bluuebunny/crossref_metadata_2025 huggingface dataset:
Toward a Better Living with Schizophrenia
Authors: Kovess-Masfety V
Published: November 2019

“Toward a Better Living with Schizophrenia” is a French three-year research program that focuses on themes that aims to improve the every day well-being of people with schizophrenic psychoses by providing new insights on their integration:

-The announcement of the diagnosis to the person herself and/or to the close ones:the positive consequences of a sound information and recommendations for a strategy.

-The search for information on the internet: persons living with Schizophrenia are using the web to gather information on their problems and on treatment ; some recommendations were listen to secure and improve web sites.

-How a short training of French health authorities staff members not involved in patients care, could decrease significantly their negative vision of such persons.

-67 people were interviewed face to face: 20 persons with schizophrenia, 20 person with bipolar disorders and 27 close ones to schizophrenic patients. A semi-structured interview concerned: the availability of staff, their feelings during the hospitalization and at discharge, the offer of psychoeducation; “The Brief Illness Perception Questionnaire” allows to measure and compare perceptions of the disease: its duration, prognostic, compliance, stigma and the beliefs about the causes of schizophrenia.

Results show less threatening perceptions of the disease for the persons themselves than for close ones. A better access to diagnosis is associated with a shorter perceived probable duration of the disease, while an easier communication with healthcare professionals is associated with the perception of a better efficiency of the treatment. Family psycho-education is associated with the perception of less frequent symptoms of the person.

These results will help to better integrate families, who seem to feel relatively isolated and shut down in the healthcare process, despite the strategic role they could play and despite the many recommendations of public health policies in that matter.
Impact of integrated care on the use of emergency care among older people in Stockholm County
Authors: Doheny M , Agerholm J , Orsini N , Schön P , Burström B
Published: November 2019

Background

In Sweden, health care is a regional responsibility and social care of older people is a municipal responsibility. The system is fragmented and the use of emergency care by older persons is rising. Better integration, coordination, and collaboration between health and social care providers is necessary to address the complex needs of an ageing population. Since 2006, Norrtälje municipality in Stockholm Region has integrated health and social care. This study aims to assess the impact of the integrated care system in Norrtälje on rates of emergency care visits, compared to the rest of Stockholm county.

Methods

A repeated cross-sectional study with an interrupted time series analysis compared the integrated care system in Norrtälje to a matched control from Stockholm county, using. population-based register data between 2000-2015 obtained from Stockholm Region’s administrative database of healthcare utilization and from the Longitudinal Integration database for Health Insurance and labour market studies from Statistics Sweden.

Results

There was no statistically significant difference in the post-intervention rates of emergency care visits in Norrtälje compared to the matched control. However, there was a decreasing trend in the rate of visits among females 65-79 years, those in lower income groups, those living alone and those born outside of Sweden.

Conclusions

The implementation of the integrated care system in Norrtälje had no statistically significant impact on the rate of emergency care visits among older persons compared to standard care. However, there was a reduced rate of visits among potentially vulnerable sub-groups. Further research is needed as the full implementation of the Norrtälje Model was completed as recently as 2016 and the full impact may not yet be realised.

Key messages

Bringing about change in the delivery of health and social care is complex and challenging. Thus, to observe differences in the utilisation of emergency care requires more time and resources. Innovation in the delivery of health and social care is needed to effectively manage and coordinate the ever changing needs of older persons with complex needs given the current fragmented services.
Eating habits trajectories of students using university canteens
Authors: Lorenzoni V , Triulzi I , Toncelli L , Martinucci I , De Bortoli N , Natilli M , Monreale A , Pedreschi D , Barale R , Turchetti G
Published: November 2019

Background

Diets among the young often do not meet recommendations thus increasing the risk of developing chronic condition in adulthood. The present study aims at evaluate dynamics of eating habits among university students using data automatically recorded by cashier transactions at canteen.

Methods

The study population consisted of 8,338 students enrolled in bachelor courses at Pisa University in 2010-2014 and accessing canteens at least once all over their courses duration (three year). Analyses were performed merging the administrative archive of the University of Pisa and the database of cashier transactions at university canteens. The frequency of different food-groups choice over years was evaluated using a zero- and one-inflated beta regression models, while latent class analysis (LCA) and posterior probabilities derived from that were used to evaluate the evolution of eating habits.

