bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dietary polyphenol intake, risk of hypertension and age status in adult Russian/Siberian population
Authors: Berezovikova I , Denisova D , Batluk T , Shcherbakova L , Malyutina S 
Published: October 2020

Abstract

Background
Consumption of polyphenolic compounds from various food sources is associated with a reduction in cardiovascular risk factors. The region of residence, the food habits of the population, and age have a significant impact on consumption.

Methods
Participants: the Siberian urban population (Novosibirsk, HAPIEE study, 9324 (4,249 men and 5,075 women) aged 45-69. Dietary data collected using a 141-item food frequency questionnaire. Data on the polyphenols were taken from the Phenol-Explorer database (3.6). Total polyphenols (TPH) were considered as a sum of all individual classes: flavonoids, phenolic acids, stilbenes, lignans and other polyphenols and their food sources. The consumption of polyphenolic compounds in the age groups of 45-49, 50-54, 55-59, 60-64 and more than 65 years was analyzed. To assess the relationship between CVD risk factors and the consumption of TPH, the odds ratio was calculated in quartiles of TPH consumption (OR).

Results
The consumption of TPH in men was 1273 (647) and 1203 (626) mg/day in women (P &lt; 0,05). The main class for both men and women were flavonoids, as well as phenolic acids. For men, respectively, 68 and 21% of the total consumption of TPH, for women 70 and 20%. Chances of developing hypertension in quartiles of high and low consumption of TPH showed a risk reduction in whole population by 58%, in quartiles of high and low consumption of total flavonoids - by 56% and phenolic acids - by 21%. The main sources of TPH were tea, coffee, fruits, vegetables and rye bread. With increasing age, both men and women experience a decrease in TPH consumption by 9.5 and 11%, respectively, of flavonoids - by 10.6 and 15%. This is due to a decrease in fruit consumption with increasing age.

Conclusions
The consumption of polyphenol compounds in the Siberian urban population associated with reduction of hypertension and determined by age.
The study was carried out in the framework of budget theme No. AAAA-A17-117112850280-2.

Key messages
Consumption of polyphenolic compounds in the Siberian population is associated with a reduced risk of hypertension. In recommendations for the prevention of hypertension in the older age group, it is necessary to consider the increase in the consumption of fruits and berries from local sources.
Experiences with specialist clinics health care: a cross-sectional study among adult patients
Authors: Murko E , Poldrugovac M , Kralj M , Ropret N 
Published: October 2020

Abstract

Background
The measurement of patient experiences is gaining importance in many healthcare systems, including the Slovenian one. The need for a national survey on patient experiences in the specialist outpatient settings emerged recently, leading to the establishment of a new questionnaire in Slovenia. The aim of the study was to measure patients' experiences in the outpatient specialist medical settings in the fields of surgery, gastroenterology, otorhinolaryngology, diabetology, endocrinology and metabolic diseases, dermatovenerology and pulmonology.

Methods
The survey takes into account various aspects of healthcare such as waiting period to the visit, admission, waiting time in the waiting room, physician work, nurse work, privacy, patient rights information, and familiarity with continuation of treatment. As part of the study, patients evaluated treatment at a specialist outpatient clinic on a scale of 0 to 10, and were able to give praise and suggestions for improvements. The questionnaire used was a newly developed one, based on a review of the literature and focus groups with patients. The questionnaire was also cognitively tested and piloted before national rollout.

Results
The national survey was conducted in March 2019 and included adult patients who attended a specialist outpatient clinic in certain clinical fields. The survey included 149 specialist outpatient medical offices. 8,616 questionnaires were received. The response rate was estimated to be 32%. 79.0% of patients stated that waiting period to the visit did not pose any problem for them. 80.3% of the surveyed patients rated the medical treatment with a score of 9 or 10.

Conclusions
The surveyed patients in our study rate highly the treatment in selected outpatient specialist clinics. The strength of the findings is limited by suboptimal sampling. Possible changes to the sampling methods to be used in future iterations of the survey are currently being evaluated.

