bluuebunny/crossref_metadata_2025_split huggingface dataset:
Training physicians in motivational communication to improve behaviour change counselling competency: A behavioural medicine approach to NCD prevention and management
Authors: Lavoie K 
Published: October 2020

Abstract

Background
Despite the importance of changing health behaviours in the context of preventing and managing non-communicable chronic diseases (NCD's), physician use of evidence-based behaviour change counselling (BCC) is low, and BCC skills competency is generally poor.
Motivational communication (MC) is a patient-centred, evidence-based BCC approach used by healthcare providers, designed to increase patient motivation to adopt a healthy lifestyle. MC-based approaches improved a range of health behaviours (smoking, diet, physical activity) in patients with NCDs, leading to increased demand for physician training. Despite the widespread dissemination of training programs, data on their efficacy in achieving competency among physicians is limited. This is likely due to a lack of consensus on the core communication competencies to be achieved, and in the absence of acceptable, valid and reliable tools to measure skill acquisition.

Results
Using an integrated knowledge translation (iKT) approach that engaged 199 international physicians, behaviour change experts and health administrators, we have identified 11 core evidence-based communication competencies that physicians should acquire in the context of NCD prevention/management. They have been incorporated into a basic 4 hr face-to-face MC training program called “LEARN THE BASICs”. To assess MC competency, we have also developed a reliable, engaging, efficient, 'user-friendly' case-based digital assessment tool called the MC-Competency Assessment Test (MC-CAT).

Conclusions
Strategies for optimizing and tailoring this program, including finding the most cost-effective training dose, the impact of supplemental training components (e.g., in person vs. digital coaching; booster sessions), and delivery modes (e.g., face-to-face vs digital/online), will be discussed in the context of optimizing implementation success.
Digital biomarkers and digital phenotyping in mental health care and prevention
Authors: Andrea A , Agulia A , Serafini G , Amore M 
Published: October 2020

Abstract
Biomarkers are physiologic or pathologic characteristics that can be objectively measured and evaluated as indicators of biologic processes, or biological responses to therapeutic interventions. Traditionally, psychiatry has suffered from a relative paucity of these, with no lab tests or medical devices available for the diagnosis or monitoring of mental health disorders. The widespread adoption of personal digital devices including smartphones and wearables allow to retrieve, record and store large amounts of user-generated data that have been hypothesized to play as “digital biomarkers” - intended as a new type of medical information that can produce actionable insights into the biological state of individuals, just as “normal” biomarkers, but collected through digital tools.
As well described by Onnela in 2015, digital biomarkers can define a digital phenotyping characterized by a “moment-by-moment quantification of the individual-level human phenotype in situ using data from personal digital devices,” in particular smartphones and mobile devices. Simpler said, digital biomarkers, can provide a comprehensive representation of people and patients' functioning. Their use in health research, prevention and practice is particularly relevant in the field of mental health being mental disorders highly heterogeneous in nature and over time. In the next years these novel ways of measuring mental health status will provide observations and perspectives into disease that were unavailable before and which will fruitfully inform personalized prevention and care. The presentation will introduce the concept of digital biomarkers and digital phenotyping, it will provide the state of the art on their identification and use in the field of mental health and will discuss the way forward to ensure their potential is exploited through effective collaboration between clinicians, public health researchers and the tech world in a joint effort to promote population well-being.
Has the European Union created a healthy food environment for its citizens? Application of the Food Environment Policy Index (Food-EPI)
Authors: Djojosoeparto S K , Kamphuis C B M , Vandevijvere S , Murrin C , Stanley I , Romaniuk P , van Lenthe F , Harrington J M , Poelman M P 
Published: October 2020

Abstract

Background
European Union (EU) Member states' food environments are shaped by both national and EU policies. To date however, studies assessing food environment policies developed and set by the EU are scarce. The aim of this study was to assess the strength of EU policies to improve food environments as well as to assess the extent these policies could lead to a decrease or widening of socio-economic inequalities in dietary intake.

Methods
We compiled evidence on the EU policies for each of the Food-EPI 47 indicators. A European panel of independent, non-government experts (N = 30) specialized in nutrition, obesity or chronic diseases, using the Food-EPI evidence, rated the strength of EU policies to improve food environments during an online survey in February-March 2020. The experts also rated to which extent policies could lead to a decrease or widening of socio-economic inequalities in dietary intake. In addition, experts formulated actions to improve EU food environment policies, which were prioritized during a follow-up online survey.