Results

In adjusted models, the proportion of fruit choices increased significantly in both the second (β = 0.077[0.013]) and third year of registration (β = 0.233[0.018]), similarly for vegetables (β = 0.090[0.011] and β = 0.065[0.015]). Conversely, the selection of foods commonly labelled as unhealthy decreased over registration years. LCA revealed 4 different classes each year. The 4 classes distinguished “healthy eaters” (LC1), those often choosing sweets, potatoes and legumes (LC2 “lazy eaters”), “greedy and quick eaters” (LC3) favoring the selection of fried foods, sandwiches and sweets while LC4 represented “selective eaters” composing their meals combining mainly grains and vegetables. The probability of being a “lazy” or “greedy and quick” eaters declined significantly overs registration years. “Selective eaters” almost doubled over years while the probability of belonging to the “healthy” class showed a weak increase over years.

Conclusions

During the years following enrollment students tended to limit choices towards unhealthy foods in favors of healthier dishes.

Key messages

Intervention for the promotion of healthy eating among young adults is essential as awareness of choices may raised only in adulthood. The present work outline the use of digital traces for public health research.
Macro- and micro-nutrient intake among Hungarian general and Roma adults
Authors: Llanaj E , Vincze F , Kósa Z , Ádány R
Published: November 2019

Background

Few studies have been conducted with reference to dietary intake among adults in Hungary and none among Roma. In this study, we assess dietary intake of both Hungarian general (HG) and Hungarian Roma (HR) adult population and provide an up-to-date preview on highly health-relevant macro- and micro-nutrient intakes and dietary profile of the HG and HR adult population.

Methods

The study population comprised 797 Hungarian adults (HG: N = 410, response rate=82% and HR: N = 387, response rate=79%), representative in terms of geographic, sex and age distribution with the general population aged 20-64 years, from the 2018 GINOP Complex Health Survey. Energy and selected nutrient intakes were calculated with NutriComp v.3.0, based on a qualitatively validated double 24 hours dietary recall, adopted for the Hungarian population.

Results

Total daily energy and selected nutrients intake among HG and HR adult subjects are reported. In spite of the presence of diluted underestimation effects, intake of nutrients with high relevance to health (i.e. sugars, sodium, saturated fats, cholesterol, etc.) remains relatively high, while consumption of fibre-rich products and beneficial nutrients appear to be low, particularly among Roma. Considering both health and environmental impact of the diet, animal-based proteins are way over the target value (i.e. 6%E) of the recent EAT-Lancet report.

Conclusions

Findings provide data on dietary patterns of HG and HR with nutrient-level estimations, highlighting the importance of establishing and integrating Roma nutrition in national surveillance and monitoring systems for key dietary risk factors. Public health strategies to modify current dietary patterns in Hungary are a great opportunity for improving nutrition, health and environmental impact of dietary choices, especially within the current framework of the UN Decade of Action on Nutrition (2016-2025).

Key messages

Our study highlights the importance of establishing and integrating Roma nutrition in national surveillance and monitoring systems for key dietary risk factors. Current findings warrant further investigations of the nutritional and dietary patterns among Hungarian General and Roma adult population and their impact on health and environment.
Taste and food preferences of the Hungarian Roma population
Authors: Diószegi J , Pikó P , Kósa Z , Sándor J , Ádány R
Published: November 2019

Background

Behind the unfavorable health status of the Roma population, harmful health behavior is also supposed to exist, such as unhealthy nutrition.

Methods

In the framework of a complex comparative health survey individuals, representative of the Hungarian general (n = 410) and Roma populations (n = 387) were randomly enrolled. In the questionnaire-based part of the survey, sweet, fat, salty and bitter taste preferences were ascertained by question items measuring taste and food preferences. Preference for sweet versus salty foods was also analyzed. Questions from the Hungarian version of the European Health Interview Survey were included, to characterize fruit and vegetable consumption and to determine the quantity of added sugar to consumed foods and beverages and the frequency of salting without tasting the food. The data were analyzed using STATA 9.0 statistical software.

Results

Roma reported significantly less frequent consumption of fresh fruits (OR = 1.84, 95% CI: 1.43-2.37, p < 0.001) and vegetables (OR = 1.64, 95% CI: 1.27-2.11, p < 0.001) than the Hungarian subjects. Roma had higher preferences for sweet (OR = 1.57, 95% CI: 1.21-2.04, p < 0.001) and salty foods (OR = 1.33, 95% CI: 1.03-1.71, p = 0.029) and added higher quantities of sugar to consumed foods and beverages (OR = 1.88, 95% CI: 1.38-2.57, p < 0.001) and salted the food without tasting more often (OR = 2.18, 95% CI: 1.64-2.88, p < 0.001). They could be characterized by lower preferences for bitter tasting kohlrabi (OR = 0.64, 95% CI: 0.49-0.82, p = 0.001), grapefruit (OR = 0.47, 95% CI: 0.36-0.60, p < 0.001), black coffee (OR = 0.48, 95% CI: 0.36-0.64, p < 0.001) and bitter chocolate (OR = 0.56, 95% CI: 0.44-0.72, p < 0.001) and preferred sweet snacks versus salty ones (OR = 0.56 for salty snacks, 95% CI: 0.42-0.74, p < 0.001).

