bluuebunny/crossref_metadata_2025 huggingface dataset:
Results of the 1:1-matching of the CTC-EFF study: A non-randomized evaluation study
Authors: Röding D , Soellner R , Birgel V , Groeger-Roth F , Brender R , Reder M , Feierabend N , Kleiner C , Walter U
Published: October 2021

Background

In Germany, more and more communities are implementing the U.S. approach “Communities That Care (CTC)” to prevent youth problem behavior. To evaluate the effectiveness of CTC, we planned a prospective natural experiment. This required the development of a specific novel recruiting and matching procedure. In this talk, we examine the ability of our procedure to achieve base-line equivalence regarding the matching characteristics.

Methods

The matching procedure is based on community-level data from official statistics 2017 (www.inkar.de) and police crime statistics 2019. From April 2019 to January 2020, we recruited communities that are implementing CTC (intervention communities, IC). For each IC, we recruited a matched community in the same federal state not using CTC (comparison community, CC). To examine whether the ICs (n = 15) and the CCs (n = 15) are equivalent, chi-square tests were performed for categorical variables and Mann-Whitney U tests for metric variables.

Results

The following are preliminary results. Of the ICs/CCs 10%/7% are large cities, 25%/29% medium-sized cities, 40%/43% larger towns, 15%/14% smaller towns, and 10%/7% rural communities (p=.995). Regarding the community development of ICs/CCs 10%/21% are shrinking, 5%/14% stable, 55%/36% growing and 30%/29% strongly growing (p=.533). The mean fiscal power (€per capita and year) of the ICs/CCs is 1,150€/770€(p=.192). The mean long-term unemployment rate is 1.19% in ICs and 1.03% in CCs (p=.726). The average annual prevalence of violent crime per 100,000 inhabitants is 1.67 in ICs and 1.78 in CCs (p=.690). Prevalence of shoplifting per 100,000 inhabitants is 3.4 in ICs and 3.5 in CCs (p=.389).

Conclusions

The results show that ICs and CCs are equivalent with respect to matching characteristics.

Key messages

The developed novel recruiting and matching procedure is appropriate for enrolling communities in non-randomized trials. The CTC-EFF study evaluates the effectiveness of CTC in Germany for the first time.
Dermatoglyphic markers as predictors of high blood pressure in young soccer players
Authors: Argüello-Gutiérrez YP , Castro-Jiménez LE , Sánchez-Rojas IA , Aguirre-Rueda DM
Published: October 2021

Background

Finger dermatoglyphics has been used as a genetic marker that contributes to the detection of sports talents and the establishment of predisposition to develop physical capacities. Additionally, it has begun to venture as a strategy in the early detection of risk factors for the development of chronic non-communicable diseases (CNCD), with arterial hypertension being one of the least studied factors in athletes; since its prevalence is < 3%, and it has been associated primarily with lifestyle. Therefore, the objective of this study was to know the correlation between the dermatoglyphic characteristics and the increase in blood pressure (BP) in young soccer players.

Methods

Analytical study. The sample was 86 male soccer players between 18 and 26 years of age; the case definition was soccer players with high blood pressure according to the AHA classification. Controls were those with normal blood pressure. The dermatoglyphic profile was scanned according to the Cummins and Midlo protocol on the 10 fingers of the hands. Statistical analyzes were processed in SPSS 25.0, at a significance level of p ≤ 0.05. The quantitative variables were evaluated with the Shapiro-Wilk test, the non-parametric with Mann-Whitney and the qualitative with the chi-square test.

Results

The Shapiro-Wilk test detected an abnormal distribution of the crests of the fingers index and atrial of the right hand (RH); of the index and middle fingers of the left hand (LH), and the summation of crests - SQTL of LH. In addition, a significant intergroup difference in all fingerprint patterns (arches, loops and whorls). Finally, a substantial difference for the fifth finger LH; fourth and fifth finger RH, and ulnar loops is more frequent in atrial LH, in annular and atrial RH in the high BP group.

Conclusions

Dermatoglyphics are suggested as a marker for the early diagnosis of elevated BP in young athletes.

Key messages

Dermatoglyphic patterns are a marker for the detection of high BP in young soccer players. Early detection of risk factors reduces the incidence of CNCD.
Does parents’ educational level affect children's sedentary behaviour? A cross sectional analysis
Authors: Sanmarchi F , Soldà G , Salomoni MG , Gribaudo G , Capodici A , Marini S , Masini A , Dallolio L , Ferretti F , Arrichiello F
Published: October 2021

Background

Evidence links sedentary behaviours (SB) with poorer health outcomes; i.e. higher screen time is associated with poorer fitness and cardiometabolic health, as well as unfavourable measures of adiposity, mental health and social behaviour in children. The WHO guidelines for children recommend reaching at least an average of 60 min per day of physical activity (PA). Several studies show a correlation between parental education (PE) and children PA levels. This study aims to analyse the influence that PE has on childrens' sedentary lifestyle and PA habits in Italian society.

