bluuebunny/crossref_metadata_2025 huggingface dataset:
The academic viewpoint on Big data and patient data ownership (as seen in the scientific literature)
Authors: Mircheva I , Mirchev M
Published: October 2020

Background

Ownership of patient information in the context of Big Data is a relatively new problem, apparently not yet fully understood. There are not enough publications on the subject. Since the topic is interdisciplinary, incorporating legal, ethical, medical and aspects of information and communication technologies, a slightly more sophisticated analysis of the issue is needed.

Aim

To determine how the medical academic community perceives the issue of ownership of patient information in the context of Big Data.

Methods

Literature search for full text publications, indexed in PubMed, Springer, ScienceDirect and Scopus identified only 27 appropriate articles authored by academicians and corresponding to three focus areas: problem (ownership); area (healthcare); context (Big Data). Three major aspects were studied: scientific area of publications, aspects and academicians' perception of ownership in the context of Big Data.

Results

Publications are in the period 2014 - 2019, 37% published in health and medical informatics journals, 30% in medicine and public health, 19% in law and ethics; 78% authored by American and British academicians, highly cited. The majority (63%) are in the area of scientific research - clinical studies, access and use of patient data for medical research, secondary use of medical data, ethical challenges to Big data in healthcare. The majority (70%) of the publications discuss ownership in ethical and legal aspects and 67% see ownership as a challenge mostly to medical research, access control, ethics, politics and business.

Conclusions

Ownership of medical data is seen first and foremost as a challenge. Addressing this challenge requires the combined efforts of politicians, lawyers, ethicists, computer and medical professionals, as well as academicians, sharing these efforts, experiences and suggestions. However, this issue is neglected in the scientific literature. Publishing may help in open debates and adequate policy solutions.

Key messages

Ownership of patient information in the context of Big Data is a problem that should not be marginalized but needs a comprehensive attitude, consideration and combined efforts from all stakeholders. Overcoming the challenge of ownership may help in improving healthcare services, medical and public health research and the health of the population as a whole.
Decision-making and strategic planning in a public research organisation: The case of Fiocruz
Authors: Ermida V
Published: October 2020

The study was drawn to investigate an unusual form of 'industrial democracy', in Fiocruz, the Brazilian public research organisation in the health field, linked to the Ministry of Health. It is a single case study research making use of two contrasting cases: Embrapa and Pasteur Institute. The former is the Brazilian public research organisation in the agriculture field, similar to Fiocruz in space; and the latter is the French public research organisation for health, similar to Fiocruz in the field. The investigation works with the triangulation of methods approach, combining the analysis of quantitative and qualitative methods aiming at an in-depth analysis of the decision-making and the strategic planning processes of these research-led organisations. For this purpose, two exclusive tools were created and applied to their management boards and key actors. The first tool, an online questionnaire, was applied to the management boards; the second tool, a face-to-face interview, was made with the key actors. The findings were examined considering the literature, whose results supported the analysis of the context of each organisation and their strategic plans. The research revealed an original approach to industrial democracy by Fiocruz, based on a concept postulated by Arouca, which underpinned the creation of SUS, the Brazilian National Unified Health System: 'Democracy is health'. It represents a paradigm shift in the way the health concept is addressed, by adding a political dimension to it, which includes the citizenship, the free self-determination, the capacity of mastering the future. This unique approach to industrial democracy underpins the decision-making and the strategic planning of Fiocruz, revealing that it is, in fact, a new type of public research organisation; thus, questioning the validity of the existing framework concerning such entities.

Key messages

Democracy is Health is an original conceptual approach postulated by Arouca, which underpinned the creation of the Brazilian National Unified Health System. Fiocruz is the Brazilian Public Research Organisation in the Health field, whose unique administration approach questions the literature in the field.
The social ecology of power in participatory research
Authors: Roura M
Published: October 2020

Issue

As health research funding institutions increasingly require researchers to engage with patients and the public, stakeholder involvement claims have become popular. However, there are renewed concerns that its underpinning participatory requirements are merely applied as a tick-box exercise. Widespread advocacy for the approach without due problematisation is troubling, as it may ultimately reinforce the social inequities that it originally intended to address.

Description of the Problem

Success histories avail the enormous potential of participatory research but important caveats caution against romanticizing the approach. Despite its enormous potential, there are increasing concerns that participatory research can become a risky method of social inquiry, with potential negative consequences. The “dark side” of participation speaks of the professional and personal risks for the researchers and stakeholders involved, where diverging interests and underlying power inequities are not acknowledged and adequately managed.

Results

Robust monitoring and evaluation frameworks that explicitly account for power dynamics are urgently needed to assess the distribution of both the benefits and costs derived from participatory research. We outline a socio-ecological framework to comprehensively examine micro, meso and macro level factors influencing processes and outcomes in participatory research, so power dynamics can be adequately monitored and addressed.

