bluuebunny/crossref_metadata_2025_split huggingface dataset:
What kind of patient benefits the most from an intensive physiotherapy after total hip replacement?
Authors: Dionisi L , Accame I , Praino F , Abinova G , Sanguineti I , Gentile AM , Nante N 
Published: October 2022

Abstract

Background
Hip replacement is a common orthopaedic surgery procedure that produces great improvement in the quality of life. Despite this, a globally standardized post-operative physiotherapy protocol still does not exist. The aim of this study is to identify the factors that influence the motor and functional outcome after early, intensive, hospitalized treatment.

Methods
A retrospective study was conducted in 2019 on 509 patients admitted to an Italian private clinic specialized in post-surgery rehabilitation, which applies an original bio-psycho-social-environmental protocol and individual rehabilitation plans. Data regarding each patient were collected from medical records: age, haemoglobin, Body Mass Index (BMI), Cumulative Illness Rating Scale (CIRS), Tinetti scale (TS) and Barthel scale (BS) at admission and discharge. The outcome was measured as the difference (Δ) between the values at discharge and admission of BS (ΔBS) and TS (ΔTS). We performed a univariate linear regression using STATA, to determine which factors influence the outcome. A p &lt; 0.05 was considered statistically significant.

Results
Our sample (57.4% female) was 70.1 ± 10.4 years old. ΔBS was significantly influenced by motor performance at admission (BS: Coef. - 0.708, CI 95% [- 0.743 - - 0.673]; TS: Coef. - 1.697, CI 95% [- 1.849 - - 1.544]), global health conditions (CIRS Severity index: Coef. 4.925, CI 95% [1.037 - 8.814]) and age (Coef. 0.312, CI 95% [0.221 - 0,403]). ΔTS was significantly influenced by the same factors, BS: Coef. - 0.167, CI 95% [- 0.184 - - 0.149]; TS: Coef. - 0.667, CI 95% [- 0.703 - - 0.631]; CIRS Severity index: Coef. 1.254, CI 95% [0.012 - 2.511]; age: Coef. 0.090, CI 95% [0.061 - 0.120]. BMI and haemoglobin did not influence the studied outcomes.

Conclusions
Patients with worse health conditions, advanced age and lower motor performance at admission obtain a higher outcome.

Key messages
• A broader knowledge of rehabilitation influencing factors would provide higher outcomes.
• The diffusion of individual rehabilitation plans would allow the achievement of better results.
Perspectives of clinicians and patients on community-based maintenance care for adults with obesity
Authors: McBride K , Alsultany G , Termaat J , Williams K 
Published: October 2022

Abstract

Background
Tertiary metabolic health services are in high demand as people with severe obesity increase. Once predetermined health goals have been achieved patients must transition to community-based care to urgently free up capacity in tertiary services. Maintenance of successful outcomes achieved via tertiary services is therefore important to limit rates of relapse back to these services.

Methods
This qualitative project explored community-based care needs to help individuals living with obesity maintain health gains. An interview schedule guided one-on-one interviews with patients and staff from metabolic clinics in Sydney, Australia.

Results
We interviewed 22 patients and 13 clinicians. A lack of appropriate and consistent clinical support in the community was identified by patients and clinicians. Most clinicians agreed primary care was key to successful maintenance care. Lack of primary care understanding of appropriate management and support for patients with obesity, lack of bariatric equipment and limited funding for allied health were all seen barriers to appropriate support beyond their clinics. Patients were highly reluctant to transition from tertiary clinics and reluctant to engage with community-based care due to experience of limited clinical/social support and bariatric equipment, demeaning clinical interactions, lack of care coordination and being stigmatised. Support groups outside of the clinic were also identified important in mitigating social isolation and stigma. Both patients and clinicians felt support groups have potential to provide important supplementary help to individuals with obesity outside tertiary settings.

Conclusions
Currently, individuals aiming to maintain their weight are likely to struggle in the context of existing community care provisions. Integrated, community-based and affordable models of care are needed now to allow tertiary metabolic services discharge their patients safely.

