bluuebunny/crossref_metadata_2025_split huggingface dataset:
HBPM to refine the diagnosis of hypertension in a Family Health Care Unit in RJ, Brazil - LapARC
Authors: Mello T S , Botelho B G , Hollanda J V G , Antequera L A , Mourão M A O , Azevedo R B , Aragão L F , Botelho E G , Velasco P J P , Muxfeldt E S 
Published: October 2020

Abstract

Background
The new hypertension (HT) guidelines recommend the use of out-of-office blood pressure (BP) measures for its diagnosis however, in the scope of public health in Brazil, it is still based on office BP (OBP) for logistical and financial reasons. Furthermore, in our country, it is not yet clear whether the use of out-of-office BP would really be more reliable for the diagnosis.

Objective
To evaluate the importance of using Home Blood Pressure Monitoring (HBPM) in diagnosing HT in a young adult population in primary care in Brazil.

Methods
A cross-sectional population study enrolled adults between 20 and 50 years in a primary healthcare unit in Rio de Janeiro. Office BP was the mean value of 2 measures, while the HBPM followed a 7-day protocol. It was considered normal a Home BP &lt; 135x85 mmHg and OBP &lt;140x90 mmHg. Patients were classified into 4 phenotypes: normotension (controlled OBP and HBPM); white coat HT (uncontrolled OBP and controlled HBPM); masked HT (controlled OBP and uncontrolled HBPM) and sustained HT (uncontrolled OBP and HBPM).

Results
A total of 462 individuals were enrolled [38% males; mean age 36±9 years]. Sedentary lifestyle (43%), dyslipidemia (38%) and obesity (28%) were the main CV risk factors. OBP, the prevalence of HT was 13%, HBPM it was 19%, with low concordance between them (kappa=0.472). After HBPM, 17% changed the diagnosis, being 6% of them white-coat HT and 11% masked HT. The variables that were independently associated with HT diagnosed by OBP were male gender (OR 1.83,CI95%:1.01-3.33,p=0.04) and increased neck circumference (OR 3.77,CI95%:1.59-8.93,p=0.003), whilst by HBPM they were obesity (OR 2.18,CI95%:1.27-3.76,p=0.005) and increased neck circumference (OR 2.37,CI95%:1.05-5.33,p=0.04).

Conclusions
If the diagnosis was based only in the office BP values, 17% of the subjects would've had an erroneous diagnosis of hypertension, suggesting the importance of implementing out-of-office BP measurements in primary care.

Key messages
Home monitoring blood pressure corrected the diagnosis of hypertension of 17% of patients, allocating them correctly into white-coat HT and masked HT. Increased neck circumference was independently associated with the diagnosis of hypertension by both methods.
High-risk lifestyle and all-cause mortality in older Australians with stroke: A data linkage study
Authors: Peng W , Hayen Andrew , Maguire J a n e , Adams J o n , Sibbritt David 
Published: October 2020

Abstract

Background
Stroke prevention via lifestyle modification is a public health priority in developed countries. Few studies have examined the association of high-risk lifestyle factors with long-term mortality of stroke survivors. Therefore, this study aims to explore the effect of key lifestyle factors on all-cause mortality after stroke.

Methods
Sample is derived from the 45 and Up Study, the largest ongoing study in the Southern Hemisphere focusing on the health of people aged 45 years and older living in NSW, Australia. The lifestyle data in the 45 and Up Study between 2006 to 2015 were linked with data from the NSW Registry of Births, Deaths and Marriages, NSW Cause of Death Unit Record File, and NSW Admitted Patient Data Collection by the Centre for Health Record Linkage. We defined a high-risk lifestyle as no vigorous exercise, smokers, or &gt; 10 alcoholic drinks/week. Multivariate Cox regression model is used to examine the effect of high-risk lifestyle on survival using 10-year all-cause mortality as the main outcome, adjusted for key confounders.

Results
We analysed information on 8410 adults with a stroke event occurring prior to the baseline 45 and Up Study, and 31% of them died in 10 years. 6219 participants were identified as having a high-risk lifestyle at baseline. Being a current smoker and without vigorous exercise were associated with 41% (95% CI: 16%, 73%) and 52% (95% CI: 30%, 78%) increase in the likelihood of death in 10 years, respectively. However, high-risk alcohol drinking was not significantly associated with survival. Of note, having cardiovascular-related comorbidities showed greater risks of mortality (HR range, 3.6-7.2).

