bluuebunny/crossref_metadata_2025 huggingface dataset:
The AAPRISS Platform: Learning and Taking Action to Reduce Social Inequalities in Health to help PHIR
Authors: Lang T , Marquis C , Haschar-Noé N , Kelly-Irving M , Huot-Royer M , Grosclaude P , Delpierre C
Published: November 2019

Today, the reduction of social inequalities in health is on the political agenda in public health. The complex reality of the determinants of these health inequalities remains difficult to understand and translate into practical actions. One of the reasons is that the circulation of expertise amongst researchers, actors in the field, and public decision is not systematic and still too rare.

In 2013, the Federative Institute of Interdisciplinary Research and Studies Health Society (IFERISS) of Toulouse has an interdisciplinary platform (health, the humanities, and the social sciences) that directly offers expertise to public health actors, institutions, and local communities in order to respond to public health issues.

At the request of the actors, AAPRISS can intervene at all stages of a study or an intervention, from conceptual and methodological construction to implementation support, and data analysis and use. In particular, the team has expertise in public policy evaluation, support for transferability according to the key functions/implementation/context (FIC) model, and awareness-raising at the intersection of urban planning and health. The platform is in a multi-year partnership with local authorities, the regional health agency of Occitanie, the primary health insurance funds of Occitanie, and various partners in civil society. Six years after the establishment of the AAPRISS platform, there is a strong demand for support and research from the actors and institutions. However, funding for activities remains uncertain despite the support of the National Cancer League and an increasingly strong network of partners. Mixed structures housing spaces for both research and action, which create a dynamic of Population Health Intervention Research, are showing themselves to be effective and seem to meet a need, but their financial stability is insufficient to sustain their activities and promote sustainable reduction of social inequalities in health.

Key messages

Mixed structures housing spaces for both research and action, which create a dynamic of Population Health Intervention Research, are showing themselves to be effective and seem to meet a need. But the financial stability of this mixed structures is insufficient to sustain their activities and promote sustainable reduction of social inequalities in health.
Pre-participation screening of the athletes in Turkey: approach of primary care physicians
Authors: Dursun M , Bilir E , Kaymaz K , Sakarya S
Published: November 2019

Background

The pre-participation screening is crucial as the risk of sudden death for competitive athletes is higher than that of non-athletes. In Turkey, screening could be performed at the primary health care setting both by family medicine specialists (FMSs) and by general practitioners (GPs). Although there is a guideline, there is no legal regulation for the process. The aim of this study is to evaluate the approach of primary care physicians in pre-participation screening.

Methods

An online questionnaire based on the Turkish Medical Association (TMA) guideline, and the 14-item Screening Guideline of the American Heart Association (AHA) was delivered to primary care physicians. Knowledge, experience and approach of the physicians were assessed. Self-confidence, application of AHA criteria, accurate referral ratios and further test requests were taken as outcome measures. Descriptive and inferential analyzes were performed and p < 0.05 was considered significant.

Results

Of 214 participants, 39.3% were women, the average age was 44.9 years, the average work experience was 7.9 years. 89.7% of the participants were aware of their authorization, 90.2% had previously given this report, but only 6.5% feels confident. Only 13.1% knows the presence of TMA guideline, and only 23.8% states being educated on the subject at any part of their career. More than 60% of the participants consider further testing necessary in addition to medical history and physical examination. Blood and urine test requests were significantly more for GPs compared to FMSs (p = 0.026, p = 0.011). Accurate referral decision ratio was only 59.3% with no difference between FMSs and GPs (p = 0.216). Work experience had no effect on any of the outcomes.

Conclusions

As the legal regulations and awareness of the guideline are insufficient, pre-participation screening is not standardized, and this increases tendency for further testing or referral.

Key messages

The pre-participation screening of athletes in Turkey is not standardized among primary care physicians. Further testing request ratio is high and accurate referral ratio is low.
Evaluation of medical students to interest in the health research in Kazakhstan at 2018
Authors: Akanov A , Koikov V , Abduazhitova A , Aubakirova A , Otargalieva D
Published: November 2019

Background

Since medical education is significantly different from other conditions of higher education, it is necessary to analyze the influence of the health research component on the quality of training a future health specialist.

Methods

A quantitative analysis based on the survey. 2 types of original questionnaires were based on the AGREE method: a) to analyze the involvement of medical students, and b) to analyze the teachers of medical universities to integrate health research into the educational process. The survey involved 1,439 medical students.

Results

85±1.02% of medical students agree that the triangle of science, education and practice is the main principle of doctors. 63±2.76% of students indicate a discussion with the teacher about the latest advances in medical science. 77±3.24% of surveyed students believe that health research is conducted at a good level. 78±5.8% of students confirm a good health research infrastructure at the University. The continuity of the scientific school and the discussion of the health research results was confirmed by 74±1.24% of students.