Key messages
• Tertiary obesity services are at capacity.
• Subsequent community care for people wth obesity needs to be mote appropriate tp promote weight maintenance.
The COVID – 19 pandemic influence on hospitalizations for ambulatory care-sensitive condition
Authors: Marasovic Šušnjara I 
Published: October 2022

Abstract

Aim
To explore whether the COVID-19 pandemic influenced hospitalizations for ambulatory care-sensitive conditions (ACSCs) during the COVID-19 pandemic in Split-Dalmatia County, Croatia.

Methods
We employed a cross-sectional comparative study using two different time periods, the prepandemic (March 2019 to February 2020) and the pandemic (March 2020 to February 2021) to explore possibilities of COVID-19 pandemic influence on hospitalizations for ambulatory care-sensitive conditions (ACSCs) during the COVID-19 pandemic in Split-Dalmatia County. The research used data from the national information system on hospitalizations from the Clinical Hospital Center Split, University Hospital Split. The ACSCs was classified in the categories of vaccine preventable, chronic and acute disease. The indicators were statistically analysed. The z-score test for two population proportions is used.

Results
During prepandemic (March 2019 to February 2020) there were 48,289 hospitalizations, in the pandemic period (March 2020 to February 2021) there were 37,999 hospitalizations. The ACSCs hospitalizations made 6.4% in the prepandemic and 7.1% in the pandemic period. In the pandemic there was a significantly higher ACSCs hospitalizations compared to the prepandemic (z =-3.9348; p = 0.00008; p &lt; 0), which was supported by a significant increase regarding ACSCs hospitalizations in the category of acute diseases, among women (z=-3.6614; p = 0.00026; p &lt; 0 .05), in age groups 0-19 years (z=-4.0492; p &lt; 0.00001; p &lt; 0.05) and 20-64 years (z= -3.8818; p = 0 .0001; p &lt; 0.05).

Conclusions
The results of the study show that the COVID-19 pandemic contributed to the total number of hospitalizations as well as the hospitalization of the ACSC. One of the reasons for these changes was certainly the changed organization of the work of the entire health system due to the COVID-19 pandemic.

Key messages
• The results of the study show that the COVID-19 pandemic contributed to the total number of hospitalizations as well as the hospitalization of the ACSC.
• One of the reasons for these changes was certainly the changed organization of the work of the entire health system due to the COVID-19 pandemic.
Hospital discharge for stroke patients: Transitional Care is Brain
Authors: Sgueglia AC , Zeduri M , Rissone M , Bertuccio P , Cavallini A , Martignoni A , Muzzi A , Cutti S , Ambrosio AG , Odone A 
Published: October 2022

Abstract

Background
Among cerebrovascular disease, stroke is a life-threatening neurological event and a main cause of serious long-term disability, with relevant healthcare and economic burden. Treatment of stroke is time dependent and organised integrated stroke care enables quick and effective responses to reduce stroke-related death and disability. This study aimed at evaluating the amount of hospital discharge to transitional care facilities for stroke patients to support integrated care models in the city of Pavia (Italy).

Methods
In 2017 in Pavia, Fondazione IRCCS Policlinico San Matteo started a partnership with Fondazione Mondino to build a specific stroke pathway, becoming a leading centre for stroke treatment. We conducted a retrospective chart review (RCR) of patient-centred data to quantify the volume of discharge for stroke patients. Two trained public health residents reviewed medical records with stroke admission diagnosis during 2021, analysing onset (e.g., Emergency Room, other hospital, emergency network), ward, treatment and discharge types (e.g., home, death, transitional care facility).

Results
Our RCR found 669 patients with a stroke diagnosis treated at San Matteo hospital in 2021, the vast majority of which were admitted to the neurology ward (375 patients, 56%). The recanalization rate was 32% (150 on 464 ischemic stroke patients). Regarding the discharge type, 299 patients (45%) were sent home, while 297 patients (44%) needed transfer to rehabilitation or long-term care facilities. About 8% (52 patients) of the overall sample died in hospital.