Conclusions
High-risk lifestyle factors were associated with an increased risk of long-term all-cause mortality, suggesting that enhancing public health initiatives to promote 'healthy' lifestyle behaviours can be of great benefit to stroke survivors.

Key messages
It is essential for stroke survivors to maintain a healthy lifestyle to delay all-cause mortality. Stroke survivors with high-risk lifestyle may be associated with increased likelihood of death if they have comorbidities such as diabetes and hypertension.
Non-communicable diseases in Latin America: a case study of Latin American tobacco control diplomacy
Authors: Carballo M 
Published: October 2020

Abstract

Background
This research emphasizes on better understanding what is leading Latin America to collaborate on tackling Non-communicable diseases (NCDs). The uniqueness of this research lays on analysing the case of tobacco control diplomacy in the region, from a multi-actor and multi-level diplomacy approach in global health. By doing so, it addresses the existent research gap on academic literature focusing on NCDs in Latin America and global health diplomacy.

Methods
The research is framed within a qualitative approach to global health. It includes both primary and secondary sources, with a geographical focus in Latin America. Semi-structured interviews were conducted with representatives of key global health actors.

Results
The process of addressing NCDs in Latin America has highlighted several challenges including: the difficulty to achieve awareness of the urgency of NCDs, while countering the tobacco industry interference in public health.the limited funding for the initiatives seeking to tackle NCDs in the region vs the financial and political power of the industry.the limited comprehensive approach to NCDs, that goes beyond risk factors to address NCDs as a whole issue.

Conclusions
The analysis shows that tobacco control has been a pioneer in global health diplomacy on NCDs in Latin America. Furthermore, it has portrayed a leadership role of Latin America and an increasing tendency to collaborate at regional level. The recommendations that arise are: There is a need to regulate products as alcohol and ultra-processed food in Latin America following the examples set by the successful regional tobacco control efforts.There is a need to expose tobacco industry interference in public health, since it undermines regional efforts to tackle NCDs.There is a need for regional NCDs efforts to focus on the diversity of global health actors involved.It is imperative to collaborate on NCDs at regional level, given the escalating economic burden of NCDs

Key messages
The focus is analysing the challenges that Latin America faces when addressing NCDs, from a global health diplomacy perspective. The case study of tobacco control diplomacy contributes to better understand the factors that have been leading up to regionally collaborate on NCDs.
Diabetes mellitus and associated factors, determined by glycated hemoglobin
Authors: Carvalho Malta D , Duncan B B , Schmidt M I , Eloah Machado I , Gomes da Silva A , Tomie Ivata Berna R , Moehlecke Iser B P , Felisbino Mendes M S , Rizato Stopa S , Landman Szwarcwald S 
Published: October 2020

Abstract

Objective
To analyze the prevalence of diabetes mellitus (DM) according to different diagnostic criteria, in the Brazilian adult population, according to laboratory results from the Brazilian National Health Survey.

Methods
Analysis of laboratory data from the National Health Survey, collected between 2014 and 2015. The prevalence of diabetes was calculated according to different diagnostic criteria. The prevalence of diabetes was calculated according to the criterion of glycosylated hemoglobin ≥ 6.5% or using medication, using Poisson regression and calculating crude and adjusted PR and 95%CI.

Results
The prevalence of diabetes according to different criteria varies from 6.6 to 9.4%. Intermediate or pre-diabetes hyperglycemia ranged from 6.8 to 16.9%. Considering laboratory criteria or medication use, the prevalence of DM was 8.4 (95%CI 7.65-9.11). The adjusted PR for gender, age, educational level and region was lower for males (PR 0.75; 95%CI 0.63 - 0.89), increased with age: 30 to 34 years (PR 2.32; 95% CI 1.33 - 4.07), 40 to 59 years PR 8.1; 95%CI 4.86 - 13.46), 60 years old or older (PR 12.6; 95%CI 7.1 - 21.0), and higher educational levels was protective (PR 0.8; 95%CI 0.6 - 0.9). Therewas a higher PR in the Central West Region (PR 1.3; 95%CI 1.04 - 1.7), in overweight people (PR 1.8; 95%CI 1.4 - 2.1), and in obese people (PR 3.3; 95%CI 2.6 - 4.1).

