bluuebunny/crossref_metadata_2025 huggingface dataset:
A retrospective study of an International Vaccination Centre in the Lisbon Metropolitan Area
Authors: Galhano Lopes D , Bragança Pereira M , Machado Gil M , Duarte S , Moreira A , Cunha I , Abreu Gomes F , Bastos L , Esteves H , Chemela J
Published: October 2020

Background

Vaccination is one of the most cost-effective disease prevention strategies. Trips from Portugal to other countries have increased in the past 5 years. Depending on the destination, certain vaccines are advised to travellers in order to reduce travel-related risk. We analyzed the data of an International Vaccination Centre (IVC) in the Public Health Unit of the Primary Care Centres Group (ACES) of Loures-Odivelas.

Methods

A retrospective observational study comprising data from an IVC database between 2014 and 2018. Variables included were sex, age, destination, purpose, referral, and prescriptions. Descriptive analyses were performed for all variables.

Results

Between 2014 and 2018, there was a total of 4,873 users. Regarding individual characteristics, 51% were female, 80% had between 15 and 64 years of age, and 51% were referred by general practitioners of the ACES. Africa was the leading destination (66% average for all years) with a downward trend (from 82% in 2014 to 47% in 2018) followed by South America (12%) with an upward trend (from 4% to 16% in the same period). The primary purpose of travelling was tourism (74%) followed by work (15%). A total of 7,323 vaccines were administered, with an annual increase from 1,250 administrations in 2014 to 1,862 in 2018. The yellow fever vaccine accounted for 36,9% of all administrations, followed by typhoid fever vaccine (32,3%) and hepatitis A vaccine (10,2%).

Conclusions

African countries are still the most common destination for Portuguese travellers, but changing trends might influence the vaccination strategies in the IVC. Information provided in the IVC can be optimized to suit individual profiles better.

Key messages

As travelling increases, the International Vaccination Centre has an essential role in the prevention of disease. Africa remains the most common destination, requiring pre-travel health counselling and vaccine prophylaxis.
FLUChallenge: an innovative strategy to increase flu vaccination in two Italian Teaching Hospitals
Authors: Barbara A , Azzolini E , DiPumpo M , La Milia D I , Vallone D , Lagioia M , Cambieri A , Damiani G , Ricciardi W , Laurenti P
Published: October 2020

In Europe flu vaccination among healthcare workers (HCWs) is strongly recommended even though not mandatory such as elsewhere (USA). Despite this, vaccination coverage in EU countries is usually low: 30.2% in 2016-17. In Italy, at the end of the same season it was 15.6%. Aim of this study is to describe and evaluate the new strategy adopted by Gemelli and Humanitas Research Hospitals, two Italian Teaching Hospitals (THs) part of the MIRO Public Health Center, to increase the vaccination coverage among their HCWs.

Before the 2019-20 campaign, experts of the two THs met up to identify a common strategy to promote flu vaccination among HCWs in addition to the ones already implemented. It was decided to launch a FLUChallenge: a platform of monitoring updated bi-weekly and available on the THs' internal websites with the vaccination coverage overall and stratified by job category and macro-areas of activity. Descriptive and inferential analysis were performed.

Preliminary Results

6673 HCWs included (4241 Gemelli, 2432 Humanitas). The overall flu vaccination coverage at the end of the 2019-20 campaign was 28.4% (1026 HCWs vaccinated Gemelli, equal to 24.2%; 869 HCWs vaccinated Humanitas, 35.7%). Both THs significantly increased the vaccination coverage compared to the previous year (+10% Gemelli, 22% in 2018-19, p = 0.01; +45.7% Humanitas, 24.5% in 2018-19, p < 0.001). Physicians had the highest coverage both in Gemelli (483/1320, 36.6%) and Humanitas (443/979, 45.2%), while the lowest was registered among nurses in Gemelli (357/2017, 17.7%) and other HCWs in Humanitas (134/605, 22.1%). Infectious disease was the macro-area with highest coverage in Gemelli (32.3%), while in Humanitas the emergency department (63.9%).

The FLUChallenge intervention was an effective strategy to increase flu vaccination coverage in the two TH. The website platform was useful for the purpose of accountability and able to create a positive challenge between the HCWs working in the two THs involved.

Key messages

Flu vaccination among healthcare workers (HCWs) is recommended to prevent influenza and to avoid its transmission. It is important to promote new engagement and innovative strategies to increase flu vaccination coverage among HCWs, when it is not mandatory.
Tailored communication intervention in a Somali community, Sweden, to improve vaccine confidence
Authors: Jama A , Byström E , Rubin J , Kulane A , Lindstrand A , Godoy-Ramirez K
Published: October 2020

Background

Sweden sustains a high and stable vaccination coverage for measles-mumps-rubella (MMR) vaccination (>96%) but despite a high national coverage, there may be local gaps. One example is a Stockholm suburb hosting a population with largely Somali origin that since 1998 has showed low MMR vaccine rates (70%). A baseline study using the Tailoring Immunisation Programme (TIP), child health clinics (CHC) nurses reported poor communication with vaccine hesitant parents who worried that the MMR vaccine may cause autism. Following, a tailored intervention with emphasis on strong and preferred oral communication was designed to address parentś concerns and, seminars to reinforce nurses in improving their encounter with parents.

