bluuebunny/crossref_metadata_2025 huggingface dataset:
Public health recovery - building back healthier and more resilient societies
Authors: Koornstra A , Boode K
Published: October 2021

During the Covid-pandemic it became clear that some groups were suffering more from the regulations against the spread of the virus than from the virus itself. To ensure social support for the regulations and to avoid increasing social economic health differences, the Dutch Association of Municipal Health Services (GGD GHOR Nederland) started a program. It was based on a plan form a group of doctors working in these health services and who worried about the health impact and wanted to strengthen the resistance against the virus and the resilience to cope with the lockdown. The aim was to build back better health on the level of society. individual Covid-patients received recovery care to gather strength - and so should public health build back a stronger and healthier society. The program consists of three parts: extensive monitoring of the impact of Covid-19, mitigating effects of the lockdown on lifestyle and mental/social wellbeing and seizing the political moment to strengthen prevention in public policy and in care. We will present examples of actions taken and their results.

Key messages

Societies need public health to recover from the impact of Covid-19, both the disease and the regulations taken to prevent spreading the virus. It is crucial to seize the moment to build back better health, both professionally to improve our services and politically to strengthen public health.
Prognostic factors of self-rated health deterioration during Covid-19 in the Baltic States
Authors: Mikelsone M , Reine I
Published: October 2021

Background

In order to implement the necessary measures to prevent the consequences of the Covid-19 pandemics, long-term assessment of health status is needed. The objective of the study - to determine the prognostic factors of self-rated health deterioration during the first wave of Covid-19 pandemics.

Methods

The study was based on a sample of individuals from wave 7, wave 8 and Covid-19 add-on of the Survey of Health, Ageing and Retirement in Europe (SHARE) in the period from 2017 till 2020. The sample size was 4429 respondents - Latvia: 649, Lithuania: 1083, Estonia: 2697. Descriptive statistics as well as univariate and multivariate binary logistic regression was performed, including health determinants, demographics and factors associated with Covid-19.

Results

Based on univariate binary logistic regression analysis, the main predictors for deterioration of self-rated health (unadjusted OR; 95%CI) were: age 80+ years (reference group 50-59 years) for Estonia (3.03; 2.93-3.14), diagnosed with major condition since Covid-19 for Latvia (15.45; 15.14-15.77) and Estonia (6.75; 6.57-6.94), fair or poor health since Covid-19 for Lithuania (4.92; 4.86-4.99), loneliness since Covid-19 for Lithuania (5.03; 4.94-5.12), limited in activities due to health condition for Latvia (4.53; 4.42-4.64), depression since Covid-19 for Lithuania (3.78-3.71-3.85), limited in activities due to age for Latvia (3.01; 2.95-3.08), nervousness since Covid-19 for Lithuania (2.08; 2.04-2.12). All predictors were statistically significant for all three Baltic countries.

Conclusions

The results in all three Baltic States indicated a similar trend that, taking into account the influence of other factors, the most important predictive factors were related to health and demographic indicators. Only one factor related to the first wave of Covid-19 (in Latvia - nervousness since Covid-19, in Lithuania and Estonia - less or no direct contact with children since Covid-19) predicts deterioration in health.

Key messages

The results indicate that deterioration in health cannot currently be considered to be caused by the first wave of Covid-19. Further research to assess long-term impact of Covid-19 to health is needed.
Psychological assistance at disaster in Bulgaria - contemporary policies for health risk management
Authors: Dimitrova D , Georgieva E
Published: October 2021

Issue

Health risk management (HRM) in Bulgaria is provided to citizens in emergencies, disasters, accidents and catastrophes (E&DAC). According to the legislation in the country, this is a part of the mandatory package of medical provision for the injured population (MPIP) and concerns any acute life-threatening condition (LTC). In the dynamically changing environment of E&DAC, a special form of health consequences among survivors are related to mental health (MeH).

Description of the problem

In practice, any serious E&DAC has a direct or indirect psychological impact. It can manifest itself acutely or remotely over time, puts the victims in temporary or permanent disability and is followed by serious social effects. A strategy has been proposed for inclusion in the obligatory package of MPIP in case of significant E&DAC and primary psychological assistance (PPA) for every citizen who has survived.

