bluuebunny/crossref_metadata_2025_split huggingface dataset:
Policy communication for health and sustainability: comparison of food-based dietary guidelines
Authors: Aguirre Sánchez L , Teschner R , Malinverno N , Jungbluth N , van der Horst K , Marques-Vidal P , Suggs LS 
Published: October 2021

Abstract

Background
Food-based dietary guidelines (FBDGs) provide advice on what constitutes a healthy diet, influencing both decision-making at the policy level, and educational programs addressed to consumers. There is a growing body of literature that allows to estimate the health and environmental impacts of the wide adoption of FBDG at the country and global levels. This unlocks the possibility of evaluating the most sustainable dietary guidelines from a communication perspective. This study aims at answering what are the key converging messages and main differences in the communication of FBDG that have a high environmental potential, and what of those FBDG do communicate a sustainability purpose in an explicit way.

Methods
A mixed-method comparative review of FBDGs with a two-stage sampling process was developed. Building on Springmann et al (2020) we identified the countries where the wide population adoption of dietary guidelines would have the highest potential of reducing food-related greenhouse gas emissions (GHGe) while delivering positive health outcomes. In a second stage, a purposeful sample of FBDGs was designed to cover countries from different WHO regions, income levels, and languages.

Results
This study is in progress and results are preliminary. Out of the initial sample of identified FBDG with a GHGe reduction potential of more than 25 percent, a few of them, Germany, Brazil, Sweden, Netherlands, and France had been previously identified in the literature as having sustainability-based recommendations. Other guidelines with similar GHGe reduction potential, such as those of Switzerland and Italy also address sustainability in an explicit way.

Conclusions
FBDGs have been traditionally focused on health and nutrition messages. Several countries have updated recommendations considering the environmental impacts of food consumption. Not all the FBDG with a high environmental potential explicitly communicate sustainability concerns.

Key messages
Several countries can improve their health and climate change outcomes by promoting a wider adoption of their official dietary guidelines. Communication is a key aspect of this process.
Adoption of Telemedicine During the COVID-19 Pandemic: Perspectives of Primary Healthcare Providers
Authors: Lintz J 
Published: October 2021

Abstract

Background
As the pandemic has unfolded across an array of communities worldwide, telemedicine has been promoted and scaled up to attend to and reduce person-to-person transmission of COVID-19 in the U.S. and internationally. This study examined the major barriers to adoption of telemedicine among primary healthcare providers at a primary care clinic in north Texas during the pandemic.

Methods
A self-administered questionnaire was mailed to 67 primary healthcare providers at a primary care clinic in north Texas, with a 70% percent response rate (n = 47). The survey collected information on perceived barriers to telemedicine adoption and experience with telemedicine in the last 12 months. In addition to descriptive statistics, multiple logistic regression was conducted to determine characteristics related to use of telemedicine in the past year. Chi-square tests were also performed to examine the relationship between the number of perceived barriers and telemedicine usage.

Results
Results revealed that the lack of reimbursement was a significant obstacle to telemedicine adoption. Plus, the number of perceived barriers to telemedicine usage was negatively associated with using telemedicine.

Conclusions
The findings suggested that the barriers to using telemedicine existed across an array of situations and that decreasing these obstacles would be critical in encouraging future telemedicine adoption among providers during and after the pandemic. This will especially be the case for primary care practices where scarce financial resources have been a traditional problem for such providers.-This complicacy is likely to be amplified owing to the inimical effects of the pandemic, during and after its potential containment or successful management of it.