Methods

The intervention was developed using the TIP guide including an adapted version of the Behaviour Change Wheel model, it included communication tools (films, videos), public seminars in Somali on MMR vaccine, vaccine-preventable diseases and autism, and training of peer parent group. CHC nurses were given tailored seminars with updated information on vaccines with emphasis on how to communicate with vaccine hesitant parents.

Results

Preliminary results suggest that the tools implemented have been well received by all stakeholders and a positive trend in vaccination coverage has been observed. Parents have engaged actively, 32 parents completed the peer-to-peer training and all nurses attended the seminars. Preliminary data of qualitative interviews with 11 nurses indicates that increased knowledge strengthened their confidence to meet the parents and address vaccine hesitancy. The films and information materials facilitated the nursés communication with parents.

Conclusions

Tailored communication interventions need to be tested, implemented and evaluated as tools to motivate change in parental attitudes and to strengthened health care providers role aiming to increase vaccine acceptance and resilience in the immunisation programmes.

Key messages

Tailored communication intervention on vaccination need to be implemented and evaluated as tools to motivate changes in attitudes and behaviours regarding vaccine acceptance. Tailored interventions has been positively received by all target groups and a positive trend in vaccination coverage has been observed.
Flu vaccination coverage among healthcare workers: a comparison between 2018 and 2019 campaigns
Authors: Varadi G , Vacchi O G B , Moretti V , Pozzi D , Chirico L , Del Pin M , Brunelli L , Cocconi R , Brusaferro S
Published: October 2020

Background

In Italy, recommended annual influenza vaccination is free to healthcare workers (HCWs) to prevent flu spread. No official data are available on HCWs' vaccination coverage (VC), which minimum target is set at 75%. Aim of this study is to compare 2019-20 and 2018-19 flu vaccination coverage in order to evaluate last year campaign effectiveness.

Methods

2019-20 flu vaccination campaign efforts at Udine Hospital (Italy) were improved with the aid of public health residents to tackle HCWs convenience concerns. From October 29th to December 5th 2019, dedicated areas and days were increased, informative course about influenza vaccination (efficacy, benefits and safety) toward HCWs were conducted. Data about HCWs getting their flu shot within the hospital were traced and analyzed, grouping different categories.

Results

During 2019-20 flu season, vaccinated HCWs were 29.1% (1,169/4,012), while they were 22.7% (955/4,203) in 2018-19 (p < 0.0001). The 2019-20 campaign resulted to be effective among doctors (45.0% vs 38.4%; p = 0.0132), residents (52.4% vs 40.7%; p = 0.0003) and nurses (24.1% vs 17.3%; p < 0.0001). The less compliant category was midwives, who maintained the worse vaccination coverage in both seasons (20.4% and 24.1%; p = 0.6555). Regarding other HCWs in 2019-20, 18.6% were vaccinated (in 2018-19 14.0%, p = 0.002).

Conclusions

A significant improvement in vaccination coverage during 2019-20 flu season was reached by the specific vaccination campaign for all categories except midwives. Despite this, the global vaccination coverage is still far from the desired target and more must be done to fill this gap. Evidence of HCWs categories for which this intervention was more effective, could be useful in planning next flu vaccination strategies.

Key messages

Continuous efforts made by public health professionals in promoting flu vaccination show their effect on healthcare workers flu shot adherence. A planned vaccination agenda and educative course about influenza infection and benefits of vaccination, seem to be good strategies to improve vaccination coverage.
Monitoring regional-level vaccination coverage rates in Lombardy Region (Northern Italy)
Authors: Croci R , Rossi D , Odone A , Signorelli C
Published: October 2020

Background

Lombardy is Italy's most affluent and most populated region, with the highest national per capita GDP, and over 10 million residents - more than 16 out of 27 EU countries. In 2017, two measures were approved against vaccine hesitancy, i.e. the National Plan for Vaccine Prevention (2017-2019) and Law no. 119 on mandatory vaccinations. Aim of the study is to monitor Lombardy regional-level vaccine coverage trends and to assess the new legislative framework's overall impact.

Methods

We analysed and critically interpreted Lombardy regional-level vaccination coverage (2000-2018 for childhood vaccinations; birth cohorts 1997-2005 for HPV; flu seasons 1999-2000/2018-2019 for influenza). All data were extracted from the Italian Ministry of Health website. We carried out descriptive trend analysis for measles and polio-containing vaccines in 24 month-old-children, Human Papilloma Virus vaccine in 12-year-old females, and influenza vaccine in seniors over 65 years. Regional data were compared with the corresponding Italian national averages.