Lessons

If the credibility and legitimacy of participatory research is to be sustained, strategies to monitor and tackle power dynamics are urgently needed.

Key messages

Power dynamics in participatory research can operate at micro, meso and macro levels. We present a socio-ecological framework to evaluate power dynamics in participatory research.
Early detection of Pseudomonas aeruginosa and Escherichia coli. using zinc tetraphenylporphyrin
Authors: Sharma A , Kumar S , Handa S , Pandey S K , Bhondekar A P
Published: October 2020

The sensory characteristics of food are considerably effected by the metabolic processes of various micro-organisms in the food stored in the field or at ambient temperature. Also, this microbial contamination can pose serious health hazards to public health. Chemical analysis of the complex mixture of volatiles produced during bacterial growth and investigation methods of these microorganisms presents a big challenge. There remains major unmet need to shorten and improve detection methods. Therefore, early detection of the microorganisms will open many frontiers for quality control in the foodstuffs industry. Accordingly, the aim of this study was to assess the feasibility and performance of chemoreceptive sensors for the rapid detection of bacterial pathogens, specifically Pseudomonas aeruginosa and Escherichia coli.

In Uv/vis study, zinc tetraphenyl porphyrin solutions (in DMF) was tested with various volatile compounds, such as propanal, hexanal and heptanal which are commonly found to be released during the growth of bacteria. These sensors were used to detect the bacterial odours of two pathogenic species (E.coli and P.aeruginosa) during their growth cycle at 4 °C and ambient temperature.

Hypochromic shifts in Uv/vis and hydrogen bonding in FT-IR studies confirmed the interaction between the volatiles and porphyrin. The porphyrin used detected the presence of microorganisms after 12 hrs incubation and showed more sensitivity for volatiles released during aerobic activity P. aeruginosa as compared to E. coli at 4 °C and ambient temperature.

Zinc tetraphenyl porphyrin based chemoreceptive membranes has been proved successful for the detection of P. aeruginosa. Hence, the present study proves wide scope of improvement over current laboratory techniques for the detection of pathogens in terms of speed, ease of use, and cost.

Key messages

The developed technique allows rapid detection of spoiled food. Chemoreceptive property of porphyrin has been exploited for the early detection of bacteria.
Sodium intake among adolescents who eat inside and outside the home. Campinas-Brazil
Authors: Pita Ruiz AM , Lima M G , Luz R , Barbosa L , de Azevedo Barros M B , de Azevedo Barros Filho A
Published: October 2020

Background

Excessive sodium consumption (>2g/day) is one of the risk factors for the development of cardiovascular diseases, which impact the world's public health systems. Rapid urbanization, busy life, the high availability of ultra-processed foods and the short time for meals, especially inside the home, are factors that interfere in the population's food choices.

Objective

To estimate sodium intake according to the place of meal consumption and its association with demographic, socioeconomic and salt-related variables.

Methods

Cross-sectional population-based study, carried out with 901 adolescents aged 10 to 19 years, who answered the Food Consumption and Nutritional Status Survey, ISACamp-Nutri 2015. The mean sodium intake was estimated by the 24-hour recall and the association with the independent variables, using linear regression.

Results

Sodium consumption among adolescents was 3.52 g/day (95% CI 3.42-3.63). Those who consumed at least one meal away from home had an excess of 0.19 g/day (P = 0.012) of sodium, which corresponded to a 6.1% increase compared to adolescents who had eaten exclusively at home. Of the total meals eaten by adolescents, 15.9% are taken outside the home, with 6.6% eating at school and 9.3% in different places. There was a significant increase in sodium consumption among adolescents who had breakfast CR = 0.16g (p = 0.032), afternoon snack CR = 0.09g (p = 0.002) and dinner CR = 0.30g (p = 0.029) outside the home.

Conclusions

sodium consumption by adolescents exceeded the WHO recommendation. Eating at least one meal away from home was associated with a higher sodium intake among these individuals. Regulatory measures in the food industry and strategies for food and nutrition education are relevant to reduce sodium consumption in this age group.

Key messages

High sodium consumption among adolescents, exceeding WHO recommendations. Eating outside the home was associated with a higher sodium intake.
Salt facts: public awareness, attitudes and practices in Sri Lanka
Authors: Jayatilleke A U , Gunawardena N , de Silva A , Wickramasinghe C , Gamlath L , Siriwardena T , Wickramasinghe A , Thalagala I , Vidanapathirana J , Pendse R
Published: October 2020

Recent national surveys have estimated that Sri Lankans are consuming much higher salt than the recommended 5 g/day. However, population-level knowledge, attitudes, and practices regarding dietary salts have not been assessed. This study was conducted with the objective of assessing the knowledge, attitude and practices related to salt consumption among adolescents aged 15-18 years and adults in Sri Lanka.

We conducted a countrywide cross-sectional descriptive household survey among a nationally representative sample of 1016 adult and 505 adolescents aged 15-18 years selected from 10 of 25 districts, using a multi-stage cluster sampling method. We used an electronic, interviewer-administered multicomponent questionnaire for data collection.

