bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experiences and challenges in collecting survey data in an ethnically diverse social housing area
Authors: Nygaard S , Srivarathan A , Mathisen J , Kristiansen M , Lund R 
Published: October 2020

Abstract
Socio-economically disadvantaged groups are characterised by a higher burden of disease than the background population. Paradoxically, they are often underrepresented in health research. Failing to include socio-economically disadvantaged groups in research impairs the ability to address the social mechanisms creating health disparities. The study describes how we have tried to accommodate identified challenges from the literature in conducting a questionnaire survey in a socio-economically deprived and ethnically diverse social housing area, and which new challenges we identified. The survey is planned before, during and after the structural changes take place. Through innovative approaches, we sought to accommodate identified barriers to reaching participants. The questionnaire was translated from Danish to the seven most prevalent languages in the area, based on data from the national register. A survey corps of native speaking interviewers went door-to-door to perform face-to-face interviews. To encourage participation, we used a recruitment strategy inspired by ethnographic data collection traditions, such as local presence, participation in local activities, and graphic facilitation on invitation letters. Wave 1 and 2 had a response rate of 35% (N = 209) and 22% (N = 132), respectively. 79 respondents participated in both waves. Despite our efforts to accommodate identified challenges such as language, illiteracy, and mistrust, the response rates are low. We identified new challenges in recruiting participants including participation fatigue, frustration with the restructure process, and a feeling of limited individual gain from participation. Many challenges are associated with conducting research among socio-economically disadvantaged groups. Documenting processes and learning from experiences are important steps in including groups with lower socio-economic status in health research in order to address the underlying social mechanisms creating health disparities.
Changes in life expectancy and contribution of causes of deaths and age groups in Belgium, 1997-2018
Authors: Scohy A , Van Oyen H , Renard F 
Published: October 2020

Abstract

Background
Concerns have been expressed about a recent decreasing growth of life expectancy (LE) in some developed countries. This study examines whether a slowing down in the LE increase was observed in Belgium between 1997 and 2018, and describes the contribution of causes of deaths (COD) and age groups to the 2000-2015 change in LE.

Methods
Changes in yearly LE increase were analyzed by linear regression and joinpoint regression analysis. The contribution of age and COD to the change in LE in Belgium was measured with the Arriaga decomposition method using 3-year moving average to reduce random fluctuations over years.

Results
No significant breakpoint was identified. The slope of the linear regression of annual LE changes in men was practically flat (slope = -0.0002, CI: -0.014, 0.013) and slightly, but not significantly, decreasing in women (slope = -0.002, CI: -0.019, 0.015). A larger increase in LE was observed in men compared to women and in people aged 70 years and over compared to younger ages. The COD contributing the most to the increase in LE was ischemic heart disease in men and in women. It was followed by transport accident and lung cancer in men and by cerebrovascular diseases and other circulatory diseases in women. Dementia, Alzheimer, and Parkinson contributed negatively to the LE increase in men and in women. The largest negative contributor was lung cancer in women.

Conclusions
In contrast to neighboring countries, no evidence for a significant stalling of life expectancy were found in Belgium between 1997 and 2018. Progress in reducing the major causes of deaths (cardiovascular diseases, some cancers, and transport accidents) have contributed to the increase of LE, but some COD are impeding further progress, particularly lung cancer in women.

Key messages
No evidence of stalling life expectancy in Belgium between 1997 and 2018. Monitoring causes of deaths is crucial to identify conditions impeding progress in life expectancy.
Translating a whole of system approach to an urban community setting: a realist evaluation
Authors: Maitland N , Wardle K , Haigh F , Allender S , Jalaludin B 
Published: October 2020

Abstract

Introduction
The recent Lancet Commissions report on The Global Syndemic of Obesity, Undernutrition, and Climate Change highlights the need for comprehensive actions to address the global epidemic of obesity. The Campbelltown - Changing our Future project utilised a community led participatory systems mapping approach to develop interventions to address childhood obesity in an urban environment. While there is evidence demonstrating the impact of systems approaches on outcomes, there is limited examples internationally demonstrating what works in which circumstances, for whom and most importantly how.

Methods
A realist evaluation framework was used by project staff to identify key mechanisms that enabled project outcomes. This framework uses four key interrelated concepts: “mechanism”, “context”, “outcome pattern” and “context-mechanism-outcome (CMO) pattern configuration”. Five key underlying properties that influenced the project were analysed using the CMO pattern configuration.

Results
The five key properties that the project team has identified as key influences in the translation of a whole of system approach in an urban community are: endorsement, ways of working, deliberative learning, personality traits and partnerships. These mechanisms enabled over 90 community-led actions to be established.