Conclusions
The prevalence of diabetes was higher in females, people over 30 years of age, in populations with low educational levels, and people who were overweight and obese. The study advances in determining the diabetes situation in the country through laboratory criteria. These data demonstrate the importance of controlling hyperglycemia in order to avoid the vascular and systemic effects of DM.

Key messages
This is the first study to analyze the prevalence of DM using laboratory data from a representative sample of the Brazilian population. The study pointed to a strong association between overweight and obesity and diabetes, showing the importance of public health measures to encourage healthy eating and physical activity.
Characteristics of patients with gastric cancer, treated at the National Cancer Institute-Bogotá
Authors: Manrique-López M , Puerto-Jimenez D 
Published: October 2020

Abstract

Background
Gastric cancer has the highest mortality rates for both sexes in the country, is one of the five most prevalent in both Colombia and the world and in the country most cases are detected late.

Methods
Participants: Gastric cancer patients selected according to inclusion criteria; observational, cross-sectional and descriptive study.

Results
39 participants: 21 men (54%) and 18 women (46%); with a mean age at diagnosis (± standard deviation) of 56 ± 12 years; Primary studies (43%), low socioeconomic status: 74%; no access to sewage aqueduct in childhood (61.5%); cigarette consumption (41%), consumption of alcoholic beverages: 84.6%; Overweight: 49%. Helicobacter Pilory infection was only documented in 20 of the 39 patients (yes: 23%, no: 28%), in the remaining 19 patients no data were evidenced. 36% of patients were diagnosed in stage II; and 77% cases received a late diagnosis. These are preliminary results.

Conclusions
The results show that the majority of patients belong to a low social class and almost half have only primary studies - which has an impact on exposure to various risk factors, lack of knowledge about risk factors, or access to health services. Likewise, a late diagnosis or the detection of cancer in advanced stages (II; III; IV) represents a social, economic impact for both the patient, the family and society. A posteriori, the investigation will allow to recognize differences / association patterns in the different characteristics between the early and late stages in this group of patients, which will allow to generate recommendations for the early detection and prevention of gastric cancer in the country.

Key messages
It is necessary to establish prevention programs, timely detection and improve access to health services according to the social, economic contexts of the different regions of the country. A timely and early diagnosis can generate greater chances of recovery and survival not only in gastric cancer, but in other types of cancer.
The status of integrated care on the chronic abuse of alcohol response - A cross-sectional study
Authors: Moreira de Sousa A , Lopes L , Costa P , Martins-Coelho G , Capucho R 
Published: October 2020

Abstract

Background
In 2017, the risk-weighted prevalence of alcohol consumption was the health indicator with a more negative impact on the Institute for Health Metrics and Evaluation Sustainable Development Goals Health Index Value in Portugal. According to data from 2012-14, the Alto Tâmega and Barroso (ATB) had the highest value of Years of potential life lost (YPLL) in North Portugal - 4570,1/10.000 people. Liver chronic disease was the specific cause of death that contributed to the value of YPLL - 465,4/10.000 people.

Methods
A cross-sectional study was conducted with data from the Northern Health Administration and the General Directorate for Intervention on Addictive Behaviours and Dependencies. We compared the number of patients with chronic alcohol consumption (CAC) in 2018, the leading causes of death between 2012-14, the main morbidity causes according to data from primary healthcare (PHC) physicians in 2018 and the number of patients in specialized treatment team (STT) for alcohol abuse treatment in 2018 in ATB.

Results
In 2018, 2643 patients of ATB had a diagnosis of CAC; only 178 were followed by an STT. Although CAC had a massive influence on YPLL, this was only the 11º cause of morbidity in ATB according to the data from PHC. The number of women with CAC was stable between 2012 (n = 284) and 2018 (n = 291). In the same period, there was an increase of 52,86% of CAC on men (n = 1523 to n = 2348).
Even though 18,4% of YPLL due to chronic liver disease happen in women, only 11,2%of the patients with CAC in the PHC are women.

