-leave process, not only regarding official decisions. Social validity for work ability evaluations is depending on the provided information and the applicability to the clients’ situation.

Key messages
Social validity is depending on the provided information and the applicability to the clients’ situation. Authorities need to communicate clearly with clients through the whole sick-leave process.
High mortality in manual occupations and the role of alcohol in 2001-2015 in Finland
Authors: Rinne H , Laaksonen M , Notkola V 
Published: November 2019

Abstract

Background
High mortality is concentrated in low socioeconomic positions which may largely be explained by excessive use of alcohol. The aim was to identify specific manual occupations with high mortality and to examine whether there are differences in the role of alcohol in explaining the excess mortality among manual occupations with high all-cause mortality.

Methods
A register-based study of employees aged 30-64, followed for mortality 2001-2015. Age standardized mortality ratios (SMR) were calculated to compare the mortality rates of manual occupations. The contribution of alcohol related mortality to excess mortality was obtained by comparing the excess mortality in all deaths and deaths not related to alcohol.

Results
Men had 31 and women 11 manual occupations with SMR statistically significantly over 120 compared to all employees. Mortality rates were highest among building construction labourers (SMR 180, 95% CI 163-199) among men and building caretakers (SMR 155, 95% CI 135-179) among women. With few exceptions, high mortality was a combination of high alcohol-related and high non-alcohol-related mortality. Among men, the contribution of alcohol-related mortality to the excess all-cause mortality compared to all employees was over 10% in half of the high mortality occupations. Among women excluding the alcohol-related deaths had a minor effect on all-cause mortality.

Conclusions
Diminishing the alcohol-related mortality would level excess mortality of high mortality manual occupations but not eliminate it. Targeting the improvement of working conditions and occupational health care to certain occupations would diminish the mortality differences between occupations and social classes.

Key messages
To prevent the high mortality of manual occupations, improvements should be targeted to several different aspects of working conditions. Occupational health care of manual occupations with high mortality should be improved and provide with early interventions towards risky alcohol behaviour.
Gender differences in managers’ attitudes toward depressed employees: a cross-sectional study
Authors: Mangerini I , Bertilsson M , de Rijk A E , Hensing G 
Published: November 2019

Abstract

Background
Depression is known to carry negative attitudes within society and organisations. In the workplace, managers are responsible for the psycho-social work environment and attitudes to depression will likely affect that environment. The few studies performed among managers have found that female, more educated and managers working in the public sector were less likely to report negative attitudes. However, these studies did not take organization characteristics into account. The aim was to investigate the association between gender and negative attitudes toward employees with depression controlling for individual and organisational factors.

Methods
A cross-sectional web-survey was sent to 4737 Swedish managers, aged 20-65 years in 2017, response rate 71%; We included those answering the “Managerial stigma toward employee depression” instrument, n = 2663 (901 women, 1762 men), consisting of 12 items tapping negative attitudes towards depression. The 3rd quartile was used as a cut-off. Multivariate logistic regression analyses on attitudes towards depression were performed (95% CI) to generate odds ratios (OR) adjusted for co-variates (individual and organisational characteristics).

Results
Male managers were more likely to report negative attitudes compared to female managers (OR 1.64, 95% CI 1.28 - 2.10) irrelevant of individual (age, education, current workplace management experience, lifetime experience in management, managerial position) or organisational (work sector, staff gender composition, presence of staff members with Common Mental Disorders) characteristics.

Conclusions
A gender difference in reporting negative attitudes was appraised regardless any of the co-variates included. To manage depression within the workplace, companies should also address managers’ attitudes towards depression.

