bluuebunny/crossref_metadata_2025 huggingface dataset:
vSampler: fast and annotation-based matched variant sampling tool
Authors: Huang Dandan , Wang Zhao , Zhou Yao , Liang Qian , Sham Pak Chung , Yao Hongcheng , Li Mulin Jun
Published: October 2020

Sampling of control variants having matched properties with input variants is widely used in enrichment analysis of genome-wide association studies/quantitative trait loci and negative data construction for pathogenic/regulatory variant prediction methods. Spurious enrichment results because of confounding factors, such as minor allele frequency and linkage disequilibrium pattern, can be avoided by calibration of statistical significance based on matched controls. Here, we presented vSampler which can generate sets of randomly drawn variants with comprehensive choices of matching properties, such as tissue/cell type-specific epigenomic features. Importantly, the development of a novel data structure and sampling algorithms for vSampler makes it significantly fast than existing tools.

Availability and implementation

vSampler web server and local program are available at http://mulinlab.org/vsampler.

Supplementary information

Supplementary data are available at Bioinformatics online.
Reducing Catheter-associated Urinary Tract Infections via Cost-saving Diagnostic Stewardship
Authors: Luu Allison , Dominguez Fernando , Yeshoua Brandon , Vo Christopher , Nallapa Swathi , Chung David , Wald-Dickler Noah , Butler-Wu Susan M , Khaleel Huda , Chang Kate , Canamar Catherine P , Holtom Paul , Spellberg Brad
Published: October 2020

We conducted a quality improvement project at our large, public, tertiary-care, academic hospital to reduce the standardized infection ratio (SIR) of hospital-acquired catheter-associated urinary tract infections (CAUTIs). Our diagnostic stewardship program, based on education and audit and feedback, significantly reduced inpatient urine culture orders and CAUTI SIR.
Angiogenesis after acute myocardial infarction
Authors: Wu Xuekun , Reboll Marc R , Korf-Klingebiel Mortimer , Wollert Kai C
Published: October 2020

Acute myocardial infarction (MI) inflicts massive injury to the coronary microcirculation leading to vascular disintegration and capillary rarefication in the infarct region. Tissue repair after MI involves a robust angiogenic response that commences in the infarct border zone and extends into the necrotic infarct core. Technological advances in several areas have provided novel mechanistic understanding of postinfarction angiogenesis and how it may be targeted to improve heart function after MI. Cell lineage tracing studies indicate that new capillary structures arise by sprouting angiogenesis from pre-existing endothelial cells (ECs) in the infarct border zone with no meaningful contribution from non-EC sources. Single-cell RNA sequencing shows that ECs in infarcted hearts may be grouped into clusters with distinct gene expression signatures, likely reflecting functionally distinct cell populations. EC-specific multicolour lineage tracing reveals that EC subsets clonally expand after MI. Expanding EC clones may arise from tissue-resident ECs with stem cell characteristics that have been identified in multiple organs including the heart. Tissue repair after MI involves interactions among multiple cell types which occur, to a large extent, through secreted proteins and their cognate receptors. While we are only beginning to understand the full complexity of this intercellular communication, macrophage and fibroblast populations have emerged as major drivers of the angiogenic response after MI. Animal data support the view that the endogenous angiogenic response after MI can be boosted to reduce scarring and adverse left ventricular remodelling. The improved mechanistic understanding of infarct angiogenesis therefore creates multiple therapeutic opportunities. During preclinical development, all proangiogenic strategies should be tested in animal models that replicate both cardiovascular risk factor(s) and the pharmacotherapy typically prescribed to patients with acute MI. Considering that the majority of patients nowadays do well after MI, clinical translation will require careful selection of patients in need of proangiogenic therapies.
Regional and global contributions of air pollution to risk of death from COVID-19
Authors: Pozzer Andrea , Dominici Francesca , Haines Andy , Witt Christian , Münzel Thomas , Lelieveld Jos
Published: October 2020

Aims

The risk of mortality from the coronavirus disease that emerged in 2019 (COVID-19) is increased by comorbidity from cardiovascular and pulmonary diseases. Air pollution also causes excess mortality from these conditions. Analysis of the first severe acute respiratory syndrome coronavirus (SARS-CoV-1) outcomes in 2003, and preliminary investigations of those for SARS-CoV-2 since 2019, provide evidence that the incidence and severity are related to ambient air pollution. We estimated the fraction of COVID-19 mortality that is attributable to the long-term exposure to ambient fine particulate air pollution.

Methods and results

We characterized global exposure to fine particulates based on satellite data, and calculated the anthropogenic fraction with an atmospheric chemistry model. The degree to which air pollution influences COVID-19 mortality was derived from epidemiological data in the USA and China. We estimate that particulate air pollution contributed ∼15% (95% confidence interval 7–33%) to COVID-19 mortality worldwide, 27% (13 – 46%) in East Asia, 19% (8–41%) in Europe, and 17% (6–39%) in North America. Globally, ∼50–60% of the attributable, anthropogenic fraction is related to fossil fuel use, up to 70–80% in Europe, West Asia, and North America.

