bluuebunny/crossref_metadata_2025_split huggingface dataset:
Telemedicine in management of heart failure: experience of the south-east Tuscany in COVID-19 period
Authors: Bosco R , Miserendino A , Cartocci A , Tina F , Messina G , Nante N 
Published: October 2023

Abstract

Background
The lockdown imposed by the COVID-19 pandemic has prompted the implementation of the use of Telemedicine (TL), overcoming the assumption of a service: the simultaneous on-site presence of the producer and user of that service. We aimed to evaluate the impact of TL on the management of the out-patient (MOP) with heart failure in both clinical and economic terms.

Methods
A prospective randomized trial of heart failure patients was performed at the Medical Area Cardiology of Cortona Hospital, Tuscany. From May to September 2020, 300 patients were enrolled and followed for 9 months. They were equally and randomly assigned to the MOP group with the possibility of ordinary hospitalization or to the TL group and followed through home care. The groups were homogeneous in terms of gender, age, comorbidities, presence or absence of caregivers, ability to connect to internet, and provision of the necessary tools to monitor their condition.

Results
48% of the services provided were TL (Televisit and Teleconsultation) while the remaining 52% were MOP services. There is no significant difference in terms of care delivered. In TL, per service, 0.09h were spent while in MOP 0.26h (also considering the application of anti-COVID procedures). In addition to savings in space, staffing and technology used, there was also a significant reduction in costs with TL (e.g., € 1600.00 per day of ICU admission, € 850.00 per day of ordinary hospitalization, € 150.00 per Emergency Department access).

Conclusions
TL has achieved economic savings, appropriateness of care with increased equity, effectiveness, and efficiency (due to continuous patient monitoring) resulting in reduced hospitalization. However, this requires an initial investment in resources as well as good integration between Hospital and Territory.

Key messages
• Telemedicine has reduced costs, time per visit, and resources in general. It constitutes an advantage for monitoring chronic patients.
• To make the best use of telemedicine, a good network between hospital and territory is needed.
Building Community Health Literacy with a Social Network Perspective
Authors: Sentell T , Saiki K , Abrams M A , Jones A , Melendez K , Chevrolet J , Roman M , Barnes J , Patterson E 
Published: October 2023

Abstract

Background
The COVID-19 pandemic underscored the vital importance of health literacy to combat misinformation, increase trust, and ensure health equity. Health literacy is a collective responsibility, including for organizations to “equitably enable individuals to find, understand, and use information and services.” This presentation will share key insights concerning health literacy in a social context. from a 2-year regional effort to build a sustainable, health literate community by growing trusted, multi-sectorial partnerships, relationships, and networks.

Methods
Advancing Health Literacy Franklin County is a 2-year project initiated in June 2021 with a goal of building a sustainable, health literate community in Franklin County, Ohio, USA. The project is a collaboration among public health departments, health care organizations, an academic institution, and community organizations. Evaluations include social network analysis of organizational relationships over time, training outcomes, validated organizational health literacy (OHL) measures, and key informant interviews.

Results
Social network analysis show growth in the number of engaged organizations and stronger ties in these relationships. Training outcomes reveal increased knowledge, skills, and recognition of the importance of health literacy. OHL measures show engagement and improved capacity. Key informant interviews highlight the importance of the social perspective for health literacy.

Conclusions
Considering health literacy in a social context is important to building community-level health literacy in a sustainable way, including networks of organizations working together and the engagement of community leaders to share trusted, community relevant health information in their professional and personal social networks. Insights from this real-world implementation can inform future practice, policy, and research.
Exploring job and workplace factors associated with nurse retention in the Irish Healthcare System
Authors: O'Donoghue C 
Published: October 2023

Abstract

Background
The COVID-19 crisis put unprecedented pressures on nurses both globally and in Ireland. This has led to concerns that a ‘great resignation’ could take place. Prior to the Covid-19 pandemic, significant numbers of Irish nurses migrated for better pay and working conditions. Understanding the factors involved in retaining nurse professionals and supporting them to remain in the Irish health system is thus critical to creating a fully functioning health system and maintaining and improving population health.

Methods
A secondary data analysis was carried out with two HSE ‘Your Opinion Counts’ surveys from 2016 and 2018. The surveys examined staff opinions and experiences on a range of issues, including job satisfaction and workplace culture. Descriptive statistics and association tests were run to examine which factors were the most associated with intention to stay within the HSE. The study also assessed the changes over time (2016 versus 2018) on intention to stay and by nurse subcategory. These data were then compared with actual turnover data for nurses over the COVID-19 era.

Results
Preliminary results indicate that public health nurses and nurse specialists were the nurse cadres most likely to intend to remain working within the HSE. Furthermore, staff nurses and midwives had greater intention to stay in 2018 compared with 2016. Feeling valued and recognised at work was among the most associated factors related to intention to stay.