Conclusions
There is a need for the improvement of CAC diagnosis in PHC, and the improvement of referral of patients to STT and hospital care. Besides, to reach the SDG3, there is the need to work intensely on SDG 17 (partnership for the goals). The Public Health Unit of ATB is organizing Operation PROMETEU to improve communication, institutional collaboration, and monitoring of the existing health activities that are tackling CAC.

Key messages
The need to integrate data from different healthcare sources for a better analysis on health problems. The urgent need to tackle the alcohol abuse problem in ATB.
Gastric cancer incidence and predictions: Observational Study (Monastir, Tunisia: 2002-2030)
Authors: Bannour R , Zemni I , Ben Nasrallah C , Aroua N , Abroug H , Ben Fradj M , Kacem M , Sriha A 
Published: October 2020

Abstract

Introduction
Gastric cancer is a major health burden worldwide. Based on GLOBOCAN 2018 data, stomach cancer is the fifth most common neoplasm and the third most deadly cancer, with an estimated 783,000 deaths in 2018. Unfortunately, only a few countries have set up extensive programs of early screening. In Tunisia the gastric cancer ranks among the ten most frequent cancers with more than 637 new cases per year. The aim of this study was to we report trends in the gastric cancer incidence during the span of time between 2002 and 2013 from the population-based cancer registry of the centre of Tunisia, and to predict the future number of cancer cases by 2030.

Methods
The cancer incidence data were collected from the cancer register of the Tunisian Center from 2003 to 2012.The data were stratified by cancer site, sex and age. We used SPSS software in order to calculate the crude incidence rates and standardized incidence rates. SPSS software was used in order to estimate the future number of cancer cases by 2030.

Results
During our study period, 326 cases of gastric cancer were observed. 53.1% of our patients were male with a sex ratio male to female 1.13.The crude incidence rates were 5.71 for male patients and 5.43 for females. The standardized incidence rates were 7.22 and 6.3 respectively for male and female patients. A stable trend was observed. Only 28 cases of gastric cancer are predicted by 2030.

Conclusions
Over the recent, there has been a slight decrease in gastric cancer rates. Many preventive steps should be encouraged in order to maintain this decreasing trend such as changing dietary habits by encouraging the consumption of fresh fruit and vegetables, as well as decreasing the use of tobacco and salt.

Key messages
Gastric cancer is a major health burden worldwide, only a few countries have set up extensive programs of early screening. Changingdietary habits by encouraging the consumption of fresh fruit and vegetables, as well as decreasing the use of tobacco and salt.
Oncoepidemiological situation of sarcomas in Kazakhstan
Authors: Pyssanova Z h U , Serikbaev G A , Kaydarova D R , Tuleuova D A , Shinbolatova A S , Kurmanaliev A K 
Published: October 2020

Abstract

Background
Sarcoma is a malignant tumor of soft tissues and bones. They make up 1% of all malignant tumors in adults and 15% in children. More common in men 1.1: 1. By age: 20.7% - up to 40 years old, 27.6% - 40-60 years old and 51.7% over 60 years old. In 2018, in the Kazakhstan, malignant tumor of connective and soft tissues of 444 (1.4%) cases was registered and ranks 19th in the structure of cancer, bones and articular cartilage 188 (0.6%), takes 22nd place. Of these, with sore cases, bone sarcomas were recorded - 12.7%, soft tissues - 9.5%. The mortality rate from soft tissue sarcoma is -177 (1.2%) people, bone sarcoma - 85 (0.6%) people. Five-year survival of patients from soft tissue sarcomas is 53.8%, from bone sarcomas - 67.3%.

Methods
from 2015 to 2019, 1,068 patients with malignant tumor of bones and articular cartilage, 963 patients with malignant tumor of connective and soft tissues addmited to KazNIIOiR. Of these, 225 patients underwent organ-sparing surgeries - endoprosthesis replacement of limbs.

Results
In Kazakhstan over the past 5 years there has been an increase in the incidence of sarcomas of bones and soft tissues.

