bluuebunny/crossref_metadata_2025_split huggingface dataset:
Family physicians’ barriers to addressing patients smoking: cross-sectional data from 2002 and 2014
Authors: Põld M , Pärna K 
Published: October 2020

Abstract

Background
Family physicians have an excellent opportunity at primary health care level to influence patients' smoking behavior. Routine screening of all patients for tobacco use is recommended. The objective of the present study was to explore factors related to addressing patients' smoking habits among FPs.

Methods
Two postal cross-sectional surveys were conducted among the sample of all practicing physicians in Estonia (n = 4140 in 2002, n = 5666 in 2014). Questionnaires of under 65-year-old FPs were included (n = 473 in 2002, n = 468 in 2014). Frequency of addressing patients' smoking habits and agreement with statements concerning perceived barriers, along with confidence intervals (CI) were calculated. Associations of addressing patients' smoking habits at least once during last 7 days with perceived barriers were calculated using logistic regression analysis. Fully adjusted odds ratios (OR) were determined with corresponding 95% (CI).

Results
The prevalence of addressing patients' smoking at least once during last 7 days was 96.4% (95% CI 94.2-98.7) in 2002 and 97.1% (95% CI 95.0-99.1) in 2014. FPs who agreed that lack of time is a barrier to addressing patients' smoking, were significantly more likely to address patients' smoking (OR 3.53; 95% CI 1.36-9.16) compared to FPs who did not agree with the statement. FPs who agreed that lack of habit is a barrier, were significantly less likely to address patients' smoking (OR 0.14; 95% CI 0.06-0.34) compared to FPs who did not agree. FPs smoking status was not significantly associated with addressing patients' smoking.

Conclusions
Majority of family physicians addressed patients' smoking habits. Addressing patients' smoking habits was significantly associated with agreeing that lack of time and lack of habit is a barrier to addressing patients' smoking. Results of the present study are useful for policymakers and other institutions involved in organization and development of smoking prevention training and cessation services.

Key messages
Majority of family physicians addressed patients’ smoking. Addressing patients’ smoking was significantly associated with lack of time and lack of habit as barriers to addressing patients’ smoking. Smoking prevention training and organization of cessation services would further enable family physicians to routinely address patients’ smoking habits.
Comparing quality of care using patient-reported outcomes in patients with localized prostate cancer
Authors: Kowalski C , Sibert N , Breidenbach C , Feick G , Carl G , Roth R , Dieng S , Wesselmann S , Burchardt M , Fichtner J 
Published: October 2020

Abstract

Introduction
The Prostate Cancer Outcomes (PCO) study, funded by the Movember Foundation, has been recruiting patients in prostate cancer centers in Germany, Austria and Switzerland certified by the German Cancer Society (DKG) since July 2016. It is a joint project of the Federal Prostate Cancer Self-Help Association (BPS), DKG, OnkoZert and meanwhile over 100 participating centers. The aim of the study is to compare the outcome quality between the centers for mutual learning and to use patient-specific evaluations for treatment planning.

Materials and Methods
The protocol was set up according to the International Consortium for Health Outcomes Measurement (ICHOM) Standard Data Set with patients filling out the EPIC-26 before and at least once (after 12 months) after treatment. The EPIC-26 includes the functional outcome domains 'incontinence', 'irritative / obstructive', 'gastrointestinal', 'sexuality', and 'hormonal “. Questionnaire data are linked to disease and treatment data in the centers. The EPIC-26 domain scores are then analyzed centrally to provide case mix adjusted center comparisons stratified by treatment.

Results
As of May 2019, 11,303 patients were recruited the PCO study. For 3,953 of them, results of the follow-up survey after 12 months were available for analysis. The results show changes in the scores similar (e.g. an adjusted decrease in the incontinence domain by 15 points for patients receiving radical prostatectomy) to what was known from the international literature 12 months after primary therapy. Results vary significantly between the centers, suggesting differences between providers that warrant improvement interventions.

Conclusions
The results are used to develop strategies for improvement together with providers and patients and to implement patient-specific evaluations for treatment planning in everyday treatment.