Results

In the country, PPАs to citizens for decades is an on-demand service provided mainly by the private sector. Within the BRC, a group has been formed to provide PPA with a modest resource capacity. The emotional citizens culture in the country is far from active demand for PPA in general and severely limited in resources and the MeH is not a priority. This system of public health care, based on withdrawal from the MeH, also exposes to increased risk of psycho-somatic and distress-provoked physical illnesses (PSDPPhI).

Lessons

Carrying out timely PPA for those in need changes the range of adverse mental effects, reducing them. Provides a better adaptive response to reduced risk of PTSD and PSDPPhI. A volume of preventive measures organized in stages over time gives a greater chance to a larger number of victims.

Key messages

The health of the nation is a complex program for controlling both the acute health problems at E&DAC and the protection of MeH. To provide modern sustainable policies for the implication of PPA in everyone who has seriously experienced E&DAC is resulted in good health practices.
Cracks in the ice: a digital health initiative disseminating evidence-based information about ‘ice’
Authors: Kershaw S , Birrell L , Champion K , Duong F , Grager A , Stapinski L , Newton N , Kay-Lambkin F , Teesson M , Chapman C
Published: October 2021

Background

Crystal methamphetamine (‘ice') causes significant societal harm and attracts a high level of concern in Australia. Cracks in the Ice (CITI: cracksintheice.org.au) is a digital public health initiative that was developed as part of a national response to concerns about ice. CITI is the first centralised national online portal for evidence-based information and resources about ice in Australia. It provides targeted information and resources for health workers, people who use ice, their family and friends, community groups and schools. CITI was developed collaboratively with input from drug and alcohol experts and over 500 Australian community members, including people with lived experience. A national online survey was conducted to evaluate whether CITI is meeting the needs of the Australian community.

Methods

Eligible participants were Australian residents aged 18 years and over, and were recruited via the CITI website, email direct marketing, and social media. The survey assessed participants' perceptions of CITI (e.g., usability, navigation, utility) and their knowledge and attitudes about ice.

Results

2110 participants completed the survey, including people who use ice, affected family members, health workers, and general community members. Participants' response to CITI was overall positive and their knowledge of ice was generally good, but many held negative or stigmatising attitudes towards ice and people who use it.

Conclusions

Digital public health initiatives stand to overcome structural, geographical, and attitudinal barriers to alcohol and other drug (AOD) prevention efforts. CITI ensures evidence-based information about the drug ice is readily available across all of Australia. Community evaluations have shown that CITI is meeting the needs of the Australian community.

Key messages

Crystal methamphetamine (‘ice’) attracts a high level of concern in Australia. CITI is the first centralised national online portal for evidence-based information and resources about ice. Digital health initiatives stand to overcome structural, geographical, and attitudinal barriers to AOD prevention. Community evaluations ensure these initiatives meet the needs of their end-users.
A social media-based campaign to promote COVID-19 vaccine uptake in underrepresented groups in the US
Authors: de Vere Hunt I , Dunn T , Mahoney M , Chen M , Zhang L , Bousheri S , Bernard D , Linos E
Published: October 2021

Problem

The COVID-19 pandemic highlighted existing healthcare disparities in the US, with people of color dying from COVID-19 at twice the rate of white people. A striking disparity in vaccination rates for racial minorities followed, with vaccination rates among white people over 2.5 times that for Latinx and nearly twice that for Black people (March 2021). It is vital we ensure tailored public health messaging regarding the COVID-19 vaccine is delivered to all communities. Facebook provides an opportunity for large-scale, targeted health promotion.