Conclusion

Our results suggest that air pollution is an important cofactor increasing the risk of mortality from COVID-19. This provides extra motivation for combining ambitious policies to reduce air pollution with measures to control the transmission of COVID-19.
Effect on the donor lungs of using abdominal normothermic regional perfusion in controlled donation after circulatory death
Authors: Tanaka Shin , Luis Campo-Cañaveral de la Cruz Jose , Crowley Carrasco Silvana , Romero Román Alejandra , Hoyos Mejía Lucas , Manuel NaranjoGómez Jose , Córdoba Peláez Mar , Sánchez Calle Álvaro , Gil Barturen Mariana , Pérez Redondo Marina , García Fadul Christian , Varela de Ugarte Andrés , Gómez-de-Antonio David
Published: October 2020

OBJECTIVES

Controlled donation after circulatory death (cDCD) donors are becoming a common source of organs for transplantation globally. However, the graft survival rate of cDCD abdominal organs is inferior to that of organs from brain-dead donors. The rapid retrieval (RR) technique is used by most donor organ procurement teams. The abdominal normothermic regional perfusion (A-NRP) technique has been implemented to minimize warm ischaemic damage to the abdominal organs. However, there is limited information on the effect of A-NRP on the quality of the donor lungs. This study aimed to compare lung transplantation outcomes using lungs procured from cDCD donors using the A-NRP and abdominal RR techniques.

METHODS

A single-centre retrospective analysis of consecutive transplant recipients of cDCD lungs from June 2013 to December 2019 was performed. The recipients were divided into 2 cohorts according to the abdominal procurement technique used. The recipient and donor characteristics (age, sex, cause of brain injury, warm ischaemic time, diagnosis, lung allocation score and other factors), incidence of primary graft dysfunction and early survival were monitored.

RESULTS

Twenty-eight consecutive lung transplantation recipients were identified (median age 59 years; 61% male); 14 recipients received lungs using the A-NRP and 14 using abdominal RR for abdominal organ retrieval. There were no significant differences in the baseline characteristics, primary graft dysfunction (P = 0.70), hospital mortality (P = 1.0) and 1-year survival rate (P = 1.0) between the 2 groups.

CONCLUSIONS

No difference was observed in lung transplantation outcomes irrespective of the abdominal organ procurement technique used (A-NRP or abdominal RR).
Drug Use Disorders and Violence: Associations With Individual Drug Categories
Authors: Zhong Shaoling , Yu Rongqin , Fazel Seena
Published: October 2020

We conducted a systematic review that examined the link between individual drug categories and violent outcomes. We searched for primary case-control and cohort investigations that reported risk of violence against others among individuals diagnosed with drug use disorders using validated clinical criteria, following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We identified 18 studies published during 1990–2019, reporting data from 591,411 individuals with drug use disorders. We reported odds ratios of the violence risk in different categories of drug use disorders compared with those without. We found odds ratios ranging from 0.8 to 25.0 for most individual drug categories, with generally higher odds ratios among individuals with polydrug use disorders. In addition, we explored sources of between-study heterogeneity by subgroup and meta-regression analyses. Cohort investigations reported a lower risk of violence than case-control reports (odds ratio =  2.7 (95% confidence interval (CI): 2.1, 3.5) vs. 6.6 (95% CI: 5.1, 8.6)), and associations were stronger when the outcome was any violence rather than intimate partner violence (odds ratio = 5.7 (95% CI: 3.8, 8.6) vs. 1.7 (95% CI: 1.4, 2.1)), which was consistent with results from the meta-regression. Overall, these findings highlight the potential impact of preventing and treating drug use disorders on reducing violence risk and associated morbidities.
The needs of pregnant women and their significant others regarding professional smoking cessation support
Authors: Weiland S , Warmelink J C , Peters L L , Berger M Y , Erwich J J H M , Jansen D E M C
Published: October 2020

Introduction

Despite the health risks of smoking, some women continue smoking during pregnancy. Professional smoking cessation support (SCS) has shown to be effective in increasing the proportion of women who quit smoking during pregnancy. However, few women actually make use of professional SCS. The aim of this study is to investigate the needs of women and their partners for professional SCS.

Methods

Semi-structured interviews were held with pregnant women and recent mothers who smoked or quit smoking during pregnancy, and their partners, living in the North of the Netherlands. Recruitment was done via Facebook, LinkedIn, food banks, baby stores and healthcare professionals. The interviews were recorded, transcribed and thematically analyzed.