Of all respondents (n = 1521), only 40% were aware of the recommended limit of 5g/day or less. Importantly, 90% of adults and 86% of adolescents knew the adverse health effects of high salt intake. Discretionary salt was a major contributor to intake, with half the survey population (50%) adding salt when cooking rice, the staple food. Although the household monthly purchase of salt indicated the per-person consumption is double the recommended amount, 48% of adults and 46% of adolescents believed that they consume the correct amount of salt. A majority (72% of adults; 69% of adolescents) were of the view that it would be easy to reduce their salt intake. Most preferred (adults - 72%, adolescents - 69%) media source for health-related information was television.

The majority of Sri Lankan adults and adolescents are not aware of the recommended limits for salt intake. The average salt consumption is double the recommended amount. Although the belief that 'the respondents consume the correct amount of salt' was common, it was encouraging to note that a majority had positive attitudes towards reducing their salt consumption'. Raising public awareness to reduce daily salt intake should use preferred media sources.

Key messages

Sri Lankan adolescents and adults are not well aware of the recommended limits for salt consumption and consumed high amounts of dietary salt, mainly discretionary salt. Majority of the participant had positive attitudes, believing that they can easily reduce salt consumption, indicating opportunities for behavioral changes.
Time of introducing solid food into infant’s diet and risk of Type I Diabetes: a systematic review
Authors: Giannakou K , Bolanou I , Chrysostomou S
Published: October 2020

Background

Type I Diabetes mellitus (DT1) is a multifactorial disease with various genetic and environmental factors involved in its pathophysiology. Several nutritional factors such as the timing of exposure to solid foods may increase the risk of DT1. The aim of this systematic review was to investigate the association between the time of introducing solid food into infant's nutrition during the first year of life and the risk of developing DT1.

Methods

PubMed and Science Direct were searched from inception to October 2019 for observational studies that investigated the above association. No restrictions on language or publication date were applied. Specific inclusion and exclusion criteria were set for the selection of articles. Title and abstract screening were performed by two independent researchers and data were extracted from shortlisted articles.

Results

In total, 76 studies were screened, and 7 articles met the inclusion criteria. The analysis shows that early exposure (before or during 3 or 4 months) and subsequent exposure (during or after 6 or 7 months) was associated with an increased risk of developing DT1 and/or pancreatic islet autoimmunity, compared to an intermediate exposure period (4-6 months, 4-5 months or 3-6 months).

Conclusions

The evidence suggests that an interim exposure period of genetically predisposed infants to DT1 from 4 to 5 months of age may reduce the risk of developing DT1 in later life as compared to early or later exposure. However, due to the limitations of the studies, further investigation is required to inform DT1 prevention practices.

Key messages

There is some evidence indicating that early exposure and later exposure to solid food may increase the risk of developing DT1 in children with a genetic predisposition. Due to the methodological heterogeneity across the studies included, more reliable data from large prospective studies and randomized clinical trials are needed.
Household food insecurity and association with sociodemographic factors in Abidjan
Authors: Sackou Kouakou J , Lobilé Y H , Kouadio Kouakou K L
Published: October 2020

Background

Surveys in Côte d'Ivoire have shown an increase in food insecurity. In rural areas, it rose from 12.6% in 2009 to 20% in 2013. The situation was even more serious in urban areas, with 71% of households experiencing food insecurity. In peri-urban areas resulting from inappropriate urbanization, the food security situation may present others specificities compared to the urban area. Therefore, this study was conducted to assess the present situation of food security in a peri-urban neighborhood in Abidjan.

Methods

A cross-sectional study was conducted among 648 households in April 2019. A structured interview was conducted. The questionnaire included households'sociodemographic characteristics on one side and measures of three food access indicators on the other. Those indicators were household food insecurity access scale (HFIAS), household dietary diversity score (HDDS) and household food consumption score (HFCS). Statistical analyses were carried out using Chi square test.

Results

Cereals and tubers were the most consumed foods 91.2% and 59.3% respectively. Few households consumed dairy products (1.4%), fruit (2%) and vegetables (7.9%). HFCS was adequate at 99.2% and HDDS was high in 44.2% of households. Only 3.8% of households were food secure. HFCS was related to the household head's age (p = 0.04). HDDS was associated with the sex and marital status of the household's head (respectively p = 0.019 and p < 0.001) while education levels and marital status were related to severe food insecurity (HFIAS) (p = 0.002 and p = 0.005 respectively).

Conclusions

Our results highlight that some sociodemographic factors are related with the food security. Therefore, policymakers, producers and consumers should work together to better understand food access in periruban area and to help improve the food environment in ivorian cities.