Description of practice

Our goal is to increase COVID-19 vaccination uptake across the US, with a specific focus on reaching underrepresented communities most affected by the pandemic. We created a public health campaign centered on a representative group of physicians conveying their own short (<1 minute) video messages that the COVID-19 vaccine is safe and effective. We placed these videos as advertisements on Facebook and directed them using geotargeting to reach zip codes in the US with the highest COVID-19 death rates cross-referenced with zip codes in which >50% of the population is Black or Latinx. We launched the campaign in California on April 9, and nationwide on April 12 2021. The primary outcome measures of the campaign were reach (number of individuals exposed, frequency and duration of views) and engagement (number of likes and shares).

Results

During our campaign (April 9-April 30), the videos appeared on Facebook newsfeeds 54.4 million times, reaching 9.9 million individuals an average of 5.5 times each. Overall, the videos received 10,053 reactions and 1,161 shares. 1.8 million video plays ran for at least 25% of the video.

Lessons

We demonstrate the feasibility of rapid, social media-based dissemination of tailored public health messages regarding the COVID-19 vaccine to communities in need. We are now focusing efforts on strategies to assess the impact of such messaging on vaccination uptake.

Key messages

Geotargeting on social media enabled rapid dissemination of COVID-19 vaccine uptake messages to underrepresented communities. Further work is required to evaluate behavioral change impact.
Association of cyberbullying with depression in high school adolescents
Authors: Villegas Dominguez J , Garcia Sanchez Z , Olazo Chiquito HA , Murillo Monroy J , Marquez Celdonio FG
Published: October 2021

Background

During the SARS-COV 2 pandemic, schools in Mexico adapted to the online modality as a strategy to contain the epidemic, being this new modality for high school students, which could facilitate, together with their social context, a damage to their mental health.

Objectives

To determine the association of cyberbullying with depression in high school adolescents. A comparative, observational, cross-sectional and prospective study was carried out in Veracruz, Mexico, between January and April 2021, including high school students with online classes, and those with a diagnosis of depression, anxiety or if they were consuming drugs that It could alter your mood. A non-probabilistic sampling was carried out and the DASS-21 test (Cronbach 0.87) was applied to determine stress, anxiety and depression and the ECIPQ test to determine cyberbullying (cronbach 0.87)

Results

311 students were included, of which 129 (41.5%) were men, with brown skin in 63.7%, white (32.2%) and yellow in 4.2%, with bisexual sexual preference in 8.4%, with depression in 43.4% %, anxiety 42.8%, stress 26.7%, being cyber victims 43.1% and cyberbullying 20.6%. Being a cybervictim presents OR for depression of 4.1 (95% CI 2.5-6.6), OR for anxiety of 3.8 (95% CI 2.4-6.2), stress OR of 4.2 (95% CI 2.5-7.3). The factors that facilitate cyberbullying were having yellow skin color with OR 4.6 (95% CI 1.2-17.3) and being bisexual with OR 5.0 (95% CI 1.9-12.8), all with a value of p < 0.05.

Conclusions

being a cybervictim facilitates the presence of depression, anxiety and stress in adolescents. Having yellow skin color and being bisexual increases the risk of cyberbullying

Key messages

Being a cybervictim facilitates the presence of depression, anxiety and stress in adolescents. Having yellow skin color and being bisexual increases the risk of cyberbullying.
Quality of life, health and social costs of patients with spinal cord injury: A systematic review
Authors: Diop M , Epstein D , Gaggero A
Published: October 2021

Objective

To systematically reviews the costs, resource uses, clinical complication and quality of life among patients with spinal cord injury.

Methods

A systematic review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement was conducted through Scopus, PubMed and Embase databases.

Results

A total of 52 studies were eligible for inclusion. The estimated lifetime economic burden per individual with SCI ranges from $1.5 million to $3.0 million. Among studies which reported clinical outcomes, the mortality rates were estimated less than 4%, the most medical complication reported are spasticity, pain, pressures score and neurological deteriorations. Overall health status is negatively associated with QoL. People with a higher severity the of injury, a longer duration of injury, ambulatory mode, and with depression are more likely to report score low values of QoL. Employment and salary are consistently positively associated with better QoL. Age is negatively correlated with QoL.