Key messages
Instructive to healthcare providers in the United States and around the globe vis-à-vis developing a holistic strategic plan of action to address the key barriers in the adoption of telemedicine. To motivate healthcare providers to utilize telemedicine, a variety of administrative, financial, and technical barriers should be remedied during the pandemic.
mHealth to support healthy lifestyle in early stroke prevention
Authors: Mälstam E , Patomella AH , Guidetti S , Asaba E 
Published: October 2021

Abstract

Background
A healthy lifestyle is a strong mediator for reducing the risk for cardiovascular diseases, including stroke. mHealth apps can be an integral part of disease prevention and to support self-management of different chronic conditions and the use of apps have increased. It is however crucial that digital tools that are developed for implementation in healthcare are explored in target populations. A digitally augmented intervention called ‘Make My Day' has been developed for Swedish Primary health care setting to support a change toward healthy behaviours and habits in everyday life for persons at risk for stroke. The aim of the study was to explore experiences of this new intervention which integrated a mobile app and onsite group sessions for persons who have been identified with a risk for stroke.

Methods
A qualitative design was utilized comprising interviews and observations conducted over 18 months with persons (n = 12) at risk for stroke. A constant comparative method was utilized.

Results
Preliminary findings show that the app contributed to opportunities for the participants to discover own strengths, weaknesses, current activity patterns, as well as keep track of lifestyle habits and risk factors. The app nudged the participants to incorporate healthy everyday routines. Suggested improvements of the app included automated and personally tailored options for registrations and feedback. The utility of the app also depended on how well it accounted for aspects of participants literacy levels.

Conclusions
mHealth apps can offer support in incorporating health promoting behaviours and everyday routines as part of lifestyle-based stroke prevention. Increased personalization and tailoring was however important for user satisfaction.

Key messages
mHealth apps can promote increased awareness of current activity patterns, keep track of lifestyle habits and risk factors and serve as nudging to incorporate healthy everyday routines. Personal relevance and literacy levels are important to consider in stroke prevention mHealth apps to promote motivation to behaviour change and use of mHealth apps.
Digital sexual and reproductive health resources for women living in a migrant camp in Serbia
Authors: Graham A 
Published: October 2021

Abstract

Prior to Covid-19 (C19), I delivered sexual and reproductive health (SRH) educational workshops to refugee/migrant women in a migrant camp in Belgrade, Serbia. SRH education and access are key to the public health for all but specifically this vulnerable population. C19 and a national lockdown meant an alternative, none face to face delivery method was required. Migrant camps exist throughout Europe, and restrictions due to C19 continue across the world increasing the applicability of this practice in many settings. My previous experience informed my knowledge for course content, however not suitable delivery methods. Most women had mobile phones, however barriers to accessing online content included intermittent internet access, low computer literacy, inadequate privacy, and need for translation. Following research into alternative formats, over a number of months we piloted; texts +/- attachments, voice messages, video streaming, online videos to download. The questions posed were 1. Which format was the most accessible/acceptable to the women? 2. When the format was decided, how many women would access the content and was this number comparable to the workshops? The feedback showed texts with links to unlisted YouTube videos with burned subtitles were best, enabling download when internet access/privacy allowed and requiring minimal computer skills. We created an SRH programme of 5-minute videos with feedback obtained via text. Each video has 4-21 views (averaging 8 and continuing to increase) at time of submission, comparable or more than the workshops. This innovative practice delivers SRH information to women in this migrant camp. It doesn't replace workshops but when access is restricted it can be used independently, or ordinarily as a supplementary tool to workshops. It is applicable in any setting when access is restricted. Benefits include; choice of when/where/how to access; repeat views; potential for wider reach/scaling to reach larger populations.

Key messages
These carefully designed digital resources have allowed non-English speaking migrant women in a migrant camp to continue accessing sexual and reproductive health education during Covid-19 lockdowns. This innovative practice of delivering information to vulnerable, hard to reach groups is applicable in many settings when face to face access is restricted.
Patient experience with telemedicine in primary care during the COVID pandemic: a qualitative study
Authors: Tulupova E , Dobiášová K , Kopsa Těšinová J 
Published: October 2021

Abstract

Background
The Czech Republic is one of the countries with the low rate of digitization of health care processes, and the current legislation provides only isolated elements of electronic health care. Due to the COVID-19 pandemic, general practitioners (GPs) in the Czech Republic, as in other countries, had to rapidly switch to telemedicine visits. Information on patient perspectives about these visits is lacking. Our study aims to understand patients' perceptions about telemedicine visits at GPs during COVID-19, and to identify barriers and benefits of telemedicine in primary care.