Key messages
In March 2019, the first national survey on patients' experience in selected public outpatient specialist clinics in Slovenia was conducted. 80.3 percent of the surveyed patients rate the medical treatment highly with a score of 9 or 10.
PROMs as an intervention – a randomised controlled study
Authors: Oschmann L , Kuklinski D , Geissler A , Pross C , Vogel J 
Published: October 2020

Abstract

Issue
Patient-Reported Outcome Measures (PROMs) are becoming part of the patient journey and are increasingly used as a mechanism to reward quality and to indicate the 'value' of the health care provided. However, only in rare cases, PROMs are not only applied to measure quality but used as a basis for medical intervention.

Description of the problem
Digitisation and patient-centred care are of major importance to highlight quality deficiencies and to promote transparency of patient pathways. However, there is little evidence on how to use the patient's feedback to transform the patient journey and to improve health outcomes. Additionally, there is rare information on scientifically tested or elaborated threshold values that could be applied to trigger an intervention in case of critical recovery. The patient's reaction to such interventions or alerts is unknown, although it promotes health literacy and could support cross-sectoral care and better health outcomes.

Results
In our two-arm RCT, we examine the effects of PROMs as an intervention and related health care costs by digitally collecting PROMs of around 10,000 patients in the field of endoprosthetics in 9 German clinics. The magnitude of the study and its digital approach suggest that the procedure can be easily transferred to other indications and countries. For the after-care period, PROM threshold alert values were defined with the support of an expert consortium of physicians, to signal critical recovery of patients in the intervention group. Study nurses are automatically alerted and post-treatment physicians informed to intervene in case of critical PROM values.

Lessons
Preliminary results suggest that patients respond positively to their contact with the study nurse and that they agree with informing their physicians about critical results. We expect an intervention of every 10th patient of the study and so far, the threshold definition seems robust in the way that it is neither too specific nor sensitive.

Key messages
PROMs used as an intervention can promote health literacy and outcomes. Development and testing of thresholds is needed.
What drives absenteeism among doctors in rural primary healthcare setting in Bangladesh? A qualitative exploration
Authors: Nahar N 
Published: October 2020

Abstract
Absenteeism', among physicians, has been a long-standing issue in Bangladesh, but little is known about the intersection between political structures, health system policy and shortages that drives provider behaviour. Using an in-depth interview guideline 30 interviews were conducted with physicians working in rural and urban facilities through purposive sampling. Data were analysed in Atlas ti and synthesized following Gales framework method. Senior doctors were usually absent due to the lack of opportunities to specialise/dual/private practice in rural facilities. Absence of career progression (especially among junior physicians), inadequate and unsafe living and workplace arrangements, absence of transport facilities, lack of community understanding and ownership, non-cooperation from colleagues and absence of incentives or recognition de-motivated physicians to stay at their posts in rural facilities. Incidences of abuse (verbal/physical) by local community were common with female physicians particularly vulnerable. Disciplinary actions against absenteeism were unclear, and many respondents were unaware of these. Almost all of the doctors wished to move out of rural areas. Those who were successful, used their social and political networks and the payments of bribes to facilitate movement into urban settings. Doctors who did not have access to financial resources or to these networks failed to move out of rural areas and one left the profession.
Addressing the challenge of bringing evidence in decision-making for public health emergencies: can HTA reach out to preparedness?
Authors: de Waure C , Miglietta A , Favaretti C 
Published: October 2020

Abstract

Background
Preparedness is one of the fundamental public health activities as it allows health systems to effectively manage threats. It can be considered a continuous quality improvement process, therefore requiring an assessment both in planning and checking phase. The assessment should consider several aspects spanning contextual factors but also health technologies being used. In order to manage threats, epidemics in particular, several health technologies are generally deployed. Among them, vaccines, antimicrobials, medical devices (i.e. masks), procedures (i.e. quarantine). Indeed, an early and as much as comprehensive evaluation of their value in the mitigation of epidemics' impact is needed. Health Technology Assessment (HTA) could help doing that. It could be also useful to predict the magnitude of the problem and to shed light on alternatives and needs for organizational reengineering. Anyway, what are the actions required to make HTA reaching out preparedness?