Evaluation of the participation of teachers in the study showed that 32±3.41% of respondents do health research at the time of the survey. 63±7.1% of teachers agree that the “science-education-practice” triangle is the main principle of doctors. 70±5.17% of teachers indicated the use of Case-based learning, Project-based learning and Research-based learning in their teaching practice.

Conclusions

The analysis showed a lack of involvement of medical students in health research and a lack of commitment of educational organizations to the principle of the triunity of science, education and practice.

Key messages

Medical students who are engaged in research have professional competencies related to the practical use of their knowledge and skills than their peers who are not involved in research. Involving medical students in research provides benefits for Universities, medical students and stakeholders.
Who has access and who participates in parkrun? - implications for selecting future event locations
Authors: Schneider P P , Smith R , Bullas A , Haake S , Brennan A , Goyder E
Published: November 2019

Background

parkrun is an international organisation which hosts free, weekly volunteer-led, running events. More than 300,000 people participate across 21 countries each week. The present study investigates how access to, and participation in, parkrun events varies across England. We go on to make policy recommendations for new parkrun event locations, in order to maximise geographical access and participation whilst taking account of the impact on inequalities.

Methods

We combined location data of census areas, parkrun events and public parks in England. For the census areas, access was defined as the distance of the area’s centroid to the nearest parkrun event, and parkrun UK provided information on 2018 participation rates per area. Linear regression was used to investigate the effect of deprivation on access, and the effect of deprivation and access on utilisation. We propose a flexible algorithm for identifying optimal new parkrun event locations and provide two sample sets of recommendations.

Results

The median distance to the nearest parkrun event was 3.4 km, but the distribution was heavily skewed: for approximately 10% of the population, the nearest event was more than 10 km away.

Despite statistical significance, the relationship between deprivation and access was very weak. However, access and deprivation had a considerable effect on participation: less deprived areas, and areas with good access had higher participation rates. The best locations for new events are contingent on what parkrun aims to maximise. We demonstrate that optimal locations for maximising equitable geographic access differ from locations for maximising participation.

Conclusions

Access to parkrun is generally good and is similar across socioeconomic groups, but participation is markedly higher in less deprived areas. Our algorithm can be used by parkrun to further improve access for deprived communities. However, better access alone is unlikely to reduce inequities in participation.

Key messages

In England, access to parkrun is generally good, and our algorithm can be used to further optimise it. However, better access alone is unlikely significantly increase participation from deprived areas.
Exploration of perceptions of health of low SES citizens in the Netherlands
Authors: de Jong M A J G , Wagemakers A E
Published: November 2019

Background

Health promotion programs (HPPs) have not yet succeeded in substantially reducing the health gap between higher and lower socioeconomic groups. It is thus a challenge to develop more effective strategies, based on an ecological perspective. To develop such strategies and activate citizens, this study explores citizens’ perceptions of health and what they need to improve it.

Methods

Setting Community HPP Voorstad on the Move (VoM) (July 2016-Jan 2020) in a district (+-11,000 inhabitants) in Deventer. Inhabitants’ socioeconomic status (SES), perceived health status and lifestyle are low relative to other city districts.

Study design: A qualitative study of 11 community groups (n = 89) participating in two focus groups. Concept mapping was used to cluster and prioritize health perceptions. Social Practice Theory (SPT) guided the analysis of needs to change health-related behavior.

Results

“We don’t assume that everyone has the same idea about health, do we?” (citizen)

Participants differed in age (16-82), cultural background (17% non-Dutch origin) and type of group activity. High-ranking dimensions of health are social relations, physical activity, a positive life attitude, healthy eating and empowerment. To improve health, social support from family and friends and self-confidence were the main needs. Physical impediments, (chronic) illness and financial aspects were also mentioned as barriers. The focus groups contributed to new activities as part of the VoM program facilitated by a health broker: e.g. a swimming group, biking buddies, social meetings.

Conclusions

Citizens perceive health as multidimensional, encompassing the physical and social environment, lifestyle behaviors, positive attitudes and being in control. Using SPT to unravel these needs in terms of meanings and competences helped to facilitate citizens’ active involvement in health-promoting activities.

Key messages

Low SES citizens perceive social relations, physical activity and a positive life attitude as important dimensions of health. Insight into citizens’ meanings and competences about health behaviors facilitates the development of health-promoting activities.
The relationship between sleep quality and nutrition of medical school students in a city of Turkey
Authors: Pehlivan E , Yalcin E , Firinci B
Published: November 2019

Background

Students need quality sleep and regular feeding during an intensive training proces. The aim of this study was to determine the sleep quality of Faculty of Medicine students and whether there is a relationship between sleep quality and eating attitudes and habits.

Methods

In this cross-sectional study; a face-to-face questionnaire was administered to 352 students who attending Inonu University Medical Faculty between January and March of 2019. The sample group is stratified according to class sizes (total 1665 students. The sleep quality and eating behaviors of students were questioned. For purpose, Pittsburgh Sleep Quality Index (PUKI, developed by Buysse et al,1989), and Eating Attitude Test (EAT,developed by Garner et al 1982) was used to assess quality and disorders. Kolmogorov Smirnov normal distribution test, Mann Whitney U and Kruskal Wallis test were used in analysis of the data.