Conclusions

Although spinal cord injury is related with high costs, no studies were found with detailed resources use. Also, A variety of instrument were used to examine how different factors have a role in predicting quality of life in spinal cord injury population. However, it is important to consider that differences found in those studies may at least be part in function of the instruments used. Therefore, standardized instruments should be used as part of these process.

Key messages

Paraplegia or the severity of SCI impact negatively quality of life and positively on healthcare and social costs. Promoting the employment of subjects with SCI generates a positive impact on their quality of life.
Cancer mortality attributable to cigarettes smoking in Tunisian adults, 2016
Authors: Cherif I , Khiari H , Mallekh R , Hsairi M
Published: October 2021

Background

The carcinogenic effect of tobacco smoking has been well established. In Tunisia, cancers ranked second leading cause of deaths from non-communicable diseases in 2014. In addition, Tunisia is classified among North African countries with the highest prevalence of tobacco smoking. We aimed in this study to estimate cancer mortality attributable to current cigarettes smoking among Tunisian adults aged 30 years and older in 2016.

Methods

Cancer mortality attributable to current cigarettes smoking was estimated using the population attributable fraction method. This estimation requires to have the number of deaths by cause, age and gender, the prevalence of tobacco use by age and gender, and the relative risks (RR) as measure of associations of tobacco use and diseases related to tobacco. The age and cause specific number of deaths were obtained from the health metrics database. The relative risks were mainly obtained from the Cancer Prevention Study II and the prevalence of current cigarettes smoking in Tunisia was taken from the Tunisian Health Examination Survey, a nationally representative household survey conducted in 2016.

Results

In 2016, 2410 and 31 deaths among Tunisian men and women respectively were attributable to current cigarettes smoking accounting for 54.3% and 1.7% of all deaths from cancers. Among neoplasms, lung and upper aerodigestive tract cancers had the highest proportion of deaths attributable to tobacco smoking. They were responsible for 1702 and 392 deaths attributable to current cigarettes smoking corresponding to 74.5% and 49.1% of the total number of deaths from lung and upper aerodigestive tract cancers respectively.

Conclusions

More than half of cancer deaths among Tunisian men were attributable to current cigarettes smoking. The enforcement of smoking free legislation and the promotion of smoking cessation interventions are thus necessary.

Key messages

Majority of all cancer deaths observed among Tunisian men aged 30 years and over in 2016 were attributable to current cigarettes smoking. Lung cancer had the highest proportion of deaths attributable to Tobacco.
Improving sport spaces into urban areas for healthy and inclusive communities: the case of Milan
Authors: Gola M , Buffoli M , Rebecchi A , Fior M , Daprà F , Vettori MP , Capolongo S
Published: October 2021

Background

Cities are health promoters, although many of them lack of spaces for sport practice. In the meanwhile, for instance, several recreational and sport spaces, that can be open to the community, are offered by the network of churches. A research is developing a tool for making more efficient the assets of sport activities in parishes in a multi-generational, inclusive and health education perspective, in response to increasingly evident needs related to social and sports demand, education health, enhancement of the built heritage and social inclusion. The social and technical value based tool merges several issues related to Public Health, Urban Health, sport facilities design, urbanism and social impact.

Methods

The first part of the tool refers to an urban analysis of the city to be investigated and it highlights the correlations among the parishes, sport infrastructures, population density and social inequalities, physical activity and green areas. All the analysis refer to the GIS systems in which all the data are collected and organized by districts.

Results

The application was done in the city of Milan (Italy). The analysis with GIS system gives rise to several maps (a-population health status with a focus on physical activity, b-sport infrastructures availability, c-parishes available, etc.) with different results and they have been merged together. Some areas show some critical aspects related to the lack of public sport spaces, green areas and social inequalities. It permits to select the case studies to be taken in consideration for the application of the Strategic Design Framework, and it will allow to give rise to a detailed examination of the parishes' potentialities for improving the sport practice.

Conclusions

The tool is working progress and it will be validated through the application on 5 case studies in the city of Milan. The research is funded by Politecnico di Milano - PoliSocial Award 2019, entitled “SPèS” (Sport is Society).