Methods

We conducted a cross-sectional analysis among 428 children aged 6-11 recruited in a primary school of Calderara di Reno (Italy) in 2017. Children's and parents' information were collected at baseline (i.e. age, BMI, occupation, instruction). PA level and SB were evaluated using a weekly diary investigating screen time (PC and TV), sports practice and active play (i.e: running, jumping, riding a bike, etc.). We investigated the relationship between lifestyles and PE (high school degree or lower vs college degree or higher) through multiple linear regression models adjusted for age and gender.

Results

Our models show that fathers' educational level is not related to children's SB. PA habits and weekly sports activities are not related to PE. On the other hand, higher mothers' educational level shows to be linked to a decreased TV screen time (p = 0.003) and time spent using a computer (p = 0.035). Notably, older children spend more time using PCs or devices (p = 0.001), net of confounding variables.

Conclusions

Our findings show that mothers' educational level positively influences children's lifestyle. This result might be related to the fact that, in the Italian context, mothers are usually the principal children's caregiver influencing their daily routine. In light of this, mothers might be considered a primary target when implementing public health interventions to reduce children's SB.

Key messages

Higher mothers’ educational level is positively associated with healthier lifestyles in children, in particular in determining a less sedentary behaviour. Fathers' degree of education does not display any impact on children's attitude toward sports and PA.
What is a relationship between BMI and life satisfaction?
Authors: Gugushvili A , Jarosz E
Published: October 2021

Purpose

In this study we investigate whether individuals' BMI categories are associated with life satisfaction (LS), how this association is affected by the social comparison that individuals make, and what the role of the overall BMI levels in this process is.

Methods

We use data for 21,577 men and 27,415 women, collected in 2016 by the European Bank for Reconstruction and Development, from 34 countries in Europe, the Middle East, and Central Asia. To mitigate a selection bias into specific BMI categories, we use inverse-probability weighted regression-adjustment estimators. To understand the moderating effect of contextual environment we use multilevel mixed effect logistic regression models and data for national, regional, and cohort-specific BMI levels.

Results

We find that the association of BMI and LS differs by gender, with overweight men reporting higher LS than men with normal weight, and obese women reporting lower LS than women with normal weight. For contextual effects, we find that in the regions with low BMI levels underweight men have higher LS than underweight men in regions with high BMI levels. As for women, the effect of obesity on LS is not observed in regions with overall high BMI levels. Conversely, obese women in regions with low BMI levels report lower LS.

Conclusions

Our study adds additional nuance to the quality-of-life research by showing that the association between BMI and LS is, at least partially, moderated by the contextual environment, and that the character of these effects differs by gender.

Key messages

The association between BMI and LS is moderated by the contextual environment. The character of these effects differs by gender.
Implementing a diversity sensitive curriculum in medical education – challenges and potentials
Authors: Sorensen J , Langer Primdahl N , Nørredam M , Krasnik A
Published: October 2021

Background

Migrant and ethnic minority populations in Europe are growing, consequently increasing the need for the health systems and health educations to adapt to an increasingly diverse population with diverse needs. Improving health professionals' diversity competences has been proposed as one of the solutions to tackle inequalities in health between different ethnic groups and ensure that all patients receive the care that they need. The objective of this study was therefore to investigate potentials and challenges for implementing diversity competences in medical teaching programmes.

Methods

Four focus groups interviews and one individual interview was conducted with three groups of stakeholders: medical students, course leaders and newly graduated medical physicians. The focus group and individual interviews were conducted physically and digital and one focus group used both. The interviews had a duration between 30-90 minutes and informed consent was obtained from all participants. The data was transcribed and were coded using content analysis.

Results

6 main themes and 14 sub-themes were identified in the analyses. One theme indicated that there was a general wish for more focus on diversity competences in the curriculum. Other themes pointed to challenges regarding competing priorities in the context of medical education, a condescending discourse about social and humanistic medicine and lack of support to medical students regarding challenges in relation to migrant and ethnic minority patients in the clinical settings. Another major theme focused on medical teachers' challenges when teaching a diverse classroom.

Conclusions

Our results showed that action in this area is needed. The themes indicated that many opportunities to implement diversity competence in curriculum exist, but also illuminated the challenges. The results suggested a need for focusing on individual competences for medical teachers and students, but also for organisational change.

Key messages

A widespread interest for implementing diversity competence in curriculum, but competence development for teachers is also needed. Important to focus on individual competences, but also on organisational change.
Students' self-assessment on the influence of research on their education in medical schools
Authors: Abduazhitova AM , Akanov AB , Koikov VV , Aubakirova AS , Otargalieva DD
Published: October 2021

Background

The reform of medical education and the introduction of the Bologna process into the higher medical school of the university changed the views on the research component in the process of studying a student in Kazakhstan following the principles of Soviet teaching of a medical school student.

Methods

A questionnaire was developed based on the AGREE methodology. The questionnaire is posted on the SurveyMonkey online questionnaire resource. A total of 1,439 university's students participated in the survey.

