bluuebunny/crossref_metadata_2025_split huggingface dataset:
Promotion of Health Literacy in a Colorectal Cancer Screening
Authors: Costa A , Torres J , Vieira A , Henriques A 
Published: October 2023

Abstract

Background and objectives
Colorectal cancer is the 4th deadliest cancer in the world. Colorectal Cancer Screening (CRCS) allows to an increase in the associated overall survival. Biannual fecal immunochemical screening has been shown to be more cost-effective than colonoscopy. Health Literacy (HL), as a mediator in decision-making, can be fundamental in adhering to this screening. The objective is to map the interventions that promote Health Literacy within the scope of CCR screening.

Methods
Scoping review, following the methodology recommended by the Joanna Briggs Institute. Using the Participants, Concept and Context (PCC) strategy, participants were defined as people aged between 50-75 years; as context, the community, and as concepts of Health Literacy and CRCS. Five studies were included in the scoping review.

Results
In the studies included in the review, educational activities aimed at screening were carried out. It was also found increasing the use of digital media promotes Health Literacy. These activities can result in an increase in adherence to this screening. The study by Temucin & Nahcivan (2020) highlights the decisive role of nurses in education and counseling on CRCS. These interventions result in greater empowerment of populations and consequent decision-making related to the CRCS.

Conclusions
It was found that there are still few studies that relate the levels of Health Literacy and adherence to CRCS. However, interventions considering HL levels can result in more knowledge, awareness, and adherence to CRCS.

Key messages
• Health Literacy interventions that empower populations in the decision-making related to the Colorectal Cancer Screening.
• Health Literacy interventions through digital media increase adherence to Colorectal Cancer Screening.
The Global Impact of Edentulism: A Systematic Review
Authors: Hunter E , Congdon N , de Moura Brito L , McKenna G , Petrauskiene E , Rodrigues Leles C , Tsakos G , Woodside J , Virgili G , Piyasena P 
Published: October 2023

Abstract

Background
The evidence to describe the consequences of edentulism has been limited. This systematic review aimed to identify, appraise and summarise the evidence available to describe the broad health and socio-economic impacts of edentulism experienced by individuals living in low-, middle- and high-income countries.

Methods
Searches were carried out on five databases: Scopus, Web of Science, CENTRAL, EMBASE and MEDLINE. Grey literature was searched, in addition to professional recommendations and reference cross-checks. The search was completed on 15th June 2022 and updated on 21st March 2023. Searches were restricted to human studies of community dwelling adults aged ≥18 years. No restrictions were placed on publication date, language, gender or country. Data was independently extracted by two researchers and risk of bias assessment was conducted using the QualSyst Tool. The study was registered on PROSPERO (CRD42022320049).

Results
402 articles were identified from database searches, reference cross-checks and professional recommendations. Title, abstract and full text screening resulted in 32 articles for narrative review. A diverse range of outcomes were identified, including frailty, nutrition, health behaviours, quality of life, mental health and general health conditions. Due to heterogeneity between studies, Synthesis Without Meta-Analysis (SWiM) Guidelines will be used to synthesis the study results. Results from the synthesis using SWiM Guidelines are pending. Despite the inclusion of broad search terms, no relevant studies to explore the impact of edentulism on socio-economic outcomes such as productivity were identified.

Conclusions
There was a lack of high quality interventional evidence to support robust conclusions within this review. Further research to understand the impact of edentulism and establish causal relationships is needed to inform future preventative and treatment strategies.

Key messages
• Global disease burden of edentulism is high. The World Health Organisation (WHO) has estimated that global prevalence of edentulous adults aged ≥60 is 23% (WHO, Oral Health Factsheet, March 2023).
• Many of the factors that contribute to edentulism are preventable and distributed inequitably. Understanding the impact of edentulism remains an area of global public health importance.
The processes and practices of intermediaries in connecting individuals to local physical activity
Authors: O'Grady M , Barrett E , Connolly D 
Published: October 2023

Abstract

Background
Community-based health-related staff, acting as intermediaries, connect individuals to non-medical community services, such as physical activity and exercise. This study explored the practices of intermediaries in different health-related sectors in Ireland, in connecting individuals to local physical activity [PA], as part of a larger project investigating the role of intermediaries in promotion of physical activity.