Key messages

Social governance, health promotion and urban inclusion, through the reactivation system of the sport infrastructures in the parishes of Milan. Local parishes as health promoters of sport practice: sport infrastructures for the local communities in Milan.
Associations between migraine and dyslipidaemia in the E3N cohort study
Authors: MacDonald CJ , Madika AL , Menegaux F , Boutron-Ruault M C
Published: October 2021

Background

Previous case-control and cross-sectional studies have suggested that migraine is associated with an increased likelihood of dyslipidaemia, but it is uncertain if these associations are driven by lifestyle factors such as weight and exercise. This study aimed to explore cross-sectional associations between migraine and dyslipidaemia, whilst controlling for multiple potential confounders, including BMI and physical activity.

Methods

We included 71,582 women from the E3N study, who had provided information on migraine and dyslipidaemia in questionnaires. Dyslipidaemia and migraine were based on self-reports. Logistic regression models were used to assess the association between migraine and prevalent dyslipidaemia, controlling for potential confounders including BMI. As a sensitivity analysis, only dyslipidaemia cases with reimbursement for lipid-lowering medications were considered valid.

Results

Women were at a mean age of 70.9 years at inclusion. Dyslipidaemia was reported by 32,271 women and were reimbursed for lipid-lowering medications in 71.1% (n = 22,919) of cases. History of migraine was reported by 19,589 women. In unadjusted models, ever history of all migraine was not associated with the odds of dyslipidaemia (OR migraine = 1.01 [0.98: 1.05], p = 0.41), but this association was positive after adjusting for potential confounding factors such as age, BMI, and physical activity (OR migraine = 1.04 [1.01: 1.08], p = 0.02) and was consistent when considering only treated dyslipidaemia (OR migraine = 1.04 [1.00: 1.08], p = 0.03).

Conclusions

Migraine was associated with an increase in likelihood of dyslipidaemia, regardless of BMI and physical activity.

Key messages

Migraine is a disease with high prevalence in women. History of migraine is associated with an increased risk of dyslipidaemia.
Cannabis use in high school adolescents of SousseTunisia: Incidence and predictors
Authors: Zammit N , Bennasrallah C , Ghammem R , Ben Fredj S , Farhaoui S , Rim K , Maatoug J , Ghannem H
Published: October 2021

Background

Adolescence is a period of physical, psychological and social transformation. It is during adolescence that people are introduced to psychoactive substances such as cannabis. Understanding the predictors of this risk behavior, would help dealing with this problem more efficiently. The current study aimed to determine the incidence and the predictors of cannabis use among high school students in Sousse governorate between 2017/2018 and 2018/2019

Methods

A prospective longitudinal study was conducted in four high schools in the governorate of Sousse during the period from 15/09/2017 to 30/06/2019. Pre-tested self-administered questionnaire served to collect data anonymously among participants about their socio-demographic characteristics, cannabis use, tobacco use, use of electronic cigarettes, illicit substances use, sedentary behavior and mental health disorders among them.

Results

A total of 404 students were included in our study. The average age of participants was 16.4 (±1.1) years. The cumulative incidence of cannabis use among high school students was 2.2%, (95%CI: 0.8%-3.6%). School failure, anxiety problem, cigarette smoking, vaping and illlicit substances use among friends were found to be significantly associated with cannabis experimentation among them. Whereas its most influential factors were: Current cigarette smoking and current vaping with adjusted odds ratio of: 12.9; 95% CI: 2.4-70.2) and 7.2; 95% CI: 1.3-38.8 respectively.

Conclusions

This study highlights the association between cigarette and e-cigarette smoking and cannabis use. Future prevention interventions should focus on these risk behaviors with regard to the environmental context.

Key messages

Cannabis use is not rare among the adolescents of Sousse, Tunisia. Adolescents represent vulnerable sub-group that merit special attention regarding substances use.
Health sciences students’ perception on stigmatization related to COVID-19
Authors: Leventi N , Kazakos E , Vodenitcharova A , Popova K , Velikov S , Yanakieva A
Published: October 2021

Background

The current COVID-19 pandemic is a challenge for the health sector all over the world. According to WHO, stigma related to COVID-19 can lead to underreporting, increased exposure and low adherence to standard safety precautions thus complicating adequate responses to the pandemic. The purpose of our research was to analyze students' perceptions on issues related to the COVID-19 pandemic with a special focus on relevant ethical issues. Herein, we present results related to student's perceptions on stigmatization.