Conclusions
Changing workplace cultures to more supportive environments where staff feel valued and recognised may increase staff retention. Policy makers should invest in understanding mechanisms and interventions that can change workplace cultures to increase staff retention.
Are differences in caesarean section rates between countries in Europe decreasing or increasing?
Authors: Velebil P , Tica V , Durox M , Nijhuis J , Alexander S , Zeitlin J , Gissler M 
Published: October 2023

Abstract

Objective
Caesarean section (CS) rates differ greatly between European countries, but whether these variations in practices between countries are increasing or decreasing has not been investigated. Improved scientific evidence to underpin CS indications as well as common trends in maternal characteristics could lead to convergence of rates. This study aimed to analyse trends in CS rates between 2004 and 2020 for all births and for specific risk sub-groups.

Methods
The study uses data from the Euro-Peristat network which collected national-level routine data on CS overall and by sub-group using a standardised protocol on births in 2004, 2010 and 2015-2020. Sub-groups were: parity (nulliparous, multiparous), multiplicity (singleton, multiple), previous CS (yes/no), breech (yes/no) and preterm/term. 25 countries had data at all time points. We divided countries into terciles based on 2004 rates and analysed trajectories in these three groups.

Results
The CS rate ranged from 14.4% to 37.8% in 2004 and from 16.2% to 44.8% in 2020. Cutoffs for the terciles in 2004 were 19% et 25%. Countries in the first tercile (low rates, 9 countries) continued to have low rates with flat or mildly increasing trajectories. In the second tercile, there were two trajectories - flat or mildly increasing (3 countries) or sharper increases over time (4 countries). Countries in the highest tercile had increasing rates (8 countries). These patterns were observed most clearly in singleton and nulliparous pregnancies. For sub-group analyses, patterns varied, with some low CS countries having high CS rates for breech or preterm births, but practices within sub-groups were relatively stable over time.

Conclusions
Differences in overall CS rates between European countries over time have widened with more marked clustering into high and low CS groups. These analyses suggest a lack of progress in developing an evidence-base that would lead to standardisation of practice.
Excess physical disease burden associated with selected mental health disorders in Europe
Authors: Wienand D , Wijnen L I , Heilig D , Wippel C , Arango C , Knudsen G M , Goodwin G M , Simon J 
Published: October 2023

Abstract

Introduction
People with mental health disorders (MHDs) have worse physical health compared to the general population. To date, no comprehensive epidemiological overview exists and the extent of the excess public health burden is unknown. Our aim was to estimate the prevalence of excess PHC diagnoses associated with MHDs in the European working-age population.

Methods
We estimated excess PHC diagnoses associated with depressive disorders (DD), bipolar disorder (BD), schizophrenia (SZ), and alcohol use disorders (AUD) for year 2019. Levels of excess risks for PHCs were identified by a structured literature review and synthesised per MHD and categories of PHCs using random-effects meta-analyses. Estimated relative risks (RRs) were combined with country-level disease prevalence and population data to calculate population attributable fractions (PAFs). Based on obtained PAFs we calculated excess PHC diagnoses due to underlying MHDs for all EU-27 member states, Iceland, Liechtenstein, Norway, Switzerland, and the United Kingdom.

Results
We identified 72 studies for estimating excess levels of risk for PHCs, focused on DD (n = 29, 40%), SZ (n = 26, 36%), BD (n = 9, 13%), AUD (n = 4, 6%), or multiple MHDs (n = 4, 6%). Estimated RRs ranged from 1.3 to 1.8 (DD), from 1.8 to 15.8 (BD), from 1.5 to 4.0 (SZ), and from 1.9 to 3.3 (AUD). Corresponding excess PHC diagnoses in the total European working-age population (312.5 million) were 24.6 million (AUD), 12.6 million (DD), 6.6 million (BD), and 0.9 million (SZ).

Discussion
This is the first comprehensive estimation of the public health burden of excess PHCs associated with DD, BD, SZ, and AUD in the European working-age population. Our results unequivocally demonstrate broader population health benefits of investments into integrated mental and physical healthcare. Targeted policies should consider prevention strategies as sustainable and equitable approaches to alleviate substantial physical health disparities in people with MHDs.