Results

28 interviews were conducted, 23 with pregnant women and recent mothers, and five with partners of the women. The following themes were identified: 1) Understanding women's needs, 2) Responsibility without criticism, and 3) Women and their social network. These themes reflect that women need support from an involved and understanding healthcare professional, who holds women responsible for smoking cessation but refrains from criticism. Women also prefer involvement of their social network in the professional support.

Conclusions

For tailored support, the guideline for professional SCS may need some adaptations, and women and their partners should be involved in the development of future guidelines. Women prefer healthcare professionals to address smoking cessation in a neutral way and to respect their autonomy in the decision to stop smoking.
Strengthening core competences of medical and public health students for public health emergencies
Authors: Petráková A , Príkazský V , Kollárová H , Fundano N , Asswad A Ghazal , Khan H , Holm S
Published: October 2020

Background

The importance of public health capacity development with a focus on public health emergencies and humanitarian assistance is continuously increasing at the global scale. In the time of Public Health Emergencies of International Concern is crucial to provide basic training in core public health competences to all health professionals, including students. Faculty of Medicine & Dentistry, Palacký University Olomouc, Czech Republic (full ASPHER member), implemented in medical as well as public health curricula new topics focused on core competences of health professionals in the area of public health emergencies and humanitarian assistance.

Objectives

To strengthen competences and skills of medical as well as public health students to prepare them better for public health emergencies and humanitarian assistance in the time of increasing risk of global public health emergencies. New modules were proposed and tested in all education programmes at our Faculty of Medicine & Dentistry, Palacký University Olomouc (CZ): General Medicine (Czech and English programmes), Dentistry (Czech and English programmes) and Public Health (Czech programme).

Results

New modules on Public Health Emergencies, including preparedness, responses, risk management and risk communication were successfully tested in all education programmes during the academic year 2018/19 and fully implemented for the academic year 2019/20. New module has blended learning structure based on combination of face-to-face seminars and exercises with e-learning parts, including self-assessment. New module is presented in details.

Conclusions

This new education module fully supports international recommendations to strengthen public health competences and skills of medical as well as public health students to be ready for any unexpected public health emergencies at all levels, in particular at the local community level. COVID-19 pandemic confirmed.

Supported by university project CZ.02.69/0.0/16_015/0002337

Key messages

Medical and public health students with competences and skills on public health emergencies and humanitarian assistance will be an asset for any public health emergency of international concern. New education module on public health emergencies will support both medical and public health students to be prepared for risk communication, advocacy and action if needed and called to action.
Chronic kidney disease in migrant and non-migrant populations: data from an Italian regional project
Authors: Gibertoni D , Mandreoli M , Santoro A , Gherardi G , Fantini M P
Published: October 2020

Background

The proportion of migrants among incident patients with chronic kidney disease (CKD) in the Emilia-Romagna region is steadily increasing. Inequalities in access to health services and in outcomes between non-migrant and migrant patients already known in the literature are found also for those affected by CKD. We compared migrants' groups and Italian patients to provide evidence which may be useful to public health professionals and nephrologists for migrant patients' management.

Methods

Italian and migrant patients followed up in PIRP (a regional project devised to delay progression to kidney failure in subjects with CKD) were identified. Migrants were grouped by geographical area of origin and compared to Italians by means of descriptive statistics and survival analysis.

Results

As of 30.4.2020, migrants account for 3.1% (n = 955/30523) of all PIRP patients and 4.2% (n = 481/11335) of prevalent patients; their proportion among incident patients grew from 1.0% in 2004 to 5.5% in 2019. All areas of origin were adequately represented, from 6.4% of East Asia to 26.1% of East Europe. Wide differences were found for: age at first visit (Italians=73.1 years vs. Sub-Saharians=47.7), proportion of males (75.0% for South Asians to 49.6% of East Europeans), diabetes (from 45.1% in East Asians to 19.4% in Sub-Saharians), comorbidities and type of nephropathy. Italians had the smallest median annual eGFR decrease (-1.0 ml/min), while the largest were found in migrants from East Asia (-2.2) and Arab States (-2.5). 5-year survival to renal death (dialysis or transplantation) was lower in South Asians (51.4%) than in Latino-Americans (85.3%) and Italians (85.0%).

Conclusions

Migrant chronic kidney disease patients have widely different features and outcomes compared to non-migrants and among migrant subgroups. Our findings pave the way to further investigation, whose results may be essential to tailor surveillance and treatment programs on specific groups of migrants.