Key messages
A patient-reported outcome routine was successfully implemented in over 100 prostate cancer units in central Europe adopting the same data infrastructure. Benchmarking results demonstrate meaningfully differences across units that warrant improvement interventions.
A coprological survey of zoonotic tapeworm Bertiella spp. in free living nonhuman primate in Brazil
Authors: Tietz Marques S , Meyer J , Meller Alievi M 
Published: October 2020

Abstract

Background
Bertiella genus is parasitic tapeworms of non-human primates in nature. B. studeri and B. mucronata have been identified in children and adults with some contact or association with non-human primates. This study aimed to identify zoonotic tapeworms of the genus Bertiella in stool samples from Alouatta guariba clamitans, a primate from the New World, living free in a human community.

Methods
The study of Bertiella spp. comprised a coprological survey of feces collected from 131 brown howler monkeys, male and female, infant and adult, from free-living troops in nine neighborhoods in southern Porto Alegre, including places with increasing anthropization and population pressure, and an estimated population of 83,312 inhabitants. The study lasted four years (2015 to 2018), with stool samples collected from primates under care at the Centre for Wildlife Rehabilitation and Conservation of the Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, Brazil. As per usual protocol, all wild animals treated at the Center undergo parasitological examination. Individual freshly collected samples were subjected to the Willis-Mollay method and the Lutz technique.

Results
The average prevalence of Bertiella spp. was 31.3% (41/131). The annual frequencies were 27.3% (6/22), 30% (11/37), 25% (5/20) and 36.5% (19/52), respectively for the years 2015, 2016, 2017 and 2018.

Conclusions
The results demonstrate that Bertiella spp. was present in parasitic fauna over the four years studied and represents a zoonotic potential. Therefore, these methods should be carried out routinely, as they help in the appropriate treatment when necessary. The control and the prevention of this zoonosis are difficult since the intermediate hosts are cosmopolitan. It is suggested that an epidemiological inquiry in humans be performed to ascertain the true prevalence of this parasitosis.

Key messages
Create a schedule of routine test with underserved populations to monitor zoonoses. Poor communities need to be included in government programs.
Valorising Public Health activities, a regional shared Methodology: Final Products 2017-20, Italy
Authors: Smaniotto C , Del Bianco F , Bolzonello C , Bomben L , Candela G , Caffieri C , Oppi C , Campanale C , Cinquini L , Brusaferro S 
Published: October 2020

Abstract

Issue
Italian Public Health services still lack adequate measuring systems for effectiveness and sustainability, as well as standard definitions for many Public Health activities (PHA), meaning a shortage of data reflecting performance and generation of value. Within the Friuli Venezia Giulia region, the Final Products (FP) project created a process-based management system for PHA to support scheduling, allocation of resources and the assessment of quality and appropriateness.

Description of the Problem
From June 2017 to October 2018, 68 Public Health professionals (PHP) from 10 Public Health areas composed flowcharts and dossiers for 102 processes (named FP). Within each of them, they traced and collected PHA in a regional glossary of 184 items, providing standard definitions for them. A Committee of 18 PHP from the original team validated the system to perform from June to July 2019 a valorisation phase, in which all regional PHP were asked to valorise PHA through a matrix-based assessment in terms of personnel involved and time required.

Results
Valorisation was performed by 445/557 PHP (80%). Data were analysed both as a regional output and as grouped for Public Health district, allowing comparative assessments. A Summary Document (SD) for each FP was created, tabulating time and personnel data. SDs will be returned to the Committee in 7 regional meetings (February-October 2020), one for each Basic Healthcare Levels (A-G) category, and a wrap-up document will be presented to regional policymakers in November 2020.

Lessons
The project allowed the region to acquire a document summarising process standards for PHA. Mapping and standardising processes while framing the current organisational set-up defined more clearly the role of all PHP within Departments of Prevention to add value to each professional figure. Time quantification, especially, showed different approaches to PHA and processes among different regional Public Health settings.

