bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stroke Pathway impact on healthcare processes and outcomes: a retrospective observational study
Authors: Di Pilla A , Camporesi J , Strumia S , Paolucci M , Cacciuttolo M G , Orsini D , Assorgi C , Specchia M L 
Published: October 2023

Abstract

Background and Aim
The Stroke Pathway performance assessment is a key quality improvement element in healthcare. The aim of this study was to carry out a retrospective assessment of the Stroke Pathway in a first level Stroke Unit in Northern Italy and the possible impact of the COVID-19 pandemic.

Methods
A retrospective observational study was carried out analysing data from 1/01/2010 to 31/12/2020. Data considered were: case volume and characteristics of patients undergoing intravenous thrombolysis, baseline modified Rankin Scale (mRS) and National Institutes of Health Stroke Scale (NIHSS) scores, Onset-to-Door (OTD), Door-To-Imaging (DTI) and Door-To-Needle (DTN) Times, mRS score 3 months after the ischemic event onset (3m-mRS) and NIHSS score 24 hours after the ischemic event onset (24h-NIHSS). The study also compared the pre-COVID-19 pandemic period (March-December 2019) with the one following it (March-December 2020).

Results
During the considered 10 years range, 418 patients underwent pharmacological thrombolysis. Treatment was extended to older patients (mean age from 66.3 to 75.51 years; p = 0.006) and with a higher baseline disability level (from 0.22 to 1.22; p = 0.000). A statistically significant reduction was found for DTN (from 90 to 61 minutes average value; p = 0.000), so that in 2019 more than 50% and in 2020 more than 60% of patients were treated within 60 minutes (golden hour). Comparing pre- and COVID-19 pandemic periods, the number of patients remained almost unchanged, but with a significantly higher baseline disability (mRS=1.18 vs 0.72, p = 0.048). The OTD increased from 88.13 to 118.48 minutes, although without a statistically significant difference (p = 0.197).

Conclusions
The study highlighted the Stroke Pathway positive impact, even during the COVID-19 pandemic, both on healthcare processes and patients’ outcomes. Nevertheless, both of them could be further improved through specific changes of the Pathway hospital phase and health communication actions.

Key messages
• Stroke Pathway hospital phase (DTN score) could be improved by starting thrombolysis in the diagnostic imaging department to further align with the international guidelines standards.
• Communication actions should be promoted to improve the Stroke Pathway pre-hospital phase (OTD score) providing the public with essential information to timely recognize stroke signs and symptoms.
Use of dyadic longitudinal interviews in health services research: a case example
Authors: Nielsen H S , Schmidt L 
Published: October 2023

Abstract

Introduction/background
Pregnancy loss (PL) is common (∼25% of pregnancies). PL has a negative psychological impact on women and growing evidence that partners are impacted too. Thus PL is a unique public health issue - a “couple” problem that affects both partners. With millions of pregnancies each year, a significant number of pregnant women and their partners will have experienced prior PL and may be vulnerable in pregnancy given their reproductive history. But are their needs met by the standard pregnancy care? This study used dyadic, longitudinal interviews to examine: what are couples’ perceptions of the health care and support provided in a subsequent pregnancy after PL and do their needs change across a pregnancy? The combination of dyadic and longitudinal methods is rarely used in health services research, but seems especially well-placed to examine how needs for health care change across the pregnancy and the perception of both partners.

Methods
Semi-structured dyadic interviews were conducted with 15 couples over four time periods across a new pregnancy after PL (after pregnancy test and once in each trimester). Couples were recruited from a national cohort of couples with PL. Interviews were held in person or via Zoom in Denmark. Qualitative dyadic and longitudinal interview data were analyzed using thematic analysis with a focus on identification of common themes within and across couples and trimesters.

Results and analysis
Dyadic data showed that both partners experienced anxiety and worry about the safety of the fetus and possibility of miscarrying. Longitudinal data revealed that couples believed that standard pregnancy care in the first trimester of pregnancy was insufficient for their needs. They wished for ongoing access to regular scans and close monitoring to provide reassurance and detect problems early. They reported that their needs for care were met through antenatal care provided in the later stages of pregnancy.

