bluuebunny/crossref_metadata_2025_split huggingface dataset:
Review the Primary Health care for Travellers Projects (PHCTPs) in he Eastern Region
Authors: Quirke B , Collins M , Kavanagh L , Kelleher C 
Published: October 2023

Abstract

Issue/Problem
Minority ethnic minority groups globally experience similar health challenges in accessing appropriate health services. Irish Travellers are a Minority Ethnic group who experience health inequalities. Our objective is to review the PHC model adapted for Travellers to identify the appropriate elements, resources, standards and principles required to develop, implement and sustain an effective model of good practice in PHCTPs.

Description of the Problem
We reviewed 10 PHCTPs in the Eastern region. Different methods were used taking cognisance of literacy and experience levels among Traveller Community Health workers (TCHWs), Project Coordinators and Steering group members. Scoping exercise conducted to review the literature and collate project reports; questionnaires designed for Coordinators and steering group members; Regional workshops and focus groups were run with PHCTP coordinators and TCHWs these included SWOC analyses; Spider graphs and graffiti wall exercises.

Results
The scoping exercise showed improvements in levels of satisfaction and utilisation of health services by Travellers in its areas; TCHWs were very enthusiastic about their training and experience of working in the projects. Focus on replicating the outcomes of the original PHC model but not the process involved to engage Travellers; Project Coordinators require further training to develop skills to improve the capacity, training standards and scope of the projects. Results fed back to all the groups and the collation and analysis informed the development of a Good Practice guide for a sustainable model of PHCTP.

Lessons
Development of culturally appropriate information and services in partnership with marginalised communities; work with rather than for; respect the expertise that each partner brings to the project.

Key messages
• A sustainable model of good practice identified for Primary Health care for Traveller Projects to facilitate expansion.
• Highlights value of PHC as a model for adaptation for other minorities/settings.
The chronic diseases and health-related quality of life among nursing home residents in Armenia
Authors: Muradyan D , Giloyan A , Harutyunyan T , Petrosyan V 
Published: October 2023

Abstract

Background
The study assessed the impact of chronic diseases (and each of them) on health-related quality of life (HRQoL) and each of the eight domains of HRQoL in nursing home residents in Armenia.

Methods
In 2021, a cross-sectional study surveyed 313 nursing home residents using a structured interviewer-administered questionnaire to collect data on socio-demographics, chronic diseases, HRQoL, smoking, and sleeping disorders. An ophthalmic examination was conducted to assess visual impairment (VI).

Results
The participants mean age was 72.5 years. The most common chronic diseases were bone/joint diseases, hypertension, and heart diseases. In the adjusted analysis having at least one chronic disease, sleeping disorder, and VI were negatively associated with the total score of HRQoL. Stroke was negatively associated with all domains of HRQoL in the adjusted analysis. Chronic bone/joint and heart diseases were associated with almost all domains of HRQoL except emotional well-being and social functioning (for the former) and role limitation due to physical and emotional problems, and social functioning (for the latter). Chronic renal diseases significantly decreased scores in the domains of energy/fatigue, emotional well-being, pain, and general health, while chronic respiratory diseases/asthma decreased scores of social functioning and pain in the adjusted analysis.In the adjusted analysis having two or more chronic diseases was negatively associated with all domains of HRQoL, with pain (β = -36.3, p &lt; 0.001), role limitation due to physical health (β = -29.0, p &lt; 0.001) and physical functioning (β = -26.5, p &lt; 0.001) being the most affected domains.

Conclusions
Chronic diseases significantly decreased HRQoL among participants, with stroke and bone/joint diseases having the broadest impact on HRQoL domains. Strategies should be developed for the adequate management of chronic diseases. Those with multiple chronic diseases should be priority targets for such interventions.

Key messages
• Stroke and bones/joints diseases have the broadest impact on HRQoL domains.
• Having two or more chronic diseases significantly decreased HRQoL in all domains, particularly affecting pain, role limitation due to physical health, and physical functioning.
Exploring attitudes of people with chronic conditions towards telerehabilitation: A qualitative study
Authors: Barry Walsh C , Cahalan R , Hinman R S , O’ Sullivan K 
Published: October 2023

Abstract

Background
Patient attitudes towards telerehabilitation have been explored in condition-specific cohorts. However, less is known about how patients perceive generic group telerehabilitation programmes for a range of chronic conditions. The aim of this research is to explore the attitudes of people with a range of chronic health conditions towards group-based telerehabilitation, and the acceptability of generic telerehabilitation programmes.