Methods
A qualitative descriptive design was used for this study. Semi-structured interviews were carried out with three categories of intermediaries: Health Promotion and Improvement Officers [HPIO] (n = 10), Local Sports Partnership Officers [LSPO] (n = 8) and Social Prescribing Link Workers [SPLW] (n = 11). Interviews were audio recorded and transcribed verbatim. Data were analysed using qualitative content analysis.

Preliminary findings
The practices of each intermediary were varied. HPIO focus on providing individuals with smoking cessation services, rather than connecting to PA. LSPO provide ‘light touch interventions': one-off contacts, followed by connection or signposting to PA groups delivered by the partnership. SPLW provide a continuum of support from ‘light touch’ to more intensive interventions, with as much practical or instrumental support needed by the person to connect to local PA. Referrals from healthcare professionals to intermediaries specifically to increase PA were low. However, many individuals who are referred for other reasons such as loneliness and mental health issues are connected to local PA.

Conclusions
Each category of intermediary reported different processes for connecting individuals to PA and provided differing levels of support, but received low numbers of referrals from healthcare professionals specifically for physical activity. Future studies are needed to investigate the impact of interventions provided by these intermediaries on PA levels of individuals attending their services.

Key messages
• Local sports partnership officers and social prescribing link workers facilitate connections to local, community-based physical activity, by providing different levels of support.
• Intermediaries may be an under-utilized resource by healthcare professionals to increase physical activity, and future cohort studies are needed to investigate the impact of the intermediary role.
Effectiveness of dietary intervention among people with diabetes mellitus: A quasi-experimental study
Authors: Kumar Gupta S , Lakshmi P , Malhotra S , Rastogi A , Kaur M 
Published: October 2023

Abstract

Background
This study was aimed to evaluate the impact of intervention based on the behaviour change theory on dietary practices among patients with T2DM living in rural areas.

Methods
A quasi-experimental study was carried out in a rural area of district Fatehgarh Sahib of Punjab, North India. A total of 700 people with T2DM was screened for the eligibility from the randomly selected rural health centeres. The baseline survey included a total of 584 eligible T2DM patients (283 in the intervention and 291 in the control arms), whereas the endline survey included a total of 479 participants (242 in the intervention and 237 in the control arms). A prevalidated and structured food frequency questionnaire at baseline and at the end of 6 months of follow-up. The outcomes of study were mean changes in the total calorie intake from carbohydrate and fat, salt intake, fiber intake and biochemical measurements namely fasting plasma blood glucose, and proportion of population having HbA1c ≤ 7%. Difference in difference analysis (DiD) using Generalized Estimating Equation (GEE) model was applied to adjust for confounders. Statistical significance was considered p &lt; 0.05.

Results
DiD suggested a significant decrease in mean: total calorie intake (-857 kcal/day; 95% CI -1115 - -599, p &lt; 0.001), calorie intake from carbohydrates (-569 kcal/day; 95% CI -729 - -410, p &lt; 0.001), calories intake from fat (-329 kcal/day; 95% CI -438 - -220, p &lt; 0.001) and dietary salt intake (-5 gm/day; 95% CI -7 - -3, p &lt; 0.001). There was also a significant increase in the mean dietary fiber intake (4 gm/day; 95% CI 0.82 - 7, p = 0.01), a decrease in the mean FPBG (-42 mg/dl; 95%CI: -55 - -29, p &lt; 0.001) and a significant increase in proportion of participants having HbA1c within range (≤7%), (8%; 95%CI:1% - 14%, p = 0.01).

Conclusions
Study suggested dietary interventions based on the behaviour change theory helped to achieve optimal dietary habits and glycemic stability among patients with T2DM living in rural areas.