Conclusions
Our analysis showed that, while most stroke patients were discharged and sent home, more than two-third need to be transferred to continue to get the right healthcare from the right professional. Transitional care facilities should receive the greatest consideration by systems and providers seeking to implement care models to reduce residual neurological disabilities for stroke patients.

Key messages
• A fast and accessible emergency chain is essential to reduce residual neurological disabilities and the related healthcare and economic burden in stroke patients.
• Extending the stroke path model to other time-dependent diseases is increasingly high-priority to shape a strong and resilient healthcare system, ensuring qualified health coverage.
Can the virtual reality intervention VR FestLab improve Danish studentś alcohol competences?
Authors: Guldager J , Kjær SL , Grittner U , Stock C 
Published: October 2022

Abstract

Background
VR FestLab is a newly developed simulated “party” where the player is being offered alcoholic beverages while steering their own party experience in virtual reality. We evaluated the efficacy of VR FestLab on drinking refusal self-efficacy of Danish male and female 15-18-year-old students and tested user satisfaction. Secondary outcomes were drug refusal skills, knowledge/awareness, communication skills, social support willingness, susceptibility to peer pressures, and outcome expectations.

Methods
The intervention consisted of 15 minutes of gameplay and 30 minutes of group/in class discussion. The intervention group played VR FestLab where the control group played the VR game “Oculus Quest - First Steps” (no educational content). In a cluster-randomised controlled trial schools were randomly assigned to the intervention/control group. 13 Danish schools were recruited containing 181 students in intervention/191 in control groups. Students completed a questionnaire before and immediately after the intervention. Data was analysed using mixed linear regression models.

Results
50% of students found VR FestLab to be realistic, 57% would like to explore it further, and 43% would recommend it to friends. We found a small, but non-significant effect on drinking refusal self-efficacy favoring the intervention. No differences between the intervention and control group were observed for the secondary outcomes.

Conclusions
VR FestLab should be used with higher frequency than in this trial and in combination with other evidence-based alcohol prevention interventions adolescents. Further research is needed to improve the effectiveness of VR FestLab.

Key messages
• VR FestLab could be a valuable contribution to school-based alcohol prevention education but cannot stand alone.
• Future research should focus on the dose-effect relationship of the novel tool.
Assessing perceived and functional health literacy among Cypriot parents
Authors: Menikou I , Middleton N , Papastavrou E , Nicolaou C 
Published: October 2022

Abstract

Background
Health literacy (HL) refers to people’s competencies in accessing, understanding, assessing and applying health information to meet demands in healthcare, preventing illness and promoting health. In the case of children, parental HL is important in establishing health-promoting behaviours and better health outcomes.

Methods
A cross-sectional study was conducted among parents of children, aged 6 months to 15 years, in Cyprus with the aim of assessing perceived and functional HL. A convenience sample of parents presenting in pediatric outpatient departments in three Cypriot cities rated their HL using the HLS-EU-Q47 and the NVS (Newest Vital Sign), a performance-based measure of HL. Participants were classified according to the overall and domain-specific scores and associations with socio-demographics were explored.

Results
HLS-EU-Q47 mean score among 416 parents (83.2% female, 83.8% tertiary education) was 35.30 (SD = 7.45). Based on suggested ranges, almost half (42.6%) were classified as having inadequate or problematic HL. Consistently, 62.8% showed high likelihood or significant possibility of limited functional HL, based on the NVS with a mean score of 2.73 (SD = 2.02). Competency of understanding health information was rated higher (37.71, SD = 7.39), whereas assessing health information was rated lower (33.55, SD = 9.05). Among the three domains of the HLS-EU-Q47, the highest mean score was for healthcare (36.16, SD = 7.04) and the lowest score for health promotion (34.60, SD = 8.88). Parental HL was statistically significantly associated with education and financial difficulties.