Methods
We conducted a qualitative research study using semi-structured focus groups via videoconferencing software. A purposive sample of 18 people with chronic health complaints including cardiorespiratory, neurological and musculoskeletal conditions were recruited. The sample included both those who had (n = 11), and had not (n = 7), previously engaged in telerehabilitation programmes. An online questionnaire collected demographic information and data regarding previous telerehabilitation participation and preferences. Focus groups were conducted via videoconferencing, in accordance with the Consolidated Criteria for Reporting Qualitative Research Checklist, and analysed using thematic analysis following Braun and Clarke's methodology. Findings were triangulated with quantitative questionnaire data.

Results
Four focus groups were conducted including participants with chronic cardiorespiratory (n = 8), neurological (n = 6) and musculoskeletal (n = 4) conditions. Three themes were identified regarding telerehabilitation: 1. Benefits and Facilitators 2. Challenges and Barriers, and 3. Preferences

Conclusion(s)
Telerehabilitation is convenient for people with chronic conditions, however, concerns exist regarding technology and the limitations of this healthcare delivery method. The role of telerehabilitation is valued, and future programmes should acknowledge patient preferences including a hybrid model of care, exercise and educational content, social interaction, and synchronous components.

Key messages
• Patients value the role of telerehabilitation in the future as an adjunct to traditional in-person rehabilitation, not as a replacement.
• The acceptability of a generic telerehabilitation programme for a group of people with a range of chronic conditions remains unclear, and may differ between groups.
Differences in breast cancer incidence between women with and without disabilities in South Korea
Authors: Kang H Y , Oh J K 
Published: October 2023

Abstract

Backgrounds
Breast Cancer (BRC) is a leading cause of morbidity and mortality in women. BRC incidence has steadily increased in South Korea. Women with disabilities encounter multiple challenges in accessing cancer prevention and diagnosis. This study aims to estimate the incidence of BRC among women with and without disabilities in South Korea.

Methods
We analyzed 2.87 million women aged ≥30 years in 2002 who participated in the National Health Screening Program in 2002-2003 retrieved from the National Health Insurance Database (NHID). Disabilities were identified by the disability registration data in the NHID from 2002-2019. BRC incidence was determined by the National Cancer Registry in 2003-2019; for women with disabilities, BRC diagnosed after registering disability were included. Age-standardized incidence rates (ASRs) and ratios (SIRs) compared to incidence in the general population were estimated for those with and without disabilities.

Results
During the follow-up period (2003-2019), incident cases were 2,605 (0.9%) and 46,267 (1.8%) among 296,689 women with- and 2,576,182 without disabilities, respectively. Women without disabilities had a 1.65 times higher risk of BRC than those with disabilities. The BRC risk in women with disabilities (SIR = 0.59, 95% CI 0.57-0.62; ASR = 58.2 per 100,000) was lower than the general population. However, women without disabilities (SIR = 0.98, 0.97-0.99; ASR = 96.0 per 100,000) were similar to the general population. Women with disabilities were less likely to undergo BRC screening (RR = 0.92, 0.92-0.92) and more likely to have advanced stages than women without disabilities. Even though the incidence was higher among women without disabilities, BRC mortality was similar between the two groups.

Conclusions
Women with disabilities had a lower BRC incidence but a similar mortality rate to those without disabilities. Lesser accessibility to healthcare services in women with disabilities may partly explain the lower incidence rate.

Key messages
• Women with disabilities had a lower incidence but a similar mortality rate of BRC compared to women without disabilities.
• Women with disabilities were less likely to undergo BRC screening and more likely to have advanced stages than those without disabilities.
Effect of urban green space on parental sleep quality in the two years after childbirth
Authors: Chen P A , Hsu H W , Zou M L , Lin W Y , Wu C D , Chen Y H 
Published: October 2023

Abstract

Background
Green spaces are beneficial for sleep quality, particularly for maternal sleep quality, which in turn affects maternal health as well as the growth and development of offspring. However, few studies have examined the effect of green space on parental sleep quality, and even fewer have utilized the Normalized Difference Vegetation Index (NDVI). This study thus aims to explore the impact of urban green spaces on parental sleep quality during the two years after childbirth.

Methods
Participants were selected from the Longitudinal Examination across Prenatal and Postpartum Health in Taiwan cohort study. The study recruited and followed participants from early pregnancy to 6 years postpartum at five hospitals in Taipei since 2011. Participants who had used hypnotics were excluded. Sleep quality was assessed using self-reported questions at 24 months postpartum. Urban greenness was assessed using NDVI within a designated radius (250, 750, and 1500m) of participants’ residences during both the pregnancy and postpartum. Data were analyzed using multiple logistic regression.