Results
In order to do it, several conditions should be brought about. The first one is the recognition of the importance of HTA in projecting health technologies impacts by health authorities and institutions. The second one is the timeliness of the assessment. In fact, HTA is generally a time and resource consuming approach as it is based on the collection of available evidence and data. Nevertheless, an early interaction with all stakeholders, the availability of flexible computer infrastructures for data collection and the preventive development of impact models might allow developing the assessment in a limited time. Furthermore, having dedicated working teams at supranational/national level could help keep down time and efforts to conduct the assessment.

Conclusions
Based on available experiences, advances and barriers in the use of HTA for preparedness might be highlighted and actions to strengthen the role of HTA in this field can be recognized.
Estimating burden of foodborne diseases where public health impact is higher and data scarcer: a study in four African countries
Authors: Desta B 
Published: October 2020

Abstract
Low and middle-income countries, in particular from Africa, bear the highest burden of foodborne disease (FBD). However, because research and disease surveillance data from Africa are limited, previous burden estimates are subject to uncertainty. The main challenge to estimating burden of FBD in Africa is lack of data, where factors ranging from lack of capacity to lack of political commitment, and a focus on priority diseases, limit existing surveillance systems. To address this, we are working with Ethiopia, Mozambique, Nigeria, and Tanzania, to estimate the burden of, and strengthen surveillance systems for, FBD in Africa. We are conducting a population survey (to estimate incidence and distribution of diarrhea in the community), a systematic literature review (to estimate proportions of diarrheal disease caused by different agents), and an active review of available FBD reports (to estimate the extent of under-reporting in existing surveillance). Together, these findings will provide more accurate estimates of the burden of FBD for African countries. Lessons from this large-scale project can be extrapolated to other countries and regions where the burden is high but data are scarce. We highlight applying leadership attributes, including delegation of duties, setting milestones, regular meetings, transparency, and risk mitigation plans. The leading role of experts in this project helps to reduce hurdles. We have also adapted existing data collection tools for use across our diverse African study populations. We are engaging stakeholders who will use our research outputs, by involving them at all stages of the project. This integrated Knowledge Translation approach is translatable to other settings. These studies are part of FOCAL (Foodborne Disease Epidemiology, Surveillance, and Control in African LMIC), a multi-partner, multi-study project co-funded by the Bill and Melinda Gates Foundation and the United Kingdom's Department for International Development.
Association between marital status and mental health among cohabitating same-sex couples in the UK
Authors: Hagen D , Goldmann E 
Published: October 2020

Abstract

Background
A large body of research suggests that the formalisation of opposite-sex relationships is associated with favourable mental health outcomes, particularly among males. Despite the recent introduction of same-sex civil partnership and/or marriage in many countries, there is little evidence as to whether this salutary effect of formalised partnership extends to same-sex couples.

Methods
Using data from wave 8 (2016-18) of Understanding Society: the UK Household Longitudinal Study (UKHLS), respondents living with a same-sex partner were included in the analytical sample (n = 225). Respondents from Northern Ireland were excluded, as same-sex marriage did not exist there at the time of data collection. Mental health status was assessed using the General Health Questionnaire (GHQ)-12 (range: 0-36) and the established cut-off point of 11/12 to identify psychiatric caseness. The association between marital status (marriage, civil partnership, and cohabitation only) and psychiatric caseness was examined in logistic regression models in the overall sample and stratified by sex.