Conclusions

The Hungarian Roma diet may be linked to taste preferences predisposing to unhealthy nutrition. This assumption needs further studies on their nutritional behavior.

Key messages

Hungarian Roma taste preferences may predispose to unhealthy nutrition. Understanding the determinants of food choices is essential to the development of public health strategies targeting the Roma.
Do perspectives on healthy environment differ between health/social professionals and urban planners?
Authors: Mourits K , Van der Velden K , Molleman G
Published: November 2019

Background

In a multidisciplinary collaboration it is essential that professionals understand from each other what is meant by a healthy environment and of what aspects it consists. However, the field of health and social welfare and the field of urban planning differ in many aspects, including language. Therefore, this study examined: what is the perception of professionals in the field of health and social welfare and in the field of urban planning about a healthy living environment? And do these perceptions differ?

Methods

Using the concept mapping method, 94 professionals (government and non government) in the city of Nijmegen(NL) were asked to generate statements on healthy living environment. Next, the professionals sorted these statements and rated them on priority and opportunity within urban planning processes.

Results

In the brainstorm 45 professionals generated 136 statements. After clearing doubles, 92 statements were sorted by 32 professionals. Which, after analysis, resulted in a map of ten different clusters together indicating what professionals perceive as aspects of a healthy living environment.

There was agreement on priority and opportunity between both groups of professionals regards clusters urban quality and invited to move. The two groups professionals have different views about five clusters. Professionals of both fields agree on the three clusters with the least priority and possibilities. Interesting is the relatively limited possibilities that professionals see to stimulate healthy behavior and to improve social connectivity in urban planning.

Conclusions

There is a consistency between professionals in the field of health and social welfare and in the field of urban planning about the most and least important aspects of healthy environment in urban planning process. It is interesting to see that, although there is a lot of agreement, there are also relevant nuances between both groups on priority and possibilities at 5 out of 10 clusters.

Key messages

There is a consistency about the most and least important aspects of healthy environment in urban planning process. It depends on the aspect of a healthy living environment if understanding and collaboration between professionals easy is.
The relation between hearing loss and sustainable employability of teachers
Authors: Schriemer A G , Roelen C A M , Abma F I , van der Klink J J L , Bültmann U
Published: November 2019

Background

Teachers need to hear well. Hearing loss (HL) hinders their daily work. HL is associated with burn-out, depression, sick leave and disability. New retirement policies in The Netherlands encourage people to work longer. Consequently, age-related HL will be an increasing occupational health problem, especially in communicative work such as teaching. Aim of the present study was to examine the relationship between HL and sustainable employability of teachers.

Methods

We invited teachers to participate in an internet survey. Sustainable employability was measured with the reliable and valid Capability Set for Work Questionnaire. Secondary outcome measures were work ability, self-rated health and sick leave. To determine HL among teachers, we used an online speech-in-noise screening test, supplemented with 4 questions about hearing. Ordinal logistic regression analyses were conducted to examine the associations of HL with sustainable employability, work ability, self-rated health and sick leave, adjusted for age, gender, level of education, current hours at work, work content (teaching or a mix of teaching and other tasks) and working as gymnastics teacher. Odds ratios (ORs) and 95% confidence intervals (CI) were estimated.

Results

Of the participating N = 801 teachers, N = 521 had normal hearing and N = 280 had hearing loss. HL was associated with a lower capability set (OR 0.56, CI 0.42-0.73), lower work ability (OR 0.34, CI 0.26-0.46), poorer self-rated health (OR 0.41, CI 0.30-0.55) and a non-significant trend towards more sick leave (OR 1.34, CI 0.98-1.85) as compared to normal hearing.

Conclusions

Hearing loss in teachers was negatively associated with sustainable employability. This underlines the importance of assessing the hearing status of teachers, because of age-related HL especially in those aged 50+. Teachers with HL should be advised on supportive measures, e.g. hearing aids, improved acoustics in the workplace and tasks with less oral communication.

Key messages

Measuring the hearing status, e.g. in periodical health examinations, is highly advisable for sustained employability of teachers. Teachers with hearing loss should be counselled on possible interventions to support them in their work.
Work participation trajectories in 1098748 Finns: determinants and the incidence of sickness absence
Authors: Lallukka T , Kronholm E , Pekkala J , Jäppinen S , Blomgren J , Pietiläinen O , Lahelma E , Rahkonen O
Published: November 2019

Background

Early exit from paid employment is a notable public health and societal challenge. Previous research has largely focused on the relationships among variables instead of the relationships among individuals with different work participation history. Person-oriented methods enable to identify latent groups of individuals who are likely to follow similar development in their work participation over time. We thus aimed to identify work participation trajectories during early and midlife careers and their social determinants. A further aim was to determine the cumulative incidence of sickness absence due to key diagnostic groups, mental disorders and musculoskeletal diseases within the trajectories.