Methods
A qualitative approach was applied. 40 semi-structured interviews were conducted (25 with patients who had telemedicine visits with a GP, and 15 with representatives of patients' organisations). Data was analysed using a thematic analysis.

Results
It has been shown that telemedicine visits took place mainly through telephone and email communication, without using the full potential of telemedicine. The absence of legal regulation and guidelines for telemedicine and the implementation of telemedicine in primary care without prior adaptation generates a number of problems in the patient-physician relationship. In some cases, the unregulated use of telemedicine leads to inequalities in access to healthcare. Persistent medical paternalism has also been shown to significantly affect telemedicine visits in primary care.

Conclusions
The results of the research will be used for the proposal of legislative changes in the field of distance care. Telemedicine guidelines will be created, considering the specifics of primary care. An educational program for patients on the improvement of their digital health literacy and on communication in healthcare using digital technologies will be created.
Project funding: TL04000105 Digital literacy in primary health care: COVID-19 as a challenge for the development of information communication technologies, Technology Agency of the Czech Republic.

Key messages
Implementation of telemedicine in primary care, without prior adaptation to a new way of communication, generates problems in the patient-physician relationship. The absence of legal regulations and guidelines for telemedicine can lead to inequalities in access to healthcare.
Postmenopausal women with osteoporosis – The effect of exercise on markers of quality of life
Authors: Gustafsson H , Marini S , Wright SAI , Maffei F , Dallolio L 
Published: October 2021

Abstract

Background
Osteoporosis (OP) is a major and increasing health problem worldwide, especially in European countries, where the modern, sedentary lifestyle from an early age leads to brittle bones later in life. Patients affected by OP tend to move less and have a lower quality of life (QoL). This study aims to evaluate how OP affects individual markers for QoL in postmenopausal women and assess the influence of exercise on these markers.

Methods
The EQ-5D questionnaire was administered to evaluate Mobility, Self-care, Usual Activities, Pain/Discomfort and Anxiety/Depression in a sample of Italian women with osteoporotic vertebral fractures, aged 60-75. Markers linked to QoL were compared for these women with those of an average female Italian population (AFIP) of similar age. Concurrently, a 6-month exercise trial was conducted, in which the OP patients were divided into two groups: an exercise group (EG) and a control group (CG). The QoL was assessed for both groups at the end of the trial.

Results
A larger proportion of OP patients reported some problems with Mobility as compared to the AFIP (37.5% versus 31.2% respectively, p = 0.001) and in performing Usual Activities (45% versus 23.9%, p = 0.002). OP patients (77.5%) experienced some Pain/Discomfort, compared to 48.1% of the AFIP (p = 0.001). Anxiety/Depression was reported by 40% of OP patients and 18.8% of the AFIP (p = 0.001). Concerning the exercise trial, the results indicated a positive trend for Mobility and Usual Activities in the EG, while the CG markers remained unchanged.

Conclusions
Overall, results confirm that OP significantly affected QoL in postmenopausal women. In particular, OP negatively influenced the markers Mobility, Usual Activities, Pain/Discomfort and Anxiety/Depression. Exercise programs tailored to OP patients can improve some markers linked to QoL. Evidence suggests that health policy makers in Europe can consider including OP-adapted exercise programmes in guidelines for OP management.

Key messages
Osteoporosis negatively affects the quality of life for postmenopausal women. In particular, Mobility, Usual Activities, Pain/Discomfort and Anxiety/Depression markers were affected. Exercise can improve some markers linked to quality of life (Mobility and Usual Activities). Thus, it could be proposed as a treatment for osteoporosis in postmenopausal women.
6-10-14 for Health - as an example of an interdisciplinary model of care for a patient with obesity
Authors: Metelska P , Brzeziński M , Jankowski M , Niedzielska A 
Published: October 2021

Abstract

Issue
Overweight and obesity are public health challenges of growing importance in Poland. The fastest increase has been observed in children and adolescents. Some studies show that 22% of elementary school children are currently (2013) overweight or have obesity (IZZ), compared with no more than 15% in 1990 (WHO Europe, 2012).