Results

The mean age of the students was 21.5 ± 2.5 and 54.3% were female and 45.7% were male and 25.0% smoked cigarette. 64.4% of the study group had normal body mass index. The median value of the PUKI (cut of point is 5.0 and under 5 is good) score by gender is similar with 6.0 (1.0-15.0). The median value of the PUKI score was 6.0 (1.0-16.0) in social media / internet users and 5.0 (1.0-13.0) in non-users. According to Internet / social media users before going to sleep, the difference is significant (p: 0.016). The difference between cigarette smoking and median value of PUKI was significant (p: 0.029). there was a difference between classes in favor of upper classes in terms of EAT values (p = 0,046). 12.2% of the students are at risk of Blumia and 10.8% are at risk of Anorexia. There was no significant but positive correlation between the PUKI and EAT (p = 0.074, r = 0.096).

Conclusions

In general, the students’ sleep quality and eating attitudes and habits were found close to the cut-off points accepted by the tests. But blumia and anorexia is significant. This study was supported by the Research Fund of the Inonu University (No. 1792)

Key messages

Social media / internet usage of students before going to sleep affects sleep quality significantly. Although 64.4% of the students have normal body mass index, eating disorders (bulumia and anorexia) risk are noteable.
Misconceptions, not evidence guide occupational physicians’ decisions on legionellosis prevention
Authors: Riccò M , Balzarini F , Mezzoiuso A G , Colucci M E , Catellani W , Veronesi L , Corradi M
Published: November 2019

Introduction

Legionnaire’s diseases (LD) is a significant cause of community-acquired pneumonia. An increasing number of cases has been linked with occupational exposures. The aim of this study was understanding knowledge, attitudes and practices of occupational physicians (OPh) towards LD.

Methods

A questionnaire-based cross-sectional study (April 2019), collecting a convenience sample of OPh operating in the Parma Province. Knowledge status (KS), Risk Perception (RP), and actual participation to the LD risk assessment were assessed. Multivariate odds ratios (mOR) for factors associated with participation to the LD risk assessment were calculated by means of a binary logistic regression analysis.

Results

80 OPh participated to the survey (76.9% participation rate; mean age 48.2±11.2 years): even though the majority of them assisted at least one enterprise at potentially high risk for LD (i.e. 41.4% retirement houses, 27.1% water treatment plants including spas and pools, 25.7% hospitals) only 42.9% had participated to the LD risk assessment. The majority of OPh did not acknowledge diabetes (52.9%), cancer (65.7%), alcoholism (77.1%) as risk factors for LD, while a large share of OPh did not recognize hospital (50.0%), retirement houses (48.6%), swimming pools (48.6%) and spas (35.7%) as high risk environments. Moreover, participants underestimated both actual frequency (>1000 cases/year) and severity (lethality 10-15%) of LD in Italy, and occupational RP was not coincidentally low (43.2%±20.3). Participants reporting better KS were more likely to participate to the risk assessment (mOR 4.82 95%CI 1.06-21.94), while RP was eventually unrelated with preventive practices.

Conclusions

OPhs were diffusely affected by significant knowledge gaps on the actual risk factors for LD. Their misperceptions have the potential to negatively influence daily practice, impairing prevention of LD on the workplaces, and should be specifically targeted by information campaigns.

Key messages

Occupational Physicians were affected by significant knowledge gaps, particularly on individual and occupational risk factors for legionnaire disease. In order to better address the increasing threat of Legionnaire Disease, Occupational Physicians should be specifically targeted by information campaings.
Clear proceedings as workplace health promotion. Supervision and management tools in rural Uganda
Authors: Piccinni G , Putoto G
Published: November 2019

Health centres and supervision teams in rural/poor settings in developing countries are affected by limited resources, uneasy reporting to higher level of power and unclear proceedings to filling the gaps. Inconsistency in supervising visits lead to mistrust. Supervisees react with resistance or indifference. Supervisors react behaving as policemen. In Uganda, Oyam Health District, february-august 2018, actions were taken in order to solve conflicts, sustain quality, improve interactions. Sharing the concept and the implementing process could inspire colleagues engaged in workplace health promotion.

Key points were informed by direct observations, talks with staffs, literature review, ugandan Ministry of Health official directives and tools, NGO’s adaptations. Selected issues were discussed during two workshops held in april ’18 involving all the concerned staff: 100 people. Agreement reached, based on a 3 (gap-act-resp) 5 (0-4 grading) algorithm, re-designed tools were able to reduce aléa during inspections, grade the gaps, guide actions and to address the appropriate level of responsability. User friendly reporting formats, database and unicode for linkage were designed ex novo. Information flow was agreed with the Health District Authorities.