Key messages

People in Abidjan still lack dietary diversification and experience food insecurity. It is important to work on factors such as education level to improve food security.
Metabolic and psychological effects of increased consumption of less-processed foods in daily diets
Authors: Nano E , Isoardo G , Migliaretti G , Ciullo S
Published: October 2020

Aim

This study evaluated whether the consumption of locally produced food without additives might have a positive effect on known risk factors for non-communicable diseases (NCDs) such as hypertension, and levels of fasting glucose and visceral adipose tissue (VAT). Attention was focused on various types of cheese, sausages, fresh pasta, pastries, biscuits and chocolate without additives to make them palatable and durable for transport.

Methods

Healthy volunteers were randomized to purchase the foods under study from either local producers not using additives (group 1) or supermarkets (group 2). At baseline and after 6 months, both groups underwent evaluation for weight, blood pressure, VAT, serum sodium, potassium, fasting glucose, insulin, C-peptide and creatinine levels, and also the State-Trait Anxiety Inventory (STAI) and Beck Depression Inventory (BDI-II) by examiners blinded to group allocation. At baseline, the state part of the STAI and Wechsler Adult Intelligence Scale IV were also performed, and body mass index, HOMA index and estimated glomerular filtration rate calculated.

Results

Data for 159 subjects (89 in group 1, 70 in group 2) were analyzed. Baseline evaluations did not differ between groups. At 6 months, HOMA scores and fasting glucose levels were lower in group 1 than in group 2 (P < 0.01). Also, in group 1, VAT (P = 0.006), systolic blood pressure (P = 0.001) and BDIII score (P = 0.0005) were decreased, whereas serum fasting glucose (P = 0.04) and C-peptide (P = 0.03) levels, and diastolic blood pressure (P = 0.02), were increased in group 2.

Conclusions

Consumption of the locally produced food under study improved some of the major risk factors for NCDs after 6 months.

Key messages

We evaluate whether the consumption of locally produced food without additives might have a positive effect on known risk factors for non-communicable diseases (NCDs) and psychological factors. Consumption of the locally produced food under study improved some of the major risk factors for NCDs and psychological test scores after 6 months.
The mediating effect of lifestyles on the association between social factors and DNA methylation
Authors: Maugeri A , Barchitta M , Favara G , La Mastra C , La Rosa MC , Magnano R , Lio S a n , Agodi A
Published: October 2020

Background

Social disadvantage and unhealthy lifestyles may induce molecular changes associated with aging and age-related diseases. For instance, previous studies reported socioeconomic difference in DNA methylation, which in turn led to aberrant gene expression and genome instability. Socioeconomic status (SES) alone, however, does not completely explain this difference, and further studies are needed to unveil what factors contribute to it.

Methods

We conducted a cross-sectional study on 349 Italian women, aged 25-64 years, to assess SES differences in LINE-1 methylation level - a surrogate marker of global DNA methylation - and to examine the mediating effect of lifestyles (i.e. diet, smoking habits, physical activity, and weight status). Educational level was used as SES indicator. The adherence to Mediterranean diet (MD) was assessed by the Mediterranean Diet Score (MDS). Leukocyte LINE-1 methylation was assessed by pyrosequencing. Mediation analysis was conducted using the PROCESS macro for the SPSS software.

Results

We first observed that women with high educational level were more likely to be normal weight (p < 0.001) and to adhere to MD (p = 0.018), and less likely to perform physical activity (p = 0.012) than their less educated counterpart. Moreover, age-adjusted linear regression demonstrated that LINE-1 methylation level increased with increasing educational level (β = 0.016; SE = 0.003; p < 0.001). In line, mediation analysis demonstrated an indirect effect of high educational level on LINE-1 methylation through the adherence to MD (β = 0.003; 95%CI=0.001-0.006). Specifically, the mediator could account for 9.5% of the total effect. None of the other lifestyles, instead, exhibited a significant mediating effect.

Conclusions

To our knowledge, this is the first study demonstrating the mediation of diet in the relationship between SES and DNA methylation. Thus, our findings add even more value to the promotion of healthy dietary habits among social disadvantaged people.

Key messages

Social disadvantage is associated with epigenetic changes related to aging and age-related diseases. Adherence to the Mediterranean diet might mediate the association between socioeconomic status and DNA methylation.
Biofilm production by Listeria monocytogenes strains: detection with colorimetric analysis
Authors: Centorame P , Iacone L , Salini R , Ciarulli A , Guidi F , Pomilio F
Published: October 2020

Background

In literature, there are no standardized laboratory methods to detect formed biomass by colorimetric analysis. The purpose of this study was to compare three staining methods and two different wavelengths for determination of biofilm formation of Listeria monocytogenes (Lm) strains.

Methods

Three strains of Lm isolated from different origin were tested using 96 well polistirene plates at 12 °C and 30 °C, after incubation the wells were subjected to washing, detaching and staining with crystal violet (CV) at 0.2% and 2% (Panreac EU) in 95% ethanol and with Gram's crystal violet solution (Merck KGaA, Germany). The absorbance at 492nm and 540nm wavelengths was read using a spectrophotometer (SIRIO S, Seac, Firenze, Italia).