Key messages
Important to heed managers’ attitudes to CMDs and their impact on RTW processes. Gender-tailored approach in managers’ training is suggested for awareness and knowledge on mental health.
Healthcare providers’ perceptions of difficulties related to frequent users of emergency departments
Authors: Grazioli V , Kasztura M , Chastonay O , Graells M , Schmutz E , von Allmen M , Lemoine M , Daeppen J-B , Hugli O , Bodenmann P 
Published: November 2019

Abstract

Background
Frequent users of emergency department (FUEDs; ≥ 5 ED visits/ year) are often vulnerable individuals cumulating medical, social and substance use problems. FUEDs often require complex and sustained care coordination generally unavailable in ED and are commonly considered contributing to ED crowding. In view of supporting ED health-care providers through specific training and interventions tailored to FUEDs, this study aimed to explore ED healthcare providers’ perceptions of difficulties related to FUEDs.

Methods
Participants (N = 208) were ED healthcare providers (i.e., nurses, physicians) from 75 university and community hospitals in Switzerland (71% of all EDs) who answered a questionnaire on FUEDs. They were asked to indicate the extent to which FUEDs represent a problem in their ED. Perceived difficulties related to FUEDs were elicited by an open-ended question. Conventional content analysis was used to extract common categories and themes.

Results
Among the 208 participants, 134 (64%) reported that FUEDs represent a problem. Of those, 132 provided 1 to 5 answers to the open-ended question. Twenty-eight categories were identified and organized in 4 themes. First, participants reported difficulties related to FUEDs’ characteristics themselves (e.g., problem’s chronicity; behavioural difficulties) leading to healthcare complexity. Second, participants perceived negative consequences related to the presence of FUEDs in the ED (e.g., work overload, staff helplessness and fatigue). Third, ED healthcare offer was considered inappropriate and inefficient to respond to FUEDs needs and fourth collaborating with FUEDs’ existing healthcare network was perceived as difficult.

Conclusions
ED healthcare providers experience a wide range of difficulties related to the management of FUEDs. Providing training and implementing a case management intervention tailored to FUEDs might support ED health-care providers and contribute to address FUEDs’ complex needs.

Key messages
ED healthcare providers perceive FUEDs to represent a problem. Perceived difficulties might decrease through training and case management support might contribute to better address FUEDs complex needs.
Is there an association between social determinants and care dependency risk?
Authors: Schneider A , Blüher S , Grittner U , Anton V , Schaeffner E , Ebert N , Martus P , Kuhlmey A , Schnitzer S 
Published: November 2019

Abstract

Background
Despite a growing body of knowledge about the morbidities and functional impairment which frequently lead to care dependency, the role of social determinants is not yet well understood. The purpose of this study was 1) to examine the effect of social determinants on care dependency onset and progression, and 2) to analyse the effect of social determinants on various levels of care dependency.

Methods
We used data from the Berlin Initiative Study (BIS), a prospective, longitudinal, population-based cohort study including 2069 older participants (≥70 years of age) with visits in 2009, 2011 and 2013. Care dependency was assessed if participants require substantial assistance in at least two activities of daily living for 90 minutes daily (level 1) or three hours+ daily (level 2). Social determinants were defined as partnership status, education, income, age and gender. Data were analysed with multi-state time to event regression modeling which simultaneously model several competing events, as well as not only first but also second or third event in one model.

Results
During the study period, 556 participants (27.5%) changed their status of care dependency. Persons who reported having no partner at baseline were care-dependent more often than participants with a partner (43.7% ’no partner’ / 27.1% ’with partner’). In the multiple model having no partner compared to having a partner was associated with a higher risk of transition from no care dependency to level 1 (HR: 1.25, 95%CI: 0.97-1.64), however failed significance. The significant association between care dependency and income and between care dependency and education ceased as well after adjustment for co-morbidities.

Conclusions
Results indicate that older people without a partner tend to be on a higher risk of care dependency onset but not on a higher risk of care dependency progression. Inequality between education and income groups can be explained in terms of morbidity.

