bluuebunny/crossref_metadata_2025_split huggingface dataset:
Home-based exercise program for women with osteoporosis: focus on adherence
Authors: Pinelli E , Barone G , Benvenuti F , Audino G , Zinno R , Bragonzoni L 
Published: October 2021

Abstract

Exercise program is important for maintaining or increasing bone mineral density in people with low bone mass. The home physical activity was the only alternative to keeping active people with osteoporosis during covid-19 pandemic. This study aims at investigating the adherence to an exercise program specifically designed for women with postmenopausal osteoporosis when administered as individual home training (IHT) or online group training (OGT). 40 women, aged between 67 ± 6,5 years, were recruited for the study. A randomization was performed to divide the women into two groups: IHT or OGT. The OGT group was supervised by the trainers during exercise session utilizing a video conferencing software. The IHT group received a book with the exercises explained, a diary and a training program. Every 6 weeks the program was changed and the IHT group met the trainers in order for them to explain on video call the new excercise the group had to perform. They were also monitored by call every 15 days. Both groups performed 24 weeks of training, twice a week for 1-hour session. The training sessions was 48 in total (100%). The adherence was registered with a diary for the IHT and with a register for the OGT. The adherence in both groups was 65% (26 women), while 35% was not adherent (14 women:7 OGT and 7 IHT). The causes of not adherence depend on family problems 50%, health issue 14%, work duties 14% and IT ability and possibility to have broadband connection 21% (only OGT).The relationship between trainers and participants is important in maintaining adherence to a physical activity program. When physical contact is not allowed, as happened during the pandemic period, frequent contact by telephone or other appropriate technological tools can help to maintain adhesion. Despite the home environment often prevents participation in a physical activity program, online training promotion represents an indispensable opportunity to reach elderly people who are unable to go to the gym.

Key messages
The relationship between trainers and participants is important in maintaining adherence to a physical activity program. online training promotion represents an indispensable opportunity to reach elderly people who are unable to go to the gym.
Healthcare organization and management barriers and facilitators for health promotion in primary care
Authors: Rogers HL , Pablo Hernando S , Nunez Fernandez S , Sanchez A , Martos C , Moreno M , Grandes G 
Published: October 2021

Abstract

Background
There are challenges in translating evidence-based interventions into practice, and the need for health care organization, management, and policy changes to align with health promotion activities within the health and social care system is well-documented. This study aims to elucidate the role of these factors as barriers/facilitators influencing the implementation of an evidence-based health promotion intervention in primary care centers in the Basque Country, Spain.

Methods
Seven focus groups were conducted with 49 health professionals from 6 primary care centers participating in the Prescribing Healthy Life (PVS) program. Text was analyzed using the Consolidated Framework for Implementation Research (CFIR) focusing on those constructs related to health care organization, management, and policy.

Results
The health promotion intervention was found to be compatible with the values of primary care professionals. However, professionals at all centers reported barriers to implementation related to: (1) external policy and incentives, (2) compatibility with existing workflow, and (3) available resources to carry out the program. Specific barriers related to high caseloads, contracting issues, short consultation times, and lack of appointment times for lifestyle counselling. Other barriers/facilitators were related to CFIR constructs networks and communication, culture, relative priority, and leadership engagement. A set of nine specific barriers-facilitators emerged.

Conclusions
In some centers, certain facilitators addressed barriers identified in other centers influencing implementation of a health promotion intervention in primary care. Proactive identification and modification of barriers by healthcare managers and policy makers can help to ensure effective integration of health promotion into primary care.

Key messages
Implementation science methods for program evaluation can help identify barriers and facilitators to health promotion implementation in primary care. Policy and incentives, compatibility, available resources, networks and communication, culture, relative priority, and leadership engagement influenced successful health promotion implementation.
Online Health information, health literacy and therapeutic compliance: a theoretical framework
Authors: De Caro W 
Published: October 2021

Abstract

Introduction
The expansion of information sources and easy access to virtual sources are radically changing health information-seeking behavior. In the past, direct interaction with health care providers is rapidly decreasing. A high percentage of individuals are in the habit of checking their health online: information overload, fake news, misinformation and echo chambers effect will be encountered.