After the learning period, staffs felt empowered about resolving gaps and less stressed advocating higher authorities. Conflicts lost harshness. Satisfaction was captured by a self-filled anonymous questionnaire in june 2018 (n = 80, 12 core questions, 0-4 likert scale, mean >3, SD < 1, median= 4, open sentences positives). Quality improvements of health care services were measured by the Ugandan Ministry of Health independently.

Unclear targets, shortage of means, ineffective communication flows reduce quality and trigger frustration. Sustaining transparency, organizing communication flows and proceedings, sourcing staff’s experience could enhance success both in reaching targets and promoting relational health at workplace.

Key messages

Transparency, shared decisions, clear communication, awareness of the aims and mastership are able to reduce conflicts and misunderstandings, sustaining a healthier workplace relational environment. People spend 60 to 80% of their active time at workplace. Well designed tools, policies and information flows, could be effective health enhancer as well. Work style is a lifestyle.
The association between eating vegetables at start of meal and dental caries among Japanese children
Authors: Ito K , Isumi A , Doi S , Ochi M , Fujiwara T
Published: November 2019

Background

Dental caries is still serious problem among Japanese children. Previous studies suggested that higher consumption of vegetables prevent dental caries. Eating order habit, such as eating vegetables at start of meal, called “Vege-first”, may increase the amount of vegetable consumption, and in turn, prevent dental caries. However, no published studies have examined the impact of “Vege-first” habit on dental caries. The aim of this study to investigate the association between “Vege-first” and dental caries among Japanese children.

Methods

We used the 2015 cross-sectional data from the Adachi Child Health Impact of Living Difficulty (A-CHILD) study, a population-based study of all first-grade students in Adachi City, Tokyo, Japan. The number of DMFT (decayed, missed due to decay, and filled teeth) was used as an outcome. Poisson regression analyses were applied to determine the independent association between “Vege-first” habit and the number of DMFT after controlling for the effects from child’s sex, parents’ marital status, socioeconomic status, and frequency of tooth brushing, drinking sweet beverages, and snacking.

Results

Of 3,689 valid Japanese children participants, 38.2% had DMFT and 11.6% were having the “Vege-first” habit. The number of DMFT decreased linearly with “Vege-first” habit (p < 0.001). After controlled for covariates, the number of DMFT was still significantly and independently decreased with “Vege-first” habit (prevalence ratio=0.89 (95% confidential interval [0.81-0.98])).

Conclusions

This study showed that having the “Vege-first” habit was associated with dental caries even accounting for socioeconomic status, dental health behavior, and dietary habits. Health policy introducing “Vege-first” habit may be effective to prevent pediatric dental caries.

Key messages

Eating habit which vegetables at start of meal called “Vege-first” may increase the amount of vegetable consumption and possibly reduce dental caries. The habituation of Vege-first was likely to reduce child’s dental caries even accounting for socioeconomic status, dental health behavior and dietary habits.
Important factors to ensure wellbeing in a whole-school setting – a photovoice study
Authors: Ese J , Flobakk J , Castellan C , Ihlebaek C
Published: November 2019

Background

The whole-school approach focuses on promoting health and wellbeing for pupils, employees, and parents. In Norway, several schools are now developing such an approach and opening the school premises for community activities. The aim of this study was to investigate what pupils, employees and parents themselves experience as important factors to ensure wellbeing in a whole-school setting. More knowledge about such factors as perceived by the users could give important information in order to ensure health promotion in other schools wanting to implement a whole-school approach.

Methods

The participatory method Photovoice was used. Seven pupils, six employees, and four parents at Alvimhaugen Primary School, Norway photographed what they perceived as factors generating wellbeing at the school premises. The school is located in an area with challenges related to living conditions. The pictures were used as basis for six focus group discussions by the participants. All interviews were audiotaped, transcribed and analysed using Malterud’s Systematic Text Condensation and Drew & Guillemins framework for image analysis. The results were discussed within the framework of Sense of Coherence (SOC).

Results

The factors that emerged as important for wellbeing among all stakeholders were interconnected. Important factors were the built and natural environment, activities before/during/after school hours, and organisational characteristics. Further, these factors were associated with a sense of security, belonging, social support and manageability expressed by the stakeholders.

Conclusions

The factors identified are all known to be central in strengthening SOC. These factors are therefore important for promoting health, not only in pupils but also in employees and parents. The whole-school approach could contribute to address complex public health issues and wellbeing, and might be especially important in schools in deprived areas.

Key messages

The built and natural environment, activities before/during/after school hours, and organisational characteristics are all important aspects to ensure wellbeing in a whole-school approach. The whole-school approach could contribute to promote wellbeing, and might be especially important in schools in deprived areas.
Is medical ionizing radiation negligible or neglected? How to interact with patients?
Authors: Nicoulet I
Published: November 2019

Issue

Medical exposure is in France, the first source of artificial exposure of populations to ionizing radiation (IR). The use of ionizing radiation in diagnosis, (CT scan) is steadily increasing. With IR, nothing is visible, nothing is lost, everything is cumulative and transformed. How to explain it to patients and how to answer their questions? How, in this area, can patients become empowered?