Results

About 85% of students in medical schools of universities in Kazakhstan agree on the trinity ‘science - education - practice' - the main principle of teaching students. When answering the question “Teachers at the university, when conducting lessons and lectures, always provide information about new research results,” 63% of respondents agree with this. About 77% of students believe that research is of high quality at the university. 78% of respondents noted the availability of research infrastructure at the university. About 80% of the respondents answered positively to the question of the relevance of research topics at the university. Students' participation in the research was assessed by them at a low level (about 45% of positive answers versus 51% of negative answers).

Conclusions

Analysis of the current situation on student participation in research in medical schools of universities in Kazakhstan shows an insufficient level of student involvement in research activities and an insufficient commitment of universities to the principle of the trinity of science, education and practice. Students who are actively and productively engaged in research have professional competencies in using the acquired knowledge, skills and abilities in practice than their colleagues who are not involved in research.

Key messages

The insufficient level of student involvement in research activities reflects the insufficient commitment of universities to the principle of the trinity of science, education and practice. Early involvement of students in research allows to generate their professional competence ispolzovanieya acquired knowledge and skills in practice.
Gender-differences in outcomes of patients in Intensive Care Unit: findings from the SPINUTI network
Authors: Favara G , Barchitta M , Maugeri A , Rapisarda G , Vinci R , Mura I , Agodi A ,   SPIN-UTI network
Published: October 2021

Background

Achieving gender equality is one of the most important Sustainable Development Goals to guarantee health and wellbeing worldwide. Here, we aimed to assess gender-differences in risk factors and outcomes among patients admitted to Italian Intensive Care Units (ICUs).

Methods

Here, we included 12,534 patients from the “Italian Nosocomial Infections Surveillance in Intensive Care Units” (SPIN-UTI) project, who stayed in ICU for more than 48 hours. Firstly, characteristics at ICU admission were compared between males and females using the Mann-Whitney U or the Chi-Squared tests. Next, we compared the probability of death between genders by applying a logistic regression analysis. Results were adjusted for covariates (i.e., age, patient's origin, trauma, non-surgical treatment for acute coronary disease, surgical intervention and presence of intubation) and reported as Odds ratio (OR) and 95% Confidence Interval (CI). Finally, the Kaplan-Meier analysis was applied to assess gender difference in survival.

Results

Compared with male patients, females were older, more likely to come from other wards or healthcare facilities and to undergo a surgical intervention (p-values<0.05). By contrast, they were less likely to be intubated or traumatized and to undergo non-surgical treatment for acute coronary disease (p-values<0.05). Interestingly, a higher proportion of deaths was reported in female patients (p < 0.001), so that their odds of dying was 13% higher than males (OR = 1.13; 95%CI=1.00-1.28; p = 0.046) after adjusting for covariates. Accordingly, females reported lower survival in ICU than males (median= 32.0 days vs. median= 34.0 days; p < 0.001).

Conclusions

Our results pointed out gender-differences in patients' characteristics at ICU admission, which resulted into a higher risk of death and lower survival among females. In a Public Health point of view, these findings underline that is still important to sustain gender equality in ICUs and other hospital wards.

Key messages

There are several gender-differences in risk factors and outcomes among patients admitted to ICUs. Gender poses per se a higher risk for death in ICU, also considering other risk factors.
Behavioural change intervention for re-framing antenatal education to make “every contact count”
Authors: Middleton N , Kolokotroni O , Christodoulides V , Hadjigeorgiou E , Nicolaou C , Papadopoulou M , Kouta C , Karanikola M ,   Baby Buddy Forward team and Associated Partners, Erasmus+, Limassol, Cyprus
Published: October 2021

Issue

A trusted source of information, the Baby Buddy webapp was co-created with parents and professionals to support the educational role of maternal healthcare providers. However, providers in Cyprus and elsewhere may not actively engage in antenatal education (AE) to make “every contact count”.

Description of Problem

The impact of Public Health digital interventions can be maximized when adopted in care pathways. To define barriers and enablers in behavioural terms complimentary methods were used guided by the COM-B model and related Theoretical Domains Framework: questionnaire survey (N = 49), focus group (N = 11) and round-table workshops (N = 40) among in-training and registered midwives.

Results

Beliefs about the benefits of AE are strong and viewed as a core function of the professional role, yet not supported nor prioritized by current practice. Many problematic areas relate to organizational context, such as weak interprofessional collaboration and lack of policy, protocols and resources. Medicalization of birth and socio-cultural norms are sustaining alienation of the midwife and conditions of power dynamics. AE was perceived as a means to enhance the autonomy of the profession but the phenomenon is complex and also pertains to perceptions and behaviours of service users. There are also issues with procedural knowledge and the need for skill development was identified.