Key messages
• Dyadic longitudinal interviews generate nuanced data about a shared experience of receiving health care across a pregnancy.
• A better understanding of needs can inform development and provision of effective health care and support to fill identified gaps and promote overall family, maternal and infant health.
Cost-efficient child vaccination project results from hard-to-reach rural communities in Kenya
Authors: Shah M , Hasan M , Afeworki A 
Published: October 2023

Abstract

Child immunization is a cost-effective public health measure for reducing child morbidity and mortality. Child immunization coverage in Kenya has improved in recent years, with coverage rates for most vaccines exceeding 80%. However, there are still pockets of low coverage, particularly in remote or hard-to-reach areas. We implemented a community-based project to improve access and equity in child immunization services in three Kenyan counties (Nairobi, Wajir and Mandera). We trained health workers, promoted community acceptance, and provided logistical support to Ministry of Health (MoH) for child immunization services through community outreach centers. During the project period (January 2020 to February 2023), our project facilitated full immunization coverage for 93,879 children and we reached 200,554 community members whom we communicated relevant messages for recommended practice about health, nutrition and child vaccination. Our project achieved a 26 percentage-point increase (increased from 62% at baseline in 2020 to 88% at endline in 2022) in age-appropriate child vaccinations by end of the project. We also conducted a cost-efficiency analysis by taking the actual costs incurred and project achievements into account. The key results from the cost-efficiency analysis revealed approximate cost for a fully immunized child as 21 US dollar, while per capita cost for communicating health messages to community members and health care worker training was 10 US dollar. UNICEF estimated approximately 32 US$ as vaccine delivery cost (=total cost - cost of vaccine and supply) per fully vaccinated child with standard schedule for children &lt; 24 months which is higher than the cost for ensuring a fully immunized child in our project. These data clearly indicate the efficiency and success of community-based approach for strengthening MoH child immunization services in Kenyan rural and hard-to-reach communities.

Key messages
• Strong collaboration with Ministry of Health and community participation are critical key aspects for implementing child vaccination program successfully and cost-efficiently in rural communities.
• Facilitating Ministry of Health for health system strengthening focus yields sustainable impact as footprint after end of a short-term of a community based project in developing country settings.
Health behaviors and cancer screening in family caregivers vs. general population
Authors: Hwang I , Kim K , Kim M , Lee S , Shin J , Cho B , Cho W , Kim H , Yoo S 
Published: October 2023

Abstract

Purpose
This study aimed to compare health behaviors and healthcare utilization between family caregivers of advanced cancer patient and general population.

Methods
Data of 158 family caregivers were obtained from one oncologic clinic and from 3,775 Korean adults aged 40 years or older who participated in the Eighth Korea National Health and Nutrition Examination Survey. Propensity-score matching was employed to match family caregivers with general population (1:1). We assessed health behaviors and healthcare visit, cancer screening, and influenza vaccination among two groups. Further, we performed subgroup analysis to explore factors associated with health behaviors and healthcare utilization of family caregivers.

Results
After propensity-score matching, the proportion of individuals performing moderate to high-intensity physical activity (MVPA) of 500 METs or more was higher in the caregiver group (p = 0.004). Also, the proportion of cancer screenings over a two-year period was significantly lower in the family caregiver group compared to the non-caregiver group (62.1% versus 73.1%, p = 0.045). In subgroup analysis, family caregivers with higher HADS depression scores were less likely to engage in MVPA, while those with higher HADS anxiety scores showed a significant decrease in healthcare visits. Family caregivers who received social care/economic support had an increased aOR in healthcare visits for own health (aOR 0.18 95% CI 0.04-0.91). Moreover, caregivers who had high competency and rewards were more likely to engage in MVPA.

