bluuebunny/crossref_metadata_2025_split huggingface dataset:
Life course socioeconomic conditions, multimorbidity and polypharmacy in older adults
Authors: Jungo K T , Cheval B , Sieber S , van der Linden B W A , Ihle A , Carmeli C , Chiolero A , Streit S , Cullati S 
Published: October 2020

Abstract
Many older adults have multiple chronic conditions (multimorbidity). With multimorbidity often comes the concurrent intake of multiple medications (polypharmacy). Our aims were to assess if childhood socioeconomic conditions (CSC) are associated with multimorbidity and polypharmacy in older adults, and how these associations change when adjusting for adulthood socioeconomic conditions (ASC).
We used data from the European longitudinal Survey of Health, Ageing, and Retirement (SHARE), which follows individuals aged 50 years and over in 27 countries since 2004. We analysed data from 35,229 individuals with multimorbidity (mean age: women=64.1, men=65.4) and 20,757 individuals with polypharmacy (mean age: women=69.2, men=70.2). Multimorbidity was defined as 2 or more self-reported chronic conditions and polypharmacy as the intake of 5 or more medications. Confounder-adjusted multilevel logistic regression models were used to analyse associations of CSC (5 categories: most disadvantaged-most advantaged) and ASC with multimorbidity and polypharmacy. All analyses were adjusted for country, age, weight, alcohol consumption, smoking status and physical exercise. In addition, we adjusted the polypharmacy model with the number of chronic conditions, mental health, activities of daily living and living situation. We stratified the analyses by sex.
34% of women had multimorbidity and 26% received polypharmacy. In men, these percentages were 34% and 28%. All categories of CSC (except for disadvantaged CSC in men) were associated with multimorbidity. In both sexes, a higher advantage was associated with lower odds of multimorbidity. In women, advantaged and most advantaged CSC were associated with lower odds of polypharmacy (OR = 0.53, 95% CI 0.31-0.89; OR = 0.48, 95% CI 0.24-0.94). In men, CSC were not associated with polypharmacy. ASC attenuated the association of CSC with multimorbidity among women, but CSC remained associated. In men, CSC were attenuated after adjusting for ASC.

Key messages
Lower childhood socioeconomic conditions increase the odds of having multiple chronic conditions in older adults. In women, the odds of polypharmacy are marginally linked with CSC. Less disadvantaged socioeconomic conditions in adulthood may allow for compensating a more disadvantaged start in life, particularly in men.
Results of process evaluation of the Unplugged school-based prevention program in Nigeria
Authors: Vigna-Taglianti F , Emelurumonye I N , Donati L , Alesina M , Akanidomo I , Pwajok J , Prichard G , van der Kreeft P , Virk H K , the Unplugged Nigeria Coordination Group  
Published: October 2020

Abstract

Background
The UNODC with the collaboration of the Government implemented in Nigeria a large-scale project to promote healthy lifestyles in schools, families and communities. Within the project, the prevention program Unplugged was tested through a randomized controlled trial. This study aims to evaluate the implementation of the program in the intervention schools and the satisfaction of teachers and students.

Methods
32 schools were randomly extracted from a list of 60 schools provided by the Federal Ministry of Education. 16 schools were randomly allocated to intervention and implemented Unplugged. To monitor program implementation, the teachers filled a form reporting data on fidelity of implementation. To monitor satisfaction, teachers and students filled an anonymous form at the end of the program.

Results
69% of intervention schools participated in the process evaluation. The duration of the units was on average 55 min. The implementation rate was very high. All classes implemented six units whilst less than 10% did not implement the other six units. The highest rate of not implementing classes was observed for unit 11 and 12. The highest student interest as declared by the teachers was observed for Unit 1 and 8, the highest interactivity for Unit 9 and 8. Most teachers found the units easy to lead and referred an improvement of teaching skills, knowledge about substances, relationship with the students and class climate, and found very useful the Teacher Handbook. Ninety percent of students considered Unplugged useful for their choices, for 82% it improved the vision of themselves, for 95% their knowledge, for 80% the relationship with mates and for 77% the relationship with teachers. 97.5% of students would like to have a similar program next year.

Conclusions
Unplugged reached in Nigeria very good results in terms of implementation and satisfaction of teachers and students. Process evaluation is useful to improve the quality of prevention interventions.

Key messages
School based prevention interventions like Unplugged can be successfully implemented in low income countries, especially when supported by printed Handbook for teachers. Teachers and students participating in Unplugged perceived an improvement of class climate and relationship between teachers and students due to the program.
Schools health promotion among adolescents in Northern Nigeria
Authors: Smith L , Sarki A , Onukwugha F , Magadi M 
Published: October 2020

Abstract

Background
Jigawa and Kano States, Northern Nigeria have some of the worst human development outcomes globally for adolescents across a wide range of health indicators. Our aim was to understand health awareness, beliefs, and behaviours of adolescents in school in Jigawa and Kano States, to inform prioritization and development of health promotion interventions in the region.