Key messages

Among chronic kidney disease patients, non-migrants and migrants exhibit different clinical characteristics and outcomes, and thus require different surveillance and treatment approaches. Future research should analyze the causes of disparities between migrant and non-migrant chronic kidney disease patients, specifically focusing on those related to inequalities in access to healthcare.
Health promoting pharmacies in Northern-Italy: more than drugstores
Authors: Brunelli L , Morsanutto A , Tosolini M , Iob A , Schiava F , Degrassi L , Pancino C , Andreatti M , Tonutti G , Brusaferro S
Published: October 2020

Issue

In Friuli Venezia-Giulia Region (Italy), accessibility to health services can be substantially influenced by the geographical context. In fact, during recent years, at-risk inhabitants of mountain villages were less likely to be vaccinated against flu in comparison with other areas. To tackle inequalities, local pharmacies were identified as a proximity health promotion network to be engaged in the 2019/2020 flu vaccination campaign.

Description

Within the mountainous Carnia District, 43 pharmacists from 25 pharmacies were trained before the campaign to promote flu shot uptake through counseling in over 65 and high-risk subjects. After counseling, subjects were directed to General Practitioners who performed vaccine administration and registration. Anti-flu counseling offered by pharmacists was traced and vaccine coverage against influenza among target categories was considered as the principal outcome. A reward was granted to pharmacies in relation to flu vaccine conversions among counseled subjects.

Results

Between October 2019 and January 2020, a total of 2,748 counseling sessions with people accessing pharmacies for any reason were conducted. Within Carnia District, flu vaccine was administered to 6,484 out of 10,895 (59.5%) over 65 subjects in comparison with 5,569/10,251 (54.3%) who got their flu shot during the 2018/19 flu season, achieving an improvement of + 5.2%. This result exceeded the regional global outcome reaching +2.2%, being the best among all districts. In particular, in comparison with the previous year, +10.2% over 65 and +37.8% at-risk subjects were vaccinated against flu in Carnia District.

Lessons

Pharmacies played an important role in promoting flu vaccination locally, and proved their potential contribution in tackling inequalities related to difficult contexts. The collaboration of health professionals, including pharmacists, should be taken into consideration to improve health promotion and health services access.

Key messages

Pharmacies are trustworthy healthcare system access points for people, therefore their role in health promotion should be fostered. Pharmacists can help in improving flu shot uptake in contexts where health service access is hindered.
Strengthening implementation of antimicrobial resistance national action plans
Authors: Anderson M , Schulze K , Cassini A , Plauchoras D , Mossialos E
Published: October 2020

Antimicrobial resistance is one of the major challenges of our time. Countries use national action plans as a mechanism to build engagement among stakeholders and coordinate a range of actions across human, animal, and environmental health. However, implementation of recommended policies such as stewardship of antimicrobials, infection prevention and control, and stimulating research and development of novel antimicrobials and alternatives remains inconsistent. Improving the quality of governance within antimicrobial resistance national action plans is an essential step to improving implementation. To date, no systematic approach to governance of national action plans on AMR exists. To address this issue, we aimed to develop the first governance framework to offer guidance for both the development and assessment of national action plans on AMR. We reviewed health system governance framework reviews to inform the basic structure of our framework, international guidance documents from WHO, the Food and Agriculture Organization, the World Organisation for Animal Health, and the European Commission, and sought the input of 25 experts from international organisations, government ministries, policy institutes, and academic institutions to develop and refine our framework. The framework consists of 18 domains with 52 indicators that are contained within three governance areas: policy design, implementation tools, and monitoring and evaluation. Countries must engage with a cyclical process of continuous design, implementation, monitoring and evaluation to achieve these aims.
Health Literacy Policy in Israel – Culturally Appropriate Health Systems
Authors: Levin-Zamir D
Published: October 2020

Background

The diverse culture in Israel created the need for developing and implementing a national policy for culturally and linguistically appropriate health services. The need stems from trends in immigration to Israel, various levels of religiosity, and the ethnic diversity of the veteran population. Health literacy plays a prominent role in this policy.

Methods

A national policy directive was developed and disseminated by the Israel Ministry of Health calling for culturally appropriate health information to the public, communication while receiving healthcare including ongoing staff training, health promotion intervention, and research for needs assessment.

Results

The national policy has been implemented for the past five years in primary care, hospitals and non-governmental health organizations. Cultural health liaisons have been integrated into primary healthcare teams in over 30 community clinics caring for Ethiopian immigrants, telephone translation services are available for Amaharic/Tigrinia, Russian and Arabic speaking communities, quality healthcare standards defined on topics such as of diabetes, and training of staff on cultural sensitivity continuously conducted. Culturally appropriate printed and digital sources of health information are available for diverse ethnic and religious communities. Appropriate health promotion intervention is routinely implemented on healthy lifestyle, early detection, and self-care, focusing mainly on NCDs and system navigation, supported by applied research and evaluation.