Results

Childhood vaccinations: Lombardy and Italy have never met the 95% target for measles-containing vaccines (average coverage 2000-2018: Lombardy 91,79%, Italy 86,94%). Polio-containing vaccines have always remained above the 95% threshold, with a drop in 2015-2017. In 2018 they increased back to safety levels (Lombardy 95,31%, Italy 95,09%). HPV: coverage has always kept below WHO/SAGE intermediate 80% goal (average coverage, birth cohorts 1997-2005: Lombardy 75,58%, Italy 72,73%). Influenza: mean coverage has been alarmingly inadequate (Lombardy 54,09%, Italy 57,98%) compared to WHO-recommended minimum of 75%.

Conclusions

Except for influenza, coverage in Lombardy is slightly higher than the Italian average. Exploring Lombardy's response to the national legislation could guide policymakers in developing tailored vaccination strategies.

Key messages

Overall, vaccination coverage in Lombardy is slightly higher than the Italian average. In 2017, law n.119 on mandatory vaccinations came into force, acting as a powerful tool for coverage increase.
Pertussis in Italy: maternal immunization to protect infants
Authors: Fiasca F , Necozione S , Mattei A
Published: October 2020

Background

Despite effective pertussis vaccines and high rates of pediatric vaccination in Italy, the number of reported pertussis cases has steadily increased. To minimize severe illness and deaths, particularly in infants, in addition to active immunization, maternal vaccination has been nationally recommended. To support this prevention measure, this study sought to gain more insight into the current pertussis burden among hospitalized infants.

Methods

A retrospective observational study investigating infant hospitalizations for pertussis within the first year of life from 2007 to 2018 in Italy was carried out using the Hospital Discharge Database as informational flow. Four age groups were analyzed (<3, 3-4, 5-10, and 11-12 months), according to the expected age for the dose administration of the primary course of pertussis vaccination. The temporal trend of hospitalization rates was analyzed by the slope of the regression line. p < 0.05 was the criterion for statistical significance.

Results

There were 4262 pertussis-related admissions among infants less than 12 months of age. Overall, 61.10% were infants aged <3 months. The overall hospitalization rate was 69 x 100000 infants. When stratified by age, infants <3 months old had the highest hospitalization rate at 169 x 100000 infants, with an increasing trend (β = 9.12, p = 0.002); for the other age groups, the trend increased less strongly or was substantially stable.

Conclusions

This nationwide study highlighted that most of the pertussis admissions in Italy occurred in the first few months of life, before infants had started the primary vaccination course. This result indicates that more needs to be done to protect young infants (<3 months) who are the most vulnerable to severe disease. The implementation of maternal immunization programs could offer the hope of much better pertussis control in infants too young to be vaccinated.

Key messages

Infants aged <3 months showed the highest rates of hospitalization for pertussis, with an increasing trend. The implementation of maternal immunization programs could protect these high-risk infants.
Vaccine prevention at the time of covid-19: the ASL Roma 4 experience
Authors: Fusillo C , Galliano E , Belfiori G , Marchini R , Turci C , Ursino S , Matera C , Quintavalle G , Sinopoli M T
Published: October 2020

The end of January 2020 WHO sanctioned an international public health emergency and the Italian government issued directives with urgent measures to counter and manage the epidemiological emergency: bans, suspensions of activities have profoundly changed school, work and health social life which have an impact on vaccination prevention

Vaccinations Service (VS) of ASL Roma 4 vaccinates people of all ages and the healthcare professional (HP) noticed that the fear in the population is making the accesses less frequent and the vaccination coverage decrease and the infectious diseases will re-emerge. DPCM 4/3/2020 has established rules to contain the virus, the ASL task force and VS adopted and adapted them for a protected vaccination activity. Results Surgeries are cleaned more frequently and fomites have been removed. The rules were published on the ASL website, social networks, displayed on posters posted before entering the clinic and waiting rooms: vigilantes lets you enter without crowding the waiting room; only one parent enters; the adult enters alone; if you have a cough or sneeze cover your nose and mouth with a tissue or ask for the surgical mask, wash your hands with the disinfectant gel, sit only in the spaced chair. Inside the children find a nice poster with drawings to explain how to avoid the virus to be colored at home. Health care workers wear masks designed to calm children. As long as the epidemiological situation allows the vaccine prevention activity must be maintained. HP must give messages of trust for activities that are carried out safely. An emergency plan within the VS also provides the behavior to be used in the event that many health workers fall ill. At the time of Covid-2019 infection all forms of prevention are to be remodeled, not just vaccine prevention. Reducing the preventive actions could in a short time lead to the emergence of infectious diseases and not only with consequent important damages, including economic ones

Key messages

Healthcare professionals must give messages of trust for activities that are carried out safely. At the time of Covid-2019 infection all forms of prevention are to be remodeled, not just vaccine prevention.
Influenza vaccine effectiveness studies in Europe: SWOT analysis of DRIVE collaborating sites
Authors: Punzo O , Bellino S , Miller E , Salmaso S , van der Sande M , Haag M
Published: October 2020

Background

DRIVE is a European public-private partnership that aims at creating a network that works on high quality, brand-specific effectiveness estimates for all influenza vaccines used in the EU each season. The SWOT analysis aims at assessing the quality and feasibility of DRIVE operational model after its implementation, i.e. the operations of the study site network as applied in DRIVE.