Methods
We carried out a cross-sectional survey followed by focus group discussions (FGDs) with adolescents aged 15 to 20 years from four schools in Jigawa and Kano States (July-August 2019). Adolescents (274 per school) were randomly selected stratified by class-year (SS1 and SS2); 64 participated in FGDs (8 groups of 8). Trained researchers administered a questionnaire face-to-face via smart phones. Topics included: mental health; tobacco use; substance misuse; violence and unintentional injury; physical and dietary behaviours; and hygiene. FGDs investigated topics in greater depth. Here we report prevalence and predictors of mental health calculated from survey responses, and thematic analysis of interview findings.

Results
One thousand and seventy-nine students completed the survey (98%);∼50% girls. Preliminary analysis showed prevalence of moderate-severe anxiety was higher in girls than boys (6.8% girls, 0.8% boys, p &lt; 0.001); and moderate-severe depression (10.3% girls, 0.5% boys, p &lt; 0.001). Up to 50% boys and girls experienced violence or abuse in school, and 16% used a prescription drug without a prescription in past 30 days. Multivariable logistic regression showed female gender (aOR =4.0, 95% CI; 2.7,6.0); 30-day off-prescription drug use - aOR=2.3 (1.5,3.8); and being hit or slapped by a teacher - aOR=1.7, (1.1, 2.6) were predictors of moderate to severe anxiety. Results were similar for moderate to severe depression. Qualitative findings supported and contextualized these results.

Conclusions
Results will inform school-based interventions to improve health of adolescents in the region.

Key messages
Administering a health questionnaire to gather health information of adolescents in school in Kano and Jigawa states, Nigeria was feasible. Health questionnaire and focus group data will be shared with school and community leaders to shape school-based interventions to improve health outcomes amongst adolescents.
When merging two international surveys (HBSC/ESPAD) leads to better monitoring at national level
Authors: Godeau E , Spilka S , Ehlinger V , Philippon A , Lenezet O 
Published: October 2020

Abstract
In France, since 1994, adolescents' substance use was measured among 11-13-15 year-olds with the Health Behavior in School-aged Children (HBSC) & among 16-year-olds with the European School Project on Alcohol and other Drugs (ESPAD). Since 2018, with EnCLASS, (National Survey in Middle- and High-school for Adolescents on Health and Substances), France conducts those 2 surveys in a unified way across middle- & high-school, improving the monitoring of health behaviours, substance use included throughout adolescence at national level, while ensuring optimum comparability internationally. Our paper will summarise substance use by secondary students in France with a focus on preventive interventions on substances organised in class. Data collected in 2018 in 1137 classes; nationally representative sample of 20 128 secondary-school students (grade 6-12); confidential & anonymous online self-questionnaire. Schools, parents & students could refuse to participate. Inclusion rate: 74%. Secondary school is the main period where alcohol, tobacco & cannabis are experimented. With subsequent timing: Alcohol, mainly initiated during middle school, is still the first substance used during adolescence, followed by tobacco. The consumption of cannabis tends to begin at the end of middle school, with experimentation & use developing & strengthening during high school. Overall, 10% of 6th grade students report having had an intervention on substance use, up to half in 9th grade. Regarding speakers, 1/2 report external experts, 1/3 teachers & 1/4 school nurses. It seems that alcohol, tobacco & cannabis are discussed at the same occasion. Such findings show a rather good coherence between school intervention & prevalence of substance use EnCLASS by merging HBSC & ESPAD ensures an excellent comparability of data internationally while providing a strong national monitoring of French adolescents' substance use throughout secondary school.
Factors associated to uncontrolled hypertension in Brazilian adults: National Health Survey
Authors: Vieira M A , Felisbino-Mendes M , Velásquez-Meléndez J G 
Published: October 2020

Abstract

Background
Hypertension is the main risk factor for cardiovascular diseases, contributing significantly to the increase in the number of deaths and disabilities worldwide. Moreover, hypertension control is a major action for NCDs prevention. Although pharmacological treatment has been shown effective, high rates of uncontrolled hypertension remain. The objective is to estimate the prevalence of uncontrolled arterial hypertension and the factors associated to this outcome in a representative adult Brazilian population under a pharmacological treatment.

Methods
This is a cross-sectional study conducted with 10,016 Brazilian adults over 18 years old who participated in the National Health Survey in Brazil carried-out in 2013. The sample comprised of residents from all Federative Units, Poisson multivariate regression was used to calculate the prevalence ratio (PR) and 95% confidence interval.