Results
The overview of EU-level policies resulted in a 79-pages document, describing policies (or the lack thereof) for each of the 47 Food-EPI indicators. This document has been verified for completeness and accuracy by EU governmental officials. The evidence document shows that the EU has mainly binding legislation on the food labelling whereas policies on the other Food-EPI domains are mostly voluntary. Results from the online survey and the formulated prioritized actions will be presented during the conference. The results will reflect the experts' ratings supported by documented evidence and will provide meaningful guidance to EU officials and public health advocates in their efforts to improve the food environment policies set by the EU.
Flu vaccination among health workers in Italy: results from the nationwide surveillance PASSI 2015-18
Authors: Gallo R , Minardi V , Contoli B , Possenti V , Carrozzi G , Trinito M O , Ramigni M , Fateh-Moghadam P , Masocco M , D’Andrea E 
Published: October 2020

Abstract

Background
Influenza causes a significant health and socio-economic burden every year. Healthcare workers (HCWs) are at higher risk of exposure to respiratory pathogens than general population, including seasonal influenza virus, with potential threats to their health and patients' safety. We aimed to estimate the adherence to flu vaccination of health workers in 2015-2018 seasons in Italy.

Methods
We analyzed data collected between 2015 and 2018 from the Italian Behavioral Risk Factor Surveillance System (PASSI). PASSI collects data on health behaviors in the adults (18-64 years) through telephonic administration of standardized questionnaires to a representative sample of Italian population. The answers related to flu vaccination refer to the vaccination campaign preceding the interview

Results
Preliminary data show that overall 11.9% (CI 10.3% - 13.7%) of HCWs reported to have been vaccinated vs 7.2% (CI 6.9% - 7.5%) of the total population sample. Physicians showed a higher overall adherence compared to other healthcare professionals (22.4% [CI 18% - 27.5%] vs 9% [CI 7.4% - 10.9%], respectively). Differences of adherence were found also across age groups: 18.3% [CI 15% - 22.2%] of respondents between 50-64 years reported to have received a vaccination compared to 10% (CI 7.9% - 12.5%) and 4.3% (CI 2.8% - 6.4%) of 35-49 years and 18-34 years age groups, respectively. The annual influenza vaccination coverage for people working in healthcare has increased over the years (9.8% in 2015 vs 14.1% in 2018).

Conclusions
Although coverage rates are increasing over time, adherence to influenza vaccination is still too low, especially among younger HCWs and non-medical HCWs. Strategic actions, such as local and national programs to increase self-awareness of being an at-high-risk category for contracting and transmitting infections and/or mandatory vaccination, should be adopted to sharply achieve an optimal coverage rate for HCWs.

Key messages
Adherence to seasonal influenza vaccination is still very low among Italian HCWs. A participatory attitude towards vaccination for HCWs should be pursued. Monitoring and reporting process should be improved to provide further detailed evidence for adopting targeted programs.
Influenza D virus: a potential threat for humans?
Authors: Trombetta C M 
Published: October 2020

Abstract
Influenza D virus (IDV) is a novel influenza virus, first isolated from an ailing swine in 2011 in Oklahoma. Several studies have isolated IDV in cattle from multiple geographic areas, suggesting cattle as a possible primary natural reservoir for the virus. To date, few studies have been performed on human samples and there is no conclusive evidence on the ability of the virus to infect humans.
This serological study aimed to assess the IDV prevalence in archived human serum samples collected in Italy from 2005 to 2017. The serum samples were tested by haemagglutination inhibition assay (HI) and confirmed by the virus neutralization assay.
The results clearly show that specific HI antibodies against IDV were present in at least a small subset of serum samples taken in every single year between 2005 and 2017, although IDV was isolated and described for the first time in 2011. IDV antibodies displayed low levels, between 5.1% and 9.8%, in the years 2005 to 2007, followed by a sharp increase in 2008; the highest levels (33.9% - 46.0%) were reached in 2008, 2009, 2010, 2013, 2014 and 2016, while the lowest levels (11.9% - 25.7%) were seen in 2011, 2012, 2015 and 2017. In addition, the highest levels of HI seropositivity (HI titers ≥ 1:40) were found in serum samples collected in 2008, 2009, 2012, 2013, 2014 and 2016.
This increase was not constant over the years, it shows sharp rises in some years followed by drops in subsequent years. The seroprevalence peaks detected in humans appear to follow IDV epidemics in animals. Moreover, as the titers did not remain high in the years following the increase, but dropped to lower levels, it is likely that a spill over event from an animal reservoir occurred, and that the virus does not circulate primarily in humans. Ultimately, the virus showed the ability to infect and elicit an immune response in humans and not to persist in the human population.

Key messages
Current knowledge of influenza D virus in humans is still limited. Neither potential threats to exposed individuals nor public health issues can be fully excluded.
Effectiveness of PEHRs use to increase vaccine uptake: a systematic review
Authors: Balzarini F , Oradini Alacreu A , Frascella B , Gaetti G , Signorelli C , Odone A 
Published: October 2020

Abstract

Background
The digital transformation provides tools to empower individuals and enable feedback and interaction between users and healthcare providers. Although Personal Electronic Health Records (PEHR) have been identified as innovative tools enabling the provision of patient-centered care and prevention, evidence on their impact is scant.