Methods
A review of the literature on health literacy, online health information and its influence on health status and therapeutic compliance was carried out in order to develop a new theoretical framework. The insight approach will allow health care providers to account for the complexity of the relationship between health status and online information and will be useful in moving to a different perspective to assess the field.

Results
The development of this theoretical framework focuses on the role of online information seeking behaviors' and its connection to levels of health literacy, health status and treatment compliance.
Evidence of the spread of misinformation, fake news and at the same time the echo chamber effect has an important effect on the health. An important debate is growing in the literature on the role of fact checking and institutional/expert information in really changing the health behavior of individuals.

Conclusions
The main development of this framework is certainly related to the need to assess the level of health literacy, also in order to ensure a comprehensive understanding of health information behaviors and their relation to health status. Furthermore, it would be desirable to develop innovative health promotion campaigns as well as to develop the role of nurses as health educators. There is a need to further evaluate the barriers that prevent individuals from having full compliance and an informed and critical understanding of health information.

Key messages
Adherence is a key factor. Health information online is the key for improve health literacy levels.
HIV/AIDS stigma among University students in Ancona (Italy) and Novi Sad (Serbia)
Authors: Fortunato C , Radić I , Barbadoro P 
Published: October 2021

Abstract

Background
Sigma associated with HIV/AIDS can be a considerable barrier to HIV prevention. The aim of the study was to assess factors associated with stigmatizing attitudes among university students.

Methods
The study was conducted as a cross-sectional study among 1305 university students in Ancona (Italy) and Novi Sad (Serbia) from October to December 2020 (67.7% females). The mean age of participants was 21.94 ± 2.45. The instrument of the study was an online questionnaire that included socio-demographic data and questions about attitudes toward HIV/AIDS. Stigma was analyzed using five questions and the stigma score was calculated (a lower score indicated a higher stigma attitude).

Results
Among University students 89.7% would share a classroom with a student with HIV/AIDS, 2.5% of students think that students with HIV/AIDS should have separate classes and 5.8% are not sure if they should be in separate classes. Only half of the students (50.1%) said that they would share a bathroom with HIV/AIDS positive students and 80.4% said that they would buy fruits from a HIV/AIDS positive person. Every second student (55.1%) thinks that HIV-positive women should have children. The mean stigma score of the respondents in this study was 3.66 ± 1.26. Stigma score was lowest among youngest participants and among students at lower study year. The stigmatizing attitude was less present among students of medicine (4.09), comparing to other faculties (3.33) (p &lt; 0.001). There were no statistical differences according to gender, data about who they live with, material status of the family and between Universities.

Conclusions
Results of this study showed that there are some negative attitudes toward people living with HIV/AIDS among university students. The stigmatizing attitude was more common among younger students.

Key messages
Stigmatizing attitude toward HIV/AIDS is still present among younger generations. Need for more health promotion activities among students from both countries.
Determinants of eating disorders among morrocan medical students
Authors: Tsoumbou-Bakana G , Slith H , Traore B , Mchichi Alami K , Nani S 
Published: October 2021

Abstract

Introduction
Eating disorders (EDs) are multifactorial in origin. Medical students are a special population because they are particularly young and exposed to stress, workload and the experience of illness in the field.

Objective
To determine the prevalence of EDs and associated factors among medical students

Methods
This was a cross-sectional study conducted from November to December 2020 among medical students at the Faculty of Medicine and Pharmacy in Casablanca. Data were collected using a hetero questionnaire distributed online. The presence of EDs was measured using the SCOFF (Stick, Control, One stone, Fat, Food) scale and anxiety and depression were measured using the HAD (Hamilton Anxiety and Depression) scale. The sample size was calculated a priori and multivariate statistical analyses such as logistic regression were performed. The α threshold was set at 5%.