Lessons

As a digital tool, Baby Buddy can enrich the user-provider exchange. However, AE beyond the formal setting of the antenatal class is perceived to be a ‘bad fit' with current practice. Training (e.g. skills strengthening), persuasion (e.g. reflection on professional identity), enablement (e.g. protocols) were identified as promising intervention functions. Modelling was identified as the most promising both in terms of “credible models” for the role itself as well as re-framing the concept of AE not as preparation for childbirth but in the context of shared decision-making.

Key messages

Barriers to being an effective antenatal educator are several, originating from an unsupportive system and wider socio-cultural norms of users and providers. In addition to designing a theory-driven research-informed intervention, the process functioned as a participatory learning experience through collective reflection.
Creating healthy food environments in family childcare settings
Authors: Kunkel K , Schroeder M , Jones R , Anderson D , Lien K
Published: October 2021

Background

Considering nearly two-thirds of preschool children in the United States are in some form of child care, child care settings are an opportunity to improve the food environments and reduce the risk of obesity in young children. University of Minnesota Extension developed a culinary nutrition education training for family child care providers. This is relevant for other countries whose child care system includes caring for children in home or center settings that prepare food for children.

Objectives

Start Strong: Cooking, Feeding and More (SS), consists of four two-hour culinary nutrition education sessions for family providers. The overall goals of SS are to 1) increase providers' knowledge and skills to procure and prepare healthy foods for children and 2) increase providers' knowledge and understanding of Federal food assistance programs to share the information with food-insecure families. Each session includes a cooking skill, nutrition topic, and food assistance program.

Results

Twelve rural participants who self-identified as female, non-Hispanic White participated in the SS sessions and completed pre, post, and three-month follow-up surveys, to assess the impact of the program on providers' knowledge, confidence, and practice. Based on the paired samples t-tests between pre-to-post and pre-to-follow-up surveys, there were statistically significant increases in providers' confidence in preparing whole grains, using beans and low-cost protein sources, and cooking techniques to reduce. The increase in confidence using cooking techniques to reduce salt was still statistically significant three months after the training. The providers' awareness of Federal food programs between pre-post increased and three months later increased.

Conclusions

SS increased family child care providers' skills and confidence to prepare healthy foods for children in their care. This increases the likelihood children will make healthy choices now and in the future.

Key messages

Start Strong is a culinary nutrition education training for family child care providers. Start Strong improves providers’ knowledge and skills to prepare healthy foods for children in their care.
The Effect of Spousal Military Deployment during Pregnancy on Birth Outcomes: A Systematic Review
Authors: Morris K
Published: October 2021

Background

Stress experienced during pregnancy is associated with adverse birth outcomes including pre-term delivery and low birth weight. Pregnant spouses and partners of deployed military personnel can experience heightened stress due to several factors associated with the military lifestyle which may increase the risk of pre-term delivery and low birth weight. This systematic review aims to establish the potential effect of spousal deployment on birth outcomes in a population who have increased psychosocial risks for birth complications.

Methods

A systematic review following the PRISMA guidelines was conducted of English language literature to assess the effect of deployment on the birth outcomes (pre-term delivery <37 weeks; low birth weight < 2500g) of babies born to partners of serving military personnel who were deployed at the time of delivery. Comparison was made to pregnant women whose military partners were not deployed at the time of delivery. EMBASE, Medline, Global Health, Web of Science and PubMed databases were searched for relevant articles using a keyword Boolean search strategy. A quality review and risk of bias was conducted on each of the three included studies.

Results

Three cohort or cross-sectional studies fulfilled the eligibility criteria. Each study was conducted in the US military, involved a total of 11,028 participants and were published between 2005 and 2016. Evidence suggests that spousal deployment may be a risk factor for pre-term delivery. No association between spousal deployment and low birth weight was found.

Conclusions

Pregnant partners or spouses of deployed military personnel may be at increased risk of pre-term delivery. There is a paucity of rigorous research in this area and more research is required to help inform healthcare professionals of the needs of this cohort of women and whether tailored public health interventions are required to reduce the risk of adverse birth outcomes in this population.

Key messages

Pregnant partners or spouses of deployed military personnel may be at increased risk of pre-term delivery due to psychosocial factors associated with the military lifestyle. Stress is a risk factor for birth complications. More research involving military spouses is required to understand the antenatal needs of this population.
Socioeconomic inequalities in health among Armenian adolescents: the role of bullying perpetration
Authors: Torchyan A , Bosma H , Houkes I
Published: October 2021

Background

Bullying perpetration might be an alternative way of hierarchy formation among adolescents. It can potentially suppress the socioeconomic inequalities in health or might compensate for the negative health influences of low socioeconomic status (SES), rewarding this unwanted behavior.

Methods

A nationally representative sample of 3679 adolescents aged 11-15 years participated in the Health Behavior in School-aged Children 2013/14 survey in Armenia. Complex samples multiple logistic regression were used to estimate the associations between two SES measures (family socioeconomic position [SEP], material well-being) and three health outcomes (perceived health status, psychosocial well-being, psychosomatic symptoms).