Key messages
• This study emphasised the advantage of behaviour change interventions implementation based on behaviour change theories among patients with T2DM.
• T2DM patients can be encouraged to follow healthy dietary habits by using tailored instructions.
Exploring spatial patterns of cardiovascular disease among women in India
Authors: Patil T , Jana A , Gaurav S 
Published: October 2023

Abstract

Cardiovascular disease (CVD) has become a leading cause of mortality and morbidity in India, surpassing the global rate. While CVD is influenced by gender due to sex-specific risk factors in women, it remains underdiagnosed, and undertreated in women. WHO provides a list of ‘best buys’ which does not consider sex-specific risk factors. Hence, we assessed prevalence, unawareness and spatial variations of CVDs in women (15-49 years). We used NFHS (2019-20) WHO causal links between underlying drivers, behavioral risk factors, metabolic/physiological risk factors, and CVDs. We used ordinary kriging interpolation techniques to measure the spatial heterogeneity of CVD prevalence and spatial autocorrelation techniques using global Moran I statistic. Furthermore, ordinary least square were used to examine spatial predictors and geographically weighted regression and multiscale geographically weighted regression model were used to map the local spatial variations. CVDs prevalence in women is 11.7% [95%, CI: 0.117-0.118], its unawareness is 12% [95%, CI: 0.116-0.117] among women. Spatial regression analysis suggests observed geographical variation of CVDs significantly correlated with risk factors- metabolic (BMI), behavioral (tobacco consumption), and underlying (sex-specific - women's education as a proxy for autonomy and socioeconomic depriviation- household wealth). India has a high burden of CVDs in women, with state-level disparities and a lack of awareness about the disease. Women are not a target population for CVDs in SDG 3.4 and India's National Health policy, 2017; however, its rising epidemic burden on women demands a need for policy choices targeted at women. The study provides evidence to inform the policy choices in reducing CVDs burden in women. It suggests a need to develop gender-specific guidelines for CVD prevention and management in India.

Key messages
• The study provides evidence to inform the policy choices in reducing CVDs burden in women and suggests a need to develop gender-specific guidelines for CVD prevention and management in India.
• India has high burden & unawareness of CVDs in women with risk factors- BMI, tobacco consumption, sex-specific - women's education as a proxy for autonomy; socioeconomic deprivation- household wealth.
Fixing food together: transitioning Ireland to a healthy sustainable food system – CHA position paper
Authors: O'Brien O , Owens S , Stanton A , Allman J , Browne S , Cox J , Fitzgerald R , Harrington J , Morrissey J , Tierney A 
Published: October 2023

Abstract

Problem
The Climate & Health Alliance (CHA) is a coalition of medical, health and advocacy organisations that seeks to highlight the significant health co-benefits of addressing the climate crisis. Our global food system contributes to diet-related chronic disease and has resulted in climate change, pollution, biodiversity collapse and nature loss. A healthy sustainable food system is needed to minimise interrelated obesity, climate change and malnutrition pandemics.

Description of the problem
The CHA conducted an extensive literature review to: 1. Demonstrate the need for a food system transition ; 2. Identify Ireland's challenge areas ; 3. Make recommendations for a healthy sustainable diet in the Irish context; 4. Recommend policy-level actions for Ireland.
The CHA launched ‘Fixing Food Together’ in May 2023. We identified six challenge areas for Ireland: 1. Ending the junk food cycle; 2. Promoting transition to a more plant-based diet; 3. Harnessing the power of international and national guidelines; 4. Reducing food waste; 5. Improving agricultural practices and land use; 6. Using policy to affect behaviour change.

Results
The CHA presented individual-level recommendations for future Irish dietary guidelines, including breastfeeding, ultra-processed foods, protein foods and food waste. Seven policy recommendations were made: 1. National guidelines; 2. Regulations/laws; 3. Research, processing and technology actions; 4. Financial actions ; 5. Agricultural actions; 6. Public institution actions; 7. Public awareness actions

Lessons
‘Fixing Food Together’ represents the first time a healthy sustainable diet and food system has been defined for an Irish context. The cross-sectional nature of the alliance provides a valuable consensus from its member organisations. It brings an often missing public health perspective to the climate and food systems dialogue.