Conclusions
The five properties work harmoniously together when performed in an enabling context to produce comprehensive, community-led action. Understanding “how” these theories interact and the optimal context provides opportunity for a broader understanding on the process of practical implementation of a whole of system approach.

Key messages
Provides insight into how a practical example of a whole of system approach is implemented. Endorsement, flexible ways of working, deliberative learning, personality traits and partnerships are enablers of systems based participatory approaches addressing obesity within a community setting.
An international comparison of pool lifeguard requirements and qualifications
Authors: Demant D , Peden A , Lam W 
Published: October 2020

Abstract

Background
Drowning is one of the leading causes of the global burden of morbidity and injury-related deaths. In highly industrialised countries, death and injuries from drowning are commonly associated with recreational activities and disproportionately affect minors. In aquatic facilities, drowning is often the result of risky behaviours and management issues. Pool lifeguards are an important factor in lowering the drowning burden. However, research on lifeguard training and formal requirements is scarce.

Methods
The aim of this study was to review official and unofficial (training) requirements for pool lifeguards in 24 high-income countries. Information was extracted from (1) legislative databases, (2) publicly available information from governmental and non-governmental organisations as well as a (3) cross-sectional survey on training and employment practices sent out to specialist organisations and aquatic facilities.

Results
All jurisdictions had a minimum standard for physical fitness, swimming ability, eligible minimum age, and further training and qualification requirements. However, the depth and length of further training differed drastically between jurisdictions and many of these standards were 'de-facto' industry standards rather than legislated. Only some jurisdictions had regulations regarding visual and hearing impairments (n = 13) or infectious and chronic conditions (n = 13). Only three jurisdictions had a character requirement.

Conclusions
Pool lifeguards are an important factor in preventing injury and death from drowning and require a high-level of physical endurance, first aid and rescue knowledge as well as analytical skills to be effective. A stronger legislated regulation of pool lifeguard requirements may be effective in reducing risk of drowning.

Key messages
Pool lifeguards are an important factor in preventing injury and death from drowning and require high-level physical endurance, first aid/rescue knowledge as well as analytical skills to be effective. A stronger legislated regulation of pool lifeguard requirements may be effective in reducing risk of drowning.
Quality of health promotion programs is associated with built environment features in Jerusalem
Authors: Besor O , Manor O , Paltiel O , Dunchin M , Rauch O , Lahad A , Kaufman-Shriqui V 
Published: October 2020

Abstract

Background
Neighbourhood built environment and infrastructure influence health status. Greater walkability, green spaces and healthy food accessibility can enhance healthy lifestyles. While health promotion programs (HPPs) have been shown to improve population's health, little is known about the reciprocal influences between the built environment and quality and distribution of HPPs across a city.

Methods
HPPs operating in Jerusalem focusing on healthy diet and physical activities were located and evaluated for quality using the European Quality Instrument for Health Promotion (EQUIHP) in 2017. HPPs location, intervention type and characteristics of the target population were documented. Using Geographic Information System (GIS), we combined infrastructure data from the Jerusalem Municipality and socioeconomic score (1 lowest - 10 highest) from Israel's Central Bureau of Statistics. Associations between distribution and quality of HPPs and the built environment at the neighbourhood (n = 115) level and municipal planning area level (7 areas) were assessed.

Results
Overall 93 HPPs operating in 349 locations and serving 582,500 adult residents, were identified in Jerusalem. Higher HPP quality, at the municipal planning area, was associated with higher density of HPPs, longer bike or walking lanes and fewer food stores. Positive significant (p &lt; 0.05) correlations, at a neighbourhood level, were found between neighbourhood EQUIHP median scores and HPPs targeting women (0.262), participants &lt; 60 years old (0.324) and the Arab ethnicity (0.473). Linear regression showed a significant (p = 0.01) decrease of 0.015 in median EQUIHP score at a neighbourhood level for each increase in socioeconomic status score (p = 0.036).

Conclusions
A comprehensive evaluation of HPP quality, spatial and sociodemographic information demonstrates an association of HPP access and quality with the built environment. Fortunately, in Jerusalem high quality programs are designed for populations at need.

Key messages
In Jerusalem, the quality of health promotion programs measured by the EQUIHP score, was positively associated with infrastructure features promoting physical activity and lower neighbourhood SES. In Jerusalem, higher quality of health promotion programs focusing in nutrition and physical activity were designed for populations at need.
Students‘ attitudes towards the measures of healthy lifestyle promotion in Lithuania
Authors: Berzanskyte A , Drungelaite O 
Published: October 2020

Abstract

Background
To ensure more resistant community in the future of humanity, the early life prevention within aging societies becomes very important. The new generation clearly expresses their needs and indicates the ways that are the most attractive for positive changes of healthy behavior. The aim of the study was to reveal school children's attitudes to different measures of healthy lifestyle promotion in Lithuania.