Conclusions

The policy implementation was the result of significant investment by stakeholders at all levels and requires support for sustainability regarding health literacy, health behaviour and health outcomes. Resource allocation is necessary for assessment and outcome measurement, and for applying more participatory methods for policy development, training, implementation and evaluation.
A National Position Paper: Health Literacy from a Structural Perspective-A path to equity in health?
Authors: Terkildsen Maindal H , Vinther-Jensen K , Sørensen K , Bertram M , Aaby A
Published: October 2020

Background

Health literacy (HL) as an enabler of health equity and health promotion. HL is closely linked to other social determinants of health such as age, sex, education, social status and ethnicity. HL responsiveness is the degree to which systems or organizations make it easier for people to navigate, understand, and use information and services. HL can be enhanced through individual support, by targeting the responsiveness of the health professional workforce, or by taking a structural or organizational HL perspective.

Methods

In Denmark, the HL Network, which is part of Danish Society for Public Health, developed a position paper for approaching HL from a structural level. In 2018-2019 a rapid literature review was conducted followed by three different methodologies: (i) stakeholder meetings, (ii) expert interviews (policy, practice, research) and (iii) thematic meeting focusing on different dimension of the initial recommendation for the position paper, which was published at the National Conference for Public Health.

Results

In the position paper eight recommendations were developed to improve HL in Denmark from a structural perspective. The recommendations overall aim to prevent low HL and its consequences by targeting health services at the organizational level. The recommendations are: Integrate HL into Danish health policies and strategiesDevelop HL throughout the life courseInclude HL in health education curriculaIntegrate HL at organizational levelsIntegrate HL into partnership and co-creation processesMeasure and monitor HL using local and national dataDevelop, test and evaluate HL interventionsConsider HL in all forms of health communication

Conclusions

The recommendations can support the integration of a health literate thinking into current national health strategies, including the ongoing efforts to achieve the 17 UN Global SDGs, and thereby contribute to the equitable distribution of health in the Danish population.
Mental health and quality of life assessment among adult internally displaced persons, Tripoli Libya
Authors: Sryh M , Ozcebe H
Published: October 2020

Background

Internal displacement in Libya is one of the main results of armed conflicts since 2011. Displacement adversely affects the quality of life. Our descriptive study aims to assess the percentage of mental disorders, the level of the quality of life among internally displaced persons (IDPs) in private residents and camps in Tripoli city Libya.

Methods

In this study, 469 IDPs were reached in Tripoli city, Libya (227 IDPs in private residency and 242 IDPs in camp residency). The questionnaires including socio-economic characteristics, health status, Depression Anxiety Stress Scale (DASS 42) and Quality of Life Scale (SF-36) were filled by IDPs under observation.

Results

Among private residents 51.8% were males, 41.0% of them aged 25-34, the mean score for SF 36 Physical Sub dimension (PQOL) and Sd was 69.72±20.85 (p < 0.001) and the mean score for SF 36 Mental Sub dimension (MQOL) was 62.28±17.87 (p < 0.001), where 24.2% of them had chronic disease and 45.5% of them had a degree of mental disorder. Among camp residents 33.2% were males, 32.6% of them aged 18-24, they had mean score and Sd 59.43±17.86 for PQOL (p < 0.001) and mean score 55.56±17.20 for MQOL (p < 0.001), where 16.5% of them had chronic disease and 72.6% of them had a degree of mental disorder.

Conclusions

Camp resident IDPs had higher mental disorders and lower score of quality of life domains than private resident IDPs. Among IDPs; statistically significant association was found between low level of quality of life and camp residency, the presence of chronic disease and mental disorders. Thus efforts target the improvement of socio-economic status and mental healthcare service among camp resident IDPs are highly recommended, with special attention to people with chronic diseases.

Key messages

Internal displacement, camp residency, the presence of chronic disease and mental disorders have a deep negative impact on quality of life. IDPs living in camp residency need additional interventions to improve the quality of life.
Caries and fluoridated water in two Brazilian cities in the first decade of the 21st century
Authors: Cruz M G B , Narvai P C
Published: October 2020

Background

Despite health policies must be shaped by scientific evidence, there is no data to prove that water fluoridation increases preventive benefit to dental caries in addition to that provided by the widespread use of fluoride toothpaste.

Methods

A double census population survey was conducted in two Brazilian small cities, differentiated only by exposure or not, for at least 5 years, to fluoridated water, in 2014. The magnitude and experience of caries were assessed using the dmft (at 5-6-year-old; N = 233), DMFT (at 11-12-year-old; N = 312) and SiC (at 11-12-year-old; N = 105) indexes. Associations were tested by Pearson's chi-square statistics and prevalence ratio (PR) between unexposed (NE) and exposed (E) to fluoridated water.