The radiologists have already produced information materials for patients. Explaining the different types of exams is easy, explaining the dose is more complex; doses are not expressed with the same units. In addition, since the organs do not all have the same sensitivity to ionizing radiation, the addition of doses delivered does not always make sense. The comparison of doses delivered with the natural exposure to ionizing radiation makes it understandable. Specific awareness campaigns such as ’for lumbago radio, this is not always the right scenario’ were launched.

One of the main rule of radioprotection is the justification of the act in relation to the expected benefit. Both general practitioners and patients can influence the decision by asking simple questions. An awareness campaign on this theme is planned by HERCA (European HEad of Radiation protection Competent Authorities) in Europe in November 2019.

It aims to reduce inappropriate exams by breaking habits. It is aimed mainly to general practitioners.

Results

The French Nuclear Safety Authority will decline this campaign for both general practitioners and patients. This campaign is based on the most common questions such as: If I have already made a diagnosis, what is the added value of a radiological examination?Why should I have another radiological examination?Why refer my patient for an X-ray or CT if another examination can be done that does not use ionizing radiation?Why is it important to ask if pregnancy is a possibility?

Lessons

Illustrative documents will be presented at the congress

Key messages

Risks related to medical exposure to ionizing radiation are not sufficiently explained. A European campaign of recognized authorities and the involvement of patients should help reinforce the messages of the French campaign.
Children self-reports and Parent proxy reports of physical activity and sedentary behaviour
Authors: Sumonja S , Jevtic M
Published: November 2019

Background

Aim of this study was to determine agreement between parent proxy reports and children self-reports of physical activities and sedentary behaviour.

Methods

The sample included 7-10 year-old children and their parents (n = 188) in a local community in Northern Serbia. Data were collected by questionnaires designed to assess context-specific measures of children’s physical activity (outside play, organized sports) and sedentary behavior (TV viewing, using computer, playing electronic games). Children and their parents completed questionnaires separately. Agreement between children’s and parent`s responses was calculated with Cohen’s kappa. Differences in parent`s and children`s responses in relation to gender, grade and BMI were analyzed using χ2 test. Values p < 0.05 were considered statistically significant.

Results

Level of agreement between parents’ and children’s reports ranged from poor for variable TV viewing before going to school (κ = 0.21; p = 0.04) to substantial for variable physical activity before going to school (κ = 0.74; p = 0.00). Girls were more likely than boys to agree with parents about time spent playing on the computer after school (χ2=11.23;p=0.01). Overweight and obese children tended to report more time in TV viewing than their parents (χ2=26.4;p=0.01).

Conclusions

There are differences in reports of physical activities and sedentary behaviour between 7 to 10 year-old children and their parents The lowest level of agreement found for variable TV viewing indicates low awareness and control of this screen-based sedentary behaviour.

Key messages

Differences in parents’ and children’s reports of children’s physical activities and sedentary behaviour are confirmed. It should be taken into consideration in studies which use self-reports or proxy reports for assessing children’s physical activities and sedentary behaviour.
Health literacy and physical activity as buffers to counter act work related stress
Authors: Saboga-Nunes L , Guerra R , Madaleno P , Santos T
Published: November 2019

Background

Stress health problems affect 47.8% of the work force in Portugal. It is predicted that, in the next decade, these problems will overcome musculoskeletal disorders, the first cause of employee’s withdrawal from work. Research indicates connections between stress and dimensions of the work place (like job satisfaction). Nevertheless the conceptual understanding of these relationships is sparse. In order to better understand these relationships, this research focus on the use of job–specific models of stress, associating them with health literacy (HL) - in the context of the European Health Literacy Survey framework (HLS-EU) - and physical exercise.

Methods

A total of 748 participants from the different offices of a company in the financial sector (Portugal, main land and autonomous territories) participated in a cross sectional survey (CAWI). Age ranged from 25 to 65 years and HL was measured using the HLS-EU instrument validated to Portuguese (HLS-EU-PT). Each participant was allocated to one of the groups, either of satisfactory HL (when scores ≥30) or insufficient HL (when scores <30).

Results

Out of the 748 participants (58.7% males, average age of 39 years), 80.4% sometimes and very often experience stress and tension in the workplace. Less than one in every two (44.4%) practice physical activity several times a week. Of the participants, 7.1% have inadequate, 39.0% problematic, 36.6% sufficient and 17.3% excellent HL (HLS-EU-PT). Employees that are more active are those who experience lower levels of stress.

Conclusions

The research of the effects of HL combined with physical exercise, as buffer variables to problems related to the effects of work stress, is a new area of research that may help understand patterns of adherence to activities that can help workers deal with everyday working conditions. More research is needed to integrate HL strategies in the work place.