Methods

Young (25-38 years at baseline, n = 495663) and midlife (39-52 years at baseline, n = 603085) Finnish people, working in 2004, were followed up through 2013, with registers of the Social Insurance Institution, and the Statistics Finland. The registers provided data for the outcome (work participation) and its determinants and sickness absence. Latent class growth analysis was used to identify trajectories.

Results

Three distinctive trajectories were identified: temporary exit, permanent exit, and continuously employed people. As compared to the other trajectories, those belonging to the permanent exit trajectory were more likely men, manual workers and had a lower income. The cumulative incidence of sickness absence due to mental disorders was highest in the permanent exit trajectory group. For musculoskeletal diseases, the cumulative incidence of sickness absence increased in the permanent exit trajectory mainly in the older age groups.

Conclusions

Distinct group-based trajectories of early work exit can be identified in a representative cohort of initially employed people. Focusing on the determinants of premature exit and early intervention to tackle increasing sickness absence may promote work participation particularly in the most vulnerable groups.

Key messages

Distinct trajectories of premature exit from paid employment can be identified in a nationally representative cohort of initially employed people from Finland. Focusing on the determinants and reasons of premature long-term labor market exit may help promote work participation particularly in the most vulnerable groups.
Health care in Amazon communities for education and awareness about health in low resource settings
Authors: Olavarria G C , Ricioli I S , Greco H F , Mont’Alvão V G B , Pizzato R S , Czszacki A S , França J N M , Succi G M , Succi F M P , Freitas A R R
Published: November 2019

Background

Brazil has an extensive area and social differences. Indigenous peoples and other minorities still have great difficulty in accessing health. Although increase in the number of medical graduates, there has been a low number of professionals joining the jobs offered in the remote areas.

Objectives: The objective of this project is to sensitize health students to the importance of meeting the health demands of the populations in remote areas and low resource settings through practical experience in the care of the indigenous communities of the Amazon region supervised by teachers.

Results

The Mandic Health Boat team consists of about 40 to 50 members: 8-10 physicians (epidemiologist, pediatrician, general practitioner, gynecology, dermatology and ophthalmology), nurses, dental surgeons, 16 medical graduates , 6 dentistry graduates, 1 dental technician and 1 optician. The trips are 10 days long and are organized in integration with the local population and the health district so that the tasks are integrated into the routines of health actions. To date, the project has already carried out two expeditions and another is scheduled in June 2019. In the last one, 1619 medical consultations were performed and 639 dental consultations were donated 574 glasses and performed 97 surgeries for pterygium excision.

Conclusions

Through this program it was possible to put the academics in contact with the reality of the indigenous communities and to raise awareness of the difficulties of these original peoples. It was also possible to provide health education and medical and dental care, with spotlight to dental prostheses and glasses, that are particularly difficult to access because they require materials and equipment that are unavailable in the forest. This experience provides health to the original populations and favors the students’ awareness to social problems, as well as being an innovative scenario for the learning process in the health area.

Key messages

This experience provides health to the original populations and favors the students’ awareness to social problems, as well as being an innovative scenario for the learning process in the health area. The planning of the expeditions with the community leaderships and the local health authorities allow the integration of the actions realized through annual trips to the routines of the health care.
Social networks as a public health tool - “Non-smoking bars and restaurants”
Authors: Grujičić A , Mladenović Janković S , Matijević D , Tamburkovski G , Marković M
Published: November 2019

Issue/problem

In Serbia, 34,7% of adults are smokers. Although Framework Convention of Tobacco Control was signed in 2005, there are measures still not applied. Implementation of the existing laws on tobacco control is inconsistent. Inadequate regulation is particularly related to catering objects - restaurants and cafes, which contributes to a general tolerance towards smoking. Although 84% of the population is aware of the harmful effects of second-hand smoking, complete smoking ban in restaurants and cafes is supported by only 19% and 14%, respectively.

Description of the practice

The initial idea was to identify smoke-free catering objects, as well as those that properly obey current laws. This led to creation of a Facebook page with a map of such objects in Belgrade. Another goal was to raise awareness about the effects of second-hand smoking and encourage people to articulate their needs, but also to emphasize the significance of this topic to the media and other relevant parties.

Effects

In two years, the page reached nearly 4000 organic followers. It is daily used for sharing news and study results and for discussing tobacco control related topics. Some posts reach up to twenty thousand Facebook users. The map includes over 100 strictly non-smoking catering locations. The page has been further publicized via popular internet portals, newspapers, TV channels, specialized magazines and foreign tourist guides.