Results
Out of the 804 pairs included in the analysis, we observed that an increase of 0.1 units in NDVI within a 1500m radius during pregnancy and postpartum periods (0-24 months) was associated with a 1.24 and 1.25-fold increase in maternal better sleep quality (95%CI:1.07,1.43 and 1.08, 1.43, respectively), after adjustment. These findings were consistent for both NDVI_250m and NDVI_750m. However, we did not find any association between NDVI and paternal sleep quality at any radius or time period.

Conclusions
We highlight a positive association between exposure to urban green spaces during perinatal periods and better maternal sleep quality. These findings have implications for parents in choosing their living environment, as well as for policymakers in urban planning and environmental improvement initiatives to promote both maternal and child health.

Key messages
• Urban green spaces have a positive impact on maternal sleep quality from pregnancy to postpartum periods.
• The residential environment is critical to facilitate sleep quality and promote maternal and child health.
Using mixed methods to better assess the effects of citizen sensing on individual behaviors
Authors: Dardier G , Jabot F 
Published: October 2023

Abstract

Citizen sensing initiatives have multiplied in recent years as a way to better understand and act upon urban air pollution at the individual level. However, assessing their effects on behaviors remains a challenge. In 2019, a multidisplinary academic team conducted a research on a French initiative where volunteer citizens were equiped with fine particle micro-sensors, and mobilized mixed methods to assess its impacts on individual practices. A cross analysis of quantitative data from the micro-sensors (3001 measure sessions from 73 sensors) and qualitative data from the volunteers (70 interviews and 49 questionnaires) was performed to analyze the strategies of capture deployed by the volunteers and the impact of the initiative on individual behaviors. Each data set analysis established a relationship between the ways in which volunteers use the sensors and the evolutions of the initiative. Their cross analysis strengthened this relationship and enriched its understanding by identifying the mechanisms at play: volunteers’ capture behaviors over time and space are determined by their initial drive to participate in the initiative, the support they receive to use the sensor, understand the data and relate it to personal concerns, and their sense of belonging to a community of clean air ambassadors. The confrontation of data sets also helped nuance the declarative statements of volunteers regarding behavior change and identify common patterns in the process of adoption (types of new behavior, triggers and maintenance over time). This research confirms that mixed methods are relevant to evaluate the effectiveness of citizen sensing initiatives since they can be used to both assess their effects on individual behaviors and try to explain those changes. The work also highlighted the current limitations of mixed methods implementation (methodological issues and getting people from different disciplines to work together) and protocols for future research were recommended.

Key messages
• Mixed methods can both enhance the impacts of citizen sensing on individual behaviors, health literacy and collective empowerment, and allow researchers to better assess those impacts.
• Mixed methods require the fusion of conceptual and methodological frameworks from different disciplines in a transdisciplinary perspective, those needing new partnerships built on mutual trust.
Food policy impacts on greenhouse gas emissions from food system activities in Ireland 1990-2018
Authors: Stanley I , Murrin C 
Published: October 2023

Abstract

Food systems encompass interconnected actors and activities that bring food from farm to fork and the broader environments (economic, societal and natural) they are embedded in. Food systems operate at high cost to human and environmental health. 20-30% of total human-created greenhouse gas (GHG) emissions globally are attributable to food system activities. The agri-food sector plays a vital role in the Irish economy. In 2021 agri-food exports valued €18.7 billion and provided 7.1% of jobs in Ireland. Economic growth in the sector has come at the expense of the environment. In 2018 Ireland had the highest GHG emissions from food systems per capita in the EU. This paper presents an overview of GHG emissions from Irish food system activities 1990-2018. Data from the Emissions Database for Global Atmospheric Research were used to examine changes in food system emissions (Mt C02-equivalent(eq)) over time (1990-2018). Shares of total emissions by system stage (land use, production, processing, packaging, retail, transport, consumption and food waste) were also analysed. Food and agriculture policy developments were mapped to changes in emissions over time. After a decline from 2000 to 2011, food system emissions in Ireland are trending upwards. Total food system emissions in Ireland in 2018 measured 34Mt (C02-eq), accounting for 52% of all Irish emissions. 84% of food system emissions arose from production. Packaging and transport of food represented 3.7% each and consumption amounted to 0.84%. Increasing sustainability in the food system requires an understanding of where and how emissions arise across the whole system. Research on Irish food-related emissions has focused on agriculture and land use but little is published on activities later in the system. Estimating GHG contribution across the Irish food system this analysis provides important information for targeted policy development for mitigating food system impacts on climate change and health.