Description of the problem
The “6-10-14 for Health” is the first comprehensive health programme implemented in Poland, focused on long-term health behaviour change both among children with obesity and their families. Screening tests are carried out at Gdańsk schools. Children who are diagnosed with excess body weight are invited to the second level of programme. Target groups are children in Gdansk, aged 6, 9-11 and 14 years, their parents and the school environment. Timeline: 2011-2021

Results
effects: Approximately 400-450 new patients join the programme every year. Programme participants receive annual care from an interdisciplinary team of specialists including a paediatrician, dietitian, specialist in physical activity and a psychologist. The effect of one year's participation in the programme is the reduction of excess body weight in 75% of participants. More then 2000 patients have complieted the Programme. The programme is accredited by the European Association for the Study of Obesity and is funded by the City of Gdańsk. changes: Further implementation of the Programme depends on providing funds from the City of Gdańsk. However, it seems that the 6-10-14 for Health is one of the city's health priorities. The challenge in the field of weight reduction programs is to provide care that will not lead to stigmatization of patients

Lessons
The work on designing the model has already resulted in creation of network of specialists from different backgrounds and allowed sharing different scopes, how to use limited resources for the benefit of children and adolescens.

Key messages
The proposed care model is fully possible to implement in the care system. So far, sharing knowledge and experience, the program has been implemented in several other local governments. In the era of the COVID19 pandemic, all activities aimed at the prevention and early treatment of obesity become even more important.
Chronological trends of cardiovascular diseases in Southern Tunisia over a fourteen year -period
Authors: Maamri H , Ben Ayed H , Ketata N , Baklouti M , Yaich S , Karray R , Feki H , Dammak J 
Published: October 2021

Abstract

Introduction
Cardiovascular diseases are the leading cause of death worldwide and in Tunisia. In fact, as a result of progressive urbanization and westernization of lifestyle the spectrum and pattern of cardiovascular diseases CVD along with their risk factors are changing. The aim of this study was to describe the epidemiological profile of CVD hospitalizations, to evaluate their chronological trends and to estimate their future projected trends.

Methods
We retrospectively collected data from the regional morbidity registry of the University Hospital of Sfax, Tunisia, between 2003 and 2016. We included patients with ischemic heart disease (IHD), heart failure (HF) and rhythm and conduction disorder (RCD). Join-point regression analysis was performed to study chronological trends of CVD (Annual Percentage Change (APC); p).

Results
The mean age-standardized hospital incidence rate (ASHIR) was 94.8, 20.6 and 14/100000 inhabitants/year for IHD, HF and RCD, respectively. Trends analysis of CVD showed a significant increase in the ASHIR of IHD from 54.3/100000 inhabitants in 2003 to 123/100000 inhabitants in 2016, with an Annual Percentage Change (APC) of 3.59% (95% confidence interval (CI):0.4-6.7%; p &lt; 0.001). An upward trend was observed for HF, with ASHIR rising from 8.6/100000 inhabitants in 2003 to 22.6/100000 inhabitants in 2016, with an APC of 8.29% (95%CI:4.1-12;p&lt;0.001). For RCD, no significant change in ASHIR was found. Projections showed that the estimated ASHIR would attend 131 and 36.5/100000 inhabitants for IHD and HF, respectively, while RCD would decline to 19.6/100000 inhabitant in 2026.

Conclusions
IHD and HF were rising at an alarming rate and were expected to continue up to the next 10 years. Primary and primary prevention of cardiovascular risk factors, therapeutic education and early management would have a positive impact in the short and long term.