Methods

A web-based questionnaire was distributed among 715 students; medical students from Medical University -Sofia, Bulgaria and midwifery students from the University of Western Macedonia, Greece. It included 21 questions on socio-demographic characteristics, knowledge on the transmission, symptoms and treatment of COVID-19. The study was conducted between April and July 2020. All the students participated anonymously and voluntarily.

Results

Data collected show that the main reasons for stigma experience are the presence of cough or flu-like symptoms (67.4%) and travel from high-risk regions (72.6%). These perceptions were significantly higher among medical students (72.5% and 75.7%) compared to other specialties - midwives (59.1%, 67.6%). Asian origin, health professionals as first respondents and release from quarantine were also considered as significant stigma-related factors in about one-third of all participants, respectively.

Conclusions

Identification of the main public perceptions that may lead to stigmatization and discrimination of patients and vulnerable groups is important in a focused approach to counter its impact on societies. Providing up-to-date education to medical professionals, mitigating the spread of misinformation by real-time monitoring of digital resources, improving public literacy on COVID-19 and establishing a community-level dialogue through digital and social media platforms may raise awareness to reduce stigma.

Key messages

Long-term Public health strategies are required to combat misconceptions that perpetuate stigma, in order to achieve better outcomes and improved treatment, and protect mental health. As the global COVID-19 health emergency transforms into an unprecedented social crisis, special attention is necessary among vulnerable people to ensure social integrity.
Human rights restrictions during COVID-19 pandemic – Healthcare students’ perceptions
Authors: Kazakos E , Farmaki P , Leventi N , Vodenitcharova A , Popova K , Velikov S , Yanakieva A
Published: October 2021

Background

In order contain COVID19 spread, states adopted measures that confer transient disruptions in human rights. WHO acknowledged early on, that human rights should be embraced as an integral compound of the public health approach to COVID19. The aim of our research was to demonstrate healthcare students' perceptions on restrictions imposed on human rights, as part of COVID19 response.

Methods

Our cross-sectional survey employed a web-based questionnaire distributed among 715 students from Bulgarian and Greek health sciences faculties. All respondents participated anonymously and voluntarily. Data was collected between April and July 2020. Data analysis was conducted using established statistical methods.

Results

Among respondents, nearly two thirds of Greek students (66%), would accept, either categorically or highly probably, the implementation of measures that may impact core human rights, as opposed to 53% of those of Bulgarian origin. Inability to assess and non-acceptance of compulsory restrictions, were significantly high among participants (33% to 45%), irrespective of nationality or field of studies.

Conclusions

Remarkable disparities observed, require further evaluation as to the causes associated with non-acceptance of measures enforced during a public health emergency. This preliminary study, illustrates that stakeholders should provide priority assistance to health sciences students that may, inter alia, be used to promote risk communication, enhance public engagement and allow the allocation of frontline healthcare resources. Education, involvement in clinical activities, decision-making and policy may be used to overcome any apprehensions, given that healthcare students are the qualified workforce in future public health crises. Participation of academic institutions in shared governance ensures transparency and scientific evidence to justify emergency measures to tackle public health threats, thereby affecting positively students' perceptions.

Key messages

Evidence-based resources and addressing transient human rights disruptions are important in maximizing healthcare students’ awareness and effective participation during the pandemic. All participating bodies should safeguard core principles of human rights and ensure that all measures taken are rational, proportional, non-discriminatory and grounded in applicable legal frameworks.
Determining How Nutritional Status is related to Anger Level and Anxiety Status in Persons
Authors: Olke B , Gokce A , Ozer A
Published: October 2021

Background

Nutriments affect psychology and psychological state affects nutritional status of people. The present study is, therefore, intended to find out how nutritional status is related to levels of anger and anxiety in people receiving nutritional consultation.