Key messages
• By estimating GHG contribution across the Irish food system this analysis provides important information for targeted policy development for mitigating food system impacts on climate change.
• Increasing sustainability in the food system requires an understanding of where and how emissions arise across the whole system.
Feasibility, acceptability & preliminary efficacy of a digital preconception intervention: OptimalMe
Authors: Brammall B R , Garad R M , Teede H J , Harrison C L 
Published: October 2023

Abstract

Background
Women's health prior to pregnancy is an increasing area of public health focus. Lifestyle interventions in preconception may be an ideal to target lifestyle behaviours that impact preconception and pregnancy health. However, there are limited interventions initiated prior to pregnancy. This study assesses the feasibility, acceptability and preliminary effectiveness of a digital healthy lifestyle behaviours intervention in women planning a pregnancy.

Methods
Participants were provided digital health and lifestyle information, health checklist, goal setting tools and virtual health coaching (telephone or video conference). Feasibility was defined as 1) recruitment of eligible participants who expressed interest, 2) retention from baseline through delivery (attending both preconception coaching sessions), and 3) adherence, based on attending one health coaching session, using the digital goal setting tool and accessing at least one information article. Acceptability was based on program components evaluated as helpful/very helpful. Preliminary intervention efficacy was based on participants attending a preconception consultation with a genera l practitioner (GP).

Results
Women (n = 298) planning a pregnancy within 12 months were recruited. Feasibility objectives were met, with 60% (n = 298/494) recruitment, 76% (n = 227/298) retention and 85% (n = 252/298) adherence. Evaluation demonstrated high levels of acceptability: digital module (95% n = 205/216), physical activity/diet information (90% n = 195/216), preconception health information (91% n = 195/215), coaching (92% n = 198/216), lifestyle SMSs (72% n = 153/213) and self-weighing (74% n = 159/215). Since the intervention, 73% (n = 159/217) had visited their GP in preparation for pregnancy.

Conclusions
The OptimalMe preconception intervention demonstrated feasibility, high acceptability and efficacy in women planning a pregnancy. This supports future digital health interventions in preconception; pregnancy results pending.

Key messages
• Interventions prior to pregnancy are limited, yet women’s health prior to pregnancy is an increasing area of public health focus.
• Digital health interventions are feasible and acceptable for preconception health and lifestyle health promotion for women planning a pregnancy.
2.M. Workshop: Fostering integrated care through a large-scale structural health system reform in Finland
Authors:   Organised by: Finnish Institute for Health and Welfare, European Observatory on Health Systems and Policies, EUPHA-HSR,   Chair persons: Ilmo Keskimäki (Finland), Johan Hansen (EUPHA-HSR)
Published: October 2023

Abstract

Several countries have introduced health system reforms to foster integrated care within their health systems and in some case also between health and other welfare services such as social care. These integrated care initiatives have included reorganization of the work of professionals, developing patient pathways and removing barriers for organisations to work together. Comprehensive structural reforms to foster integrated care have not been that common. In health systems, like in public policy in general, small, micro-level reforms are common but only seldom large-scale structural reforms are enacted. Also integrated care is often fostered through small-scale reforms which are not always even scaled up from the local or regional level to national level policies. In Finland a large-scale structural reform was introduced in 2023 which can be marked as one of the most comprehensive health system reform in Europe over the past decades. As a result of the reform the responsibility for organizing health care, social services and rescue services was transferred from over 300 municipalities to 22 health and social care authorities which all get funding from the state. A key tool in pursuing the reform has been to implement administrative and financial integration both in terms of vertical integration within health system and horizontal integration between health care and social services. The workshop uses the Finnish health system reform as a case study to present how integrated care can shape the health reform agendas and implementation of the reform. We discuss how structural reformation can foster integrated care at patient level and how the rather radical restructuration of the Finnish health system looks from the wider European perspective.

Key messages
• One of the most comprehensive health-system reforms in Europe over the past decades was introduced in Finland in 2023.
• The radical structural health-system reformation can foster integrated care at patient level and offers a learning opportunity to other European health systems.
What a journey! – A short history of the Finnish health care and social service reform and administrative integration of health care and social services
Authors: Tynkkynen L 
Published: October 2023

Abstract
Finland is a Nordic welfare state with universal access to tax-funded health care. While the health system performs relatively well when measured in terms of avoidable mortality, several measures indicate that access to care, especially primary care, is poor. There are also relatively large geographical and socioeconomic inequities in access, utilization, and quality of services. To tackle these issues, a process to reform the health system was initiated in the early 2000s. However, it was not until 2021 when the large-scale reform of the system was enacted and not until 2023 when the new structure was implemented. The process involved several different reform proposals which all shaped the outcome of the reform. The key feature in almost all the reform proposals and in the final reform plan has been fostering vertical integration in health care and horizontal integration of health and social services both at the level of administration and organization as well as through processes and patient pathways. In this presentation we describe the history of the Finnish health and social care reform process and discuss, how integrated care as a policy idea and tool has shaped the reform agenda and reform proposals.