Results

Deciduous dentition: Although caries experience (dmft≥1) was not associated with exposure to fluoridated water (chi-square=2.77, p = 0.96, α = 5%), there was a significant difference in the magnitude which the disease reached the population: the mean dmft were 2.74 in those exposed and 4.17 in unexposed. PR (NE/E) was 1.21 indicating that exposure to fluoridated water corresponded to a 21% lower prevalence rate, compared to those unexposed. Permanent dentition: Although caries experience (DMFT≥1) was not associated with exposure to fluoridated water (chi-square=1.78; p = 0.18; α = 5%), a significant difference was observed in the magnitude with which the disease reached the population: the means of DMFT were 1.76 in those exposed and 2.60 in unexposed and the means of SiC were 4.04 and 6.16, respectively. PR (NE/E) was 1.13 indicating little expressiveness in prevalence difference.

Conclusions

Exposure to fluoridated water implied a lower mean value of the dmft, DMFT and SiC indexes at a level of 50%, although in the presence of concomitant universal exposure to fluoridated dentifrice. The maintenance of water fluoridated in Brazil and other countries as an effective public health measure is strongly supported by this research results.

Key messages

This research is in the interest of all countries to decide whether, even with access to fluoridated toothpastes, it is worth adding fluoride to the waters that supply their populations. The study's approach is unprecedented and describes innovative possibilities of using cross-sectional studies to evaluate the results and impacts of public oral health policies.
Cancer information overload and multiple prevention behaviors
Authors: Breyton M , Smith A B , Rouquette A , Mancini J
Published: October 2020

Background

Many people feel overwhelmed by the increasing amount of cancer-related material available in the information environment. Our aims was to evaluate the psychometric properties of the brief version of the cancer information overload (CIO) scale and to examine the association between CIO and multiple cancer prevention behaviors.

Methods

A large survey using a self-administered online questionnaire was proposed to all adult members of the Seintinelles, a French national non-profit organization. The psychometric properties of the CIO scale were evaluated. Measurement invariance across French and English languages was studied using an additional sample of 224 Australian cancer survivors from Register4. We also collected functional, communicative, and critical health literacy (FCCHL), deprivation (EPICES index), current smoking, alcohol misuse, frequent sunburns, and rare skin self-examination.

Results

Between June 16th and 30th 2016, 2 363 French participants answered the online questionnaire. The five-item CIO scale demonstrated the best balance between psychometric properties and number of items. It showed satisfactory internal consistency and adequate fit. No measurement invariance issue was found across age, gender, education level, and language groups.

CIO was increased among people with higher deprivation, lower education and a cancer information avoidant profile. In multivariate analyses, CIO was associated with tobacco use (OR = 1.05, 95%CI [1.00-1.10]), rare skin checks (OR = 1.05 [1.01-1.08]) and frequent sunburns (OR = 1.04 [1.01-1.07]), but not with alcohol misuse.

Conclusions

The 5-item CIO scale is ready to be used in French and English-speaking countries. The links observed between CIO and multiple prevention behaviors encourage further research in order to better characterize the psycho-cognitive and environmental phenomena at play. Efforts are needed to communicate adequately and empower citizens to limit the growing burden of cancer.

Key messages

The 5-item CIO scale is ready to be used in French and English-speaking countries. Efforts are needed to communicate adequately and empower citizens to limit the growing burden of cancer.
The impact of retirement on physical, mental health and wellbeing
Authors: Odone A , Frascella B , Vigezzi G , Gaetti G , Gianfredi V
Published: October 2020

Population ageing presents both challenges and opportunities for societies around the world. Increasing statutory retirement age and limiting exits to early retirement are frequent policy responses to population ageing, but this is unlikely to have the desired impact if the complex relationships that link work, retirement and health remains unknown. In this context, we designed and are currently conducting the multi-partner project on pension reforms and spatial-temporal patterns in healthy ageing, funded by Fondazione Cariplo. The project involves a multi-disciplinary research team from University Vita-Salute San Raffaele, Bocconi University and the Unit of Epidemiology of the Regional Health Service of ASL TO3.

In this first presentation we will first describe the project design, its general aim and specific objectives, then we will present a proposed conceptual framework on the association between retirement and health and its determinants. The framework is the first deliverable of the project and is the results of a comprehensive review of the available evidence and consultation with experts in the field. In particular we conducted a scoping review to retrieve, pool and critically appraise the relevant evidence on the impact of retirement and transition to retirement on physical and mental health and their determinants. We summarized the evidence collected in a conceptual framework that attempt to quantify how health and retirement are bi-directionally linked, how health is central to the timing of retirement, how labor-associated determinants condition employment cessation, how and retirement have varying effects on risk factors for physical and mental health and the role of confounding factors and mediators. Towards the end of the presentation we will outline an extensive stakeholder mapping carried out for the purposes of the project at the national and European level
Informatics competences of registered nurses – does the graduation year matter?
Authors: Kaihlanen A-M , Gluschkoff K , Laukka E , Heponiemi T
Published: October 2020

Background

Digital services have become an essential part of nurse's work and nursing informatics competence a prerequisite for nurses to carry out their professional roles. Urgent investments are needed in informatics competence development and integrating informatics into nursing curricula. However, this has shown to be a challenge in many countries. In 2015, Finnish eHealth strategies emphasised the importance of investing more in informatics education for health professionals. This study evaluated whether these strategies have succeeded in increasing the informatics competences of registered nurses.