Results
45% (95% CI: 44; 48) of hypertensive adults under drug treatment have uncontrolled blood pressure levels. Female gender [PR = 0.92; CI: 0.85; 0.99] and not having previous hospitalizations due to complications from hypertension or other causes [PR = 0.86; CI: 0.78; 0.94] were associated to low the prevalence of uncontrolled blood pressure. Participants aged 60 years old or more [PR = 1.31; CI:1.04; 1.64], who self-declared as black [PR = 1.19; CI: 1.04; 1.36], without health insurance [PR = 1.15; CI: 1.05; 1.27] and not attending the health service because of arterial hypertension [PR = 1.10; CI:1.01; 1.20)] presented higher prevalence of uncontrolled blood pressure.

Conclusions
The prevalence of uncontrolled hypertension among Brazilian adults was high among the male gender, black people, elderly, without previous hospitalizations, without health insurance and not regularly attending the health service. These results may alert the need for a reassessment of the assistance provided, in addition to raising awareness of a possible change in public policies in these groups.

Key messages
Evidence the magnitude of people who are at risk of hypertension even under pharmacological treatment. Highlight inequities related to the uncontrol of hypertension.
Behavioural risk factors in university students in Bucaramanga, Colombia
Authors: Martinez-Rueda R , Camacho M A , Díaz I J 
Published: October 2020

Abstract

Background
The changes generated in the studentś lifestyle due to the academic demands, may favour the prevalence of risk factors for non-communicable diseases as well as compromise other domains of their life. The purpose of this study was to establish the prevalence of behavioural risk factors in students of the Professional in Physical Activity and Sports program of a University in Bucaramanga, Colombia.

Methods
A cross-sectional study with a sample of 189 students was conducted. The students were surveyed with the first step of the STEPs questionnaire, which evaluates the behavioural risk factors for non-communicable diseases. A descriptive data analysis was performed, and Pearson tests were applied to determine the correlation between the analysed variables with a level of significance α = 0.05 using STATA 13.0.

Results
80% of the participants were men. The age average was 22.7 ± 3.85 years. Regarding tobacco use, 10.1% of the participants were current smokers, while 30% smoked before. The majority of the participants (92.2%) have consumed alcohol within the past 12 months, while 69.8% consumed alcohol within the last month, with 8.7% of hazardous drinking. Concerning the diet, only 24.9% met the recommended consumption of fruits and vegetables per day. When assessing physical activity levels, only 6.3% were classified as physically inactive. Additionally, an average of 6 hours of sedentary behaviour was found, with 31.2% of excessive sedentary time. A weak correlation was found between age and academic cycle with the amount of physical activity at work (r = 0.24), (r = 0.18) and with sedentary time (r = -0.28), (-0, 32).

Conclusions
Although the prevalence of tobacco consumption was slightly higher than the national average, the students showed a lower prevalence of behavioural risk factors than the general population. However, it is necessary to promote strategies aimed at the control and prevention of these risk factors.

Key messages
Being a student of a program focused on physical activity and sport, can behave as a protective factor against the most prevalent risk factors in university life. It is necessary to implement more strategies centred on making students aware of the importance of the maintenance and improvement of their lifestyles in accordance with their professional profile.
Nationwide health check program by patients with severe mental illness or long-term antidepressants
Authors: Garriga C , Robson J , Coupland C , Lay-Flurrie S , Hippisley-Cox J 
Published: October 2020

Abstract

Background
The English NHS Health Check is a unique national risk assessment, awareness and management programme for preventing cardiovascular disease (CVD), diabetes and chronic kidney disease (CKD). We aimed to assess their uptake and association with new diagnoses (CVD, hypertension, type-2 diabetes and CKD) in patients with severe mental illness (SMI) compared to patients without this condition and for patients on long-term antidepressant treatment (LTAD) (≥6 prescriptions vs &lt; 6).

Methods
Cohort study (2013-2017) using the QResearch database. 1,319 general practices across England contributed of over nine million patients aged 40-74 years. 3,492,186 patients were eligible for NHS Health Checks of which 590,218 attended. Outcomes: hazard ratios (HR) with 95% confidence intervals (CI) for uptake of NHS Health Checks and for new diagnoses within 1 year in attendees. Models were adjusted for sex, age, ethnicity, deprivation and region.

Results
65,490 people with SMI and 46,437 people on LTAD (20% of the total eligible with SMI/LTAD, respectively) attended an NHS Health Check. People with SMI or on LTAD were more likely to attend compared to people without those conditions, adjusted HRs 1.05 (95% CI 1.02-1.08) and 1.10 (95% CI 1.08-1.13), respectively. Among attendees, people with SMI and on LTAD were 23% and 55% more likely to be diagnosed with CKD (95% CI 1.12-1.34 and 1.42-1.70, respectively) than people without these conditions. Attendees on LTAD were 66% more likely to have a major CVD event within 1 year than those without LTAD (95% CI 1.41-1.94) or a new diagnosis of hypertension and type 2 diabetes, HRs 1.12 (95% CI 1.05-1.20) and 1.45 (95% CI 1.31-1.60), respectively.