Key messages
• Working-age individuals with mental health disorders in Europe suffer from substantial physical health disparities in nearly all physical health areas.
• Integrated mental and physical healthcare, and prevention strategies are equitable and sustainable approaches to reduce these physical health disparities.
Irregular migrants and work in Belgium: a case study
Authors: Dauvrin M 
Published: October 2023

Abstract
Although not allowed to work legally in Belgium, irregular migrants benefit from a range of rights, including a minimum wage, a limit on the number of hours they can work per week and access to health care. Alongside “traditional” sectors of irregular work (building, domestic staff, hotel and catering, cleaning), there are a growing number of irregular migrants employed as bicycle delivery riders. In order to benefit from access to healthcare, migrants must undergo a social investigation by the public authorities: this investigation assesses, among other things, whether the person has an income. This is a paradox: the migrant is entitled to the minimum wage but having an income may prevent him or her from receiving care as an irregular resident. During this presentation, we will explore the current situation facing irregular migrants in Belgium and the role of professional unions and health care professionals.
Understanding food discourse
Authors: Sasamoto R 
Published: October 2023

Abstract
In recent years, consumers have been faced with an increasing number of food choices, and they must consider multiple factors such as health concerns, nutritional content, animal welfare, sustainability, and climate change. While the language of food has attracted scholarly attention in linguistics, there are few studies in cognitive pragmatics that explore how consumers process information to make informed decisions. Therefore, this presentation will discuss the potential of pragmatics research, using Sperber & Wilson's (1986/1995) relevance theory as a framework, to address the reception of food discourse as presented to consumers. By examining how consumers interpret and respond to food-related messages, we can gain a better understanding of how to communicate with them effectively and encourage healthier, more sustainable food choices.
The one health approach applied to surveillance and control of Legionnaires’ disease in Switzerland
Authors: Wymann M 
Published: October 2023

Abstract

Issue/problem
Legionnaires’ disease numbers have been increasing in Switzerland since 2001. With a reporting rate of 6.5 / 100'000 inhabitants in 2022, Switzerland has one of the highest incidences in Europe. The reported cases are mainly severe, about 87 % are diagnosed by hospitals, about 5 % have already died at the time of reporting. In the majority of cases the infection source is unknown.

Description of the problem
Because the causative agent, Legionella spp., is ubiquitous in humid environments, including building plumbing systems, a collaborative, multisectoral and transdisciplinary approach is key for an efficient response to this public health threat.

Results
At the national level, a close collaboration between the federal offices for public health, food safety (public shower and bath water) and energy (buildings and energy) was established in 2019 with the creation of a dedicated legionellosis expert group. Goals were to strengthen the coordination and to improve measures to combat the observed increase.

Lessons
Stakeholders from authorities responsible for implementing measures but also building and sanitary experts, specialists in cooling technology, laboratory experts and scientists have been involved in multiple activities coordinated by the national legionellosis expert group. Together they revise recommendations for prevention and control of legionellosis, and develop factsheets for building technology engineers and an outbreak investigation toolbox. A coordinated communication to the public is ensured, for example in view of possible energy shortage measures. Knowledge gaps have been identified and scientific research to fill them is coordinated, mutually funded and the results will be transferred into practice in the coming years.

Key messages
• The One Health approach has proven to be very effective in coordination of activities and communication.
• The future will reveal if the joint efforts will have an impact on the high incidence.
Santé publique France's cross-sectoral response to the climate and environmental changes
Authors: Pascal M , Denys S 
Published: October 2023

Abstract
Heat is one of the most rapidly changing climate-related health issues. The Intergovernmental Panel on Climate Change (IPCC) considered that current existing and planned adaptation measures will not be sufficient to limit the health impacts of heat in Europe. The French heat wave alert system, set up in 2004, was one of the first and most innovative in the world thanks to a close collaboration between the French weather service Météo-France, the national public health agency and the ministry of health. It also benefits from a reactive syndromic surveillance based on emergency room visits and general practitioners emergency consultations. Yet, it is now challenged by the increase in frequency and intensity of heat waves due to climate change. The impacts of recent years show that short-term responses based on timely behavioural changes during heat waves are now insufficient. Structural adaptation measures are an asset, and should not only consider adaptation to heat, but also wider opportunities for mitigation and reduction of inequities, in order to promote robust healthy environments that protect against climate disruption. This presentation will share how Santé publique France is developing a set of interdisciplinary studies and an advocacy strategy to encourage stakeholders involved in urban planning and housing to better take into account the impact of heat in their projects.
How RIVM engages in cross-sectoral collaboration to ensure health is at the centre of climate action
Authors: Hall L , Hagens W , Limaheluw J 
Published: October 2023