Results

Bullying perpetration was not associated with less than good health or low psychosocial well-being (P > 0.05) but increased the odds of reporting high psychosomatic symptoms (P < 0.05). Perpetration did not change the SES-health gradient substantially. However, in stratified analyses, socioeconomic inequalities in health were consistently weaker among perpetrators. The largest observed difference was in the relationship between low family (SEP) and less than good health (OR = 3.60, 95% CI = 2.77-4.67 vs. OR = 1.80, 95% CI = 1.06 - 3.04), whereas the smallest difference was in the relationship between low family SEP and high psychosomatic symptoms (OR = 1.27, 95% CI = 1.03-1.56 vs. OR = 1.04, 95% CI = 0.61-1.77).

Conclusions

Our findings suggest that bullying perpetration, as an alternative hierarchy, may be looked at as a compensatory but vicious strategy in the face of the negative health influences of low SES in Armenian adolescents. For high-SES adolescents, on the other hand, social, emotional, or psychological problems might contribute to bullying perpetration.

Key messages

Less vicious alternatives to bullying perpetration should be encouraged, especially for Armenian adolescents from low-SES families. Targeted health interventions might be necessary for bulling perpetrators from high-SES families.
Prolonged pregnancy, incidence and morbidity
Authors: Bannour I , Bannour R , Chahed S , Khairi H
Published: October 2021

Background

The classic term for a pregnancy is between 37 and 42 weeks of amenorrhea. In fact, the literature has shown that exceeding the term (LD, 42WG) is the cause of many maternal-fetal complications despite close monitoring and appropriate management. A new rigorous and adapted management is essential in view of the materno-fetal prognosis.

Objectives

To describe the complications and risks associated with exceeded pregnancies and to propose a new strategy indicating an appropriate course of action.

Patients and Methods

This is a retrospective study of 50 women who gave birth at 42 WG or more at the Maternity of the Farhat Hached University Hospital Center in Sousse.

Results

the average age of our patients was 30.56 years old, 70% of which were primiparous, 82% of our patients were monitored between 41 and 42 WG. Fetal complications demonstrated in our results were increased by macrosomia in 54% of cases, pathological FHR during labor in 48% of cases, fetal distress in 26% of cases. In addition, maternal complications were increased by cesarean delivery in 48% of cases, perineal tears in 40% of cases and forceps delivery in 20% of cases.

Conclusions

By comparing the expectation under supervision to induction of labour at 41WG, we concluded that induction of labour reduces maternal-fetal outcomes in a remarkable way. A new management including systematic induction of labour at 41 WG is essential to prevent complications and guarantee a reassuring maternal-fetal prognosis.

Key messages

Exceeding the classic term for a pregnancy may cause maternal and fetal complications. A new management including systematic induction of labour at 41 WG is essential to prevent complications and guarantee a reassuring maternal-fetal prognosis.
Early support: Evaluation of the pilot projects and the development of an implementation model
Authors: Mairhofer S
Published: October 2021

Early support is an overall concept of health promoting and preventive measures for families with children up to 3 years. This includes direct interventions for children as well as offers and measures for parents and other caregivers. Based on a first research project, which showed that health and social services are repeatedly confronted with stressful family situations, but that families are often only supported late or too late, there were implemented two pilot projects in an urban and rural area of Northern Italy (called South Tyrol). The projects were evaluated using a multimethod approach, analysing existing documentation, and through focus groups, interviews, and qualitative questionnaires. The results of all the different research methods show very uniformly that many professionals and responsible persons were insufficiently informed about the health promotional and preventive potential of early support and about the importance of a good collaboration and network for a healthy start in live at the beginning of the projects. It took two years of intensive process to improve cooperation, but also knowledge and competences in this area. Through the intensive coordinated cooperation in a core team of public social and health services and psychologists (family counselling), a significant improvement could be achieved not only for these members of this core team, but above all also for the entire departments of the collaborating services. Professionals reported that not only has the quality of their work improved significantly because of this process, but there is also a noticeable lightening of the workload, which must be of great importance in the burdening fields of social and health services. Building on the results of the evaluation of these projects a model was developed of how a system of early support that accompanies families in a healthy start can be implemented in the whole region. The implementation is approved for 2022.