Methods

This descriptive-type cross-sectional study includes a universe of 180 individuals aged over 18 who received nutrition counseling between August-December 2018. The approval of the ethics committee and of the relevant institution was obtained in order to conduct the study. The questionnaire form used to retrieve the data herein consists of socio-demographic characteristics, Trait Anger and Anger Expression Style Scale, Beck Anxiety Inventory, food consumption frequency, and food consumption record. Chi-Square test, Student t-test, and One-way ANOVA test were used for statistical analysis. The significance level was set as p < 0.05.

Results

In the study group, those who consumed milk once a month had a subscale score of trait anger (22.83±3.13) that was significantly higher than that of those consumed it 3-5 times a week (18.74±3.93)(p = 0.025). Those who consumed fast food 1-2 times a week and 3-5 times a week had an anger expression score of 16.17±2.81 and 16.43±3.69, respectively; which were significantly higher than that of those consumed fast food once a month(14.07±2.42) and once every 15 days(14.12±3.05) (p = 0.028). The anger control subscale score of those who consume red meat daily is significantly lower than those who consume red meat 1-2 times a week and 3-5 times a week(p = 0.048). The body mass index and anxiety level did not have a significant difference (p < 0.05).

Conclusions

In the study group, it was found that the trait anger score was low in the groups with less consumption of milk, the anger expression score was higher in the groups with increased fast food consumption, and the anger management score was lower in the group with more frequent red meat consumption.

Key messages

People who consume fast food more frequently have increased anger expression. The level of trait anger increases as the milk consumption diminishes.
Antibiotic-free farming for poultry meat production: impact on animal welfare
Authors: Podaliri Vulpiani M , Iannetti L , Romagnoli S , Cotturone G , Vincifori G
Published: October 2021

Background

Multidrug-resistant zoonotic pathogens represent a risk for human health. The irrational use of antibiotics in production animals has contributed to the spread of antibiotic resistance (AMR) also in humans. The search for alternative systems to the use of antibiotics, including the study of ‘animal welfare-friendly' management tools, should be encouraged. The reduction of the use of antibiotics should be a controlled process, as their absence could have a negative impact on animal welfare, if not accompanied by adequate structural and managerial interventions.

Methods

Welfare Quality® protocol was used to measure the level of welfare in 14 batches of broiler chickens from 6 farms of an integrated poultry company and the results were compared (antibiotic-free vs conventional). The number of animals per batch ranged from 9,000 to 41,700. Assessments were made throughout a 9-month period, from 2018 to 2019, at-farm the day before slaughtering (age from 42 to 48 days old).

Results

No statistically significant differences between antibiotic-free and conventional in the general ‘welfare score' were reported. Stocking density was higher in antibiotic-free batches, and the ‘good feeding' principle was averagely higher in conventional batches (74.7 vs 63), with statistical significance (t=-2.45; p < 0.05). Other welfare principles (good housing, good health and appropriate behaviour) were slightly higher for antibiotic-free batches, without statistical significance. The absence of antibiotics did not affect the ‘good health' principle, ranging from 24.1 to 44.7, with the minimum in a conventional batch and the maximum detected in an antibiotic-free batch. The highest mortality (3.9%) was found in a conventional batch.

Conclusions

The absence of antibiotics in broiler farming doesn't affect animal health and welfare if associated with good management practices. Antibiotic-free farming should be standardized in order to protect both animal welfare and consumers' health.

Key messages

The absence of antibiotic use does not impact on broiler chicken general welfare score. High stocking density due to the high demand of antibiotic-free meat should be avoided and specific guidelines for antibiotic-free farming should be produced.
Food supplements consumption and the role of pharmacies: a north-eastern Italy observational study
Authors: Mazzilis G , D'Angelo M , Brunelli L , Colautti L , Cojutti P , Arnoldo L , Parpinel M
Published: October 2021

Background

Even if the food supplement industry is one of the fastest growing worldwide, the inappropriate use of these products can potentially cause harms. Considering the key role played by pharmacists in advising citizens on the purchase of food supplements, this cross-sectional observational study evaluates pharmacists' knowledge, attitudes and practice on this topic.