Results
A total of 315 students participated in the study, the mean age was 21.01+/- 2.5 years, the majority were female (68.7%), and undergraduates represented 61.7% of the sample. The incidence of EDs was 39.9%. Regarding BMI (Body Mass Index). In terms of BMI, 65.5% had a normal BMI, anxiety and depressive symptoms were absent in 48.4% and 72.2% of cases respectively. Factors associated with EDS were: use of weight control (OR: 7.14 [1.72- 32.519], p = 0.00), BMI (OR: 1.142 [1.06-1.22], p = 0.000) and anxiety symptoms (OR: 3.51 [51.98-6.23], p = 0.000).

Conclusions
The frequency of eating disorders is high among medical students. The knowledge of the potentially associated factors allows us to generate hypotheses in order to define the axes of prevention of these disorders.

Key messages
Eating disorders are a health problem among medical students. Eating disorders are multifactorial in origin.
Identifying barriers to care to inform Lassa Fever health policies in rural Nigeria
Authors: Tiv MH , Friant SR 
Published: October 2021

Abstract

Lassa fever (LF) is an emerging viral haemorrhagic disease endemic to West Africa that can potentially cause a global pandemic. Nigeria has experienced yearly LF outbreaks since 2012 and the 2018 outbreak recorded an unprecedented number of cases and deaths. A critical gap in controlling neglected tropical diseases such as LF is our limited understanding of how people access care and how structural and cultural factors constitute barriers to care. This study examines concepts of illness and healthcare-seeking behaviours to investigate these barriers. From October to December 2019, we conducted a mixed-methods community-based study consisting of 51 interviews, 21 focus groups, and direct observations, in 5 villages of a 2018 LF hotspot in Ebonyi state, Nigeria. Participants' perceived severity and frequency of diseases aligned with the current biomedical understanding. In contrast, some diseases were associated with witchcraft or bad behaviours. Most participants knew LF disease but denied its yearly recurrence. In addition, LF victims and caregivers suffered from a strong stigmatisation. We identified a mismatch between preferred and actual healthcare-seeking behaviours. Most participants preferred hospital care but defaulted to traditional healers and patent medicine vendors (chemists). Reasons reported were high care fees, life-sustaining jobs conflicting with commuting time to hospitals, and a low English literacy. Age and education correlated with healthcare-seeking behaviours: elder and less formally educated people preferred traditional healers. LF-related stigma reportedly impacted timeliness and adequacy of care during the 2018 outbreak. Participants had a good knowledge of the diseases and true barriers to care came from structural factors and LF-related stigma. This led to mismatches between disease knowledge and healthcare-seeking behaviours. Awareness campaigns may have a limited impact if they focus on disease knowledge without addressing barriers to care.

Key messages
To enhance LF detection and control, LF policies in rural Nigeria should focus on barriers to care through public health messaging addressing stigma and through bringing care closer to remote areas. This community-based study illustrates the importance of understanding the socio-cultural ecology of the diseases to inform evidence-based and locally adapted strategies for disease control.
Reduce speeding in times of COVID-19 in Buenos Aires, Argentina
Authors: Cordoba M , Sanguinetti C 
Published: October 2021