Lessons

The page has revealed the suppressed need of the majority to express the intolerance to second-hand smoke. Even though most catering owners are hesitant to declare smoke-free areas, fearing a negative business impact, others see the page as a good promotion channel. The initiative has also been recognized by different parties with an idea of future joint action.

Key messages

Social networks are a powerful tool to broadcast public health initiatives and encourage people to take actions. Social media communities have potential to create a persistent influence on stakeholders to lobby for new regulations.
Learning between European health systems: the nature of the challenge
Authors: Fahy N
Published: November 2019

Given their shared values and challenges, European health systems should be able to learn from each other about what works best. In practice, though, turning good practice in one place into more universal practice is stubbornly difficult even within single health systems, and has proved particularly challenging between European health systems. This session will explore the nature of the challenge to implementing innovation; the nature of what implementing innovation involves, why it proves to be so challenging in practice, and the particular challenges of learning between countries, and outline what can be done in research, policy and practice to help learning across European health systems more effectively in future.
Recent European Union (EU) initiatives to support national vaccination efforts
Authors: de La Mata I
Published: November 2019

Background

Vaccination is the main tool for primary prevention of disease and one of the most cost-effective public health measures available. Immunisation through vaccination is the best defence we have against serious, preventable, and sometimes deadly, contagious diseases. Thanks to widespread vaccination, smallpox has been eradicated, Europe made polio-free, and many other diseases almost eliminated.

Methods

This presentation provides an overview of recent European Union (EU) initiatives to support national vaccination efforts.

Results

The EU has launched a number of initiatives to strengthen national vaccination efforts. In December 2018 the European Council adopted a Recommendation to strengthen the EU cooperation on vaccine-preventable diseases. The initiative aims to tackle vaccine hesitancy, improve coordination on vaccine procurement, support research and innovation, and strengthen EU cooperation on vaccine-preventable diseases. EU countries are encouraged to develop and implement national vaccination plans with initiatives to improve coverage, and to introduce routine vaccination status checks.

The European Commission is also reinforcing its support to national vaccination efforts to increase coverage, including through the preparation of a Joint Action on vaccination co-funded by the Health Programme. Launching in 2018, the Joint Action will address vaccine hesitancy and seek to increase vaccination coverage in the EU. It is coordinated by INSERM (France) and involves 23 countries (among them 20 EU countries).

Conclusions

Vaccination policy is a competence of national authorities, but the European Commission assists EU countries in coordinating their policies and programmes.
The organization and delivery of vaccination services in the European Union
Authors: Rechel B , Priaulx J , Richardson E , McKee M
Published: November 2019

Background

The design and operation of health systems can influence vaccine uptake, including through the way that vaccination programmes are governed, financed and delivered. This study examined the organization and delivery of vaccination programmes in the 28 EU member states and key barriers and facilitators to improved vaccination coverage.

Methods

We undertook an umbrella review of systematic reviews on health system related factors influencing vaccine uptake and commissioned country fiches that describe the organization and delivery of vaccination programmes in each of the EU member states, followed by a comparative analysis. The focus was on measles vaccination for children and seasonal influenza vaccination for adults.

Results

In all countries covered, there is a dedicated agency in charge of developing and overseeing implementation of national vaccination plans and programmes. In 9 EU member states (Bulgaria, Croatia, Czech Republic, France, Hungary, Italy, Poland, Slovakia and Slovenia), vaccinations against measles are mandatory for children, while in the remaining 19 countries they are voluntary, but recommended by the relevant authorities. However, the distinction between voluntary and mandatory immunization is not always clear-cut. In contrast, vaccinations for adults against influenza are voluntary in almost all EU member states, with the exception of Slovakia. Vaccinations are provided in most countries through primary care physicians or nurses.

Conclusions

There are many actions that health systems can take to improve vaccination coverage. These include a mix of incentives and sanctions, targeted measures and outreach services for vulnerable population groups, and an expansion of public financing for vaccinations against influenza, as well as the removal of administrative barriers.
Academic performance in mathematics and reading and self-reported mental health problems in children across Europe
Authors: Husky M
Published: November 2019

Background

The School Children Mental Health Europe was a EU funded project designed to set up a kit of instruments enabling cross EU comparisons.

Methods

A literature review allows to select the SDQ (Strengths and Difficulties questionnaire) to be administered to the parents and teachers after a validation process in each country and the Dominic Interactive (DI), a sort of video game designed to evaluate DSM more commune diagnoses on children 6 to 11 years old.