Methods
The data were collected from 380 12-19 years students from two high schools of the regional city by self-administered anonymous questionnaires. The relative frequencies and prevalence ratios were compared in groups by different sociodemographic categories. Chi squared and Fisher's exact tests were conducted to establish statistical significance which was set at p &lt; 0.05. Confidence intervals were used for prevalence statistics.

Results
Internet was the main source for 63.2% of the sample. Healthy behavior promotion provided at the school was assessed positively by 76.8%. However, 50.3% of the students thought that there was no sufficient attention for nutrition, 36% - for drugs and alcohol prevention, 34.6% - for physical activity, 32.6% - for smoking prevention. They preferred more discussions on those topics during nature sciences lectures. The parents' key role in healthy habits was referred by 46.6% of respondents. That was more expressed if the child lived with both parents or if they were physically active, had no addictions. The tendency of healthy lifestyle promotion by famous people was evaluated critically, as more than half respondents considered them not having such competencies. The students had scarce awareness about the impact of the laws regulating the consumption of alcohol, smoking and drugs, although half of them supported stricter control.

Conclusions
The students emphasized internet, the school and the parents as the most important sources of information for promotion of healthy behavior.

Key messages
In era of technologies the internet is the most accessible and attractive source for information, particularly for new young generation. The children need relevant guidance from the schools and the parents to get the right information to manage their health properly and get resistance in future aging societies.
Health system performance assessment from the private health insured persons’ perspective in Germany
Authors: Achstetter K , Blümel M , Köppen J , Busse R 
Published: October 2020

Abstract

Background
About 11% of the German population has full private health insurance (PHI) and mainly consists of self-employed persons, civil servants or persons with an income above a certain threshold (in 2020: 62,550 €/year) who choose to opt out from statutory health insurance. It can be assumed that these persons represent a distinct population group in Germany. Therefore, the assessment of the German health system performance from the perspective of persons with PHI was subject to this research (project IPHA “Integrating the Population Perspective in Health System Performance Assessment”).

Methods
A paper/online survey was conducted in 2018 among 20,000 persons with PHI in Germany. The items for this survey were based on the intermediate (access, coverage, quality and safety) and final goals (improved health, responsiveness, improved efficiency, and social and financial risk protection) of the WHO Health Systems Framework.

Results
The survey was completed by 3,601 participants (18.0%). Participants (age 58.6 years ± 14.6; 64.6% male) assessed the German health system very differently, exemplarily shown for the intermediate goal “access” and final goal “responsiveness”: Whereas access to off-hour care was perceived as difficult by 54.1% of the respondents, 6.7% of the respondents reported unmet needs within the last 12 months due to waiting times. 51,5% of these persons with unmet needs due to waiting times were still (very) satisfied with the overall waiting time for physicians' appointments. 73,6% of persons with unmet needs who perceived discrimination in their care reported waiting times as the area of discrimination (vs. 53,4% of all participants who perceived discrimination).

Conclusions
Privately insured persons in Germany perceived the performance of the health system very differently and also partially inconsistent. Further analyses will complete the picture of the persons with PHI's perspective in health system performance assessment.

Key messages
Persons with private health insurance perceive the performance of the German health care system very differently and also partially inconsistent. Despite unmet needs due to waiting time in 6.7% of the respondents, 51,5% of these persons were still (very) satisfied with waiting times.
The management of NDM-β-lactamase-producing carbapenem-resistant Enterobacterales in Tuscany
Authors: Ninci A , Grazzini M , Paolini D , Niccolini F , Mechi M T , Righi L , Gemmi F , Pieralli F , Lorini C , Bonaccorsi G 
Published: October 2020

Abstract

Issue
An important outbreak of New Delhi metallo-β-beta-lactamase (NDM)-producing carbapenem-resistant Enterobacterales (CRE) has been reported from north-western of Tuscany since November 2018. NDM is a metallo-β-lactamase able to hydrolyze most β-lactames (including carbapenems) with limited treatment options.

Description of the Problem
From November 2018 to May 2019, 7 Tuscan hospitals notified a total of 350 infected or colonized cases. This outbreak was described in a risk assessment edited by the European Centre for Disease Prevention and Control (ECDC) in June 2019. The Ministry of Health and the Tuscany Region promptly adopted infection prevention control measures.