Methods

The data were collected in Finland with an electronic survey (end of 2018). The sample comprised 1639 nurses who were categorised in eight groups based on their graduation year. Analysis of covariance was used to examine whether the graduation year was associated with nurses' overall informatics competence and four specific competences (terminology based documentation; patient-related digital work; general IT competency; e-documentation according to structured national headings). Models were adjusted for age, gender, work setting and geographical area.

Results

Graduation year was associated with the nurses' overall informatics competence (F = 4.91 p < 0.001) and specific competences related to terminology based documentation (F = 5.27 p < 0.001), patient-related digital work (F = 4.00 p < 0.001) and general IT competency (F = 3.63 p = 0.001). Nurses graduated after the 2015 strategies (between 2016 and 2018) had the highest competence. The earlier the nurses' graduation year was the lower the nursing informatics competences.

Conclusions

Existing eHealth strategies may have urged Finnish nursing programs to add more informatics training in their curricula. Nurses' informatics competence affects the quality of health care, thus, more training should be provided especially for nurses with earlier graduation years who have not had formal nursing informatics education.

Key messages

Results highlight the importance of having eHealth strategies with educational initiatives stating the directions and objectives of education programs. Healthcare organisations should invest in providing more in-service education in nursing informatics especially for those nurses who have not had informatics included in their undergraduate studies.
The role of complementary medicine health literacy in health communication and decision-making
Authors: McIntyre E , Harnett J , Adams J , Steel A
Published: October 2020

Background

Globally, complementary medicine (CM) product use is high-including vitamins, minerals and herbal medicines. The overuse of CM raises concerns about medicine sustainability that are critical considerations for human and planetary health. Poor CM health literacy may lead to the unnecessary use of CM. This is the first study to explore associations between CM use, CM health literacy, and concurrent use of CM with conventional health care in an Australian population with a view to identifying priority areas for intervention.

Methods

Cross-sectional online study of Australian adults (N = 2019). A 50-item survey measured demographic and health characteristics, health care and treatment use, medicine use disclosure to health care providers, and CM health literacy. Descriptive statistics, Spearman's correlations and Chi-square analysis were used to analyse preliminary findings.

Results

In the previous year 49.1% of participants used a CM product. A greater proportion of those who used CM products (88.7%, <0.001), compared to those who did not, used a prescription or over-the-counter pharmaceutical. Lower levels of CM health literacy were associated with herbal supplement use (not vitamin/mineral supplement use) and with disclosing CM use to a medical doctor or pharmacist (p < 0.01). Those who consulted with a GP, specialist or pharmacist, who self-prescribed CM, or used both CM and pharmaceutical medicines had better CM health literacy (p < 0.001) than those who did not. Conversely, those who consulted a CM practitioner had lower CM health literacy than those who did not (p < 0.001).

Conclusions

The findings suggest that people with lower CM health literacy may be unsure about using CM products, while those with better CM health literacy may have more self-efficacy for making treatment decisions. Interventions are needed to improve public CM health literacy and encourage shared decision-making to ensure safe, effective and sustainable treatment decisions.

Key messages

People with higher levels of CM health literacy appear to have greater self-efficacy for making treatment decisions, while those with lower CM health literacy are more likely to seek treatment advice. Interventions are needed to ensure people using CM products are communicating with health practitioners about their treatment choices to facilitate safe, effective and sustainable treatment decisions.
Occupational exposures to blood and body fluids among health care workers in Tunisia
Authors: Kacem M , Abroug H , Bennasrallah C , Ben Fredj M , Zemni I , Dhouib W , Bannour R , Sriha A
Published: October 2020

Background

Occupational exposures to blood and body fluid are among the most frequent occupational accidents in healthcare. They put healthcare workers (HCWs) at high risk of transmission of many blood borne pathogens mainly hepatitis B virus (HBV), hepatitis C virus HCV and HIV. The aim of this study was to determine the prevalence of occupational exposures to blood and body fluids and its associated factors among HCWs at the university hospital of Monastir (Tunisia) in 2017.

Methods

An exhaustive cross-sectional study was conducted from 01 June 2017 to 31 August 2017 at the university hospital in Monastir Governorate (Tunisia). An anonymous self-administered questionnaire was used to collect data on demographic characteristics, self-reported exposures and their circumstances. We performed a multivariate analysis to determine the associated factors to these occupational exposures.