Key messages

The aim of early support is to build systems to strengthen and support all families preventively. Interdisciplinary cooperation in early support teams led to improved quality of work and lower workloads.
Adolescent girls’ recommendations for designing Human Papillomavirus Vaccination Program in Pakistan
Authors: Ali RF , Offeddu V , Siddiqi DA , Mirza A , Naz N , Abdullah S , Lim JM , Kembhavi G , Tam CC , Chandir S
Published: October 2021

In Pakistan, cervical cancer is the third most frequent cancer among women. Most cases are caused by sexually-acquired infection with human papillomaviruses (HPV). Vaccination of adolescent girls against HPV significantly reduces the incidence of cervical cancer. HPV vaccination is available in Pakistan, but plans to develop a HPV vaccination program are currently at a very early stage. We conducted a formative study to explore adolescent girls' perspectives on HPV and cervical cancer, and collected their recommendations for implementing an HPV vaccination program. We conducted qualitative focus group discussions (FGDs), with unmarried adolescent girls aged 16-19 years, residing in Karachi. We conducted four FGDs with 12 participants each. The topic guide assessed i) girls' knowledge of cervical cancer and HPV vaccination, ii) vaccination decision-making dynamics within families, and iii) factors girls would consider essential for the successful implementation of HPV vaccination program. Overall, participants displayed a positive attitude towards the HPV vaccine. However, many basic concepts related to female reproductive health were unfamiliar to them. Female relatives were indicated as girls' preferred point of contact for discussions on HPV and cervical cancer, but fathers were portrayed as the definitive decision-making authority on vaccination. Girls gave critical input for the development of a HPV vaccination program. Eligible girls should be recruited through individual household visits and the vaccine should be administered at community-based camps, which would ensure both good accessibility and a large outreach. A solid foundation of trust between girls' families, program managers, and other stakeholders emerged as a key asset for the program's success. Adolescents demonstrated great capacity and shared recommendations for a future program's acceptability. Integrating their perspectives will be essential to design an effective program in local context.

Key messages

Adolescent girls’ perspectives should be incorporated to develop context-specific recommendations for the implementation of a HPV vaccination program. Community-based camps and household visits by adolescent girls to recruit the target population could potentially increase program penetration among communities.
The Level of Cyber-Ostracism and Self-Esteem in Medical Faculty Students
Authors: Oktar D , Unsal A , Arslantas D , Mutlu A , Oznur Muz FN
Published: October 2021

Background

Social media, which has become an indispensable part of our lives in recent years, is important for young people to socialize in online groups and to develop their self-esteem (SE). One of the dangers of increased use of social media is cyber ostracism (CO), defined as not being able to join a group and being ignored on social media. In the study, it was aimed to evaluate the level of CO and SE in medical faculty students.

Methods

This is a cross-sectional study conducted on students of Eskişehir Osmangazi University Faculty of Medicine in 2021 spring semester. The questionnaire prepared based on the literature was filled out online by the participants. The study group consisted of 1092 (70% response rate) students who agreed to participate in the survey. The CO Scale was used to assess the level of CO, and the Rosenberg SE Scale was used for the assessment of SE. Mann Whitney-U test, Kruskal Wallis test, Spearman correlation analysis and Multiple Linear Regression analysis were used to analyze the data.

Results

In the study group; 593 (54.3%) were female. Their ages ranged from 17-27, with a mean of 21.6 ± 2.0 years. The scores obtained from the CO scale ranged from 14 to 70, with an average of 24.8 ± 9.9 points. A moderate positive correlation was found between the scores the students got from the CO Scale and the SE Scale (r: 0.49, p: 0.001). Multiple Linear Regression analysis showed that; living in an extended family, not sparing time for hobbies during the day, having a type-A personality, poor face-to-face communication with peers, negative evaluation of parental attitudes, age at first use of smartphone below years 12 or less, use of smartphones for 5 hours or more a day, and Creating membership in social media by hiding their identity was a predictor for CO (F: 30.338, R2: 0.212, p < 0.001).

Conclusions

It can be said that CO is at a moderate level in medical faculty students. An inverse relationship between CO and SE was found in the study.

Key messages

İt’s recommended to plan more comprehensive studies on CO which is a new concept for digital health. Public health policies to reduce the level of CO may contribute to higher SE in future physicians.
Housing environmental and design attributes and psychoneuroimmunology profiles – a systematic review
Authors: Hernandez-Garcia E , Chrysikou E
Published: October 2021

Background

Psychoneuroimmunology (PNI) indicators, with the central role in low-grade systemic inflammation, are associated with major psychiatric disorders and late effects post-cancer treatment. Immune disturbances might mediate the effects of environmental determinants on the behaviour and mental disorders. Therefore, our primary objective is to evaluate whether the exposure to household environmental attributes can trigger PNI biomarker level changes, and to what extent a set of architecture parameters influence on the spatial dynamics of environmental variables.

Methods

A restricted systematic review is employed to generate knowledge synthesis about housing and mental recovery for the COVID-19 context in a resource-efficient manner. This review is conducted in accordance with the Cochrane Handbook guideline and PRISMA statement. We searched in Medline, EMBASE, Web of Science, Scopus, the Cochrane Library and Google Scholar. Included studies need to be peer-reviewed, written in English and meet pre-defined eligibility criteria. Observational or intervention studies investigating the effects of either environmental determinants within home environments -air pollution, thermal comfort, lighting, electromagnetic fields, noise and nature- using objective metrics or housing design, or combination with a set of circulating biomarkers in PNI and correlate gut microbiome composition are included. Quantitative measures of mental morbidities common in the cancer survivorship are included as secondary outcomes. Study eligibility and quality assessments are carried out by one team member and verified by a second reviewer. A descriptive analysis is conducted.