Abstract

Buenos Aires has a mortality rate due to road crashes of 3.6 per 100,000 habitants. 6/10 fatal incidents are due to speeding. Unfortunately, the City has an outdated electronic control system and a small, corps of traffic agents oversees the execution of mobile speed controls. Under the part of Partnership for Healthy Cities, the city implemented a speed reduction policy to strengthen the existing speed management by measuring speeds. The observation points were established from the sampling of 567 avenues segments according to their level of danger and # of traffic lights. 74 observation points were selected. The final sample (1,572,879 observations) obtained a representative balance of the vehicular circulation arteries according to the territory's geographical zones. 92.1% of the vehicles that circulate on the avenues respect the speed limits while 7.9% exceed the speed limit. In passenger transport and trucks, the average number of exceeding the speed limits more than doubled. During COVID-19 lockdowns, the vehicles that exceeded the maximum speed reached 9.1%. As movement and mobility changed in Buenos Aires due to COVID-19, they used this opportunity to reduce the speed limits and add cycling lanes. At the start of 2020, there were 300,000 daily trips by bicycle and during lockdown, trips rose between 24% and 114%. It is expected that by next year they will be 500,000 per day. 17 km of bicycle lanes were built in two of the largest avenues in the city and the speed limit was reduced to 50 km/h on these avenues. In addition, it was detected that both avenues were the ones on which the most trips were carried out outside the formal network of bicycle lanes, which is 250 kilometers long. On journeys that are made outside this circuit, the risk of a road accident increases by 86%. The planning process must carry out, even when in an emergency. Training and socialization of interventions for all road actors are necessary to promote road awareness.

Key messages
Cities are catalysts for actions to promote public health interventions on the front line to emergencies and they have the responsibility of continuing to manage the NCDI and injuries. Healthy, safe, and sustainable mobility are parameters to be met in interventions that promote road safety.
Psychosocial school conditions and students’ positive mental well-being
Authors: Brolin Låftman S , Modin B , Granvik Saminathen M , Östberg V , Löfstedt P , Rajaleid K 
Published: October 2021

Abstract

Background
School is a key social determinant of adolescent health. However, earlier research on psychosocial school conditions has largely focused on their relationship with aspects of adverse health, and fewer studies have examined the links with positive health. The aim of this study was to investigate boys' and girls' experiences of school demands, teacher support, and classmate support and their associations with positive mental well-being.

Methods
Data were derived from the Swedish Health Behaviour in School-aged Children (HBSC) study of 2017/18, with information collected among 1,418 students in grade 9 (∼15-16 years). School demands, teacher support, and classmate support were captured by indices based on multiple items. Positive mental well-being was measured by the Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMBWS). Gender-stratified linear regression analyses were performed, clustering for school class.

Results
Higher demands were associated with lower mental well-being (boys: b=-0.36, p &lt; 0.05; girls: b=-0.65, p &lt; 0.05). Conversely, mental well-being increased with greater teacher support (boys: b = 0.53, p &lt; 0.05; girls: b = 0.56, p &lt; 0.05) and classmate support (boys: b = 0.70, p &lt; 0.05; girls: b = 0.50, p &lt; 0.05). Interactions between demands and the support variables showed that at the lowest levels of teacher and of classmate support, mental well-being was low and not associated with school demands. With increasing levels of teacher and classmate support, the overall level of mental-well-being increased and revealed an inverse association between school demands and mental well-being.

Conclusions
The findings indicate that psychosocial school conditions are important not only for adverse health among adolescents, but also for their positive health. The study contributes with knowledge about how psychosocial conditions in school may hinder or enhance positive health among students.

Key messages
School demands, teacher and classmate support were associated with mental well-being among both boys and girls, although the association with demands was seen only at higher levels of support. The findings indicate that psychosocial school conditions are important not only for adverse health among adolescents, but also for their positive health.
Egyptian HCPs’ awareness, attitudes and practice to SHS exposure among pregnant women and children
Authors: Hassanein Z , Langley T , Murray R , Bogdanovica I , Leonardi-Bee J 
Published: October 2021

Abstract

Background and aims
Around half of Egyptian pregnant non-smoking women and children are exposed to secondhand smoke (SHS), which cause serious morbidities. Health care professionals (HCPs) are well placed to help reduce SHS exposure by encouraging avoiding SHS. This study aimed to explore risk-awareness, attitudes and practice of HCPs in relation to SHS exposure among pregnant women and children in Egypt.