Key messages
Process management can be successfully used to identify current specific issues in Public Health activities, in order to implement solutions based on a shared methodology and reliable data. Departments of Prevention can make output assessments easier and better structured through the application of process analysis and managerial competencies.
Hospital-territory integration: the role of the Integrated Access Point service of Udine
Authors: d'Angelo M , Panzera A , Favro R , Paulin G , Innocente A , Roncastri F , Vinicio S , Moimas D , Canciani L 
Published: October 2020

Abstract

Background
The Integrated Access Point (PUI) is a service of the district of Udine, of the then University Health Agency (ASUI-Ud), which guarantees access to local health services for patients reported with a protected discharge path. The following study aims to evaluate the progress of the reports taken in charge from January to August 2019.

Methods
The reports were analyzed according to age (mean; standard deviation) and gender (M; F) of the patients; reporting date both 24 hours (h) from entering the ward and 72 h from discharge; hospital transfer, discharge with or without activation of home care services; transfer to intermediate care facilities (RSA) and evaluation date (UVM), nursing home (CDR) or Hospice (HO). The study also includes protected discharge with: non-dischargeable patient, no service provided and more. The data was extracted and analyzed with the Business Object XI program and Microsoft Excel.

Results
From January to August 2019, 24 hour reports were processed by the PUI relating to 2223 patients: 45.8% of these were M (74.8; 14.2); the remaining 54.2% instead of F (79.8; 12.8). The greater proportion of reports was also accompanied by the reporting form at 72 h 88.5%. Territorial services were activated as follows: home care services (ADI) for 42.1%, HO (2%), CDR (1.3%) and RSA (19.1%). The percentage of UVM is 22.6%; those concerning the remaining categories are respectively 10.5% (no service), 5% (other). Finally, by evaluating the monthly trend of the processings, it emerges that 27.1% of these refer to reports from the winter months (from January to February).

Conclusions
The higher volumes of the activities of the Integrated Access Point (PUI) were reported in the first two months of the investigation period. The service represents a strategic hub: ensuring continuity of care for most patients reported with protected discharge, allows for integration between hospital and local care.

Key messages
The Integrated Access Point (PUI) guarantees the continuity of care for most patients reported with protected discharge. The major volume of the activities of the Integrated Access Point (PUI) were reported during the winter months of the investigation period.
Descriptive analyse of a case control study in Portugal: identify to prevent
Authors: Braz P , Machado A , Santos J , Lacerda C , Didellet C , Dias C M , Group H W 
Published: October 2020

Abstract

Background
Prenatal exposure to environmental risk factors are one of the known causes of congenital anomalies (CA). In 2015, a cluster of anorectal anomalies, a rare malformation, in Setúbal district raised interest in researchers. The aim of study was to assess the impact of prenatal exposure of the mothers on the occurrence of CA in the offspring.

Methods
A Case-control study (1:2) was implemented between 2016-2019. Newborns with CA (cases) and newborns without CA (controls) are identified and recruited. Parents were personally interviewed by a health professional using a standardized questionnaire. A descriptive analyses was performed and cases and controls were described based on maternal residence during pregnancy. Chi-square test was used to compare cases and controls.

Results
97 cases and 194 controls were identified. There was a male predominance in the case group (60 vs. 34) and no difference in gestational age between case and control groups. The mean birth weight was similar (3115g in cases vs. 3221g in controls). There was no difference related to mean mother's age nor the presence of maternal chronic disease. Smoking had more expression in the case group (21,2% vs. 16,3%). Moita (37,8%) is the municipality with higher frequency of cases. Musculoskeletal anomalies were the most frequent (35.4%), followed by genital (22.2%) and other anomalies (11%). During the study period, five cases with anorectal anomalies were reported, 4 of them born at 2016 and in 3 the mothers residence place was Moita.

Conclusions
In this study, the high proportion of cases from Moita suggests a possible environmental exposure to a teratogenic agent. Also smoking during pregnancy could be a high risk to anorectal anomalies, as suggested in other studies. More investment in public health measures could protect population from harmful environments.

