bluuebunny/crossref_metadata_2025_split huggingface dataset:
General practitioners, pregnancy and addictions in France in 2015
Authors: Andler R , Cogordan C , Pasquereau A , Buyck J-F , Nguyen-Thanh V 
Published: November 2019

Abstract

Background
Tobacco smoking and alcohol drinking during pregnancy result in serious health hazard for both the baby and the mother. In France, about 17% of pregnant women smoke and 20% consume alcohol. General practitioners (GPs) can have an active role in preventing those behaviors as they often interact with pregnant patients: one quarter of French pregnant women have had at least one antenatal visit with a GP. The aim of our study is to describe French GPs’ practices (screening and counseling) toward pregnant patients regarding tobacco smoking and alcohol drinking.

Methods
In 2015, a telephone survey was set based on a stratified random sampling of metropolitan France GPs. A representative sample of 1,414 French GPs completed the study.

Results
Screening for alcohol consumption at least once for every patient was done by 61% of GPs and for smoking by 82% of GPs. Counselling to quit alcohol consumption was done by 77% of GPs while counselling to quit smoking was done by about 90% of them. GPs’ practices were significantly better among those who had more recent ongoing training. Regular drinkers GPs were less likely to systematically screen for alcohol use and GPs’ alcohol use frequency was adversely related to recommending quitting. Current and former smokers GPs were less likely to recommend quitting to pregnant patients smoking over 5 cigarettes per day.

Conclusions
Screening for alcohol use and smoking during pregnancy is not yet systematic among GPs in France. GPs’ prevention role with pregnant patients could be emphasized, potentially through initial and ongoing trainings adaptation. Besides, as regular alcohol use and smoking are related to unwanted practices, prevention for the benefit of GPs could be even more fruitful.

Key messages
Screening for alcohol use and smoking during pregnancy is not systematically done by French GPs. GPs’ prevention role with pregnant patients could be emphasized, potentially through initial and ongoing trainings adaptation.
Out of country tobacco purchases decrease despite a price increase and plain packaging in France
Authors: El-Khoury F , Gomajee R , Torregrossa H , Bolze C , Melchior M 
Published: November 2019

Abstract

Background
The introduction of new anti-tobacco measures in France (plain tobacco packaging, higher prices) might encourage smokers to buy their tobacco from other sources than tobacco shops. We examine whether these measures increased the likelihood of smokers purchasing tobacco abroad, depending on their driving distance from the border of a neighboring country with lower tobacco prices.

Methods
DePICT is a two-wave cross sectional national telephone survey examining the French population tobacco-related perceptions and behaviors before and after the introduction of the new measures in 2017. Smokers were asked whether they bought tobacco from abroad in the last 12 months. Shortest driving distances to neighboring countries’ border were calculated using Google Maps (&lt;100 Km, 100-200 Km, 200-300 Km, &gt;300 Km and Ile-de-France (IDF)). Data was weighted to be representative of the population living in France. Multivariate regressions, adjusted on socio-demographic characteristics as well as substance use behaviors, were carried out.

Results
Compared to smokers living at more than 300 Km from a border, those living near a border, and in IDF were significantly more likely to have bought tobacco from abroad (&lt;100 Km: ORadjusted = 3.98; 100-200 Km: ORadjusted = 2.04; 200-300 Km: ORadjusted = 1.47; IDF: ORadjusted = 1.32). Smokers in wave 2 (n = 929) were significantly less likely than those in wave 1 (n = 1238) to have bought tobacco abroad (ORadjusted = 0.81 [95% CI: 0.69-0.96]). It was mainly smokers who were in a driving distances of 100-200 Km, and 200-300 Km who were significantly less likely to buy abroad across the 2 waves (respectively ORadjusted = 0.56 [95% CI: 0.34-0.92] and ORadjusted = 0.50 [95% CI: 0.27-0.92]). Supplementary analyses showed that it was mainly for men and smokers born in France that the decrease was significant.

Conclusions
Our results suggest that the new anti-tobacco measures did not increase out of country tobacco purchases by smokers.