To the best of our knowledge, this review is the first to systematically explore and integrate the evidence available on the association multifactorial and dynamic of housing environmental and design attributes with immune and microbiome mechanisms.

Key messages

Disease surrogate markers based on systems biology and PNI approaches may help understand multi-level and multi-directional interactions among neuroimmune-microbiota function and housing exposure. This timely study contributes to understand if household environmental and architecture parameters might facilitate cancer rehabilitation via home design, restoring mental-physiological functions.
Psychological impact of COVID-19 on healthcare leaders in Friuli-Venezia Giulia, Italy
Authors: Scarpis E , Bravo G , Cocconi R , Brunelli L
Published: October 2021

Introduction

The current pandemic scenario may cause psychological distress among healthcare workers (HCWs). Although several studies highlighted this issue as particularly affecting frontline HCWs, no data are available regarding professionals dealing with the governance of healthcare organizations. This study aims to assess the psychological impact of COVID-19 on healthcare leaders (HeLs).

Methods

A cross-sectional study was carried out between October and November 2020, among HeLs working within Friuli-Venezia Giulia healthcare system (Italy). HeLs included: heads of surgical or medical department, deans of hospital, heads of doctors and nurses working at regional level or in hospital/community settings. We collected demographic data and assessed the presence of depressive (DS) and anxiety symptoms (AS), perceived stress (PS) and insomnia using internationally validated tools. Relationship between mental health outcomes and professional role was analysed using nonparametric tests.

Results

A total of 48 HeLs participated; their mean age was 53.4±7.9, women were 56.3%. Most (45.8%) were heads of department, 16.7% deans of hospital, 8.3% heads of doctors, 29.2% heads of nurses. The majority (60.4%) worked in hospital setting, 22.9% in the community and 16.7% at regional level. The prevalence of DS and AS was 14.6% and 12.5%, respectively. Moderate insomnia was found in 12.5% of HeLs, while severe insomnia in 6.3% of them. The 45.8% of HeLs showed moderate level of stress, whereas 4.2% high level. PS was significantly higher among deans of hospital. Moreover, lower PS correlated with lower DS, AS and insomnia (p < 0.05).

Conclusions

The high level of perceived stress, insomnia, depressive and anxious symptoms experienced by HeLs shows another issue of the COVID-19 pandemic psychological impact. Considered the key role of HeLs in leading healthcare organizations over the current crisis, mental health of these professionals is a major issue that needs higher attention.

Key messages

Psychological impact of COVID19 not only affects frontline HCWs, but also the professionals who are leading healthcare organization through the crisis. Promotion of mental well-being among HCWs should be improved at all levels of healthcare organizations, ensuring a healthier workplace for all professionals working for public health.
Sexual and reproductive health education for women in a migrant camp in Belgrade, Serbia
Authors: Graham A
Published: October 2021

Serbia borders the European Union (EU). It hosts 18 migrant camps for migrants/refugees blocked from entering the EU. A camp in Belgrade, houses 450 people, most residing there for over a year. The women are vulnerable due to no/low education, early marriage, multiple children, perilous journeys travelled, shared basic accommodation, and uncertain status/futures. The UN sustainable development goal 3 highlights the importance of improving sexual and reproductive health (SRH) in humanitarian settings. SRH education empowers women to plan/prevent pregnancies, prevent spread of sexually transmitted infections, and to know when to see a doctor. Many migrant camps exist across Europe housing similarly vulnerable women who would benefit from SRH education. The objectives were to 1. Create a safe space for sharing SRH concerns; 2. Assess knowledge and needs; 3. Develop and deliver a bespoke SRH programme in collaboration with the women; 4. Assess impact on knowledge. I facilitated SRH discussions and built rapport, the women then completed an anonymous questionnaire assessing knowledge/needs. I developed a series of monthly SRH workshops delivered over a year. The questions posed were 1. Was SRH education needed/desired? 2. Would women attend? 3. Would SRH knowledge improve?

The discussions and questionnaire demonstrated the need and desire for SRH education. 4-10 women (average 8) attended each workshop, with open discussions generated. The women's knowledge increased, extrapolated from workshop activities and qualitative feedback. These migrant women had an unmet need for SRH education, which was addressed via this programme. It demonstrated an increase in SRH knowledge, enabling informed SRH decision making and ultimately improving public health. Migrant women reside in camps across Europe, and would benefit from this programme. Creating a collaborative, bespoke SRH programme with migrant women in transit across Europe is both innovative and important.

Key messages

Vulnerable female migrants residing in a migrant camp in Belgrade had an unmet need/desire for sexual and reproductive health education which was addressed via a bespoke programme of SRH workshops. Migrant camps exist across Europe housing vulnerable women who urgently require access to good quality sexual and reproductive health education and care in order to improve overall public health.
Learning from the pandemic, and getting ready for the next one
Authors:   Organised by: European Commission, EUPHA,   Moderators: Isabel de la Mata (EC), Dineke Zeegers Paget (EUPHA)
Published: October 2021

Covid-19 has shown us that most countries were not focusing their emergency preparedness plans in the correct direction. Covid-19 is a long-term health event, with serious impact on so many different sectors. Preparedness plans were conceived only for health events that are more explosive in initiation and resolution.