Methods

The SWOT analysis was conducted through two meetings held among 2 of 14 partners participating in the DRIVE studies in the first season, with clinicians, nurses, data managers and lab technicians from the sites in the network. We collected data on two identified axes (1.organizational and 2.logistical, practical, and laboratory aspects), containing more than one SWOT objective. For each item classified under Strength (S), Weakness (W), Opportunity (O) or Threat (T), experts assigned a 1-5 score, meant to reflect the impact of each listed item on reaching the objectives.

Results

The most common topics, reported by both Italian and Finnish sites collaborators, were the opportunities related to the training and development of the network; funding concerns; opportunities and challenges in training the personnel; management issues due to the project practical organization (e.g. for lack of dedicated personnel, including administrative and for data entry). The scores attributed to the single items appeared skewed to the top, showing how the researchers perceived the majority of the topics as relevant for their day-to-day work.

Conclusions

The SWOT exercise was welcomed as a useful means to compare issues and practices among local study sites, but also as a chance for exchange with both peers and project lead. The results highlight the great value of communication and discussion between study groups, albeit the geographical distance. Such exercise should be included as a routine opportunity for discussion aiming at improving both collaboration and governance model in large projects.

Key messages

One of the main challenges of large public-private consortiums is building a shared governance model; opportunities for collective sharing and collaboration should be promoted in this setting. This SWOT analysis was a useful exercise that should inform the prosecution of the programming of DRIVE operational model, allowing a comparison of issues and practices among local study sites.
Measuring health outcomes of OECD countries’ urban greenspace, with a special focus on Milan (Italy)
Authors: Oradini-Alacreu A , Rebecchi A , Mezzoiuso A G , Croci R , Buffoli M , Odone A , Signorelli C , Capolongo S
Published: October 2020

Background

Urban world population has raised to 4.2 billion in 2018, with 2.5 billion more forecasted by 2050. Cities are places of opportunities but, at the same time, sites of environmental and social risk factors. Scientific evidence about urban green's environmental benefits is abundant, but Public Health outcomes are seldom carefully defined. The project aims at assessing the Public, Urban and Mental Health outcomes of urban green areas in Organisation for Economic Co-operation and Development (OECD) countries, and at exploring citizen urban greenspace perception in Milan, Italy.

Methods

A systematic review of literature was conducted according to the 2015 PRISMA statement. Two online databases (Medline and Embase), were consulted, and inclusion criteria were set, ruling in all OECD countries-based, English-written studies from 2000 to December 2019. Only objectively measurable health outcomes were deemed suitable for analysis. Based on the main review findings, a community-based survey was created, targeting residents of Milan and its suburban area to understand better how they benefit from the urban green areas in their city. The study is being carried out by an interdisciplinary team of medical doctors and architects.

Results

We grouped health outcomes into five separate domains, namely cardiovascular, obesity, respiratory, neoplasia and mental health. We found negative associations between disease prevalence and urban greenspace overall quantity. Size, perceived quality and accessibility were powerfully explanatory variables. Milan community-based survey drafting is underway. Results are still preliminary and will be presented by tables, graphs and plots.

Conclusions

Cities are increasingly becoming critical points for many emerging Public Health challenges. The results of our study may help urban planners, key stakeholders, policymakers and communities to preserve and increase existing green spaces, and to improve Urban Public Health.

Key messages

Urban greenspace is paramount to OECD cities’ current and future sustainability because of its significant impact on Public, Urban and Mental Health. Milan citizens show remarkable care for urban greenspaces integrity and development.
Factors associated with high-risk pregnancy: role of environmental contaminants, Brazil
Authors: Martins L , Fernandes J , Pamplona Y , Barbieri C , Vaz J , Braga A , Pereira L
Published: October 2020

Introduction

The Região Metropolitana da Baixada Santista (RMBS) is considered as a region with the worst maternal and child mortality rates in the state of São Paulo, Brazil. Besides this, RMBS has the worst rates of environmental contamination. High-Risk Pregnancy is one of the factors that lead to a higher chance of morbidity and mortality of the mother and fetus binomial.

Objective

Evaluate the relationship between exposure to environmental contaminants and high-risk pregnancy.

Methodology

Case-control study, using a probabilistic sample composed of 402 pregnant women divided into with and without high-risk pregnancy. The instrument used was a self-administered questionnaire and secondary data on contaminated areas obtained from the Environmental Company of the State of São Paulo. Descriptive analysis, Chi-square test, univariate and multiple logistic regression analysis were performed. The participants were also georeferenced by place of residence.

Results

It was observed an association, by chi-square test between high-risk pregnancy and age over 35 years (p < 0.05), use of insecticide (p < 0.001), consumption of foods packed in plastics (p = 0.050) and manipulation with oil paint (p = 0.002). The final multiple logistic regression model demonstrated that those who live in contaminated areas are 2 times more likely to have a risk pregnancy (OR = 1.993; 95%CI: 1.02; 3.90), as well as identified as jointly important risk factors for pregnancy: working in health services (OR = 3.97 (95%CI: 1.00; 16.09)), use of insecticide (OR = 3.45 (95%CI: 1.66; 7.16)) and use of oil paint (OR = 6.96 (95%CI: 1.38; 35.09)).