Methods
We conducted a systematic review following the PRISMA guidelines to retrieve, quantitatively pool and critically appraise the effectiveness of PEHR access on vaccine uptake. Analysis on effectiveness were carried out for the following comparison strata: i) PEHR access vs no intervention, ii) PEHR access vs access with additional features.

Results
Of identified 3125 citations, 8 studies were included, the majority published in the US before 2015. Four studies assessed differences between subjects with and without access to PEHR. Access to PEHR was reported to be an effective tool to increase vaccine uptake: when accessing PEHR, study participants were 6.7% more likely to receive influenza vaccine, parents to have children vaccinated, lifetime pneumococcal vaccination was reported to be higher in diabetic patients, a positive impact on preventive behaviors was reported. Four included studies reported on the effect of access to PEHR with or without additional communication features. In one study, the effect of electronic messages delivered through PEHRs wasn't differentially distributed in the arm receiving tailored messages on influenza, and in the arm receiving educational messages on other diseases. In other studies, active PEHR users were more likely to be vaccinated against influenza and Herpes Zoster, subjects who in addition received reminders had higher rates of influenza vaccination.

Conclusions
While immunization programs are struggling to achieve optimal coverage targets, our findings can partially outline the association between PEHR access and vaccine uptake and further experimental research is needed.

Key messages
PEHRs offer great potential to support population health and in particular immunization programs, helping to put people and patients at the center of care delivery, supporting patient empowerment. Although our findings suggest immunization coverage might benefit from people accessing PEHR, there is an urgent need to produce solid experimental evidence to quantify such effect.
Migration and outbreaks of vaccine-preventable disease in Europe: a systematic analysis (1990-2019)
Authors: Hargreaves S , Deal A , Mounier-Jack S , Campos-Matos I , Edelstein M , Hayward S , Friedland J , Carter J , Rustage K , Majeed A 
Published: October 2020

Abstract

Background
Migrant populations (defined as foreign-born) in the EU/EEA may be one of several under-immunised populations yet their role in outbreaks of vaccine-preventable diseases (VPDs) has been poorly defined to date.

Methods
We did both a temporal analysis to map published reports of migrant-related outbreaks against data from the ECDC's Surveillance Atlas of Infectious Disease, and a systematic review (PROSPERO CRD42019157473; 1990-2019) adhering to PRISMA guidelines, to explore whether migrants are involved in outbreaks in Europe and which particular subpopulations may be at increased risk. Studies on VPD outbreaks (measles, mumps, rubella, diphtheria, pertussis, polio, hepatitis A, N meningitidis, and H influenzae) in migrants residing in the EU/EEA were included.

Results
46 studies were included, reporting on 50 VPD outbreaks across 13 EU/EEA countries, of which 98% (n = 49) occured since January 2000. Measles had the highest number of reports of outbreaks involving migrants (n = 21; 5043 cases), followed by varicella (n = 10; 595 cases) and hepatitis A (n = 10; 1226 cases). 21 (40%) of outbreaks were reported from shelters for asylum seekers and refugees (mainly varicella or measles). Of 27 outbreaks where the index case was defined, 20 (74.1%) were migrants, including 9 (33.3%) from Eastern Europe and 6 (22.2%) from Africa. When mapped against the ECDC timeline of measles outbreaks, migrant-related outbreaks coincide with Europe-wide peaks in measles incidence (in 2006, 2010, and 2018).

Conclusions
Migrants represent one key group involved in VPD outbreaks, with refugees/asylum seekers residing in shelters or camps particularly at risk. Measles accounted for 38% of all reported outbreaks. Improved data collection on migrant status across Europe is crucial to understanding the complex relationship between migration and occurrence of VPD outbreaks to inform policy decisions on the most effective strategies to prevent future outbreaks.

Key messages
Migrants represent one key group involved in vaccine-preventable diseases outbreaks in Europe. Refugees and asylum seekers may be particularly at risk.
Care Manager nurse for chronic patients in primary care: a literature review
Authors: Faggian E , Balduit C , Labelli E , Gregori D , Martinato M 
Published: October 2020

Abstract

Background
The reorganization of home care provides nurses the opportunity to move to a role of “Care Manager”, affording a more effective management of chronic patients. This study aims to investigate whether the introduction of this new nursing role improved care related outcomes in people with one or more chronic conditions in primary care setting.

Methods
Articles considered for this review had to assess the outcomes obtained from outpatient care and home care in which the care manager nurse had been involved. Literature search was performed in PubMed, Cinahl, Scopus, Cochrane, and Google Scholar.