Conclusions
Moderate-to-low levels of perceived HL appear consistent with a performance-based measure of HL. As a high number of parents may face challenges in assessing and applying health information to improve outcomes for their children, healthcare services should be oriented towards identifying problematic HL, while Public Health interventions are needed to enhance parental HL.

Key messages
• According to both a perceived and a performance-based measure of health literacy, the study suggests that a high proportion of parents in Cyprus may have inadequate or problematic health literacy.
• Health education interventions within clinical settings as well as at Public Health level are needed to enhance parental health literacy, currently not standard practice.
Promoting health literacy during Covid-19 pandemic–valuable partnership with Portuguese pharmacists
Authors: Malcata F , Raposo B , Costa D , de Arriaga MT 
Published: October 2022

Abstract

Issue/Problem
COVID-19 pandemic has amplified the amount of health information available; however, hard-to-reach populations remain and much of the information available is not accurate. Therefore, the use of new proximity approaches in the promotion of health literacy is essential because people face challenges and barriers when trying to find information relevant to them.

Description of the problem
From the beginning of the COVID-19 pandemic in 2020, the Division of Literacy, Health and Wellbeing of the Directorate-General of Health in Portugal developed Social Mobilization and Community Engagement training sessions-which included a presentation and a toolkit of flyers/posters/videos. These sessions had the goal of disseminating public health measures through good practices in health literacy and communication methods/skills to promote efficient communication among people who play an active role (as microinfluencers) in prevention and mitigation of risks associated with COVID-19, as is the case of pharmacists.

Results
A total of 200 Portuguese pharmacists enrolled on the Social mobilization training session in November 2021. More than 150 initiatives were implemented thereafter by those microinfluencers (pharmacists) in the local communities-31% directed to children or young people, 31% to older adults, and 13.8% to migrants or tourists. 70% of the participants considered the materials of the toolkit as adequate and sufficient, and 62.1% answered that people in the community showed interest for those materials available in the pharmacies.

Lessons
This Social mobilization project was important because it assembled and preserved trust- basing the information of the training on reliable sources about COVID-19 virus. It also trained the microinfluencers (pharmacists) in communication strategies. All these approaches were important to prevent and mitigate the impact of COVID-19 via adoption of non-pharmacological measures and promotion of vaccination.

Key messages
• Portugal was pioneer in promoting Social mobilization and community engagement training sessions, maintaining a proximity communication, tailoring the information, and maximizing its impact.
• Within the group of health professionals, pharmacists are a privileged group to promote these communication strategies and social mobilization due to their proximity with the local community.
Measuring the burden of infodemics on health outcomes through harmonized global metrics
Authors: Ishizumi A , Dunn AG , Purnat T , Yau B , Bertrand-Ferrandis C , White B , Briand S , Nguyen T 
Published: October 2022

Abstract

Issue/problem
Infodemics happen when an excess of information makes it difficult for people to discern what they see and hear to make good health decisions. Several challenges limit the usefulness of applying infodemiology research to the practice of managing infodemics including inconsistency in how information exposure is measured and a lack of focus on assessing associations with health behaviors.

Description of the problem
In 2021, WHO partnered with the University of Sydney to develop a study toolkit. We sought to create novel tools for measuring information exposure that can be easily deployed, linked to surveys measuring health behaviors, and implements a standardized study protocol so that data can be directly synthesized into a global analysis of information risk factors associated with health behaviors.

Results
A web-based study platform was developed, comprising tools for capturing information exposures within studies that link to health behavior surveys. The first tool is a smartphone application that asks users to actively record relevant information they see or hear in diary. The second application is a web browser plugin that passively tracks webpages with relevant keywords. Because localized studies follow a standardized protocol and de-identified participant data are recorded in a common format, local study investigators can opt-in to contributing study data to support global surveillance efforts.

Lessons
Through standardization of measurement tools and relevant study protocols, the toolkit can be used to quickly collect and synthesize data for global or regional analysis of infodemics, including in Europe. Validation of the toolkit in the field is needed to inform its open-source release.