Results

The strains incubated at 12 °C displayed production of biofilm when stained with CV 2% and with Gram's crystal violet solution, both at 492 and 540 nm (with better evidence at 540 nm). If CV 0.2% was used to stain and reading at both optical densities there was evidence of weak or no biofilm production.

At 30 °C, the biofilm production was displayed at both temperature and with all the stains. For all the strains and for all the conditions tested, the absorbance was greater but not proportional using the Gram's crystal violet solution, versus the CV 0,2% and CV 2%, and absorbance was higher at 540nm versus at 492nm.

Conclusions

Results confirmed the lack of reproducibility of each of the method used to detect and quantify the biomass produced during a biofilm formation test in vitro and the absence of ratio between the different results obtained using different CV concentration and wavelengths for reading.

Key messages

Biofilm production at 12 °C could not be adequately detected staining the wells with CV 0,2%. Absorbance could be influenced by the solvent in the stain used (ethanol, methanol or phenol or mixtures). To obtain data for assessment of biomass formation, being the method characterized by poor reproducibility, the laboratory should use at least the same stain and wavelength.
Families’ influence on severe childhood obesity in Turkey
Authors: Ozcebe H , Yardim M , Bagci Bosi A T , Gogen S , Yardim N
Published: October 2020

Background

Childhood obesity is increasing in Turkey like all countries on the world. Sociocultural and environmental factors play very important roles in increasing childhood obesity. It is aimed to find out the prevalence of severe obesity and related factors in Turkey.

Methods

Turkey conducted Childhood Obesity Surveillance of WHO European Region in 2016. This cross-sectional epidemiologic study was representative for Turkey, the anthropometric measurements of 11523 children in 580 primary schools were taken by health care professionals, analyzed by using WHO criteria. Logistic regression model taking into account complex sample design was used to analyze to find out the factors affecting severe obesity.

Results

The prevalence of severe obesity was found as 2.8% in the children aged 6 to 9 years old. Severe obesity was found significantly 1.86 times higher in male children than female children (p = 0,002); 1.65 times higher in children whose mothers' overweighed (p = 0.01) and 3.50 much higher in children whose mothers' obese than normal weighted mothers (p < 0.001); 2.21 times higher in children whose fathers' overweighed (p < 0.001) and 2.72 times higher in children whose fathers' obese than normal weighted fathers (p < 0.001); 1.40 times higher in children whose mothers graduated from high school (p < 0.001) and 2.04 times higher whose mothers graduated from university than mothers graduated from primary school (p = 0.04); 0.58 times lower in children having families with three or more children under 18 living in the household (p = 0.03) and 1.83 times higher in children who had relatives with diabetes and high cholesterol history (p = 0.03).

Conclusions

This is the first result on severe childhood obesity in Turkey; the percentage is one of the highest rates in Europe. The significant factors affecting severe obesity were found as overweighed and obese parents, higher educated mothers, small family size and having family members with the diseases related to obesity.

Key messages

Family structure and family lifestyle are found as the main social factors related to severe obesity in Turkey. Especially, mothers need more information on the health problem related to severe childhood obesity, also healthy eating behaviors.
The association between types of restaurants and the consumption of ultra-processed food
Authors: Souza T N , Louzada M L
Published: October 2020

Background

Ultra-processed foods consumption is an important risk factor for disease disorders, unhealthy feeding habits and climate changes. In the United Kingdom, ultra-processed food consumption represents more than 50% of calories per day. Furthermore, many studies shown that the locations are important for health foods habits. The aim of this abstract is to analyze the association between percentage share of ultra-processed foods consumption and percentage share kcal in each location consumers on U.K.

Methods

Cross-sectional data from the U.K. National Diet and Nutrition Survey (2014-2016) were analyzed. Foods items collected using a one-day food diary were classified according to the NOVA classification: unprocessed or minimally processed foods, processed culinary ingredients, processed foods and ultra-processed foods. All locations consumers were categorized on six groups: institutional (work, school), sit-downs restaurants, coffee shops, fast foods, home and others. To test the association, we used linear regression models, 95% confidences intervals were adopted.

Results

Ours crude analyzes shows that eat on fast foods, sit-down restaurants and other locations have been associated with percentage share of ultra-processed foods on daily kcal. Sit-down restaurants were negatively associated, and fast foods and other locations were positively associated. In the multiple model, adjusted for sex and age, the associations remained, with significance <0.00.

Conclusions

Our findings showed an association between some consumption locations and higher percentage share by ultra-processed foods on daily kcal. It is possible the inverse association found in sit-downs restaurants is because in these places there is a greater participation of unprocessed and minimally processed foods. Another important fact to consider is that in this population the consumption of ultra-processed foods is naturally high.