Key messages
The introduction of new anti-smoking measures (increase in price, plain tobacco packaging) did not increase the likelihood of smokers purchasing tobacco from abroad. It was mainly male smokers and smokers born in France that had a decreased likelihood of purchasing tobacco from abroad after the introduction of new anti-tobacco measures.
Characterization of alcohol consumption patterns among older adults in Ireland
Authors: Guzman V , McEvoy C T , McHugh-Power J , Kenny R A , Feeney J 
Published: November 2019

Abstract

Background
Identifying the factors associated with hazardous drinking patterns and problem drinking is imperative to develop appropriate intervention strategies for alcohol harm reduction among the older population. The aim of this study was 1) To explore the patterns of alcohol consumption among older adults in the Republic of Ireland, and 2) To establish possible predictors of hazardous and problem drinking in this population.

Methods
A cross-sectional analysis was carried out on samples of individuals aged &gt;50 years at Wave 3 of The Irish Longitudinal Study on Ageing (N = 4948). Hazardous alcohol consumption was defined as drinking above Irish guidelines [women &gt;11 Standard Irish Drinks (SD)/week; men &gt;17 SD/week], and/or having at least one heavy drinking episode per week (&gt;6 SD/day). Problem drinking was defined as a score of &gt; 2 on the CAGE instrument. Regression analyses investigated outcome differences according to socio-demographic and health characteristics. Sampling weights were applied to account for differential non-response.

Results
The prevalence of drinking patterns was 13% for lifetime alcohol abstainers, 8% for former drinkers, 26% for occasional drinkers and 53% for weekly drinkers. Among weekly drinkers 25% exceeded the guideline threshold, 23% had at least one heavy drinking episode per week and 16% had an alcohol problem according to the CAGE. In fully adjusted models, hazardous drinking and problem drinking were associated with younger older adults, male sex, current or past smoking, higher levels of stress and/or social isolation.

Conclusions
Our findings serve as a starting point to monitor trends of alcohol consumption among older adults in the Republic of Ireland. Our results highlight areas of opportunity for targeted screening and public interventions that seek to reduce alcohol harm among this population.

Key messages
In the Irish context, older adults who are younger, male, current or past smokers, with higher levels of stress and/or social isolation are more likely to engage in hazardous alcohol consumption. Our characterization of drinking patterns highlights areas of opportunity for targeted screening and public interventions that seek to reduce alcohol harm among older adults in Ireland.
Description of low back pain attendances in French ED
Authors: Forgeot C , Viudes G , Noel G , Fouillet A , Caserio-Schönemann C 
Published: November 2019

Abstract

Background
Low back pain (LBP) is one of the leading contributors to disease burden worldwide [1]. In 2018, French health care insurance launched a population awareness campaign in order to promote effective behaviour change in France. Because LBP acute episodes often lead to emergency visits, Santé publique France, the French Public Health Agency and the Federation of Observatories for Emergency Medecine, performed a pre-campaign situational analysis of LBP in the French emergency department (ED) involved in the OSCOUR® network.

Methods
The OSCOUR network is part of the French syndromic surveillance system SurSaUD® [2] coordinated by Santé publique France since 2004. In 2017, the system collects daily individual data from about 700 ED representing 92% of the French ED attendances. Those data contain demographic, administrative and medical information including discharge diagnosis coded according ICD-10. ED attendances with a diagnosis related to LBP were analyzed from 2014 to 2017. Temporal distribution of LBP attendances, hospitalizations after discharge and stay duration in ED services were also analyzed.

Results
From 2014 to 2017, 504 ED were included in the analysis and LBP represented 1.12% (N = 481,291) of ED all visits. This proportion remained stable over the period. 60% of LBP attendances concerned 18 to 50 years old adults and almost 10% were hospitalized after discharge. This proportion increased with age to reach 43% for the 85 years old and more. LBP attendances were more frequent on Monday. Median stay duration were almost 3 hours but increased with age and for hospitalized patients.