Key messages
• Our current food system is harming human and planetary health.
• ‘Fixing Food Together’ identifies Ireland’s challenge areas and makes recommendations to transition to a healthy sustainable food system.
Patients’ satisfaction with the current access to and the quality of WASH services in rural hospitals
Authors: Omarova A 
Published: October 2023

Abstract

Background
Problems with access to safe WASH entail a deterioration in both the social and economic situation in the country and health and well-being of the people. The current study attempted to determine the patients’ satisfaction with the current access to and quality of WASH.

Methods
The survey was carried out in the hospital of the Shet district, located in the central part of Kazakhstan. Overall, 188 patients were interviewed. The obtained data was analysed aided with Epi Info 7.

Results
Almost all patients (99.47% [95% CI: 97.07-99.99%]) used the water, but 48.4% [95% CI: 35.49-66.62%] of them used it for drinking needs. Of all the respondents, 53.19% [95% CI: 45.79-60.49%] rated the color of water as “good”, smell - 57.45% [95% CI: 50.04-64.61%], taste - 45.21% [95% CI: 37.96-52.62%] and 69.15% [95% CI: 62.02-75.67%] indicated the absence of turbidity. However, 35.11% [95% CI: 28.3-42.39%] of respondents considered that the water supply source is not reliable and only 17.02% [95% CI: 11.94-23.17%] of them gave for the water quality the maximum 10 points on a 10-point scale. The type of water supply source used in the hospital statistically significantly affected the patients’ assessment of the taste of water (χ2=6.55, p = 0.04) and the reliability of the source (χ2=6.88, p = 0.03). Overall, 43.09% [95% CI: 35.9-50.49%] of respondents indicated that the available services of WASH were not adapted for them. There are also no gender-segregated toilets and conditions for hygiene during menstruation for female patients (89.89% [95% CI: 84.67-93.8%]).

Conclusions
Thus, in rural regions, the separation of toilets by gender, conditions for women during menstruation and the adaptation of the WASH for people with disabilities have been missed. There is also no proper understanding of the WASH services among patients.

Acknowledgement
The research is funded by the Science Committee of the Ministry of Science and Higher Education of the Republic of Kazakhstan (Grant No. AP09058465).

Key messages
• WASH management in rural hospitals needs to adhere to the principle of “leave no one behind” and pay more attention to building the capacity of patients in the field of WASH.
• Rural regions represent the biggest challenge in achieving SDG 6 in Kazakhstan.
Intervention Research In Health Promotion: The Challenges of Transferability of a Youth Nutrition Project
Authors: Guillemin A-F 
Published: October 2023

Abstract
Recent evidence reports the efficacy of theory-based interventions to promote physical activity (PA) among population (Gourlan et al., 2015). However, despite those encouraging results reported in the scientific literature, few documents currently exists to help professionals in the health and educational domains to implement theory-based interventions (Marcus & Forsyth, 2009). The “Great Live and Move Challenge” (GLMC) is an intervention based on the tenets of the theory of planned behavior (TPB, Ajzen, 1991) which aim to promote PA among 7-11 years old French school-aged children and their parents (Cousson-Gélie et al., 2019). Throughout the GLMC, children are asked to quantify their daily PA level by illustrating each 15 minutes of PA achieved with an “energy cube”. The cluster randomised controlled trial showed the effectiveness of GLMC in 3121 children by significantly increasing the proportion of children doing one hour of physical activity per day. During a two-year follow-up, children answered each year a questionnaire measuring TPB constructs and weekly physical activity practice both at pre- and post-intervention. A subsample of 157 children also wore an accelerometer (i.e., Actigraph GT3X+). Results notably show that the intervention had a positive impact on the proportion of children who comply with physical activity guidelines during the two years of follow-up, with an increase each year. The GLMC is now implemented in 7 French departments and reaches over 24,000 children. Based on these results, we would like to propose an adaptation of the GLMC for adults, by adapting this intervention in the professional environment, in order to maintain the community aspect of the project. After the presentation of the project and its transferability in different spaces, an interactive debate will be organised on the challenges of transferability.
Air pollution, self-reported health, and ethnicity in the UK: A spatial-temporal analysis
Authors: Abed Al Ahad M , Urška Demšar U , Frank Sullivan F , Hill Kulu H 
Published: October 2023

Abstract

Background
Air pollution is associated with poor health; though it is unclear whether this association is stronger for ethnic minorities compared to the population majority. In this study, we assessed the spatial-temporal association between air pollution and self-reported health and its variation by ethnicity in the UK.