Conclusions
in comparison with previous years, there is an increase in the incidence of malignant tumor of bones and articular cartilage, connective and soft tissues, and an increase in mortality from tumor of bones and articular cartilage in men by 16.7%, in women by 50%. Late reversal of patients at the IV stage and a high proportion posthumously recorded in patients with maliganan tumors.

Key messages
Purpose: Assessment of the epidemiological situation and incidence of sarcomas of the bones and soft tissues in Kazakhstan. Out of 25 localizations of cancer, detection is worsened during professional examinations in 10 localizations, of which bones and articular cartilage, connective and other soft tissues.
Ferraz de Vasconcelos syphilis: epidemiological profile, investigation and evolution of cases
Authors: Vieira C 
Published: October 2020

Abstract
The increased incidence of syphilis in Brazil can be explained by multiple reasons: increased reports of acquired syphilis, increased coverage of rapid tests in pregnant women provided by the Brazilian Ministry of Health, reduced condom use, inadequate treatment of patients and partners. In Ferraz de Vasconcelos, a city in the metropolitan region of São Paulo, an increasing elevation in syphilis cases in healthcare services and in the epidemiological surveillance system. In 2017, the city reported 148 cases from which 27 cases were congenital syphilis, with one death. The purpose of the survey was to evaluate the cases reported and describe the main sociodemographic, epidemiological, clinical, and syphilis investigation. A high incidence of syphilis in adults, pregnant women, and congenital syphilis was recorded with a detection rate of 45.0 per 100,000 in habitants and 12.4 and 9.3 per 1,000 live births, respectively. These rates reflect failures in the diagnosis, treatment, and follow-up of cases. Syphilis in adults was obtained in this study in a higher incidence in men 54.1%.Being 49.4% between brown and black people. It is noteworthy that more than 97% of the pregnant women reported with syphilis underwent prenatal care; however, 36.1% of them started from the second trimester, only 88.9% were given treatment, and 66.7% with record of healing. In addition, only in 27.8% pregnant women, the sexual partner underwent the specific treatment. Regarding congenital syphilis, only 81.5% newborns were given proper treatment and only 55.6% underwent laboratory investigation of cerebrospinal fluid. It is evident that these results expose the weaknesses of the municipal healthcare system. Greater coordination among services can contribute to early diagnosis and active search of cases. The epidemiological bulletin containing data from this study may enhance the organization of syphilis prevention, planning, and surveillance actions in the city.

Key messages
The increased incidence of syphilis in Brazil can be explained by multiple reasons: increased coverage of rapid tests on people, reduced condom use, inadequate treatment of patients and partners. Greater coordination among services can contribute to early diagnosis and active search of cases.
Using theory of change to assess impact of knowledge translation initiatives
Authors: Howarth C , Neil-Sztramko S 
Published: October 2020

Abstract

Issue
The National Collaborating Centre for Methods and Tools (NCCMT) offers high quality supports to public health professionals on evidence-informed decision making (EIDM). We developed a theory of change evaluation framework to guide evaluations of our programs and services to ensure that the NCCMT's resources and training continue to be high quality and meet the needs of public health professionals globally.

Description of the Problem
Our objective was to develop an evaluation framework that illustrates our reach, quality, and impact. The NCCMT contracted an external program evaluation expert to assist in developing a revised framework to better capture these aspects. An inductive approach was used to identify evaluation themes through internal document review, and a review of applicable program evaluation literature.

Results
A revised evaluation framework, influenced by theory of change, was developed and is being implemented at the NCCMT. The theory of change visualizes how the NCCMT influences EIDM and public health practice through four stages that progress from creation of products and services, to knowledge and awareness, to engagement and capacity development, and finally to policy and practice changes embedded within organizational structures. Specific outcome indicators include: public health professionals' confidence, knowledge, and skills; improved public health programs; organizational support for evidence-informed decision making; and workforce engagement and competence.

Lessons
This innovative evaluation framework informed by a theory of change resulted in significant streamlining of the centre's evaluation activities, and has provided clearer direction with respect to the purpose of evaluation, as well as enhanced ability to capture the centre's reach, quality and impact. The lessons of the importance of using theory of change to underpin evaluation activities can be applied to other public health organizations globally.

Key messages
Applying an evaluation framework supports effective and efficient programming. The evaluation framework demonstrates the NCCMT’s impact and reach in public health.