Conclusions
The broad coverage of the ED OSCOUR® network on the whole territory and the strong partnership between epidemiologists and clinicians enable Santé publique France to produce reliable results which are also consistent with ED physician’s perception. Finally those results can be used as a reference contributing to evaluate potential benefits of this campaign.

Key messages
This description of low back pain ED attendances is consistent with emergency physicians perception on field and can be used as a reference to evaluate potential benefits of the prevention campaign. The national coverage of the ED OSCOUR® network and the strong partnership with emergency physicians enable Santé publique France to produce relevant description on the main causes of ED attendances.
Hypertension and body mass index in a population of 19-year-old men in Poland
Authors: Hubert-Lutecka A H L , Binkowska-Bury M B B , Chmiel Z C , Hejda G H 
Published: November 2019

Abstract

Background
Hypertension is a main yet potentially modifiable cardiovascular risk factor. It is the most widespread disease of the 21st century, especially in highly industrialized societies. It is estimated that hypertension affects about 25% of the adult population in the world and reaches a ceiling of 32% and another 30% of the adult population is characterized by pressure values classified as pre-hypertensive. The prevalence of hypertension is geographically diverse and closely depends on economic and socio-cultural conditions. The relationship between hypertension and obesity is the subject of many studies that explicitly confirm the occurrence of positive coincidence.

Methods
The study was observational-retrospective, and included a group of 17 282 men, aged 19, from the southeastern region in Poland. All subjects met the qualifications for compulsory military service in 2017. We analyzed selected data obtained from the records of the Ministry of National Defense.

Results
Hypertension was found at 0.6%, weak body structure at 0.8% and obesity co-existing with cardiorespiratory insufficiency has been reported 2.6% of respondents. The underweight concerned almost 7%, and the overweight and obesity of 25% of conscripts. The vast majority of people with hypertension were characterized by excessive body weight (74.8%), mainly overweight.

Conclusions
Hypertension was seen in a negligible percentage of males studied and was significantly associated with an increase in BMI, particularly with regards to being overweight. Excessive body weight significantly more often affected people with a higher degree obesity co-existing with cardiorespiratory insufficiency, affecting of the system and men with hypertension. Excessive body weight was seen in a considerable percentage of males studied and was significantly associated with the prevalence of hypertension and obesity co-existing with cardiorespiratory insufficiency, but not affecting of the system.

Key messages
The assumed observation contribute to the presentation of selected indicators of health status and their relationship with hypertension in a large population of 19-year-old men. Data obtained this way, enrich the state of knowledge about the growing problem of hypertension and they can be a valuable ground for developing educational and preventive programs for Public Health.
Trends in tuberculosis incidence rates in the Region of Sousse (Tunisia) from 1992 to 2016
Authors: Sahli J , Mellouli M , Limam M , El Ghardallou M , Mtiraoui A , Zedini C , Ajmi T 
Published: November 2019

Abstract

Introduction
In 1993, the World Health Organization declared that tuberculosis is a public health emergency of global concern. All efforts were made in accordance with the Millennium Development Goals (MDGs) to reduce the burden of Tuberculosis. The MDG framework built into national priorities and development strategies has, in fact, strengthened epidemiological surveillance and the use of reliable data to make decisions based on objective data. These data are essential for planning, managing the activities of the National Tuberculosis program, monitoring and ongoing evaluation of its performance. In this context, we conducted this study to trace the trend of Tuberculosis incidence rate recorded in the Sousse Region between 1992 and 2016.

Methods
This is a longitudinal study of the registered data of tuberculosis cases in Sousse between 1992 and 2016. For the trend analysis the software JOINPOINT version 4.5.0.1 was used. This software offers the closest possible regression model of the different points and gives an annual percentage change (APC) with a 95% confidence interval.

Results
The highest TB incidence rates was recorded in 1993 (85.66 cases per 100 000 inhabitants). Between 1992 and 1997, there was a significant downward trend of TB incidence (APC = -23.2; 95% CI [-28.8, 1]). Between 1997 and 2004 the trend was stable. Between 2004 and 2016, there was a significant upward trend (APC = 8.3; 95% CI: [4.3, 12.4]).