Conclusions

Environmental contaminants play an important role in pregnancy, and mitigating measures are needed to improve the environment and reduce high-risk pregnancy in RMBS.

Key messages

Exposure to the environmental contaminants is an important rik factor in the pregnancy. The Região Metropolitana da Baixada Santista (RMBS) is considered as a region with the worst maternal and child mortality rates in the state of São Paulo, Brazil.
Land Use Regression Model for Exposure Assessment to PM2.5 and PM10 in Rio de Janeiro, Brazil
Authors: Oliveira M , Santana M , Marques M , Griep R , Fonseca M , Moreno A , Magalhães M , Ponce de Leon A
Published: October 2020

Background

Air pollution is a major public health problem. The latest data from World Health Organization show that 9 out of 10 people breathe air containing high levels of pollutants and that about 4.2 million deaths were caused by exposure to fine particles in 2016. Therefore, the aim of our study was to elaborate a model for long-term exposure assessment to air pollution.

Methods

This study was developed in Rio de Janeiro city, it has 1,200.255 km² large, about 6.7 million residents and located in the southeastern region of Brazil. The information of PM2.5, PM10 and predictor variables were obtained from government agencies. The potential predictor variables have been used: temperature, relative humidity, vehicular traffic base, Census, altitude databases, vegetation cover, land use, rock masses, hydrographic and hydrographic sub-basins, urban zoning and road network. For the development of Land Use Regression models, linear regression models were specified using the supervised stepwise procedure. Cook D statistics were used to detect influential observations. The overall model performance was evaluated by leave-one-out cross validation (LOOCV).

Results

The annual mean of PM2.5 and PM10 was 11.73 (SD = ± 4.84) and 35.57 (SD = ± 8.91) μg·m−3, respectively. The R2 value in the final model for PM2.5 was 0.3812 and p-value: 0.0907. The performance evaluated by LOOCV was not also good, the RMSE was 0.2920, with R2 value of 0.1820. The R2 value in the final model for PM10 was 0.73, p-value: 0.001. The performance evaluated by LOOCV was also good, the RMSE was 0.1386, with R2 value of 0.5832.

Conclusions

The model could be applied in areas where there is no monitoring of air quality, thus, enabling the evaluation of the health impact of exposed populations, providing support for decision-making and development of public and investments policies, medium impact and long-term, more targeted in the following areas: health, environment, transportation and urban planning.

Key messages

Oswaldo Cruz Foundation. Universidade do Estado do Rio de Janeiro.
Aboriginal Human Research Ethics Committees ensuring culturally appropriate research
Authors: Finlay S , Keed V , Kelly D , Cashman M , Green S
Published: October 2020

Aboriginal and Torres Strait Islander people, Australia's Indigenous peoples, make up three percent of the population of Australia. Like many other Indigenous peoples in colonised countries, they suffer the worst health and social status of any population group. Australian Indigenous people have a lower life expectancy (8.6 years lower for men and 7.8 years for women) compared with other Australians (ABS 2018a). The reasons for the poorer health outcomes are complex and include historical, political and social factors (AIHW 2015a).

The health disparity has driven a high number of research projects with a focus on Australian Indigenous people or mainstream research projects where Australian Indigenous people are overrepresented. Given the uniqueness of Australian Indigenous cultures as well as the historical, political and social context, in 1998, the Aboriginal Health and Medical Research Council of New South Wales (AH&MRC) established an Australian Indigenous-specific human research ethics committee (HREC). The AH&MRC is the Indigenous peak health body of New South Wales.

This presentation will outline the role and benefit of the AH&MRC HREC as a specialised HREC. The AH&MRC HREC is fully constituted and registered under the National Health and Medical Research Council (NHMRC). The NHMRC is the leading expert body in health and medical research in Australia and develops health research guidelines. The AH&MRC HREC is one of three AHRECs in Australia. The AH&MRC Ethics Committee not only guarantees that research is conducted ethically but also ensures research involving Indigenous people is undertaken in a culturally appropriate manner. One of the key elements required by the AH&MRC is that researchers consult Indigenous communities across all stages of the project from the design, implementation, analysis and write up.

The AH&MRC HREC is essential, ensuring the research is of benefit to the Indigenous community in NSW and is conducted in a culturally safe manner.

Key messages

Specialised Indigenous human resarch ethics committees are vital to enuring research is culturally appropriate. Spscialised human resarch ethics committees can be of benefit for other disctinct populations.
The practice of plagiarism in the Faculty of medicine of Tunis: Attitudes of teacher- researchers
Authors: Bettaieb J , Cherif I , Kharroubi G , Mrabet A
Published: October 2020

Background

Plagiarism is a cosmopolitan scourge, which might lead to serious consequences. The Faculty of Medicine of Tunis (FMT), involved in the international accreditation process, intends to fight vigorously against plagiarism. From this perspective, the present study was undertaken and aimed to explore the positions and attitudes of FMT's faculty members towards plagiarism and the different factors influencing them.