Methods
Cross-sectional survey of HCPs working in public maternal and child health clinics in Assiut city, Egypt. The survey included questions on risk-awareness, attitudes and counselling practice. Descriptive and regression analysis was performed to explore factors associated with high risk-awareness, supportive attitudes, and good counselling practice.

Results
367 HCPs participated in the survey with the majority being nurses (45%) and gynaecologists/obstetricians (21%). 12.5% of HCPs were smokers, and considerable proportion of HCPs reported being exposed to SHS at workplace (70.3%) and at home (51.7%). Just over half of all HCPs (55.9%) had high SHS risk awareness. Speciality, serving urban communities, and home SHS exposure were significantly associated with high-risk awareness. 52.9% of HCPs had supportive attitude towards preventing SHS exposure. Being female, serving rural communities, home SHS exposure were significantly associated with supportive attitudes. Only 51.8% of HCPs reported good counselling practice, which was explaining SHS hazards and advising to avoid it. Being female, serving rural communities, not exposed to SHS at home, and previous training on smoking cessation service were significantly associated with good counselling practice.

Conclusions
HCPs' awareness, attitudes and practice regarding the risks of SHS to pregnant women and children in Egypt are at low levels. Training is required for HCPs to improve their knowledge and skills and be able to help pregnant women and children to avoid SHS exposure and reduce consequent health burden.

Key messages
HCPs’ awareness and practice regarding risks of SHS to pregnant women/children in Egypt are inadequate. HCPs’ training is essential to help pregnant women/children to avoid SHS and reduce health burden.
Folic acid supplementation in the Congenital Anomalies population-based registry in a Spanish Region
Authors: Cavero-Carbonell C , Barrachina-Bonet L , García-Villodre L , Páramo-Rodríguez L , Guardiola-Vilarroig S , Zurriaga O 
Published: October 2021

Abstract

Background
The Congenital Anomalies (CA) population-based registry of Valencian Region (RPACCV) has identified 11376 cases, live births (LB) and stillbirths (SB), between 2007-2018 with at least 1 major CA, diagnosed prenatally or up to 1 year old. The Folic acid supplementation (FAS) during the pregnancy is also registered.

Aim
To identify differences in sociodemographic and clinical characteristics and in CA presentation, in cases from RPACCV according to prenatal FAS.

Methods
A cross-sectional study was performed using the RPACCV to identify exposure to FAS (yes/no) in pregnancies with a born (LB and SB) with CA between 2007-2018. Pregnancies with unknown exposure were excluded. Percentages and their 95% confidence intervals (95%CI) of the sociodemographic and clinical characteristics of the cases were determined and compared according to pregnant exposure to FAS. Frequency and its 95%CI of the different CA groups were identified by exposure.

Results
14.1% of pregnancies (1602) were exposed to FAS and 10.4% (1182) were not, 75.5% were excluded. Statistically significant differences weren't found for sociodemographic and clinical characteristics according to exposure. In children of women exposed 1777 CA were identified and 2019 CA in those unexposed. Statistically significant differences were found in these CA groups (shown as % in the exposed/% in the unexposed): Heart defects (7.1%/52.7%), Respiratory (0.2%/1.2%), Digestive (2.3%/5.3%), Genital (2.5%/4.8%), Urinary (3.9%/9.3%), Limb (6.8%/9.4%), Oro-facial clefts (25.4%/2.8%), Eyes, Ears, Face and Neck (3.8%/1.2%).

Conclusions
Several studies identified that FAS prevents from some CA. The fact that in only 25% of pregnant women there is information about FAS, highlight the difficulties of its registration in the clinical documentation. However, with the available information, it was identified that children of unexposed pregnant women presented more CA and from groups with a higher impact on morbidity and mortality.

Key messages
In Spain, Folic acid supplementation doesn’t require a prescription and, as its use is customary prior and during pregnancy, it doesn’t seem to be considered as significant drug exposure in pregnancy. Differences between pregnancies exposed and unexposed to folic acid supplementation were found regarding the number of congenital anomalies presented in their children and its severity.