Abstract
RIVM's mission on climate change and health is to give insight into the health impacts of a changing climate, climate measures, co-benefits and trade-offs, and to provide information, data and tools to support climate action from local to international level. To achieve this, we work closely across all RIVM's knowledge domains and with other knowledge institutes, authorities and stakeholders. The information and tools we provide are used in cross-sectoral policy and planning discussions. This ensures health is a major and timely consideration when developing climate measures, co-benefits are maximised and unintended negative effects avoided. This collaborative, cross-sectoral and interdisciplinary work enables us to tackle inherent complexities and ensures our outputs are fit for purpose. We will highlight some examples on:
Plugging knowledge gaps
• A database of extracted quantitative outcomes from the literature;
• Research on effectiveness of heat measures for the elderly;
• A survey to assess mental health impacts of flooding;
• Developing the knowledge base for municipalities and water boards to limit impacts of climate change and adaptation measures on urban water quality;
• An Expertise hub on wind energy and health with up-to-date, accessible information on wind turbines and health for municipalities and the public.
Supporting climate action
• Guidance for municipal public health services on heat and health, and an updated heat-health action plan;
• A frailty index, enabling mapping of vulnerable elderly at neighbourhood level so local actors take targeted actions regarding heat exposures;
• A sun-safety action plan with NGOs, leading to a nationwide communication campaign to promote healthy sun behaviour;
• A tool for municipalities to limit microbial risks of urban water features;
• Information on potentially negative health impacts of climate mitigation measures and examples of actions and advice public health services can put forward to minimize these effects.
The indirect impact of COVID-19 on hospitalization and mortality for ischemic stroke
Authors: Leucci A C , Berti E , Romoli M , Ferro S , Rolli M , Tedesco D 
Published: October 2023

Abstract

Background
Fear of contracting COVID infection may cause delay or reduction in hospital admissions for acute cerebrovascular events. The main objective of this study was to measure the indirect impact of the pandemic on the volume of hospitalizations for ischemic stroke (IS), in-hospital and 30-day mortality, 30-day readmissions and out-of-hospital IS mortality.

Methods
Study design was a quasi-experimental population-based interrupted time-series. Data were drawn from the Health Information System of the Emilia-Romagna region (Italy). To evaluate volume of hospitalizations and inpatient mortality, we included all inpatient care hospitalizations with a principal diagnosis of IS (ICD-9-CM: 433.x1, 434.x1, 436) between 2015-2021. To evaluate out-of-hospital mortality, we included all patients who died at home for IS (ICD-10 cause of death: H34.1, I63.x, I64.x).

Results
We observed in 2020 a 13% decrease in IS hospitalizations and an increase in the proportion of in-hospital mortality (+20%), out-of-hospital mortality (2 more deaths per day on average), and 30-day mortality (+4%). Compared to 2020, 2021 showed a 16% lower in-hospital mortality and a 7% lower 30-day mortality. Change in out-of-hospital mortality was not statistically significant. Comparing 2021 to 2015-2019, almost all outcomes did not significantly differ (in-hospital mortality: +0.62%; 30-day mortality: -3.18%; 30-day readmissions: +2.34%). Wee found a significant 12% decrease in hospital admissions and an increase in out-of-hospital mortality by 1.37 deaths per day on average, in 2021 compared to 2015-2019.

Conclusions
COVID pandemic caused a reduction in hospital admissions, resulting in worse outcomes, mostly in 2020 and to a lesser extent in 2021. The improvement in 2021 for most outcomes may have benefitted by the vaccine indirect effect.

Key messages
• Reduction in IS admissions due to COVID had a negative impact on patient outcomes.
• This lesson needs to be acknowledged and considered in a preparedness framework for future pandemics.
Religious service attendance and mortality in southern Sweden
Authors: Lindström M , Pirouzifard M 
Published: October 2023

Abstract

Aims
This study aims to investigate associations between attendance in religious service at least once during the past year and all-cause and cause-specific mortality. Study design: Prospective cohort study design.

Methods
A public health survey conducted by Region Skåne in southern Sweden in the autumn of 2008 was sent to a stratified random sample of the adult 18-80 year population with a participation rate of 54.1%. A total of 24,855 participants were included in the present study. The baseline survey was connected to prospective mortality data with 8.3-year follow-up. Analyses were conducted in survival (Cox regression) models.

Results
A total 14% had attended religious service at least once during the past year, while 86% were non-attenders. The religious service attenders were women, high and medium position non-manual employees, born outside Sweden, never alcohol consumers and participants with high generalized trust to a higher extent than non-attenders. They also displayed lower proportions with daily smoking and low physical activity compared to non-attenders. The group of religious service attenders had significantly lower hazard rate ratios (HRRs) of all-cause mortality compared to non-attenders in all multiple models. Cardiovascular (CVD) mortality was significantly lower for religious service attenders in the multiple models until BMI, physical activity, daily smoking and alcohol consumption were entered in the survival model. No significant results for cancer and other cause mortality were found.

Conclusions
Religious service attendance in Sweden, a highly secularized and individualized high-income country, is significantly associated with lower all-cause mortality. This may to some extent be by explained lower CVD mortality partly mediated by protective health-related behaviors.

Key messages
• Religious service attendance and health has mostly been investigated in the USA, and much less in more secularized countries like Sweden.
• Religious service attendance was associated with lower all-cause and CVD mortality, partly mediated by protective health-behaviors.