Conclusions
The caregiver's has vulnerable aspects of and healthcare utilization, affected by their depression or anxiety. Social care/economic support was associated with improved health behavior and utilization of caregivers. Further studies for multi-dimensional support for caregivers’ health is needed.

Key messages
• Family caregivers, especially those with higher levels of depression or anxiety, face challenges in terms of their health and healthcare utilization.
• Social care/economic support is crucial in improving their health behaviors and healthcare access.
Food and Beverage Placement in Child Focused YouTube Channels: A Content Analysis Study
Authors: Almutairi L , Alqahtani A , AlHusseini N 
Published: October 2023

Abstract

Background
High exposure to food content encourages unhealthy dietary practices among children. Nowadays, children are exposed to many food products through social media, which influence their eating behaviors. Due to the growing social media use, the number of food advertisements via YouTube has increased. Therefore, regulatory agencies worldwide are investigating social media content to implement appropriate restrictions on unhealthy food marketing.

Methods
This quantitative content analysis descriptive study aimed to analyze all food content in the child-centric channels of Arabic speakers’ vloggers on YouTube in Saudi Arabia. The authors measured the food presentation, promotional techniques, and food product/type by quantifying the appearances of each variable in each video. The variables were analyzed as frequencies and percentages.

Results
Four of the top subscribed channels in Saudi Arabia were selected; 96 videos were analyzed by watching 17 hours. Food placements appeared in 65 videos (67.7%), with a cumulative duration of 304 minutes. Among videos that featured food and beverages, 87.7% of the vloggers consumed the food that appeared. The most commonly employed persuasive marketing techniques were emotional and taste appeals, with a percentage of 90%. Unhealthy foods comprised 66.8% of the total number of products that appeared in the analyzed videos.

Conclusions
This study highlights the high prevalence of low-nutrient food products on child-centric YouTube channels in Saudi Arabia, which may negatively impact children's food choices and eating habits. To protect children from harmful content on social media, it is recommended to develop comprehensive policies that consider the different challenges of regulating media content. Parents and caregivers should also actively monitor children's social media use and educate them on making healthy food choices.

Key messages
• Children might get exposed to a high prevalence of unhealthy food products through social media, which might have a negative impact on their food preferences.
• Comprehensive policies are needed to regulate food marketing on social media in order to protect children from harmful content and promote healthy eating habits.
Anti-Vaccination movement as a supracultural phenomenon
Authors: Vučurović M , Jovanovic V , Krcmar O 
Published: October 2023

Abstract

Background
Despite efforts by public health officials to counter the spread of anti-vaccine ideology, the movement continues to thrive in various countries and cultures. This study aims to answer the question of whether the anti-vaccine movement is a supracultural phenomenon that transcends national and cultural boundaries by identifying the anti-vaccine narratives in Serbia and comparing them to anti-vaccination narratives present in Germany, Brazil, India, United States of America, Australia, Canada, Nigeria and Japan. Answering this question can inform the development of targeted interventions and communication strategies to mitigate the negative impact of the anti-vaccine movement on public health.

Methods
For identification and understanding of the anti-vaccine narratives, qualitative research is conducted using thematic analysis via the folk model on 12 Serbian social groups on the internet chosen by the criteria of an existing anti-vaccine narrative. Systematic analysis of the topic-related literature from PubMed and Google Scholar and news articles and broadcasts provided information on present narratives in other countries.

Results
Comparative analysis of the acquired data has confirmed that two narratives are present in all countries. Distrust in the vaccine composition and benevolence of its components being one and another being the malevolent political agenda behind the vaccination.

Conclusions
This study has proved that the anti-vaccine movement is a supracultural phenomenon based on the recurring narratives in countries worldwide. The importance of this discovery for public health lies in the implication that only the unified international initiative to counter the anti-vaccine movements can hope to yield lasting results because, if confronted locally, movements can be bolstered from outside sources.