Results

A total of 1493 HCWs (34.6% nurses 22% technicians and 21.6% doctors) were included corresponding to a response rate of 74%. The median age of the participants was of 36 years (IQR: 31- 46 years). The sex ratio was of 0.36. Responders from medical and surgical departments represented respectively 40.5% and 39%. Among interviewed HCWs, 56.7% reported having at least one exposure to blood or body fluid with 35.4% of them exposed twice or more. Almost half (48.3%) of the respondents had a history of needle stick injury and 32.1% had a history of blood or body fluid splash into the face.The multivariate analysis showed that doctors had the highest risk of exposure comparing to other HCWs with (AOR = 12.425; 95% CI: 05.310 - 29.075) and participants working at surgical departments were at higher risk of exposure than those at others departments (AOR=7.440; 95% CI: 4.461 - 12.408).

Conclusions

Health occupational exposures to blood and body fluids are a serious problem at the university hospital of Monastir. Preventive measures should be strengthened to alleviate this problem.

Key messages

Doctors had the highest risk of exposure to blood and body fluids comparing to other HCWs at the university hospital of Monastir. Preventive measures should be strengthened to alleviate this problem.
Epidemiological profile of diseases caused by aedes aegypti in sanitary districts of São Luis, Brazil
Authors: Dos Santos ECR , Cohren S C , Costa R G R
Published: October 2020

In recent decades, the diseases caused by the Aedes aegypti have been responsible for a high number of mortality cases worldwide, making it a serious public health problem. This article describes the diseases prevalence caused by Aedes Aegypti: Dengue, Zika and Chikungunya, in the Sanitary Districts of city of São Luis - in the state of Maranhão in Brazil, from 2007 to 2017. This study is based on data analysis recorded by the Information System on Diseases of Compulsory Declaration (SINAN). From 2007 to 2017, 25,124 dengue cases were reported in the city of São Luís, there was an increase in prevalence in 2011 with 5,378 cases, about 53% of recorded cases in the State of Maranhão, probably due to the presence of new circulating serotypes: DENV-1; DENV-2 AND DENV-4, with 14 deaths. Female gender predominated among registered cases, and the age group with the highest number of reported cases was 20 to 39 years. In 2015 started the first reports of the Zika virus and chikungunya, both with epidemiological peak in 2016. São Luis has 229 urban neighborhoods and 165 rural neighborhoods distributed in seven health districts. The Bequimão Sanitary District in the urban area of city of São Luis consists of 64 neighborhoods, has recorded a higher number of dengue cases, 6,239 cases. From 2015 to 2017, it reported 864 cases of Zika virus and 407 cases of chikungunya. It is concluded that the prevalence of diseases, caused by Aedes aegypti, shows endemic variation, in the three arboviruses, related to population density and local sanitary conditions, characteristics which are present in the Sanitary District of Bequimão where it's registered a lack of sanitary infrastructure and intermittent water supply, the study notes the need to adopt control strategies of sanitary officers, and agencies and awareness of the population.

Key messages

The research produced knowledge about the impact of urbanization on the epidemiology of dengue, zika and chikungunya, enabling knowledge of the sanitation conditions of the studied city. The knowledge produced by the research substantiates strategies and actions to combat the vector by the health authorities and conscious action of the population.
Social determinants of health among urban homeless in Delhi, India
Authors: Nambiar D
Published: October 2020

Introduction

Housing is a critical determinant of health that operates synergistically with other social determinants of health (SDH), like food and nutrition. The urban homeless count among the most neglected and marginalized groups; they live and work in conditions that make them prone to disease. We conducted a study to understand the role and interplay of various SDH among the urban homeless in India.

Methods

A qualitative study was undertaken to understand the social determinants of health among homeless people in Delhi, India. Organizations working with the population were initially consulted. Criterion sampling was used to draw a convenience sample of participants for 24 in-depth interviews and five focus group discussions. Field observations were also done. Data were analysed using a grounded theory approach using Atlas.TI 8 software.

Results

The homeless lived in proximity in shelters making them susceptible to infectious disease such as Tuberculosis, or on the roadside making them prone to road-traffic accidents owing to intake of drugs and alcohol. Injuries caused by violence were common and homeless people lined up each morning for first aid services. Single homeless women were vulnerable to being stalked and raped. At a homeless recovery shelter, where a large number of homeless people had Tuberculosis or HIV, poor nutrition was reported as a leading factor that lowered immunity and affected chances of recovery. Lack of coordination between the different departments of the government for taking effective measures for ensuring better health of the urban poor was also reported.

Conclusions

The conditions of living clearly affected the lives of homeless people. The settings - the quality of housing and social environment in addition to the ineffective role of the state played a prominent role in impacting the health of the urban poor. There clearly is a need for policy measures that can address factors that shape the health of poor people.

Key messages

Homelessness is a crucial determinant of health: it severely affects the health and well-being of homeless people. The lack of a political will to address SDH is a leading challenge.