Results

Data were collected on 7682 children randomly selected in a two stages selection: schools by country and children within the schools for whom 1) either parent- or teacher SDQ were completed: Overall, 12.8 % of children have any probable disorder with significant inter-country differences, 8.4 % probable conduct disorder, and 2.0 % probable hyperactivity/inattention. Adjusting for socio-demographic variables and parental psychological distress, country of residence did not predict the odds of having any disorder. 2) Overall, 22.0% of children were identified per their own evaluation as having at least one mental disorder, ranging from 16.4% in the Netherlands to 27.9% in Bulgaria. The prevalence of internalizing disorders was 18.4% across countries and ranged from 11.8% in the Netherlands to 24.3% in Turkey. The prevalence of externalizing disorders was lower with an average of 7.8%, ranging from 3.5% in Turkey to 10.5% in Bulgaria. Combining samples across European countries, 1 in 5 children reported internalizing problems and 1 in 12 children externalizing problems.

Conclusions

This lecture aims to present and discuss child mental health measure instruments from different informants perspectives, comparisons across countries and the challenges for interpreting the difference.
Children’s food intake in relation to preschool-level facilitators and barriers of healthy nutrition
Authors: Lehto R , Ray C , Vepsäläinen H , Korkalo L , Nissinen K , Koivusilta L , Roos E , Erkkola M
Published: November 2019

Background

Childcare is an important setting for young children’s food consumption as, in Finland, most children eat three meals a day in childcare. Thus, it is important to recognize determinants of children’s dietary intake in childcare. The aim of this study was to examine food-related factors at preschool and manager-level and their association with children’s fruit, vegetable and fibre intake at preschool.

Methods

The study was a part of the cross-sectional DAGIS survey conducted in 2015-2016. It aimed to examine 3-6-year-old preschoolers’ energy balance-related behaviors in Finland. Preschool managers from 58 preschools filled in a questionnaire on food and nutrition related factors at preschool such as kitchen type, food policies, food education, the manager’s possibilities to impact fruit and vegetable supply and cooperation challenges with the catering service. Preschool personnel kept food record for the children (n = 585) on two preschool days. Multilevel linear and logistic regression analyses were conducted with age, gender and municipality as confounders, preschool-level factors as independent variables and children’s vegetable (g/day) and fruit (yes vs. no) consumption, and fibre intake (g/MJ) as outcome variables.

Results

Having many written food policies in the preschool was associated with higher intake of vegetables (p = 0.01) and fibre (p = 0.03) among the children. Having at least 2 out of 3 different cooperation challenges with the catering service was associated with higher intake of fibre (0.03) and lower odds of eating fruits (p = 0.01).

Conclusions

Written food policies and manager-reported challenges with the catering service were associated with children’s vegetable, fruit and fiber intake at preschool. Factors that are relatively distal from the meal situations may impact children’s food intake at preschool and should be taken into account when promoting healthy food intake at preschool, but more studies are needed.

Key messages

Written food policies and good cooperation between the preschool and catering services may be of benefit to children’s healthy food intake at preschool. The relation between preschool and manager-level factors and children’s food intake are very little studied, and thus more studies are needed before conclusions can be made.
Ultra-processed food intake and risk of type 2 diabetes in a French cohort of middle-aged adults
Authors: Srour B , Fezeu L K , Kesse-Guyot E , Allès B , Chazelas E , Deschasaux M , Hercberg S , Monteiro C A , Julia C , Touvier M
Published: November 2019

Objective

The consumption of ultra-processed foods has been increasing during the last decades, and has been previously associated with increased risks of mortality and several chronic diseases. The objective of this study is to assess for the first time the prospective associations between consumption of ultra-processed foods and the risk of type 2 diabetes (T2D).

Methods

104707 participants aged at least 18 years (median age 41.5 years) from the French NutriNet-Santé cohort (2009-2019). Dietary intakes were collected using repeated 24 hour dietary records, designed to register participants’ usual consumption for 3300 different food items, categorized according to their degree of processing by the NOVA classification. Associations between ultra-processed food intake and risk of T2D were assessed using multi-adjusted Cox proportional hazard models.

Results

Ultra-processed sugary products, fruits and vegetables, and beverages were the highest contributors of the ultra-processed category (respectively 27.9, 18.5 and 15.6%). Ultra-processed food intake was associated with a higher risk of T2D (n = 821 incident cases; hazard ratio for an absolute increment of 10 in the percentage of ultra-processed foods in the diet = 1.15 (1.06-1.25); P = 0.0009, 582252 person-years). These results remained statistically significant after adjustment for other metabolic comorbidities, for several markers of the nutritional quality of the diet (red meat and sugary drinks consumption, intakes of saturated fatty acids, sodium, sugar, dietary fiber or Healthy/Western patterns derived by principal component analysis) and after a large range of sensitivity analyses.