Key messages

Stress health problems affect 47.8% of the work force in Portugal. Employees that are more active are those who experience lower levels of stress.
Importance of Health literacy in magnesium supplementation - Case study Novi Sad, Serbia
Authors: Gajic J , Dimovski D , Vukajlovic B , Jevtic M
Published: November 2019

Background

Currently the market offers wide range of magnesium dietary supplements that vary either in their pharmaceutical dosage form (capsules, tablets, direct form, effervescences etc.), magnesium compound present (magnesium oxide, - chloride, -citrate,- bisglycinate, -acetyltaurinate etc.) their dosage (ranging from 150 to 400mg) or other vitamins and minerals present (vitamin B complex, vitamin C, zinc, manganese etc). Since the public can now choose to buy dietary supplements not only from pharmacies and specialized stores but from places such as supermarkets, cosmetic shops or even markets it is important to educate the public and help them make healthier choices.

Objectives

While providing primary health care services in public pharmacy, overall choices and reasons for buying magnesium supplements were noted during the first four months of 2019 (January to April). The goal was to investigate the most important factors patients consider when opting to take magnesium supplements as well as their health literacy regarding the topic.

Results

The results indicate that the currently most popular choices are mouth dissolving forms of magnesium (more than 50% units sold), and predominantly forms the magnesium oxide form (around 75%). It is suggested that the most important factors when choosing magnesium dietary supplements are its price, media presence, friends advice, general familiarity or even product design as very few the patients asked about the present form of the magnesium.

Conclusions

Magnesium dietary supplements belong to highly desirable supplements on the free market. It is observed that patients choice mostly doesn’t coincide with health authorities recommendations.

Key messages

Importance of health literacy and understanding the dietary supplement labels. Higher impact of sources of information other than healthcare authorities.
Seroprevalence of anti-Parvovirus B19 IgG in childbearing age women in Pleven region (Bulgaria)
Authors: Petkova T , Pachkova S , Doichinova T z , Aleksandrova-Yankulovska S
Published: November 2019

Background

Parvovirus B19 is a widespread infection in childhood. Seroprevalence of anti-Parvovirus B19 increases with age and about 60% to 70% of women of childbearing age have serological evidence of past exposure to virus. Diaplacental Parvovirus B19 infection in pregnant women can lead to anaemia, non-immune hydrops fetalis and foetal death. The aim of the study is determining the susceptibility to Parvovirus B19 in childbearing age women.

Methods

We conducted a prospective seroepidemiological study in which 90 healthy women of childbearing age (19 to 40 years) were tested during the period September-October 2018 in Medical Center “Clinical Institute for Reproductive Medicine”- Pleven, Bulgaria. Participants were surveyed on a voluntary basis. The exclusion criteria were: presence of autoimmune disorder, immunosuppressive states, malignancy and populations at risk such as persons under 18 years of age and pregnant women. The presence of specific Parvovirus B19 IgG was detected using a standardized anti-Parvovirus B19 (IgG) ELISA kit. The demographic and anamnestic data were collected for each participant in Case Report Form.

Results

The average age of the women was 31.4 ± 4.9 years. Dominating were women with higher education (52.2%) living in urban areas (92.2%). The survey results showed that 37.8% of women were positive for anti-Parvovirus B19 IgG, 61.1% were negative and 1.1% equivocal. Immunty to the virus increased from 27.3% to 45% with age. There was no significant correlation between the presence of antibodies and the demographic factors (living area, education and number of family members).

Conclusions

The results of this study imply that 61.1% of the childbearing age women in Pleven region are susceptible to infection with Parvovirus B19. Because of the high susceptibility to Parvovirus B19, active monitoring of risk groups pregnant women for the prevention of fetal complications is recommended.

Key messages

There is no specific treatment or prophylaxis against Parvovirus B19 infection and epidemiological surveillance requires the introduction of effective preventive measures at the public health level. Active monitoring in childbearing age women is necessary to reduce the risk of fetal damage and the cost of healthcare associated with the infection.
Hospital acquired infection, evaluation of point of prevalence in a 147 beds italian hospital
Authors: Gori F , Vonci N , Santoriello G , Quercioli C , Messina G , Sancasciani S
Published: November 2019

Background

Hospital Acquired Infections (HAI) have become a public health priority worldwide, leading to higher medical costs, prolonged hospital stays, and increased mortality. The point of prevalence analysis (PPA) of HAI and antibiotics (ATB) consumption is extremely relevant for its social and economic impact. Aim of this study is to evaluate the prevalence of HAI and to analyze ATB consumption in 147 beds hospital.

Material and Methods

This prevalence study was conduced on March 23, 2018, we analyzed the clinical documentation of 78 patients hospitalized in the Hospital of Val D’Elsa, Siena, Italy and searched for evidence of HAI and for all indication of ATB therapy in all hospital wards. HAI were defined according to guidelines of European Centers for Disease Control and Prevention (ECDC 4.2) using Stata 12.