Results
20 studies have been selected. Care manager was introduced mainly into the American healthcare systems (80%) and only partly in the European ones (20%). Nurse provided outpatient care (95%) and home care (75%) dealing with the development of the care plan, therapeutic education and proactive prevention. The interventions were based on three fundamental principles of the Chronic Care Model: care teams, self-care support, computerized information system. The health outcomes achieved include: reduction of health care costs, hospital admissions and mortality rates; improvements of disease-specific clinical parameters and quality of life, and an excellent level of satisfaction on patients' and healthcare professionals' side (perceived quality of care).

Conclusions
The literature shows that nursing interventions carried out by the care manager in collaboration with other primary care professionals provided positive results in many ways.

Key messages
The reorganization of home care provides nurses the opportunity to take the role of “Care Manager”. This figure could afford a more effective management of chronic patients.
Nurse provided outpatient care (95%) and home care (75%) dealing with the development of the care plan, therapeutic education and proactive prevention. These interventions led to positive results.
Regional variation in appropriate care for ST-elevation myocardial infarction in Finland
Authors: Reissell E , Lumme S , Satokangas M , Manderbacka K 
Published: October 2020

Abstract

Background
Timely primary percutaneous coronary intervention (PCI) is currently the treatment of choice for ST-elevation myocardial infarction (STEMI). Although cardiac units were established in all central hospitals in late 1990s for sparsely populated Finland, studies have shown that regional variation has increased. Additionally, the dense Finnish hospital network includes non-cardiac facilities where patients may be inappropriately admitted and then transferred for PCI. We aim to investigate the current regional differences in receiving timely PCI, determinants of these variations and the effect of hospital transfers.

Methods
Finnish Hospital Discharge Register data on PCIs for STEMI patients in 2015-17 were linked to register data on socio-demographics. In these preliminary analyses we used logistic regression modelling.

Results
Our results suggest that there were significant regional differences both for timely PCI in STEMI patients and in the probability of hospital transfers during an episode of care. The regional odds ratios (OR) for receiving PCI on time varied from 0.41 (95% confidence interval 0.33-0.52) to 2.73 (2.09-3.57) compared with the capital region when controlling for age, gender and hospital transfers. The ORs for being transferred during an episode of care varied from 0.26 (0.15-0.44) to 16.6 (11.6-23.6). Patients not transferred were more likely to receive PCI (OR 1.89 (1.67-2.15)). Men received PCI on time more often (OR 1.31 (1.18-1.46)) and women were more likely to be transferred (OR 1.29 (1.15-1.45)).

Conclusions
The probability for receiving PCI on time was related to the size of the hospital's population base and academic affiliation and inversely to transfers between hospitals. Hospital transfers during care episode and atypical symptoms often seen in women may cause critical delays for PCI. Other determinants for variation of timely PCI and its effects on equity will be analysed using multilevel modelling.

Key messages
Appropriate care for STEMI varies across regions and reflects inept practices in provider network. These findings are more pronounced in women showing persisting gender-related inequity.
A social law lens on maternal mortality in the U.S.: Lessons from Germany and the Netherlands
Authors: Tonti L 
Published: October 2020

Abstract
The United States has one of the worst maternal mortality rates among developed nations. American mothers are three times more likely than Canadian mothers and six times more likely than Scandinavian mothers to die from pregnancy-related deaths. Currently, for every 100,000 live births, 26.4 mothers are dying in the U.S, with significant disparities between White mothers and mothers of color. Projections indicate that by 2030, the maternal mortality rate will rise to 45 maternal deaths out of 100,000 live births. In direct contrast, most other similarly situated high-income nations have decreased their maternal mortality rates in recent years, evidencing only single-digit mortality per 100,000 mothers.
This research examines how social protection measures afforded by the law can facilitate differences in these rates. Specifically, this presentation compares legal interventions enshrined in social law that impact maternal health in the United States, Germany, and the Netherlands, including mandated access to prenatal care, midwifery reimbursement, and obligatory duration of postnatal care. Compared to the United States, both Germany and the Netherlands enshrine more comprehensively midwifery compensation and access to postnatal care in their social legal codes and insurance benefit schemes.
Evidence accumulated by comparing these interventions with maternal mortality statistics suggests that legal interventions that spur extra attention to mothers during and after birth may help prevent pregnancy-related deaths. It also opens a discussion about how policymakers can use legal interventions to help eliminate racial disparities in maternity practice.

Key messages
Codified legal interventions that mandate extra attention to mothers during and after birth may help prevent pregnancy-related deaths. Compared to the U.S., both Germany and the Netherlands better enshrine midwifery compensation and access to postnatal care in their social legal codes and insurance benefit schemes.