Key messages
• The anti-vaccine movement is a supracultural phenomenon.
• The anti-vaccine movement cannot be countered locally.
Efficacy of a lifestyle intervention for elderly in long-term care: a randomized controlled trial
Authors: Conti A , Concina D , Opizzi A , Zeppegno P , Gramaglia C M , Grossini E , Panella M 
Published: October 2023

Abstract

Background
Long term care (LTC) services represent an important element of worldwide health systems, providing medical care and social services to thousands of elderlies. In this setting inadequate food consumption and lack of physical exercise represent major causes of mortality and morbidity due to malnutrition, sarcopenia, osteoporosis, and dehydration. While it has been acknowledged that these conditions are potentially reversible with proper lifestyle medicine interventions, the latter are rarely implemented and evaluated in LTC owing to their intrinsic complexity.

Methods
A randomized controlled trial was conducted to assess the effectiveness of a three-months combined food-physical exercise lifestyle intervention in elderlies living in an Italian LTC facility. The diet was designed to provide high levels of energy, proteins, leucine, and calcium. The physical exercise treatment was delivered two times per week, with a moderate to high effort requested to subjects. At baseline and at the end of the intervention subjects were evaluated using the Barthel Index, Activities of Daily Living, and Tinetti scales.

Results
54 participants took part to the trial. At the end of the study the intervention group showed a significant improvement in all the scales. They burned 287 Kcal/week, significantly more than the control group. In contrast to the study protocol, they introduced 11% less calories than the control group.

Conclusions
This intervention has been proved effective in increasing functionality, with the beneficial effect that might be primarily attributed to the physical exercise, considering the low adherence to diet in the intervention group. This evidence supports the hypothesis that these interventions, despite the effectiveness, are complex to be powerfully implemented. While our results encourage the efficacy of lifestyle interventions in LTC, more studies are needed to deeply understand barriers and facilitators for an effective implementation.

Key messages
• This lifestyle intervention proved effective in improving functionality in institutionalized elderlies.
• The low adherence to diet highlights challenges and complexities of lifestyle interventions in LTC.
Belgian general practitioners’ perception and use of physical activity on prescription
Authors: Bensemmane S , De Pauw R , Keune H , De Schreye R 
Published: October 2023

Abstract

Background
Physical activity (PA) reduces 19.5% of the attributable burden of chronic diseases (CDs), i.e. healthy life years lost due to morbidity and mortality. In addition, 29.5% of Belgians self-declared having at least one chronic disease. Moreover, almost 30% of the population above 15 years old is at health risk due to physical inactivity. Evidence shows physical activity on prescription (PAP) has a positive impact on PA level and metabolic health. General Practitioners (GPs) can use PAP as a prevention intervention. In Belgium, overall 94,1% of citizens have a referring General Practitioner (GP) or are affiliated with a general practice. There is no national policy on PAP, only a regional policy in Flanders. Therefore, the aim of the study is to investigate the perception and the (potential) provision of PAP by Belgian GPs.

Methods
A cross-sectional survey was conducted in Belgian GPs between January and end of March 2023. The survey has 41 (ordinal or multiple choice) questions. Descriptive statistics were performed.

Results
134 GPs completed the survey of which 56% were female. 66.4% work in Flanders, 19.4% in Wallonia and 14.2% in Brussels-Capital region. Among respondents, 44% only discuss the benefits of PA with patients with a CD. Interestingly, less than 2% never discuss PA. 86.8% (would) prescribe if patients’ health status would be remedied by increasing PA, while 35.8% (would) use PAP if patients are inactive, regardless of their health status. About 75% identified chronic disease and exercise initiation as incentives for PAP. 41% would refer to PA (motivational) coaches, 55.2% to (adapted) PA courses. Lack of training (12.7%), time (49.3%), and knowledge of local PA offer (74%) were cited as barriers to using PAP.

Conclusions
The majority of responding GPs linked PAP with CD. Although there is no national implementation and regulation of PAP, GPs used (were ready to use) PAP in their practice. However, several barriers still hinder the use of PAP.