Conclusions

In this large observational prospective study, higher consumption of ultra-processed foods in the diet was associated with a higher risk of T2D. Public health authorities in several countries recently started to recommend privileging unprocessed/minimally processed foods and limiting ultra-processed food consumption.

Key messages

The consumption of ultra-processed food is associated with an increased risk of type 2 diabetes. As the French Public Helath agency recommends, their consumption should be limited. Nutritional composition, food additives, contact materials, or neoformed contaminants might play a role in these associations and further studies are needed to understand their relative contribution.
Dietary pesticide exposure profiles in the NutriNet-Santé cohort
Authors: Rebouillat P , Vidal R , Cravedi J-P , Debrauwer L , Gamet-Payrastre L , Touvier M , Hercberg S , Lairon D , Baudry J , Kesse-Guyot E
Published: November 2019

Pesticides are commonly used in current agriculture and some negative effects are suspected for human health but evidence from dietary exposure in the general population is lacking. This study aimed to describe dietary pesticide exposure among French cohort participants. Organic and conventional food consumption was assessed using a self-administered semi-quantitative food frequency questionnaire in 2014 in the NutriNet-Santé cohort. Exposure to 25 commonly used pesticides was estimated using contamination data (CVUA Stuttgart) accounting for farming system. Dietary pesticide exposure profiles were identified using Non-negative Matrix Factorization, adapted for non-negative sparse data and then introduced in a hierarchical clustering process. The 6 identified clusters (n = 34,193) seemed to be exposed to the same molecules with gradual intensity. Cluster 1 was characterized by the lowest energy-intake and dietary pesticide exposure, and high consumption of organic food groups (23.3%). Proportion of male participants was higher than in other groups. Clusters 2 and 5 were characterized by intermediate energy intake, lower organic food consumption and intermediate pesticide exposure. High conventional fruits and vegetables intake and high pesticide exposure were observed in cluster 3, composed of a lower smokers’ proportion. Cluster 6 was characterized by the highest energy intake, lowest organic food consumption (9%), and highest pesticide exposure; high consumption levels of conventional fruits, vegetables and a higher proportion of vegans were observed. For cluster 4, pesticide exposure varied more across molecules than for other clusters. The highest exposures were observed for Acetamiprid, Azadirachtin, Cypermethrin, Pyrethrins, Spinosad pesticides. Proportion of organic food in the diet was the highest (31.5%).

Dietary pesticide exposures seem to vary across the clusters and related to the proportion of organic food in the diet.

Key messages

Dietary pesticide exposures seemed to vary gradually across the clusters and depending on the proportion of organic food in the diet. High consumers of conventional FV in this cohort seem to be more exposed to our selection of pesticides.
Health Literacy questionnaire development for 9 and 10 years old: a discussion of assessment tools!
Authors: Reis A , Barroso I , Saboga-Nunes L , Okan O , Bollweg T , Bittlingmayer U
Published: November 2019

Background

With Health literacy (HL) investments - to promote health and self-care during people’s life cycles (childhood, especially) - health professionals approach is multi-dimensional: within the family, school settings and community. The objective of this study is to explore the feasibility and usability of a questionnaire to characterize HL levels among 9 and 10 years old. It is expected that this will help health care personal to better focus health promotion initiatives in the school setting.

Methods

The CrAdLiSa project in conjunction with the HLCA German Consortium, implemented a field test for the newly developed HL assessment tool for children in the Portuguese context. This is a deductive-inductive, exploratory-descriptive study including 16 children, with 9 and 10 years old, from 2 different elementary schools in Santarém District (rural and urban areas). Semi-structured interviews aim at exploring the cognitive appraisal of concepts and indicators at the base of the questionnaire developed to assess HL levels. Data was subjected to content analysis, with a priori and a posteriori categorization.

Results

Preliminary results point to the cognitive comprehension by children of the feasibility of an instrument to assess their HL levels. It depicts discriminatory capabilities (to allow characterization of low, medium or high levels of HL). Children living in urban areas, having better financial resources are less likely to develop obesity, or low weight. Better self-perception of school performance, good relationship with family members, parents with higher education or higher levels of HL appear to have better quality of life.

Conclusions

Results suggest the need to invest in children’s and families’ HL, while taking into consideration personal, environmental and socioeconomic determinants. School settings should be considered as a natural arena to improve children’s (and, as a result, families’ and communities’) HL levels.
Healthy schools, healthy children – achieving climate-friendly and health promoting buildings for future generations
Authors: Stauffer A
Published: November 2019

Children spend a significant amount of their time in schools indoors, and the quality of this indoor environment influences their health and their ability to learn. Recent studies have demonstrated the specific vulnerability of children to air pollution, especially particulate matter (PM). However, awareness among the public, parents and policy-makers on indoor air quality in schools is low, and media reports are scarce. Therefore policy measures have largely focused on providing clean air outdoors. With the political drive to improve the climate footprint of buildings, including schools, there is an urgent need to consider air quality and health.