Key messages
The importance of the bidder of cardiovascular diseases. The necessity of primary prevention.
Comparison of two home-based polysomnography tools for OSAS diagnosis: a cost-minimization analysis
Authors: Sapienza M , Nurchis M , Di Pumpo M , Urbano M , Hart JG , Sommella L , Pascucci D , Riccardi MT , Casale M , Damiani G 
Published: October 2021

Abstract

Obstructive sleep apnoea syndrome (OSAS) is an underdiagnosed chronic disease with a high prevalence in adults. It is becoming an important social problem since it is associated with a significant adverse impact on quality of life and life expectancy. Overnight polysomnography, performed in a sleep laboratory (LabPSG), is considered the diagnostic standard. Home complete PSG (HoPSG) could represent an alternative to LabPSG for patients who want to avoid the overnight stay at a sleep center. The aim of this study was to assess the economic impact of two alternative HoPSG diagnostic techniques in the diagnosis of OSAS: the standard one versus the telemonitoring approach. The observational study was designed as a cost-minimization analysis adopting a healthcare perspective. The time horizon was 6 months (January 2021 - June 2021), thus no discounting was necessary. Direct medical costs, expressed in 2021 euros, were estimated through a micro-costing method while indirect costs were quantified adopting the Human Capital Approach. To explore the uncertainty of critical parameters, a one-way sensitivity analysis was run. Considering the direct costs, the telemonitoring HoPSG was estimated to cost around €55 less than the standard approach. The cost savings sharply increases taking into account the indirect costs that amounted to €90 million and €365 million for the telemonitoring and the standard approach, respectively. Sensitivity analyses results did not significantly differ from the base-case scenario. The diagnosis of OSAS is presently time-consuming, labor-intensive and costly. The adoption of digital health solutions as telemedicine has the potentiality to ease the diagnosis, to improve the access to health services, to reduce both direct and indirect costs, and to enhance the efficiency of healthcare facilities becoming a crucial tool in addressing the actual public health challenges.

Key messages
The telemonitoring Home complete polysomnography is cost-saving compared with the standard approach. Telemedicine has the huge potential to overcome public health challenges as increases in chronic disease in an ageing society and the associated burden in healthcare costs.
Aligning Diet, Health and Planet in the Older Population
Authors: Leydon CL , Harrington JM , McCarthy SN 
Published: October 2021

Abstract

Background
The global food system faces incessant and complex challenges of providing food for a growing population while remaining within planetary boundaries. Agriculture and food production depletes finite resources such as land, water and fossil fuels, and contributes to climate change. GHG emissions occur at every stage in the life cycle of a food from primary production through to processing, packaging, distribution, consumption, and waste. This results in approximately 34% of anthropogenic GHGEs globally. Thus, the aim of this study is to determine the levels of and contributors to dietary carbon footprint among older Irish adults.

Methods
Diet quality metrics explore associations between dietary patterns and health outcomes. A Food Frequency Questionnaire was used to assess dietary intake of participants in the Mitchelstown Cohort Study. To determine carbon footprint, foods were linked to CO2eq emission factors from life cycle assessment studies. The DASH and Mediterranean diet scores were used to determine if higher adherence to these recommended diets was associated with improved health outcomes and lower dietary GHGEs.

Results
Preliminary results suggest that the daily CO2eq is similar to a previous Irish study, which found that the daily dietary intake was 6.5 kg of CO2eq per person. As expected, consumption of red meat was the highest contributor to dietary carbon footprint. Fruit and vegetable consumption was low despite these foods having a lower carbon footprint.

Conclusions
The environmental impacts of current dietary patterns are substantial, threatening ecological integrity. Greater adherence to well-characterized diets has been associated with lower diet-related GHGE. Transforming our diets is required to build a resilient and sustainable food system, while safeguarding planetary health. However, nutrition and long-term health must remain a key component of any dietary change particularly in vulnerable and nutritionally compromised populations.

Key messages
Food systems and diets thereof are inextricably linked with nutrition, health and environmental issues. Dietary transitions are needed to reduce global burden of disease and environmental degradation. Consideration on the feasibility of adopting sustainable diets among older populations to ensure healthy ageing is required. Trade-offs arise between protein requirements and environmental impacts.