Conclusions
At the national level, between 1992 and 2002, tuberculosis experienced a fall in incidence rates, as a result of an improvement in the socio-economic level and the organization of tuberculosis control. Since 2004, the trend has been rising. Increased tuberculosis control is advocated to end tuberculosis by 2030 in line with sustainable development goals.

Key messages
After a significant decrease, the tuberculosis incidence has increased significantly since 2004. The tuberculosis prevention efforts should be intensified to reverse the current trend.
Evaluating equity in healthcare: pilot implementation of a self-assessment tool
Authors: Chiarenza A , Domenig D , Cattacin S 
Published: November 2019

Abstract

Background
Several sets of standards aiming at improving access and quality of care for service users have been published in recent years. Certain standards focused on improving healthcare providers’ responsiveness to specific target groups. The general goal of this research was to improve organisations’ awareness of equity standards that are not focused on specific groups, but on all contributing factors that put vulnerable groups at risk of exclusion. The specific objective was to evaluate the degree of compliance with a set of equity standards in 52 health care organisations from 16 countries.

Methods
A self-assessment tool (SAT) was developed to allow healthcare organisations to measure their capacity to provide equitable care for service users. The SAT indicates the main areas that should be addressed: equity in policy; equitable access and utilisation; equitable quality of care; equity in participation; promoting equity. A cross-sectional survey addressing participants from pilot-organisations was used for data collection, concerning both the self-reported compliance score with the standards, as well as the additional information provided to support the score assigned. Data were analysed quantitatively as well as qualitatively.

Results
The findings confirm that healthcare providers do invest in improving equity in the access and delivery of services to vulnerable groups. However, many health organisations have inadequate strategies to address inequities and are insufficiently engaged in improving equity in participation and promoting equity outside the organisation.

Conclusions
The participating organisations reported a significant impact from use of the self-assessment tool: some received the support from regional/national authorities to continue working on improving equity in healthcare; others linked the equity standards to existing performance-measurement strategies; others invested in new frameworks to improve service users engagement.

Key messages
The implementation of the SAT contributes to a self-reflective process, involving health professionals and managers, in which gaps and potential improvements are identified. Pilot organisations utilised the SAT as part of a process of increasing their awareness of equity issues and changing their organisational culture.
Pre-exposure prophylaxis in a sexual health clinic for Men who Have Sex with Men in Portugal
Authors: Ribeiro S , Rocha M 
Published: November 2019

Abstract

Background
Pre-exposure prophylaxis (PrEP) is defined as the use of antiretroviral drugs to prevent HIV acquisition in uninfected individuals. Recognizing the increasing use of informal PrEP in Portugal, CheckpointLX, a community clinic targeted for MSM in Lisbon, Portugal, began offering counselling and follow-up services prior to formal introduction. This study aims to characterize PrEP users attending CheckpointLX before formal PrEP introduction in Portugal, and those who were referred to PrEP in the National Health Service (NHS) following formal approval of PrEP.

Methods
Data was collected by peer counsellors between May 2015 and September 2018 and inserted in a database. Medical care followed EACS recommendations for PrEP eligibility, initiation and follow up. For formal PrEP, the General-Directorate for Health’s PrEP guidelines checklist was used.

Results
Until the end of May 2018, CheckpointLX had a total of 90 appointments for Wild PrEP, of which 64 (71%) were first time visits. As for the 380 service users referred to the NHS, most were Portuguese (N = 318, 84%), and the mean age was 31 (8.9) years old. Condomless sex in the last six months with partners of unknown HIV status was the most common eligibility criteria (N = 59, 83%).

Conclusions
PrEP delivery should be complemented with effective information on the importance of immunization and education on safer practices of drug administration, in the scope of broader preventive sexual health care. Much remains to be done in Portugal to ensure that PrEP is available to those who need it the most. Offering PrEP at community clinics could be a first step.