Conclusions
People with SMI or on LTAD were more likely to attend NHS Health Checks than people without these conditions. Higher rates of CKD in patients with SMI/LTAD and CVD, hypertension and type 2 diabetes in the latter might indicate increased risks and unmet need in these patient groups

Key messages
People with SMI/LTAD were more likely to attend NHS Health Checks. People on LTAD were more likely to be diagnosed with CVD, CKD, hypertension and type-2 diabetes than people without these conditions. SMI attendees were more likely to be diagnosed with CKD.
The health and economic burden of antimicrobial resistance
Authors: Ait Ouakrim D , Cassini A , Cecchini M , Plauchoras D 
Published: October 2020

Abstract
Antimicrobial resistance (AMR) has profound consequences for the treatment of infections. By limiting treatment options, it often makes it necessary to resort to antibiotics with a broader spectrum of action some of which are potentially less effective or safe than narrow-spectrum antibiotics. This limitation in our ability to treat infections effectively has an impact on health care budgets but also broader and potentially disastrous consequences on a variety of economic sectors. This presentation provides an overview of the health and economic burden of AMR. It first presents the current state of knowledge on the epidemiology of AMR and discusses the main analytical challenges in determining the current and long-term effects of resistance on populations in terms of morbidity, mortality, and length of hospital stay. In addition, a summary of the current literature on the economic impact of AMR is provided along with a detailed discussion of the characteristics and limitations of existing economic models. Finally, it identifies the main knowledge gaps and suggests avenues for future research and approaches to address them.
Integrating qualitative and quantitative content analysis for assessing and improving evaluability
Authors: Reed E 
Published: October 2020

Abstract
The second presentation will cover integrating qualitative and quantitative content analysis for addressing 'why' and 'how' as well as 'what' questions relating to monitoring and assessing interim and instrumental outcomes achieved or not achieved in public health initiatives and programs. Steps for developing meaningful scoring systems for synthesizing the review of multiple types of documents will be described. Examples will be given from global health engagement projects with the development or strengthening of partnerships as a key objective. Using document review as a management tool in integrating strategic planning, monitoring, and evaluation will be discussed, as a way of assessing the gaps between planning and evaluation and strengthening their relationship.
Illuminating (digital) health literacy practices using applied linguistics
Authors: Harsch S , Bittlingmayer U 
Published: October 2020

Abstract

Background
Health literacy (HL) is key to making well-informed health decision in analogous and virtual social situations and organizational contexts. Multiple models and instruments of HL exist, but an in-depth understanding of the various HL-related everyday life situations and their digital and linguistic requirements are scarce. Here, the expertise of second language courses (SLC) can be of great value as they support newcomers acquiring the necessary skills for everyday communication, including health. In the project SCURA, funded by the German Federal Ministry for Education and Research, we explored the German SLC, attended by 2.1 million migrants and refugees since 2005, and developed interventions to promote HL in it. The aim is to understand what everyday situations require (digital) HL skills, what characterizes them and what can we learn for HL models and interventions.

Methods
We conducted a qualitative content analysis (Bowen 2009) of the 8 newest, approved German second language textbooks series, identified all tasks related to HL, analyzed the situation, topic, language skills, analogue/digital and HL dimension and compared the findings with the HLS-EU conceptual model of HL.

Results
We identified 180 HL-related communication situations, including 33 tasks related to digital HL. Compared to the HLS-EU conceptual model, the HL activities in SLC reveal a broad understanding of HL including physical, mental and social aspects of HL, linguistic, cultural and digital skills and even critical HL. 5 HL-related dimensions emerged: communication for health, health literacy, health knowledge, health behaviour and life-skills. The differentiation and activities can help to develop further models and interventions that target specific situations requiring digital HL more effectively.

Conclusions
The analysis of the SLC curricula specified the various (digital) HL-related everyday life situations and! the differentiated model helps to develop promising interventions.
Beyond gender to intersectionality in NCD policy
Authors: Hankivsky O 
Published: October 2020

Abstract
Olena Hankivsky, PhD (School of Population and Global Health, University of Melbourne) will present an analysis of key policy shifts in the NCDs field internationally, which reflect more nuanced thinking about gender, and the explicit recognition that gender intersects with other factors. She will outline key issues that need to be addressed for further movement to be made on the intersectionality front including clarification of the similarities and differences between gender mainstreaming and intersectionality and how to accurately apply intersectionality in the analysis of NCDs. The presentation will include suggestions and research and policy strategies for how to addressing operational challenges and advance intersectionality in the context of NCDs related policies and how to draw on intersectionality to improve the development of comprehensive multi-sectoral approaches to national and international NCD policies.