Key messages
Pprenatal exposure to environemental risk factors increase the risk of congenital anomalies. Mothers residence and place of work could be a risk factor to pregnancy.
Expenditure trends in ambulatory care sensitive conditions in Piauí, Brazil, 2009 a 2018
Authors: Sousa R , Silva F , Silva R , Santos R , Justino A , Cardoso T , Cardoso O 
Published: October 2020

Abstract

Introduction
Hospitalizations for ambulatory care sensitive conditions (ACSC) are an indicator that assesses the effectiveness of Primary Health Care. Such hospitalizations burden the public health budget and use the resources that could subsidize other health actions.

Aim
Analyze expenditure trends in hospitalizations for Ambulatory Care Sensitive Conditions (ACSC) in Piauí, Brazil, from 2009 to 2018.

Methods
Ecological time-series study based on data from the Hospital Information System (SIH). For temporal trend analysis, a linear regression model was built using the Stata version 14 program.

Results
US$ 119,559,009.56 (Average = US$ 6,292,579.45/year) was spent on ACSC, representing 17.3% of the total hospitalizations (US$ 690,714,037.24). 2010 was the period with the highest cost (14.8%). In contrast, 2018 was the year with the lowest expenditure (5.8%). 23.7% of the costs went to hospitalizations for gastroenteritis. There was a significant decrease in total expenses with ACSC (β = -1.27; 95%CI: -1.65; -0.89; p &lt; 0.001). There was also a reduction in expenses per individual hospitalized, while in 2009, the average expenditure was US$ 230.97/hospitalization, in 2018 it was US$ 157.30/ hospitalization, representing a significant reduction of 31.9%, (β = -12.4; 95%CI: -18.2; -6.6; p = 0.001). The “asthma” and “hypertension” groups showed the greatest cost reductions, 84.8% and 80.7%, respectively. However, an increase in spending on diseases related to prenatal and childbirth (4.1 times) and skin infection (3.9 times) was identified.

Conclusions
Part of the cost reduction is explained by the reduction of hospitalizations for ACSC. The reduced spending averages are compatible with lower hospitalizations by most expensive groups. Linked to these findings, it is observed that Brazil has faced a period of recession since 2015. To this end, additional research must be carried out to relate the expansion of health coverage with the results presented.

Key messages
The costs of hospitalizations for PHC-sensitive conditions reflect the policy of inducing health system coverage, being lower for greater coverage. The evaluation of the cost of specific groups allows the induction of PHC policies focusing on the specific care for each group with a higher cost so as not to burden the health system.
Evaluation of Access on the perspective of adult users of Primary Health Care in Fortaleza, Brazil
Authors: Borges Costa L , Salles Gazeta Vieira Fernandes C , Custódio Mota T , Torquato Santos E , Moura de Almeida M , Vaudelice Mota M 
Published: October 2020

Abstract
The Alma-Ata Conference promoted Primary Health Care (PHC) worldwide as a form of universal and continuous access to quality and effective health services. In Brazil, PHC, through the Family Health Strategy (FHS), aims to be the gateway to the health system and its structuring axis. For this, it is necessary to promote access, an essential condition for the quality of health care services, following the attributes systematized by Barbara Starfield. The aim of this study was to evaluate the presence of the attribute “First Contact Access” on the perspective of adult users of public PHC services in the city of Fortaleza, Ceará, Brazil. A transversal study was carried out, in 19 PHC Units, from June to December 2019, using the Primary Care Assessment Tool (PCATool) Brazil version for adult users. Kruskal-Wallis test was used for statistical analysis. 233 users participated, mostly women (69.5%), aged 30 to 59 years old (55.3%), mixed-race (69.5%), with complete high school (38.2%), without private health coverage (89.3%), homeowners (68.7%) and belonging to families of up to 4 members (87.9%). The “Accessibility” component had the lowest score, 2.83, and the “Utilization” had the highest score, 8.06. Older age was associated with higher “Accessibility” scores (p = 0,018), while lower values of “Utilization” were associated with higher education (p = 0,004). The main problems observed were: low access for acute demand consultations, lack of access at nighttime and weekends, little access through non-personal ways, bureaucratic barriers and a long time for scheduling appointments. We conclude that, although there was an improvement in PHC coverage in the city over the years, mainly due to FHS, there is still a lot to improve to ensure timely access to health services.