The presentation will present results from a project by the Health and Environment Alliance on citizens science monitoring of outdoor and indoor air quality in more than 40 schools in 6 European capitals, Berlin, Paris, Madrid, Warsaw, Sofia and London in the spring of 2019. Pollutants measured included PM and NO2; as well as CO2 concentrations. Strategies on how to achieve an energy efficient and health promoting school environment will also be discussed.
Socioeconomic Status, Health Inequalities, and Solidarity Trends in a Mass Vaccination Campaign
Authors: Tur-Sinai A , Gur-Arie R , Davidovitch N , Kopel E , Glazer Y , Anis E , Grotto I
Published: November 2019

Background

In July 2013, Israel was swept with fear of a polio outbreak. In response to the importation of wild polio virus, the Ministry decided to take preventive action by administering oral poliovirus vaccine (OPV) to all children born after 1 January 2004 who had received at least one dose of inactivated poliovirus vaccine (IPV) in the past. This study analyzes the vaccination uptake rates resulting from the mass polio vaccination campaign on the basis of health inequality parameters of socioeconomic status (SES), principles of solidarity, and the Gini inequality index. The research explores understanding the value of the Gini inequality index within the context of SES and solidarity.

Methods

The study is based on data gathered from the Israeli Ministry of Health’s administrative records from mother-and-child clinics across Israel. The research population is comprised of resident infants and children whom the Ministry of Health defined as eligible for the OPV between August and December 2013.

Results

The higher the SES level of the area where the mother-and-child clinic is located, the lower the OPV vaccination uptake is. The greater the income inequality is in the municipality where the mother-and-child clinic is situated, the lower the vaccination uptake. As time passed in the vaccination campaign, vaccination uptake increased regardless of the location of the mother-and-child clinics. The highest vaccination uptake rate was found among populations of low SES and low Gini inequality index. The lowest vaccination uptake rate was found among populations of high SES/high Gini inequality index.

Conclusions

Public health professionals promoting vaccine programs need to make specially-designed efforts both in localities with high average income and in localities with a high level of income diversity/inequality. Such practice will better utilize funds, resources, and manpower dedicated to increasing vaccination uptake across varying populations and communities.

Key messages

The higher the SES in municipalities with mother-and-child clinics, the less likely children were to be vaccinated. The lower the Gini inequality index, there is a higher polio vaccination uptake among of children.
Impact of safety-engineered devices (SEDs) on the prevention of percutaneous injuries
Authors: Garlasco J , Ottino M C , Rainero E , Argentero A , Zotti C M
Published: November 2019

Background

Needlestick injuries represent a major occupational hazard for healthcare workers as they lead to exposure to biological fluids, with higher risk of bloodborne pathogen infections. In order to minimise this risk, safety-engineered devices (SEDs) have been developed and introduced into the daily hospital practice. An annual survey, conducted by the Department of Public Health Sciences of the University of Turin since 1999, has been evaluating the number of percutaneous accidents in the hospitals of Piedmont (Italy), assessing also the impact of the introduction of SEDs on the injury incidence rate. The aim of this study is therefore to evaluate the efficacy of SEDs in preventing needlestick injuries.

Methods

Data about percutaneous injuries and needle consumption were obtained from 42 hospitals of Piedmont for the years 2014-2017, concerning all the types of needles and sharps most commonly used in the departments. After considering the overall trend of percutaneous events, standardised rates for 100000 needles were computed for both SEDs and conventional devices. The same analysis was performed considering all sharps except standard needles, which are mainly used for procedures not involving contact with patients (e.g. drug dilution).

Results

The comparison between the incidence rates with SEDs and conventional devices showed a slightly protective effect of SEDs in 2014, 2016 and 2017, with an incidence rate ratio ranging from 0.78 to 0.97. However, by removing the confounding effect of standard needles, the analysis yielded strong statistical evidence of the protective effect of SEDs for all years (RR = 0.28-0.63). Moreover, the total number of percutaneous events shows a trend of general decrease.

Conclusions

Safety devices have proved to be significantly effective in the prevention of needlestick injuries, and their introduction into the daily practice is one of the factors who could contribute to a reduction of percutaneous events.

Key messages

Safety-engineered devices are a very important tool in the prevention of injuries in healthcare workers, and their introduction into hospital practice has reduced the number of percutaneous injuries. Safety-engineered devices are significantly protective against percutaneous injuries compared to conventional ones, especially for procedures involving contact with patients (therefore at high risk).