Methods
Individual-level data from Understanding Society: the UK Household Longitudinal Study including 67,982 adult individuals over 11 years (2009-2019) were linked to yearly concentrations of NO2, SO2, PM10, and PM2.5 pollutants using the census Lower Super Output Area (LSOA) of residence. The association between air pollution and self-reported health (Likert scale: 1-5, excellent to poor) and its variation by ethnicity was assessed using three-level mixed-effects ordered logistic models. Analysis distinguished between spatial (between areas) and temporal (across time within each area) effects of air pollution.

Results
Higher concentrations of NO2, SO2, PM10, and PM2.5 pollution were associated with poorer health. Decomposing air pollution into between (spatial: across LSOAs) and within (temporal: across years within each LSOA) effects showed a significant between effect for NO2, SO2, PM10, and PM2.5 pollutants, while within effects were absent for all pollutants. People from Indian and Pakistani/Bangladeshi origins and non-UK-born individuals reported poorer health with increasing concentrations of SO2, PM10, and PM2.5 pollutants in comparison to British-white and UK-born individuals.

Conclusions
This study supports the presence of a spatial-temporal association between air pollution and poor self-reported health, which is stronger for ethnic minorities and foreign-born individuals in the UK. Air pollution mitigation is necessary to improve individuals’ health, especially for ethnic minorities who are affected the most.

Key messages
• Exposure to air pollution is linked to poor self-reported health and this association is stronger for ethnic minorities compared to the UK majority population.
• Local measures to reduce air pollution, especially in ethnic concentration neighbourhoods are necessary to improve people’s health.
Improvement in medical consultation by using an AI-powered symptom assessment application (SAA)
Authors: Kini N , Schmude M , Gilbert S , Cotte F , Millen E , Coman M A , Nemes D , Bode P , Ungureanu M I 
Published: October 2023

Abstract

Introduction
The shortage of healthcare workers affects countries worldwide and primarily affects people in rural areas. Although Romania trains a high number of physicians, the absence of effective retention and motivation policies leads many of them to opt for higher-paying jobs in other countries. As a result, patients experience long travel and wait times. Our study assessed if using an AI-powered SAA, Ada, in a waiting room is feasible for patients, can improve consultation efficiency, and enhance patient-physician communication.

Methods
This study was conducted in the waiting room of a GP in Cluj-Napoca, Romania, from May to July 2022. Consenting patients completed a symptom assessment while waiting for their consultation. A survey was administered to patients, the study nurse, and physician to gather feedback on their experience.

Results
The study enrolled 49 patients (29 women, 20 men). Most of the patients found the questions in Ada to be of appropriate length (94%), understandable (90%), and engaging (86%). Patients using Ada felt that they could express all their health issues (79%) and explain their symptoms better to the doctor (84%). They also felt more confident to discuss symptoms that their doctor may have missed (86%) and would use Ada again (84%). Most patients completed the assessment independently (65%). The study physician reported that 70% of patients who used Ada answered questions quickly and asked more questions related to their symptoms.

Discussion
By providing personalized health information, Ada prepared patients for their consultation, resulting in improved patient engagement and facilitation of clinical conversation. Incorporating a SAA into routine patient care has the potential to enhance the quality of medical care and reduce consultation time, thus, compensating for physician shortages. Further studies to determine the efficacy of integrating SAA with telemedicine can further help tackle the issue of uneven health workforce distribution.

Key messages
• Patients found Ada, a mobile AI-powered symptom assessment application, easy to use, understandable, and would use it again. The app helped prepare patients for their doctor’s consultation.
• Doctors reported increased patient engagement in consultation among users of Ada. These apps can help save time when used by patients in the waiting room and the results are shared with the doctors.