Results
Since July 2019, a regional task force, composed by experts in infectivology, microbiology and public health, coordinated the following actions: Publication of Regional Resolutions which have established practical guidelines for the outbreak management. These measures included:(I) the introduction of screening test for CRE by rectal swab for hospitalized patients; (II) the implementation of microbiological rapid molecular tests and genotyping of rectal swab; (III) the enhancement of standard and transmission-based precautions; (iv) the strengthening of handover between hospital setting and primary healthcare; (v) the implementation of a regional data-base for outbreak surveillance.Monthly regional meetings with the infection control teams of each hospital.Site visits (n. 44) performed by a group of experts in all healthcare facilities.
After the implementation of these measures, a trend for decrease in positive blood cultures of NDM was registered.

Lessons
The spread of NDM in Tuscany has been the opportunity to standardize and improve the approach to Multidrug-Resistant Organisms (MDROs) prevention and control.

Key messages
The spread of NDM in Tuscany has been the opportunity to standardize and improve the approach to Multidrug-Resistant Organisms (MDROs) prevention and control. The cooperation among stakeholders and the standardization of precaution measures and healthcare workers’ behavior allows to effectively face the MDROs diffusion.
Nurses' perception on social network of children with chronic illness: qualitative study, Brazil
Authors: Souza M H N , Santos T J , Vasconcellos R N , MM Costa  , Lira A S , Conceição N V M , Nobrega V M , Lima H S B , Collet N 
Published: October 2020

Abstract

Introduction
The high prevalence of chronic diseases in childhood is a serious public health problem in Brazil. The family life of children with chronic illness is marked by numerous determinant and conditioning factors, whether they are biological, psychological, cultural and social. Such factors are more relevant in the absence of a social support network for care. Therefore, the greater the support offered by health professionals, the greater the resources available for the family to face vulnerability.

Objectives
describing primary care nurses' perception of the social network approach for children with chronic diseases.

Methods
Qualitative research conducted in October 2019 through an interview with ten nurses from family health units in the city of Rio de Janeiro, Brazil. The project was approved by the Ethics and Research Committees of the participating institutions. Thematic content analysis was used.

Results
For nurses, social network meant support from family members and from secondary and tertiary level services. In their practice, these professionals are often unaware of the health situation of children with chronic diseases, and they perceive lack of articulation in referral those children to other services of the Health Care Network.

Conclusions
There are gaps between knowledge and practice of these professionals on the social network approach. It is important to highlight frailties in comprehensive care of children with chronic illness and the service counter-referral to the family health unit. It is necessary to carry out training courses for professionals, helping them to belong to the social network of the family of the child with chronic disease. This strategy could implement effective approach of support, surveillance and health promotion of children.

Key messages
There is a gap in the knowledge of social network approach among primary care nurses. The social network approach of children with chronic diseases favors comprehensive care and implementation of effective strategies focused on supporting, monitoring and promoting child health.
Comparison of feeding behavior problems of hostel and non-hostel living children with ASD in Dhaka
Authors: Islam T , Islam N , Tasnim S 
Published: October 2020

Abstract

Backgrounds
The purpose of this study was to determine the distribution and differences of nutritional status and feeding behavior problems between the school going children with autism spectrum disorder (ASD) who are living either at school hostel or at home with parents of the urban lower-middle-class population in Dhaka city, Bangladesh.

Methods
This is a cross-sectional study where the children with ASD were randomly selected from 4 schools for children with special needs in Dhaka, Bangladesh. Written consent was taken from the parents of the children. Anthropometric and other nutrition referral data were taken directly from the children during school time. Demographic, parity and behavioral pediatrics feeding assessment scale (BPFAS) module have been interviewed through structured questionnaires from the parents. The referral scores have been applied to measure and compare the mean BPFAS scores.

Results
93 children have participated in this study (mean age 10.21 years). It was observed that BPFAS scores for &gt;10 years of age are higher in overall both groups of children (p = &lt;0.05). Parents from joint or bigger families reported higher feeding problems of their child living at home (p = &lt;0.05). Significant difference found in BPFAS score according to the number of siblings in the homegroup (52.0 vs. 81.8; p = &lt;0.01). Mean BPFAS score was higher in the hostel group if the children's parents were highly educated (p = &lt;0.05). No association found in feeding assessment and socio-economic status as we found the SES were quite similar in both groups.

Conclusions
In this preliminary data, we found that feeding behavior problems reported by parents are less in the hostel living children and also lower in comparatively higher aged children. This study is important for researchers and policymakers as it opens windows to think and do more research about the importance and impact of hostel disciplines and in-home family bonding for the healthy growth of children with ASD.

Key messages
Higher aged children are have less feeding problem in general. Keeping children with ASD at home in touch of family members have positive impact on their feeding problems and overall nutrition.