Key messages
Condomless sex in the last six months with partners of unknown HIV status was the most common eligibility criteria for PrEP. PrEP delivery should be complemented with effective information on the importance of immunization and education on safer practices of drug administration.
Trough community mobilization to better health for all Balkan’s Roma
Authors: Bikovski Z 
Published: November 2019

Abstract

Issue
The Roma community in all Balkan countries faces a lot of barriers in the implementation of their health right. They face inequalities in healthcare, prejudices, stereotypes and informal payments, charged by health professionals. They also have lack of access to information about ongoing changes in the health sector. Because of lack of education, poverty or some traditional barriers, Roma usually delay on Doctors treatment or improperly used a medical therapy. Roma community also faced and with populism activities related to them who exist just on the paper, without implementation.

Description of the problem
Implementation of Methodology, Social accountability and Legal Empowerment” give visible results in improving Health rights of Roma community in Macedonia. In the last three years NGOs KHAM and ESE providing mentorship to the Roma NGOs in Romania and Bulgaria. Role of the NGOs is to created power balance between Roma community and Health Authorities, and addressing problems from local to national level. Trough Legal Empowerment community learn their rights, and trough Social accountability they demand there rights and looking for changes. After three years of work we have visible results and Roma movement for health rights in Balkan region.

Results
Good practices from Macedonia was in Bulgaria and in Romania. Roma communities from Romania have progress in field of immunization of children and prenatal and antinatal care.In Bulgaria we have progress in early child development. For the very first time, Roma community sat together with Policy makers and with the arguments negotiated for better health. Details will be presented at the Conference.

Lessons
Mentoring is excellent tool for sharing the good practice between NGOs where similarities are obvious. In fact, by acting together, more pressure can be placed on the authorities to bring better policies for Roma in the region.

Key messages
Knowledge is power. Only legally strengthened communities that collaborate with each other can make changes for themselves.
The clusters and frequencies of adverse social conditions amongst the homeless people
Authors: Mabhala M 
Published: November 2019

Abstract

Background
A growing body of evidence identifies interconnected social indicators that can lead to homelessness. Several studies identify a catalogue of social disadvantages that starts from childhood and persist throughout the life course that leads to homelessness. Qualitative evidence indicates that their adverse childhood experiences(ACEs) and damage that occurred to them as children had major influences on their ability to negotiate their way through the education system, gain and sustain employment, make appropriate choices of social networks, and form and maintain healthy relationships as adults. However, very little research seeks to objectively investigate these issues. This study aims to use the cross-sectional study to document the cluster and frequency of adverse social conditions amongst the homeless people in North West England in 2019.

Methods
The study design was cross-sectional. We used IBM SPSS 21, with a significance level set at p &lt; 0.05, CI 95% to analyse the data.

Results
The mean age was 39.12, range 21-64, 90.5% male. 52%(χ2= 33.4, df = 1, p = 0.001) described their health as poor, 90% (χ2= 61.85, df = 2, p = 0.001) smoked cigarette daily, 83.3% (χ2= 76.4, df = 3, p = 0.001) used drugs daily, 78.6% (χ2= 13.7, df = 1, p = 0.001) saw a doctor in preceding 6 months,
63.4% (χ2= 73.8, df = 3, p = 0.001) left school before age 16; 26.2% (χ2= 37.7, df = 3, p = 0.001) left school at 16, 11.9% (χ2= 33.1, df = 10, p = 0.001) encounterd criminal justice system at the age of 11, 28.6% (χ2= 60.8, df = 8, p = 0.001) had reprimand/caution or conviction at 17.
ACES: 57% (χ2= 34.7, df = 3, p = 0.001) experienced humiliation by adults in their household; 54% (χ2= 30.7, df = 3, p = 0.001) threatening behaviour, 50% (χ2= 26.0, df = 3, p = 0.001) physical violence in their household.

Conclusions
These early stage preliminary results indicate that adverse social circumstances that occur in childhood are disproportionately represented in homeless population.

Key messages
Homelessness is more complex than the absence of accomodation. Adverse social circumstances that occur in childhood are disproportionately represented in homeless population.