Key messages

Consumer locations have a different impact on the caloric share of ultra-processed foods. Encouraging consumption in some places can influence the improvement in the quality of the diet, decreasing the consumption of ultra-processed foods.
Factors influencing obesity among Hungarian school-age children
Authors: Horváth E , Szabó A , Erdős C s , Dobi-Ágoston G , Paulik E
Published: October 2020

Background

Childhood obesity has increased almost 80% worldwide in the last 30 years. According to WHO COSI data, Hungary is ranked 15th in the prevalence of overweight/obesity in 6-9 years children, with national values (27.4%) higher than the average of the participating countries. The aim of the study was to investigate the factors contributing to childhood obesity, along some components of the ecological model, and to identify factors promoting or inhibiting lifestyle changes.

Methods

The survey was conducted in three primary schools of Szeged, involving 9-12 years old children and their parents (N = 459). The questionnaire examined the child's physical activity, dietary habits, mood, postnatal medical history as well as parents' anthropometric, socio-demographic data, attitudes to their child's nutrition, health-related value system, lifestyle knowledge and relevant history of obesity.

Results

The prevalence of overweight/obesity was 22.7% in the sample, with higher proportion of boys than girls (59.6% vs. 40.4%). Overweight/obese children were significantly more dissatisfied with their shape than children with normal BMI (39.8% vs. 8.9%, p < 0.001) and fewer of them participated in out-of-school sports activities (69.1% vs. 79.1 %, p > 0.05;). Obese children were significantly more likely to eat even when they were not hungry (37.2% vs. 26.4%, p < 0.05). Frequency of meals with the family was also the lowest among overweight/obese (60.6%), and three times as many of them ate alone in their room than their nutritionally normal fellows. There was no significant difference in the diet preferences and quality of food of the two groups.

Conclusions

In our study, prevalence of childhood obesity was beyond than global prevalence. Parents' attitudes, and family conventions significantly influenced the success of a child's lifestyle change hence it is high priority to increase the knowledge of the parents.

Funding

The research is supported by the EFOP-3.6.1-16-2016-00008.

Key messages

Childhood obesity is a complex problem, simultaneous, positive modification of the family, community, and social environment is indispensable for effective intervention. Parents’ lifestyle influences the children’s dietary habits, therefore parent’s health education is important in the prevention of childhood obesity.
Burden of high sodium diet in Brazilian population: Global Burden of Disease 2017 estimates
Authors: Machado I , Guedes L , Felisbino-Mendes M
Published: October 2020

High-sodium diet leads to significant health problems such as high blood pressure, chronic kidney disease, ventricular hypertrophy and stroke. In Brazil, 2008 survey data have shown an average intake of 4.7 g/day of sodium, equivalent to 12 g/day of salt. In 2014, the average ofsalt intake estimated was 9.3 g/day. In both surveys, the numbers are higher than the international recommendation of 5g/day of salt. Considering this excessive consumption and the invisibility of the major consequences of such lifestyle, the aim of this study was to estimate the burden of diseases due to a high-sodium diet in Brazil.

We used the high-sodium diet attributable disability-adjusted life-years (DALYs) and deaths estimates of the Global Burden of Disease study in 2017 among Brazilian. The burden of high-sodium diet was assessed using a comparative risk assessment approach, which allows the calculation of the population attributable fraction of each disease that has an established relation with this behavior. Input data from Brazil to reach such estimates have included surveys that report the dietary sodium. Data on disease occurrence and mortality were obtained from health information systems and health surveys.

In 2017, high-sodium diet contributed with a significant number of deaths (51,434, 95% U.I.: 9,266-105,118) and DALYs (988,258, 95% U.I.: 139,943-2,149,179) in Brazil. The states of Northern Region presented lower mortality rates (Roraima: 11.1/100,000; 95% U.I.: 1.5-24.0 and Amapa: 10.6/100,000; 1.5-23.5), while those in the Southeast have higher mortality rates (Rio de Janeiro: 33.2/100,000; 95% U.I.: 5.4-68.1 and São Paulo: 32.0/100,000; 95% U.I.: 3.5-49.6). The same pattern by states was observed for DALYs.

These findings are significant and support the urgent necessity of strategies to reinforce the promotion of a healthy diet, restricted in ultra-processed foods high in sodium, among the Brazilian population in order to prevent early morbidity and mortality.

Key messages

Salt consumption in Brazil is high and contributes to a significant number of deaths and DALYs. It is necessary to increase and reinforce actions that promote the Brazilian traditional food, such as the Brazilian Food Guide, and also the sodium reduction agreements with industries.
Knowledge, attitude and practice of preventing helminth infections among students of CMUL, Idi Araba
Authors: Aina B A , Ogunbameru A V
Published: October 2020

Background

Helminth infections (Intestinal Helminthiasis) have been recognized as an important public health concern, particularly in developing countries. It is however noteworthy that improvement in personal hygiene, sanitation, food handling and food consumption habits could provide effective prevention of transmission of the parasites. The aim of this study was to determine the knowledge, attitude and practice of prevention of helminth infections among first and final professional year students of College of Medicine, University of Lagos and determine the association between the students' levels and their responses.