Results

We analyzed a total of 78 patients (51,3% female), average age was 71,6 (sd ± 23,4) years, mean lenght of stay 7,2 (sd ± 7,9) days. Patients included in the study were recovered mostly in General Medicine ward (62,8%); 23% of patients underwent surgery. Fifty-one point three of patients had Peripheral Venous Catheter, 17,9% Central Venous Catheter and 47,4% Urinary Catheter. Three infections were discovered (PPA 3,8%); 2 HAIs were found in Medicine ward, the third one in the Intensive Care Unit. The chi-square test did not show statistically significant differences with the last year’s results in the same wards (p = 0.3305). Fifty-four percent of all patients received ATB, the most used class were third generation Cephalosporines (50%), followed by Carbapenems (19%) and Fluoroquinolones (7%).

Conclusions

PPA of HAI was 3,8%, comparable to last year’s (3,5%). This is a positive result when compared to regional and national point prevalence study realized by ECDC in 2012 (6,2% in Tuscany Region, 6% in Italy). Our analysis showed that ATB consumption was quite high: and it is in agreement with those provided by the Tuscany Region.

Key messages

in our hospital we report an excellent result about the pint of prevalence of hospital acquired infections 3,8%. The antibiotics consumption in our hospital is quite high, the most frequently used antibiotic class is the third generation Cephalosporines.
Surveillance of healthcare-associated infections in a Tunisian university hospital
Authors: Hannachi H , Ben Cheikh A , Bhiri S , Ghali H , Khefacha S , Dhidah L , Ben Rejeb M , Said Latiri H
Published: November 2019

Introduction

Healthcare -associated infections has become a worldwide public health problem. The aim of this study was to estimate the incidence of healthcare- associated infections in a university hospital of Tunisia.

Methods

This was a cohort study conducted in six intensive care units in a university hospital of Tunisia during three months (from august to October 2018). Data was provided from patients’ files. Data entry and analysis was done using SPSS version 22. Multivariate analysis was used in order to identify independent risk factors for healthcare associated infection.

Results

A total of 202 patients were enrolled in this study. The incidence rate of healthcare-associated infections was 53,96%(109/202). The ratio infection/infected was estimated to 1.65(109/66).

The incidence of multi-drug resistant pathogens was 21,28% (43/202). The most common resistant pathogens included pseudomonas aeruginosa resistant to cefdazidime in 13,76%(15/109) followed by those resistant to extended spectrum cephalosporin 11.92% (13/109), followed by carbapenem-resistant acinetobcater baumanii 6,42%(7/109) then by carbapenem resistant pathogens and enterococcus resistant to vancomycin 2.75%(3/109) and finally staphylococcus aureus resistant to methicillin 2.1%(2/1.83). The multivariate analysis showed that long duration of central line catheterisation (RR = 7.44; 95%CI[2.79-19.82]), tracheotomy(RR = 8.61;95%CI[2.09-35,39]) and length of stay (RR = 1.08; 95%CI[1.04-1.13]) were found as independent risk factors for healthcare -associated infection.

Conclusions

The emergence of mutli-drug resistant pathogens needs to be deeply studied and effective measures have to be taken in order to detect and prevent transmission of resistant strains and/or their resistance determinants, especially those with phenotypes having the fewest viable treatment options.

Key messages

The incidence of healthcare associated infection in the intensive care unit was high. Effective measures have to be taken in the intensive care unit to detect and prevent transmission of resistant pathogens.
Incidence study of surgical site infections in a large University Hospital in Rome, first results
Authors: Vallone D , Di Pumpo M , Gentili A , Tamburrano A , Berloco F , Corbo M I , Cambieri A , Damiani G , Ricciardi W , Laurenti P
Published: November 2019

Background

Surgical Site Infections (SSI) represent about a quarter of healthcare associated infections (HAI), increase the risk of mortality and hospital stay and extend healthcare costs. The aim of this work is to evaluate the incidence of SSI in patients undergoing surgical procedures of Hospital Units in the Fondazione Policlinico A. Gemelli IRCCS (FPG).

Methods

This descriptive observational monocentric study has a 30-months duration: the first phase was conducted between July 2018 and March 2019. Patients undergoing abdominal surgery procedures were enrolled. Active infection surveillance was performed, according to the ECDC, during the hospital stay and the surgical outpatient visits. We also performed a post-discharge surveillance (PDS) at 30 days (or 90 days if an implant has been inserted), through a telephone interview, made by a medical doctor resident in Public Health.

Results

During the first phase were enrolled 431 procedures in 2 Hospital Units, about emergency and hepatobiliary surgery. There were 53 cases of surgical site infection (SSI) highlighted in these procedures. Therefore, SSI’s were reported in 12.09% of the procedures. In particular, in 6.28% of cases, SSIs were diagnosed during the hospital stay. The results of this study showed statistically significant differences (p < 0.005) in incidence rate of emergency (10,70%) and hepatobiliary tract (13,17%) procedures. The average hospital stay was significant higher (p < 0.001) in patients who developed an SSI (17.27 days) than in patients without SSI (4.89 days).