Governments of a wide range of levels of competency, and covering much of the political spectrum, all failed to address the pandemic effectively, both from the health point of view and from the social point of view. So, what can we learn from our successes and from our failures?

In a ‘learning from this pandemic’ round, we ask all panellists to reflect on the successes and failures (each 5 minutes). In a second round, we will be asking the panellists for their ideas on how to be better prepared for future pandemics. The final 5 minutes are for the next generation of public health professionals, summarizing the ‘take home’ messages.

Speakers:

Andrea Ammon European Centre for Disease Prevention and Control Sandra Gallina Health and Food Safety, European Commission Michael Edelstein EUPHA-ICD Laura de la Torre Pérez Specialist in Preventive Medicine and Public Health
Delineating infection strategies ofLeishmania donovanisecretory proteins in Human through host–pathogen protein Interactome prediction
Authors: Panditrao Gauri , Ganguli Piyali , Sarkar Ram Rup
Published: October 2021

Interactions of Leishmania donovani secretory virulence factors with the host proteins and their interplay during the infection process in humans is poorly studied in Visceral Leishmaniasis. Lack of a holistic study of pathway level de-regulations caused due to these virulence factors leads to a poor understanding of the parasite strategies to subvert the host immune responses, secure its survival inside the host and further the spread of infection to the visceral organs. In this study, we propose a computational workflow to predict host–pathogen protein interactome of L.donovani secretory virulence factors with human proteins combining sequence-based Interolog mapping and structure-based Domain Interaction mapping techniques. We further employ graph theoretical approaches and shortest path methods to analyze the interactome. Our study deciphers the infection paths involving some unique and understudied disease-associated signaling pathways influencing the cellular phenotypic responses in the host. Our statistical analysis based in silico knockout study unveils for the first time UBC, 1433Z and HS90A mediator proteins as potential immunomodulatory candidates through which the virulence factors employ the infection paths. These identified pathways and novel mediator proteins can be effectively used as possible targets to control and modulate the infection process further aiding in the treatment of Visceral Leishmaniasis.
Modelling above-ground biomass ofPinus radiatatrees with explicit multivariate uncertainty
Authors: Sandoval Simón , Montes Cristián R , Olmedo Guillermo F , Acuña Eduardo , Mena-Quijada Pablo
Published: October 2021

The biomass content and carbon captured by forest plantations is of interest, for example in the context of climate change and carbon budgets.The main objective of our study was to develop functions to estimate the total biomass and its components (stem, branches, bark and leaves) of Pinus radiata D. Don trees in Chile. The methodology proposed for the model fitting uses the maximum likelihood method in a multivariate equation system fitting simultaneously. The fit strategy incorporates additivity restrictions in the estimation functions and in the variance functions to incorporate the heteroskedasticity of biomass, and three structures of the variance–covariance matrix were evaluated to assess the dependence of the different components of tree biomass. Non-linear biomass functions that used the variable $D^2H$ performed best according to several indicators of goodness-of-fit (log-likelihood, Akaike Information Criterion and Bayesian Information Criterion) and estimation precision (root mean square error (RMSE), Bias and EI). The simple structure of both biomass and variance estimation functions was $\beta _1 (D^2H)^{\beta _2}$, and in the modelling system for total tree biomass RMSE between 54.1-54.4 kg (28-36%) were obtained. The three variance–covariance matrix structures evaluated did not generate clear differences in relation to the RMSE, bias and Error Index indicators. The structure of the variance–covariance matrix that incorporated explicitly in the system equations allowed modelling of the relationship between biomass components.
Intellectual Property Law
Authors: Aplin Tanya , Davis Jennifer
Published: October 2021

All books in this flagship series contain carefully selected substantial extracts from key cases, legislation, and academic debate, providing able students with a stand-alone resource. Intellectual Property Law: Text, Cases, and Materials provides a complete resource for undergraduate and postgraduate students of intellectual property (IP) law. The only text of its kind in the field, it combines extracts from major cases and secondary materials with critical commentary from experienced teachers in the field. The book deals with all areas of IP law in the UK: copyright, trade marks and passing off, personality and publicity rights, character merchandising, confidential information and privacy, industrial designs and patents. It also tackles topical areas, such as the application of IP law to new technologies, such as artificial intelligence, and the impact of the internet on trade marks, copyright, and privacy. While the focus of the book is on IP law in a domestic context, it provides international, EU, and comparative law perspectives on major issues, and also addresses the wider policy implications of legislative and judicial developments in the area. The book is an ideal resource for all students of IP law who need cases, materials, and commentary in a single volume.