Methods

A cross-sectional study was carried out among 485 students with 222 students at first professional level and 263 students in the final year, based on the study population. A standardized questionnaire was used to collect data and the data collected were analyzed using Statistical Package of Social Science (SPSS version 22.0).

Results

Response rate was 93.4% (453 out of 485). Majority of the respondents 329(72.6%) had good knowledge on the prevention of helminth infections, 384(84.7%) of the respondents had positive attitude towards the prevention of helminth infection and most of the respondents 420(92.7%) had good practice of the preventing helminth infections. The final year students however possessed a significant higher knowledge, better attitude and practice of preventing helminth infections than the first year students (p = 0.000, 0.002 and 0.003 respectively), hereby indicating a significant relationship between students' level and their knowledge, attitude and practice of preventing helminth infections.

Conclusions

The study revealed that the respondents generally had good knowledge, attitude and practices of the prevention of helminth infections and that there is a significant relationship between these and the students' year or level of study

Key messages

Knowledge, attitude and practice of the students will affect their provision of public health services on prevention of helminth infections among the general populace when they eventually graduate. Years of training affect the knowledge, attitude and practice of undergraduate students of CMUL in prevention of helminth infections.
Investigation of vitamin utilization in primary care in Istanbul
Authors: Ataç A , Aydin  , Kiraci  , Akici
Published: October 2020

Background

Vitamins which are necessary for maintaining health and preventing some medical conditions can be used upon physician recommendation or as self-medication for supplemental purposes. In this study, we aimed to examine the usage of vitamins in primary care prescriptions.

Methods

Prescriptions of 1431 family physicians in 2016 selected by systematic sampling in Istanbul were examined in this cross-sectional study (n = 5,936,852). Among these vitamins, the ones containing ATC code of A11 were determined, where the usage of these drugs and drug groups were analyzed in terms of age, sex, diagnosis, and concurrent usage with other medicines.

Results

We identified vitamins in 8.3% of all prescriptions. In vitamin-containing prescriptions, 71.4% of them were written for women and 32.3% of them were written for people aged between 45-65 (mean age: 47.0 ± 1.38 years). Vitamins comprised 34.9% of all drugs in those prescriptions. The most common vitamins are vitamin D and analogues (41.3%), vitamin B1, plain and in combination with Vitamin B6 and B12 (37.4%), and multivitamin (20.9%). The most common drugs co-prescribed with vitamins were alimentary tract and metabolism (20.9%) and blood and blood forming organs (13.3%) drugs. Among the prescriptions with single diagnosis (n = 131,194), we mostly encountered vitamin D deficiency (23.1%) as the indication. Vitamin D analogues were found to be significantly likely to be prescribed for women (44.4%) than men (32.7%, p < 0.001) and vitamin B and its combinations were more likely to be written for men compared to that in women (43.3% vs. 35.2%, respectively; p < 0.001).

Conclusions

The majority of vitamins prescribed in primary care seem to contain D and B vitamins, which are more likely to be prescribed for women and middle-aged population. This research is expected to shed light on future studies which aim to understand overall consumption of vitamins in different settings.

Key messages

The vitamins appear to be mostly prescribed for women and middle-aged people. The majority of vitamins prescribed in primary care seem to constitute D and B vitamins.
Examining social determinants by locale to inform community linkages
Authors: Davis J
Published: October 2020

Achieving a long-lasting impact on health outcomes requires focus not just on patient care, but also on community approaches aimed at improving population health through addressing gaps in Social Determinants of Health (SDOH). SDOH have been found to disproportionately affect those in low-income brackets and the disabled to varying degrees based on locale. The purpose of this exploratory research was to determine 1) which SDOH have the greatest negative impact on disabled and elderly populations within four targeted states (Iowa, Ohio, Minnesota, Wisconsin) and 2) if there is a difference in negative SDOH impact between metro and non-metro locales. Individual-level data were obtained from disabled persons aged 65 years or older who responded to the Centers for Disease Control and Prevention's 2017 Behavioral Risk Factor Surveillance System (BRFSS) survey. Utilizing these data, frequency distributions were obtained using SPSS. Rank order variation in SDOH was observed among four Midwestern states and between metro vs. non-metro geographic regions. Frequency distributions assisted in identifying the greatest negative impacting SDOH on elderly disabled populations. An examination of the rank order tables allowed the investigator to accurately assess the rank of negative impacts.

There were variabilities in responses to questions with moving two or more times within 12 months having the lowest negative impact. When regrouped based upon SDOH negative impacts, were you able to pay your bills was the most frequent SDOH across all states. Feeling unsafe or extremely unsafe in your neighborhood was the highest negatively impacted SDOH within states. Cited determinants in three categories were highest in Ohio. Ohio also had the highest proportion of negatively impacted SDOH across all states. No money for balanced meals was a close second SDOH across states.