Conclusions

These preliminary results show that the incidence rate of SSI for gastrointestinal procedures is similar to other European Countries (9.6%). The Hospital Health Management of FPG take care to the surveillance of hospital infections and monitor the correct application of the procedures, in line with the standards defined by Joint Commission International for guarantee high level in patients’ care.

Key messages

Performing a survey to measure the incidence of surgical site infections for surgery procedures is very important to define it and to improve surveillance systems of hospital infections in FPG. Active surveillance of surgical site infections may allow to enhance appropriate preventive measures.
A systematic review of email-based reminder interventions to increase vaccine uptake
Authors: Odone A , Frascella B , Balzarini F , Oradini Alacreu A , Signorelli C
Published: November 2019

Introduction

Reminder and recall interventions have been proven to be effective in increasing vaccination coverage. Emails are a popular mean of communication, and their use as a reminder method has many potential benefits: low costs, timely delivery and no restriction of content. Nevertheless, there is limited evidence that compares the advantages of using emails for vaccination reminders to other methods, on which extensive literature is already present.

Methods

We conducted a systematic review following the PRISMA guidelines to analyze evidence from peer-reviewed studies on the application of email-based interventions to immunization programs. We included any measure of vaccine uptake or immunization coverage, in any target population and settings.

Results

We included 11 studies in the final analysis, of which 9 were RCTs, 1 was a controlled trial and 1 a before and after study. Most studies were conducted in the US. Six studies had data on the uptake of influenza vaccination, three on HPV series completion, 1 on PPSV23, and 1 on vaccines recommended for adolescents. In 4 studies email reminders proved to be more effective in increasing vaccination uptake than no reminders. Five studies didn’t show advantages of using email reminders when compared to traditional methods (phone call, mail, paper card) and digital reminders (SMS, automated phone calls). In 1 study a significantly higher increase in uptake was achieved when combining emails with Interactive Voice Response phone calls. Finally, 2 studies compared different email models.

Conclusions

In conclusion, this review outlined that not enough evidence is available regarding the use of email reminders to increase vaccination uptake. Our findings suggest that the choice of reminder method should depend on the population, and future studies should analyze its cost-effectiveness and convenience in respect to other methods, and aim at improving the content of emails to increase their efficacy as a reminder method.

Key messages

Based on our review of available studies, not enough evidence is available to prove the efficacy of email reminders to increase vaccine uptake. Additional evidence is needed to analyze cost-effectiveness of email reminders, convenience in respect to other methods, and to improve their content to increase their efficacy as a reminder method.
Health professionals as parents are not immune to vaccine hesitancy – an Italian national survey
Authors: Fonzo M , Bertoncello C , Cocchio S , Zanovello S , Bennici S E , Baldovin T , Buja A , Napoletano G , Russo F , Baldo V
Published: November 2019

Vaccine hesitancy is a growing concern in many European countries, including Italy, as instanced by alarming results from Eurobarometer 488 dated April 2019. In the view of the current magnitude of the phenomenon, our aim was to investigate its determinants among parents, with a specific view on those working as health professional.

In 2017, parents of children aged 3-84 months were recruited online. Based on self-reported vaccine status and timeliness of vaccinations, parents were classified as pro-, hesitant, or anti-vaccine. The association between baseline characteristics and hesitancy was investigated with logistic regression adjusting for child’s and parents’ age, prematurity, presence of older children, previous vaccine adverse reaction in the child at issue, parents’ nationality, education and employment status, health profession of at least one parent, single parenting, vegetarian lifestyle and perceived economic security.

A total of 3,865 questionnaires were collected (64% pro-, 32% hesitant, 4% anti-vaccine). Families with at least one health professional as parent were 20% of the sample.

Vegetarian lifestyle (aOR 3.0; 95%CI 2.20-4.08), unsatisfactory (aOR 1.67 95%CI 1.08-2.58) and partially satisfactory perceived economic security (aOR 1.40; 95%CI 1.09-1.78) and previous vaccine adverse reactions (aOR 1.25; 95%CI 1.05-1.48) were associated with vaccine hesitancy, while having older children resulted as a protective factor (aOR 0.82; 95%CI 0.69-0.98). No significant association was found with other abovementioned variables, including parent employed as health professional (aOR 0.99; 95%CI 0.81-1.22).

Vaccine hesitancy seems to be part of a lifestyle choice and, to a smaller extent, associated with previous vaccine adverse reactions and lower socioeconomic status. Interestingly, parents’ level of education and employment in healthcare do not affect vaccine acceptance. The latter poses a challenge, given their crucial role in promoting vaccination.

Key messages

Hesitancy is associated with lifestyle choices, experience of adverse reactions and socioeconomic status, while education and employment as health professional seem not to be relevant. Whether they are health professionals or not, parents’ attitude towards their child’s vaccinations is the same.