Results
A total of 112 respondents (40%) were cohabitating, 81 (40%) were living in civil partnership, and 32 (19%) were married. In bivariable analyses, respondents living in civil partnership had a lower prevalence of psychiatric caseness (30%) than those who were married (50%) or cohabitating only (51%) (p = 0.041). In models adjusted for age, sex, and education, civil partnership was associated with 84% reduced odds of psychiatric caseness (95% CI: 0.39-0.66) compared to cohabitation among females; no statistically significant effect was found for marriage or among males.

Conclusions
This study provided evidence of a inverse association between civil partnership and psychiatric caseness among females in same-sex couples. Given that same-sex marriage was only introduced in England, Wales, and Scotland in 2014, further research will be needed as more same-sex couples formalise their relationships.
Associations between workplace characteristics and “outness” in LGBTIQ workers in Austria
Authors: Markovic L , Grabovac I 
Published: October 2020

Abstract

Introduction
Lesbian, gay, bisexual, transgender, intersex, and queer (LGBTIQ) individuals are often subjected to negative attitudes at the workplace, which may lead to non-disclosure of their sexual and/or gender identities. We aimed to determine the prevalence of workplace disclosure of sexual or gender identity (i.e. “outness”; being “out”) and to examine its associations with workplace characteristics in LGBTIQ workers in Austria.

Methods
Sociodemographic, work- and wellbeing-related data were gathered using an online questionnaire between February and June 2017. From the initial 1268 respondents, 1054 (83%) provided complete data and were included in the analysis.

Results
Participants were mostly 26-35 years old (39.1%), educated (43.9% tertiary level), urban (53.8%), cisgender gay men (40.0%) with a full-time employment (63.9%). Overall, 51.7% were “out” at the workplace. Being bisexual (OR = 0.46, 95%CI 0.27-0.81), having anti-discrimination guidelines (OR = 0.53, 95%CI 0.32-0.90), living alone (OR = 0.50, 95%CI 0.32-0.79 and in shared households (OR = 0.49, 95%CI 0.25-0.96) were associated with lesser likelihood of being “out” at work. Furthermore, being “out” at work was associated with middle age (36-45-year-olds; OR = 1.74, 95%CI 1.07-2.85), duration of employment &gt;10 years (OR = 2.03, 95%CI 1.08-3.81), LGBT friendly work environment (OR 1.61, 95%CI 1.36-1.91), anti-discrimination policies enacted (OR = 2.02, 95%CI 1.23-3.32), and work council protections (OR = 1.56, 95%CI 1.04-2.36).

Conclusions
Approximately half of participants reported being “out” at work. An LGBTIQ-friendly work environment, presence of work council protections and of enacted anti-discrimination policies were linked with higher workplace outness. Instating discrimination protections might facilitate “outness” and therefore visibility of LGBTIQ workers, leading to better health outcomes and productivity.
20.A. Round table: COVID-19, infectious diseases, and human rights and risks in public health
Authors:   Organised by: GHLG (Netherlands),   Chair persons: David Patterson - Netherlands
Published: October 2020

Abstract
The 21st century has been marked by trans-national epidemics of SARs, MERS, Ebola and most recently COVID-19. In spite of WHO advice to the contrary, some States have responded by closing their borders to persons travelling from certain countries. International human rights law permits restrictions of movement to protect public health, subject to strict tests of necessity and proportionality. To a potentially unprecedented degree, however, the spread of COVID-19 has brought to the fore the use of social distancing measures, and a surge in demand for health care, both of which raise significant questions of equity given disparities in wealth and income within and across populations. This panel discussion will explore how a human rights-based approach supports evidence-based responses to epidemics of infectious diseases, and why a human rights-based response may be more effective than other measures in addressing these global threats. Issues covered will include: Advantages and possible limitations of a human rights-based approach to infectious epidemics.Emerging questions of human rights, distributive justice, regulatory authority and efficacy associated with sustained social distancing measures and the management of health care access in a time of surging demand.Early evidence of the health and social impact of legal responses to COVID-19.