Methods

It was a descriptive cross-sectional survey conducted among faculty members of the FMT during the academic year 2018-2019 using the validated English version of the 'Attitudes Towards Plagiarism' (ATP) questionnaire distributed online with Google forms. The ATP questionnaire consisted of 29 items divided into three factors: positive attitude, negative attitude and subjective norms towards plagiarism.

Results

A total of 340 faculty members responded to the questionnaire. Mean scores for positive attitude and subjective norms were 28.8±6.9 and 24.6±4.9 respectively, corresponding to low to moderate scores. The mean score of negative attitude was 22.4±2.6, matching a moderate score. Interpretation of these scores revealed an unfavorable attitude of the faculty members towards plagiarism and the belief that such behavior is associated with social disapproval and rejection. However, the temptation of plagiarism was palpable and self-plagiarism seemed to be tolerated. ATP scores were significantly influenced by age, grade, work experience, supervision, research activities, and English proficiency.

Conclusions

This study has pointed out the dilemma facing our faculty in its academic anti-plagiarism crusade. On the one hand, it should ensure the commitment of its faculty members and solicit their mobilization to carry on this fight, but on the other it should put in place clear disincentive policies to prevent plagiarism and cheating and apply them in an equal and transparent way between faculty members and students.

Key messages

This study showed unfavorable attitudes of Tunisian faculty members toward plagiarism. Self-plagiarism seemed to be tolerated.
Record linkage of routine data with cohorts’ data of infants under European and Portuguese law
Authors: Doetsch J , Lopes I , Redinha R , Barros H
Published: October 2020

The usage and exchange of “big data” is at the forefront of the data science agenda where Record Linkage plays a prominent role in biomedical research. In an era of ubiquitous data exchange and big data, Record Linkage is almost inevitable, but raises ethical and legal problems, namely personal data and privacy protection. Record Linkage refers to the general merging of data information to consolidate facts about an individual or an event that are not available in a separate record. This article provides an overview of ethical challenges and research opportunities in linking routine data on health and education with cohort data from very preterm (VPT) infants in Portugal.

Portuguese, European and International law has been reviewed on data processing, protection and privacy. A three-stage analysis was carried out: i) interplay of threefold law-levelling for Record Linkage at different levels; ii) impact of data protection and privacy rights for data processing, iii) data linkage process' challenges and opportunities for research. A framework to discuss the process and its implications for data protection and privacy was created.

The GDPR functions as utmost substantial legal basis for the protection of personal data in Record Linkage, and explicit written consent is considered the appropriate basis for the processing sensitive data. In Portugal, retrospective access to routine data is permitted if anonymised; for health data if it meets data processing requirements declared with an explicit consent; for education data if the data processing rules are complied. Routine health and education data can be linked to cohort data if rights of the data subject and requirements and duties of processors and controllers are respected. A strong ethical context through the application of the GDPR in all phases of research need to be established to achieve Record Linkage between cohort and routine collected records for health and education data of VPT infants in Portugal.

Key messages

GDPR is the most important legal framework for the protection of personal data, however, its uniform approach granting freedom to its Member states hampers Record Linkage processes among EU countries. The question remains whether the gap between data protection and privacy is adequately balanced at three legal levels to guarantee freedom for research and the improvement of health of data subjects.
Govern of conducts, risk and homeless care in Brazil: Reflections
Authors: Komoda D , Carvalho S R , Justino J , Oliveira C , Botteon L M , Dias T M , Andrade H S , Ravelli D
Published: October 2020

In this study, inspired by governmental studies on Foucault, Nikolas Rose, Deborah Lupton and Mitchell Dean, we develop considerations about the ways through which the concept of risk has been operating within the homeless health care that live in some metropolitan areas of Brazil. In this paper, we discuss risk us as a moral and political technology that produces patterns to experience and to analyze reality.: Risk as a technology that has an important role in governing conducts and production of subjectivity. We argue that whilst health policy determines healthy ways of life, its effect can contribute to active surveillance (by the health care experts and by the homeless persons) that stigmatizes and divide society around the concept o 'normality' informed, between others, by epidemiological 'evidence'. Albeit the risks associated with risk-based technologies to build up a surveillance net and standardization that reinforces submissive ways of life, we find out on our ethnographic study within the services - named 'Street Surgery'- that offers transdisciplinary healthcare for people living in the streets of Campinas, Brazil, that those technologies strikes itself continuously with practices of counter-conducts by the homeless that resist the normalization of their lives and point out to other ways of producing life and care. Others ways that, is important to say, have been very influential to change the medical and other professional experts practices of the 'Street Surgery' of Campinas and had been very important to academic researchers that have been questioning hegemonic discourses, arrangements and practices of care on the Primary Health System.