Key messages
The significant association between care dependency and income and between care dependency and education can be explained in terms of morbidity. Results indicate that older people without a partner tend to be on a higher risk of care dependency onset but not on a higher risk of care dependency progression.
Hospital volume and five-year survival after cancer surgery in 2007-2011 in Osaka, Japan
Authors: Okawa S , Tabuchi T , Morishima T , Koyama S , Taniyama Y , Miyashiro I 
Published: November 2019

Abstract

Background
The relationship between hospital volume (HV) and patient outcome is well-known evidence, and hospital volume is widely used as a quality indicator. In Japan, however, few studies are available on the associations between HV and survival after cancer surgery. This study aimed at examining the association between HV and longitudinal survival after surgeries of major cancer sites.

Methods
This is a retrospective observational study. Using the Osaka Cancer Registry database, we identified patients who were diagnosed as major sites of cancer (esophageal, gastric, colorectal, pancreatic, lung, breast, and uterus cancer) between 2007 and 2011, and undergone surgeries in Osaka. To define the quartiles of HV (high, medium, low, and very low-volume hospitals), we ranked hospitals by annual surgical volume, sorted patients in descending order of HV, and assigned them into four equal-sized groups. The study outcome was five-year survival from the diagnosis. We analyzed the associations between hospital volume and survival among eligible patients aged between 15 and 84 years old, using Cox proportional hazard models. In the models, we adjusted for characteristics of patient and treatment received by the patients.

Results
A sample of 86,867 patients were analyzed. The mortality hazards of patients treated at very low-volume hospitals were 1.4 - 2.1 times higher than that of patients treated at high-volume hospital in all selected cancers. However, absolute differences (percent points) in adjusted survival rates between high- and very low-volume hospitals were varied by cancer site: esophagus (24.2), stomach (14.9), colorectum (11.5), pancreas (9.2), lung (10.8), breast (2.4), and uterus (3.3).

Conclusions
Very low-volume hospitals showed the poorest patient survival after cancer resections. Healthcare quality assessment at lower-volume hospitals and referrals to higher-volume hospitals are potential measures to improve survival of cancer patients.

Key messages
Patients treated at lower-volume hospitals had a higher mortality risk than those treated at higher-volume hospitals. Healthcare quality assessments and effective referrals of high-risk patients are potential interventions to improve patient survival.
How to engage French professionals to undertake social responsibility at a local level?
Authors: Gautier S , Bourgueil Y 
Published: November 2019

Abstract

Background
In France, primary care is organised according to the principles of private practice: independent providers, payment by fee for service, freedom of settlement... Successive reforms have introduced more regulation i.e. gatekeeping role for GPs, better recognition of professional groups, new forms of payment and promotion of team work and multi-professional practices. Today, the concept of Health Territorial and Professional Communities (HTPC) is becoming a key element of health care reform encouraging primary care professionals to meet with specialists and social workers at a larger level than practice. HTPC should address issues such as access to services, coordination of care and promoting of preventive actions toward populations. This implies change in the roles, skills, methods and resources needed on both professional and regulatory sides. This study explores levers of the professional commitment in the HTPC and resources necessary for it.

Methods
We conducted a qualitative multiple case study in three French regions. Data was collected from thirty semi-structured interviews with key national informants, regional regulators and health professionals themselves.

Results
Professional commitment emerges at a local level on a territory defined by the collaboration practices and habits following a bottom-up process. The integration of care relies on the size of the HTPC which allows them to know each other and to work together to improve access to care and patient’s disease management. In order to achieve that, professionals claim to have access to administrative health data and to be able to analyze it. They need to develop news skills in management and group animation. The function and training of coordination professionals appear to be essential.

Conclusions
The professional commitment in HTPC relies on professional empowerment toward collective activities. This requires autonomy, skills and new roles both for professionals and regulatory authorities.

Key messages
French government relies on professionals’ investment at the territorial level by implementing HTPC to guarantee access to care and respond to population needs in primary care. HTPC implementation implies radical change for the professionals to undertake social and populational responsibility for which public health professionals should help to meet the challenge.