Key messages
States have both obligations and limitations under international human rights law in preventing and responding to infectious epidemics. The large-scale application of social distancing approaches can create acute pressure on poorer people and poses legal, moral and practical questions about the social burdens of disease control.
Which are the opportunities and current challenges for the use of polygenic risk scores in risk prediction and the prevention of common adult onset conditions?
Authors: Bottà G 
Published: October 2020

Abstract
The panellist Giordano Bottà will discuss about: Which are the opportunities and current challenges for the use of polygenic risk scores in risk prediction and the prevention of common adult onset conditions? Coronary artery disease (CAD) is a complex multifactorial disease leading cause of morbidity and mortality worldwide. Identifying individuals at high risk is crucial to guide life-style and therapeutics interventions. Notably, individuals at high genetic risk who adhere to a healthy lifestyle displayed between two and three-fold relative risk reduction, compared to individuals with a poor lifestyle. Despite such evidences, a systematic assessment of the interplay between PRS and CAD risk factors such as blood lipid levels in contributing to the overall CAD risk is still lacking. Panelists will present and disuss a study on 130,0000 individuals of the UK Biobank on the association of incident CAD with PRS and blood lipids (LDL, TC, HDL, TC:HDL, LDL:HDL). Using the largest prospective genotyped cohort available to date, researchers identified for the first time a significant interaction between LDL and genetics in determining CAD incidence. This result has deep implications in a CAD primary prevention perspective.
20.D. Skills building seminar: Design for mental health integration through built environment interventions
Authors:   Organised by: EUPHA Urban public health section, EUPHA Public mental health section, EUPHA Environment and health section, University of Crete (Greece),   Chair persons: Jutta Lindert - EUPHA-PMH, Stefano Capolongo – EUPHA-URB
Published: October 2020

Abstract
Mental illness is associated with social exclusion and stigma more than most other health issues. This affects psychiatric facility provision (Chrysikou et al 2017), prevention and early treatment interventions. The planning and design of services both conceptually (service procedures, experience designs, campaigns and physically (e.g. buildings, products, interiors) could help change that. New approaches could build resilience by increasing access to and acceptance of mental health services and enable recovery as a constant process (Slade et al 2008). This intense skill- building workshop will use a role-game approach with cross-disciplinary methods from experience design and design thinking to foster innovative spatial concepts in a co-creative manner. This helps to build capacity and knowledge on exploring and developing innovative and disruptive concepts for public urban mental health. Focus is on spatial configuration, architectural and design aspects for services and mental health systems. The highly interactive seminar-workshop starts with two 5' presentations to set the theoretical multi-disciplinary stage. A third 5' presentation addresses issues addressed to the participants and presents the locus of the role play, i.e. Crete, chosen for its unique socio-spatial and systemic characteristics. A 5' presentation explains the scenario and stakeholder roles. The group session comprises a 50' long structured series of ideation and analysis methods based on a role-play-like schedule in which delegates act as service provider for a municipal client (Crete) that request an innovative mental health care solution for a specific urban context. Then 10' will be the closing session on the process by mapping the reflections of the process on a collective SWOT diagram.
Chrysikou, E., Kostopoulou, E., Savvopoulou, E., Fatah gen. Schieck, A., 2017. Medical Architecture on the Social Valorisation of Psychiatric Patients: Employing transdisciplinary approaches between architecture, physical and mental well-being disciplines. Proceedings of the AAE 2017 Conference, Architecture Connects, 6th -9th September 2017. Oxford Brookes University, UK
Slade, Mike; Amering, Michaela; Oades, Lindsay (2008): Recovery: an international perspective. In: Epidemiologia e psichiatria sociale 17 (2), S. 128-137.

Key messages
Participants will explore participatory design methodologies to help them consider and use building infrastructure as resource for public health and healthcare actions in relation to mental health. Participants will cross disciplinary boundaries exposed to eco- and psychosocial frameworks, i.e, build and social infrastructure, to co-create healthy, vibrant, resilient and equitable communities.