Key messages
• A toolkit for measuring information risk factors associated with behavioral outcomes was developed.
• Global collaboration using the toolkit can improve synthesisability of studies investigating infodemic burden of disease.
Health literacy among older adults 77+ in Sweden
Authors: Wångdahl J , Agerholm J , Liljas A , Heap J , Lennartsson C 
Published: October 2022

Abstract

Background
Health literacy (HL) is an essential component of an individual’s ability to gain access to, understand and use information to improve and maintain good health and is an important prerequisite for managing health and care needs. Therefore, knowledge on older people’s HL is vital to meet the care needs of the rapidly aging population efficiently and equitably. Knowledge on HL in the older population is limited, both in an international perspective and in Sweden. Challenges linked to limited HL are expected to increase with advanced age, emphasizing the importance of conducting a study using a nationally representative sample of older adults. The aim of the study was to explore the level of HL in older adults living in Sweden.

Methods
A cross sectional study using data from the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD), which is a nationally representative sample of the Swedish population aged 77+ years (N = 1500). SWEOLD covers areas such as health, socioeconomic and social factors. HL is assessed with the communicative and critical health literacy scale. The data was collected through telephone interviews in fall 2021 and spring 2022. Respondents not able to answer themselves were excluded.

Results
Preliminary results show that 49 % of the participating adults aged 77+ have limited HL. HL was significantly associated with age (77-85 years OR: 1.80; 86+ OR: 3.04), education level (OR: 1.76), vision (OR: 2.40) and cognitive ability (OR: 0.88). HL was not significantly associated with sex.

Conclusions
These preliminary results shows that a large proportion of Swedish older people might face difficulties related to accessing, understanding, appraising, and applying health information in ways which promote and maintain good health, and stresses the importance of examining the topic in greater detail.

Key messages
• A high proportion of older adults in Sweden have limited health literacy.
• Health literacy among older adults in Sweden varies with age, level of education, vision and cognitive ability.
Facemasks and Public Health: analysis of bacterial contamination in FFP2 masks
Authors: Papale G , De Palma I , Amodeo D , Messina G 
Published: October 2022

Abstract

Background
Facemasks (FM), due to the Covid-19 pandemic, are extensively used and often worn beyond the recommended time. This has led to questions about the negative impact persistent contamination on FMs might have on public health. The study aims to assess the level of contamination reached in a small cohort of subjects after the recommended use (8 h) of FM.

Methods
This descriptive study was carried out between January and April 2022 on 17 people: 9 women and 8 men aged between 25-45 years. These two groups were divided into two micro-groups: women were selected according to their skincare habits (no skincare and skincare with cosmetics). In contrast, men were selected according to the length of their beards (thick or short beard). The FM was worn for 8 h in a controlled office setting, to avoid possible uncontrolled variables. Then, the FM was cut, placed in a tube with a recovery medium and centrifuged. The supernatant was removed and the pellet resuspended. Aliquots were plated on Petri plates and incubated for 48 h at 36 °C to count the Colony Forming Units (CFU). The statistical analysis was conducted using Stata software, performing the Wilcoxon matched-pairs and setting a significance level of p &lt; 0.05.

Results
Women had higher FM contamination than men (= 4960 vs 3130 CFU/ml). Also, we found more colonies (= 18890 vs 3420 CFU/ml) in the FMs of women without skincare (p = 0.06), while among men, more colonies were reported for those with a thicker beard than for those with a shorter one (= 3300 vs 2960 CFU/ml).

Conclusions
Extensive FM use increases bacterial contamination exponentially. This could lead to changes in the facial microbiome, inducing skin conditions (such as allergic dermatitis and acne). Facial skin conditions are important public health issues for people wearing FMs daily. In addition, responsible handling of this equipment is essential to avoid the spread of SARS-CoV-2 through contact with these items, which can persist for many days.

Key messages
• Gender and physical characteristics may influence the level of contamination present on FFP2 face masks.
• There is a need to increase community awareness on the proper handling of facemasks, prevent health problems for users, and limit the spread of infection to those around them.