Key messages

Risk-based approach to health can lead to the reinforcement of submissive ways of life, incompatible with a broader concept of health. For the development of a compromised and humanized care, it's important to take into consideration the.
Food safety in canteens: a public health programme in Aveiro region (Portugal) in 2018 and 2019
Authors: Sá R , Pinho-Bandeira T , Queiroz G , Ferreira D , Lopes P , Leitão R , Pedroso M J
Published: October 2020

Background

Each year, 23 million people get ill from unsafe food in Europe. Food safety refers to the absence or safe acceptable levels of hazards in food that may harm the health of consumers. The Public Health Unit of Baixo Vouga Primary Healthcare Cluster (Aveiro region) developed a programme to identify hazards and promote implementation of corrective measures in community canteens that serve children and elderly. It has three fields of action: qualitative evaluation of the installation and operating conditions, based on the legislation; microbiological surveillance of food and utensils; training of food handlers and managers. This study aims to describe the results of such programme in 2018 and 2019.

Methods

This cross-sectional study used data from qualitative evaluation and microbiological results for a descriptive analysis. Additionally, an assess of the compliance of the critical points was performed to identify the main barriers in achieving the proposed targets.

Results

From a total of 420 registered canteens, 211 and 294 were evaluated in 2018 and 2019, respectively. For these years, only 87 (41.2%) and 124 (33.3%) fully complied with all critical points. The main problems were the lack of non-manual activation system in wash basins and faucets and inadequately instructed food handlers about required hygiene measures. Microbiological surveillance results of 371 and 393 samples had a proportion of satisfactory or acceptable results of: 93.5% and 91.3% for the main dish; 56.1% and 46.6% for the salads and 82.4% and 79.8% for the utensils. Coliform bacteria were the most common agent.

Conclusions

The compliances with critical points were low, accounting for the fact they are legislation-based. The microbiological results were worst for the salads' samples. Deviations give us hints of what should be reinforced. Education of the food handlers and consulting with companies to improve procedures and equipment could be of great use.

Key messages

Community canteens’ compliances with legislated criteria were low. This programme is useful in identifying vulnerabilities and may lead to the implementation of corrective measures.
Effect of weight loss on cardiometabolic risk factors in obese patients
Authors: Penesova A , Babjakova J , Havranova A , Imrich R , Vlcek M
Published: October 2020

Background

Central obesity and dyslipidemia are a cardinal features of the metabolic syndrome and represents increased cardiometabolic risk. It has been shown that weight loss is capable to improve insulin sensitivity and lipid parameters. The aim of our study was to analyze the effect of a weight-lowering program (diet and physical activity) on LDL- and HDL-cholesterol subfractions and cardiometabolic risk factors (waist circumference, blood pressure, insulin sensitivity, physical fitness).

Methods

We studied 2 groups of obese subjects, group A composed of 43 patients with obesity grade 1 and 2 (30F/13M; age: 43.2 ±12.4 years; BMI 31.3 ± 6.1 kg/m2); group B composed of patients with obesity grade 3 (6F/7M; age: 34.7 ±9.8 years; BMI 51.7 ± 7.9 kg/m2). The weight loss interventional program (NCT02325804) in duration of 8-week (group A) or 24 weeks (group B) consisted of hypocaloric diet and physical activity. Body composition, physical fitness, blood lipids profile (using the Lipoprint system (Quantimetrix Corp., CA, USA), and insulin sensitivity were measured.

Results

The average weight loss was 7.3±1.9 kg in group A and 35.3±16.0 kg in group B. Systolic, diastolic blood pressure (BP) as well as heart rate decreased in group A, in group B only systolic BP. Fasting plasma glucose and insulin decreased as well as insulin sensitivity and physical fitness has been improved after intervention. Total, LDL2, HDL2 cholesterol, as well as triglycerides (TG) decreased with weight in group A and total, LDL, TG, VLDL, LDL2 large, and small HDL subfractions decreased and intermediate HDL increased in group B.

Conclusions

Short term life style intervention (diet and physical activity) in patients with obesity lead to notable improvement of cardiometabolic parameters (decreased body fat mass, improved insulin sensitivity, lipid profile) as well as atheroprotective changes in LDL subfractions.

Funding

Supported by grants APVV 17-0099; VEGA 2/0129/20; VEGA 2/0072/18

Key messages

Short term life style intervention in patients with obesity lead to notable improvement of cardiometabolic parameters. Weight-lowering program (diet and physical activity) lead to positive changes in LDL- and HDL-cholesterol subfractions.
The Healthy Start scheme and its association with food expenditure in low-income families in the UK
Authors: Parnham J , Millett C , Chang K , von Hinke S , Pearson-Stuttard J , Vamos E P
Published: October 2020

Background

The Healthy Start programme is a statutory benefit-in-kind in the United Kingdom (UK) which aims to enable low-income families to purchase fruit, vegetables, cow's milk and infant formula through the provision of vouchers. The scheme was introduced in 2006, however, the effect on food purchasing in participating households has not been evaluated within an eligible population. This study aimed to determine whether participation in the Healthy Start (HS) scheme is associated with differences in food purchasing in a representative sample of households in the United Kingdom.

Methods

Cross-sectional analysis of the Living Costs and Food Survey dataset (2010-2017). All households with a child (0-3 years) or pregnant woman were included in the analysis (n = 4,869). Multivariable quantile regression was used to compare the expenditure and quantity of fruit and vegetable, infant formula and total food purchases between Healthy Start participating, eligible non-participating, nearly-eligible and ineligible households.