Key messages
• PAP is identified by Belgian GPs as a non-medical therapeutic strategy to counter health risks due to inactivity.
• There is a need to harmonise and facilitate PAP in Belgian primary care.
Planning engagement with web resources to improve health habits among home-working employees
Authors: Tognon G , Holfored D , Gladwell V , Murray K , Nicoll M , Knox A , McCloy R , Loaiza V 
Published: October 2023

Abstract

Background and objectives
The increasing popularity of remote work makes the implementation of health promotion initiatives at the workplace challenging, particularly in bridging the gap between employees’ intentions to adopt healthier habits and their actual actions. Previous evidence suggests that action planning can foster the adoption of healthier behaviors. Therefore, we investigated action planning in the context of reducing sedentary behaviour and improving dietary quality for remote workers.

Methods
A mixed-methods investigation of a web-based self-help intervention featured a randomized planning trial, quantitative engagement measurements, and follow-up qualitative interviews with a participant subset. For one work week, participants received access to 2-minute workout videos to reduce sedentary time and a balanced meal approach with recipe cards for weekly lunches and dinners. The intervention group was given a motion plan and a meal plan to execute these actions, while the control group only obtained access to the resources.

Results
Having a motion plan proved more effective in increasing engagement with online resources compared to the condition with no plan. In the follow-up interviews, participants noted that the plan served as a reminder to engage with the resources and simplified adherence to the exercise and meal recommendations. Ease of use and the ability to incorporate exercises and meals around work tasks were crucial factors in promoting resource adoption, while time constraints and concerns about colleagues’ perceptions of taking breaks to utilize the resources hindered adoption. Participants’ self-efficacy correlated with overall resource use but not with plan adherence.

Conclusions
Incorporating plans (motion and meals) into online self-help resources could boost their adoption and improve lifestyles among remote workers.

Key messages
• Incorporating plans (motion and meals) into online self-help resources could boost their adoption and improve lifestyles among remote workers.
• Ease of use and the ability to incorporate exercises and meals around work tasks were found to be facilitators of adoption.
Factor’s influencing primary teacher practices in health education, life skills, health literacy
Authors: Simar C , Genton M , Regnier V , Jourdan D , Chauvin F , Cury P , Pironom J 
Published: October 2023

Abstract

Background
A health-promoting school (HPS) approach was introduced over 25 years ago and has been promoted globally since; however, the aspiration of a fully embedded, sustainable HPS system has not yet been achieved, and very few countries have implemented and sustained the approach at scale. The Alliance for health aims to enact and assess the impact of a comprehensive approach to health promotion at the school and community levels. This is an intersectoral project involving regional education authorities, regional public health agency, local policy makers, researchers, and local health promotion operators. The question arises as to how to identify factors influencing teachers’ activity in wellness (WB), health education (HE), life skills (LS) and health literacy (HL)?

Methods
This project involves 101 French primary schools and 97 associated municipalities in the AURA region randomly selected in an intervention and control groups. Primary school teachers were provided training, support, and resources to develop a health-promoting environment in school according to the Health-Promoting Schools framework. Primary school teachers were provided training, support, and resources to develop a health-promoting environment in school according to the Health-Promoting Schools framework. Each year, a questionnaire is distributed to teachers in order to monitor the development of their activity in the areas of WB, HE, LS and HL. 243 questionnaires are analyzed, collected from october 19 to March 20, 12 opening questions were analyzed (1591 items) in order to characterize their practices in the areas aboved. Based on this classification, factors contributing to activities were seeked by doing univariate, multivariate and exploratory factor analysis. Results:
The descriptive analysis showed that factors are linked to institutional, contextual, individual and collective dimensions. The results are preliminary and the complex analysis are actually in process.

Key messages
• A better understanding linked to their practices in health education, health literacy, like skills and well-being is needed to develop appropriate training and support.
• To develop adequate training and support in health promoting school, it's necessary to identify factors most linked to primary teacher practices in health education, like skills and health literacy.