Key messages
Users consider PHC as the usual source of care, demonstrated by the high score of 'Utilization', however, they are unable to use it when necessary, demonstrated by the low score of 'Accessibility'. Expanding forms of access is essential to contribute to the strengthening of PHC in Fortaleza, Brazil, facilitating the entry to its national Universal Health System.
Drinking water quality surveillance for the state health care clinics in the city of Manaus, Brazil
Authors: Menezes M D S , Menezes A C S , Costa C F , Barroso G G S , Oliveira R P , Figueira E A G , Serrao R C S 
Published: October 2020

Abstract

Introduction
Microbial contamination of drinking water is a public health problem due to its pathogenic potential. In Brazil, the MS/GM no.5/2017 ordinance, sets guidelines for monitoring water quality for human consumption (VQACH). The state of Amazonas is part of the Amazon biome as one of the seven states from the north region of Brazil and its capital, Manaus, located in the geographic center in the Amazon is shelter to more than 2.000.000 inhabitants.

Objectives
Evaluate microbiological parameters of water quality in state health care clinics in Manaus.

Methods
In the period between, January 2017 to December 2019 through actions of the Health Surveillance Foundation (FVS) and Amazonas Central Laboratory (LACEN) actions of VQACH were implemented following the current legislation standards. 62 health care clinics were monitored, making a total of 1,715 water samples, which resulted in the same number of microbiological analyzes; the reports issued had their results arranged in monthly and annual tables, allowing a comparative study between the number of samples analyzed and the percentages with absence of total coliforms and satisfactory for Escherichia coli (E.coli).

Results
The VQACH actions, resulted in significant gains in terms of improving water quality in the monitored clinics. The number of samples analyzed in the period increased from 355 to 757 (53%); the average positive index for total coliforms decreased from 28% to 19%; the average satisfactory index for E.coli increased from 93% to 97%, corroborating the result of the actions and strategies that were carried out.

Conclusions
For the period prior to 2017, there are no data released regarding the VQACH of the health care clinics in Manaus. Surveillance actions are an essential measure for restoring water quality. It is suggested to maintain the actions carried out, along with measures of a permanent educational awareness.

Key messages
Measuring the effectiveness of surveillance actions are necessary for water quality control. Vigilance actions are important to reduce morbidity and mortality due to water transmission problems.
Interventions aimed at lowering risk of falling at home in Parkinson's disease: a literature review
Authors: Faggian E , Buzzo G , Gregori D , Martinato M , Reginato E 
Published: October 2020

Abstract

Background
Falls are the most frequent domestic accidents and their impact on subjects' quality of life, healthcare system and potentially serious complications, make their prevention fundamental. 80% of patients with Parkinson's disease fall in their homes, therefore the prevention of falls becomes a priority in caring for these patients. The aim of the study is to identify the evidence relating to home falls prevention interventions in patients with Parkinson's disease.

Methods
A literature review was performed considering articles published between 2000 and 2017 and indexed in PubMed, Cinhal and Cochrane Library. 655 articles were identified and 28 selected and considered for review.

Results
Four macro types of intervention have been identified: environmental and educational interventions, through the preparation of aids, lighting systems, room adaptation, adequate footwear and involvement of caregivers; physical and rehabilitative interventions, through programs of Qigong Baduanjin, Hi-Balance, Tai-Chi, Ai-Chi, vestibular rehabilitation and exercises marked by the metronome; pharmacological interventions, through a continuous infusion system of Rivastigmine or Levodopa; alternative therapies such as vitamin C and Macuna Pruriens.

Conclusions
The available literature points out the effectiveness of multiple interventions in reducing the risk of falling at home for Parkinson's disease patients. To ensure these interventions, a multidisciplinary team management is needed. This approach allows an improvement in the management of the Parkinsonian patient, promoting the maintenance of health and quality of life, preventing complications and optimizing subject's residual abilities and promoting caregivers' involvement.

Key messages
The literature points out the effectiveness of multiple interventions in reducing the risk of falling at home for Parkinson's disease patients. Four macro types of intervention have been identified: environmental and educational, physical and rehabilitative interventions, pharmacological and alternative therapies.