Results

54% (n = 475) of eligible households participated in Healthy Start. After accounting for covariates, no significant difference was found in the quantity or expenditure of fruit and vegetable purchases between Healthy Start participating and non-participating households. Fruit and vegetable expenditure (£/week) was found to be higher in nearly eligible (β1.60; 95% CI 0.79, 2.41) and ineligible households (β2.56; 95% CI 1.77, 3.35) compared to Healthy Start eligible households.

Conclusions

The present study did not demonstrate significant differences in the fruit and vegetable expenditure of HS participating and non-participating households. The analysis demonstrates that inequalities in fruit and vegetable purchasing persists in the UK. Improved participation and increased voucher value may be needed to promote well-being and counteract the harmful effect of poverty on fruit and vegetables purchasing.

Key messages

The study found no evidence of different food purchases between Healthy Start participating and non-participating households. Increased voucher value may be needed to counteract food-price inflation. The paper reflected persistent socioeconomic inequalities in the UK, indicating the Healthy Start scheme does not sufficiently counteract the harmful effects of poverty on food purchasing.
Eating habits of women of childbearing age from Varna, Bulgaria
Authors: Chamova R , Dimitrova T
Published: October 2020

Background

Eating habits of childbearing age women are an important public health determinant. The inappropriate dietary pattern of women in reproductive age leads to deviations in their nutritional status with possible adverse health consequences for them and their offspring. Both malnutrition and over nutrition can adversely affect reproductive abilities of women as well as the course and outcome of a possible pregnancy.

Methods

We conducted a cross-sectional study on dietary habits of 107 women, aged 19 to 42 years, in Varna, Bulgaria between March-December 2019. Exclusion criteria were pregnancy and lactation. A questionnaire was applied composed of questions on diet, dietary pattern, food frequency consumption, and the respondents' physical activity. The results were compared with the National Food Based Dietary Recommendations for Adults in Bulgaria. Data was statistically analysed with SPSS version 19.

Results

The average age of participants was 25.65 ± 7.48 years. 22.4% of the surveyed women followed no particular diet. 35.5% and 30.8% of the respondents had daily consumption of milk and dairy products respectively. Meat consumption 3-4 times a week was reported by 29.9% of the respondents. Only 1/4 of the respondents consumed fish each week. The relative share of women who did not consume fish was 10.3%. Daily consumption of fruits and vegetables was 42.1% and 57% respectively.

Conclusions

The majority of the surveyed women does not follow the National recommendations for consumption frequency of milk, dairy products, meat, fish, fruits and vegetables. Respondents who do not consume fish, meat or milk and dairy products are at risk of deficiencies of both micronutrients and macronutrients. It's necessary to raise awareness about healthy eating and associated health risks.

Key messages

Nutrition of women of childbearing age is an important factor affecting public health. Inadequate dietary habits before conception raises the risk for the course and outcome of pregnancy with consequences for offspring health.
Evaluating knowledge of healthy diet recommendations of Lithuanian adults
Authors: Žandaras Ž , Stukas R
Published: October 2020

Backgroud

Studies show that diet of Lithuanian population does not follow healthy diet recommendations and is related to increased risk of cardiovascular disease. By knowing Lithuanian populations knowledge about the dietary recommendations and in what socio-demographic groups what dietary recommendation knowledge is missing, we could use effective targeted health promotion and prevention programs or provide particular information for those groups.

Methods

Cross-sectional study was conducted in 2019. 1007 residents of Lithuania aged 18-75 were surveyed by anonymous questionnaire. Survey was carried out by using multi-stage stratified random sampling.

Results

Almost half of the respondents (45.5% (95% CI: 45.5; 51.7)) knew how many times a day fruits and vegetables should be consumed. Possession of having this knowledge was significantly associated with female gender (OR = 1.67 (95% CI: 1.29; 2.14)) and higher education (OR = 1.83 (95% CI: 1.41; 2.3)). Only 21.2% (95% CI: 18.7; 23.7) of the respondents knew that bread and grain products should be taken several times a day. More than half of the population knew the recommendations for meat, fish, milk and dairy products 56.7% (95% CI: 53.6; 59.7). Respondents with higher education had a 2.05 times higher chance (OR = 2.05 (95% CI: 1.55; 2.72)) of knowing these recommendations. 39.7% (95% CI: 36.7; 42.8) knew that butter, salt and sweets should be consumed rarely and in small quantities. Having this knowledge was significantly associated with female gender (OR = 1.80 (95% CI: 1.37; 2.34)), higher education (OR = 1.75 (95% CI: 1.32, 2.32)), and living in a bigger city (OR = 1.67 (95) % CI: 1.19; 2.35)).

Conclusions

Lithuanian populations knowledge about the recommendations of healthy nutrition is insufficient, therefore, in order to reduce the morbidity of cardiovascular diseases, it is necessary to provide the population with information on healthy nutrition.

Key messages

The population of Lithuania lacks knowledge about healthy eating recommendations. Although it is necessary to provide all residents of Lithuania with information about health nutrition recommendations, the main focus should be on men and people with lower education.