Key messages

Social Determinants Impacting Elderly Disabled. Impact of Social Determinants by Geography.
'There is actually no one who is supporting me' - social networks and their relevance for health
Authors: Mairhofer S
Published: October 2020

The presented research project deals with current issues of family and services working with families (social affairs, health, education) in South Tyrol (Northern Italy). The qualitative data were collected in an extensive survey through 120 interviews with parents from different family types and service staff. The qualitative part of the project is based on the Grounded-Theory-Methodology. Therefore the differentiated subject areas were developed in the research process itself. In parallel, a quantitative data collection was implemented. For this purpose, about 1300 parents were interviewed by a written questionnaire.

Among the most significant results of the study are the often hardly existing or missing social networks of families (results of the qualitative part with ego-centred network maps and quantitative questionnaires coherent), the frequent description of pressure and stress on all levels, lack of comprehensible information (especially in the area of financing support, services and health topics) and dissatisfaction with social and health services. Based on these results, the relationships between these variables will now be investigated and first evaluations will show that there is a direct correlation between social networks and described well-being, stress or pressure perception, but also in the use of and satisfaction with social and health services. There existsis also a correlation between children's health status and parents' social networks. It is not only about the quantity of networks (number of network partners), but also about qualitative aspects, for example who these network partners are and how positive or conflictual relationships have been described.

The results illustrate the relevance of working with social networks as a public health issue and why further research is needed.

Key messages

Social networks are an important determinant of health. There is a need for more research about the connection between social networks and health.
System-mapping the child health system at a local level to reduce health inequalities
Authors: Jessiman P , Fairbrother H , Williams P , Powell K , Crowder M , Williams J , Kipping R
Published: October 2020

Background

Systems thinking has emerged as a promising approach to addressing complex public health issues. For children, the focus of the approach has been on single outcomes e.g. obesity, rather than addressing the broad range of inequalities in health outcomes. We report on an approach to developing a system-oriented perspective on the determinants of inequalities in child health and wellbeing in English local authorities.

Methods

Qualitative group concept mapping workshops (a 'soft' system science approach) were held in two contrasting English local authorities with a range of stakeholders: professionals (N = 35); children and young people (N = 33) and carers (N = 5). Initial area maps were refined using data from qualitative interviews with professionals (N = 16) and resulting maps reviewed and validated by expert stakeholders in each area (N = 9; N = 35). Commonalities between two area-specific system maps (and removal of locality-specific factors) were used to develop a map that could be applied in any English local area. Two rounds of online consultation (N = 21; N = 8) and qualitative interviews (N = 12) with experts in public health, local governance and systems science refined the final system map displaying the determinants of child health inequalities, and give insight into its potential utilisation.

Results

The process created a map of over 150 factors influencing inequalities in health outcomes for children aged 0-25 years at the local area level. The system map has six domains; physical environment, governance, economic, social, service, and personal.

Conclusions

To our knowledge this is the first study taking a systems approach to addressing inequalities across all aspects of child health. Group concept mapping can support systems thinking at the local level. The resulting system map illustrates the complexity of factors influencing child health inequalities and is a useful tool for strategy development, action prioritisation and systems evaluation planning.

Key messages

Group concept mapping can be successfully applied to facilitate a systems approach to child health inequalities at the local area level. Mapping the local child health system highlights complex relationships between physical, social, personal, service, governance and economic factors which influence inequalities and health outcomes.
Does long-term disease in adolescence predict educational career?
Authors: Rimpela A , Koivusilta L , Myöhänen A , Lindfors P , Kaltiala-Heino R-K
Published: October 2020

Background

Serious long-term diseases like asthma, diabetes or epilepsy in adolescence means extra efforts to cope everyday life in school, hobbies or at home. These also set extra challenges on adolescents to go through the developmental tasks of that age. We study here, if adolescents with a long-term disease have lower chances for an academic education compared to those without a long-term disease.

Methods

In 2011, all 7th graders in the Helsinki Metropolitan area, Finland were invited to the MetLoFin survey (8946 students from 128 schools answered). In 2014, all 9th graders, representing the same cohort were invited in the end of the lower secondary school (7629; 127). The data were linked with the national Joint Application Registry for the upper secondary schools. Serious diseases were asthma, diabetes, epilepsy and some other individual diseases (6%).

Results

At the 7th grade, the OR for continuing in vocational track or not having got a study place instead of academic track was 1.2 for those with the long-term disease. The difference stayed after adjusting for parents' education and sex but disappeared after adjusting for GPA. At 9th grade, results were similar, but the association disappeared after adjusting for parents' education and sex.

Conclusions

Even in a country like Finland, with high quality health services for children, a long-term disease can compromise educational career, even if the effect is small. The effect mediates mainly through GPA, which is the main selection criteria for upper secondary school.

Key messages

A long-term disease in adolescence can lower chances for academic educational career, even though the effect is small. The effect is mainly mediating through poorer GPA.