Methods

From September 2020 to February 2021, an online questionnaire implemented through the EU-Survey tool, was administered to pharmacists of both public and private authorized pharmacies of the Friuli-Venezia Giulia (FVG) Region (Italy). The 47 multiple-choice questions about pharmacists' knowledge (20), attitudes and practice (27), were followed by a sociodemographic section (7 items) collecting data about sex, age, years of experience, degree, role within pharmacy (owner, employee). Descriptive analyses, Chi-square, Shapiro-Wilk and Mann Whitney tests were used and a p-value<0.05 was considered as statistically significant.

Results

A sample of 232 questionnaires was collected, 70.7% of which from women. Most responders (77.2%) had a Pharmacy degree, with owners representing the 34.5%. The 61.2% of pharmacists had at least 10 years of experience. Knowledge was generally poor with just 49.2% of the sample scoring above the median value of 11 but higher among pharmacists with more than 11 years of experience. Lesser-known aspects were the possible link between cancer and multivitamin's abuse and presence of non-labeled agents in food supplements. Responders < =10 years of experience felt more unprepared about vitamin's dosage and in counselling particular groups of patients (p < 0.05). Employees more frequently reported the attitude to purchase food supplements under patient specifical request (p < 0.05).

Conclusions

Pharmacists' knowledge about food supplements is scarce and young professionals in particular need further education to ensure a safe and effective purchase of these products to patients.

Key messages

The use of vitamin supplements is growing but their consumption needs to be evaluated by expert and qualified professionals. Pharmacists play a key role in counselling people about food supplements but need continuous professional education to give adequate advice.
Employer perspectives on their supportive role in promoting sustainable RTW of disabled workers
Authors: Jansen J , Boot CRL , Alma M , van Ooijen R , Koning PWC , Brouwer S
Published: October 2021

Background

Employers play an important supportive role in facilitating sustainable Return to Work (RTW) of workers with disabilities. Little is understood about how employers deal with their supportive role, what kind of support they offer and which facilitators of employer support are important to successful RTW.

Methods

A semi-structured interview study was conducted among 27 employer representatives (e.g. supervisors, HR managers, case managers) of companies in the Netherlands who had experience in retaining at least one disabled workers within their company. Participants were included through purposive sampling on sector and company size. Data was analyzed by means of thematic analysis.

Results

We identified three different types of employer support: 1. instrumental support (offering work accommodations), 2. emotional support (encouragement, empathy, understanding) and 3. informational support (providing information, setting boundaries). Facilitators of employer support were categorized into three main themes: 1. good collaboration, with subthemes (in)formal contact, trustful relationships, mutual responsibilities and (in)formal networks, 2. employer characteristics, including supportive organizational culture, leadership skills and flexibility, and 3. employee characteristics including flexibility and resilience.

Conclusions

Different types of employer support are considered as important in the RTW process of disabled workers. Besides offering work accommodations, also emotional and informational support are necessary. In addition, good collaboration and flexibility of both employer and employee may be viewed as facilitators for optimizing supervisor and employee interaction during the RTW process.

Key messages

Instrumental, emotional and informational support by the employer are important in the RTW process of disabled workers. Facilitating factors include collaboration, flexibility and leadership.
Cost-effectiveness of DNA testing for Lynch syndrome for colorectal cancer patients in Switzerland
Authors: Salikhanov I , Wieser S , Katapodi M
Published: October 2021

Purpose

To estimate the cost-effectiveness of genetic testing for Lynch syndrome among newly diagnosed patients with colorectal cancer and targeted testing for their relatives in Switzerland.

Methods

We integrated decision tree and Markov model to calculate incremental costs per quality adjusted life-year saved for universal genetic testing for Lynch syndrome relative to using preliminary tumor tests (immunohistochemistry or microsatellite instability) followed by DNA sequencing test for patients with colorectal cancer.

Results

The incremental cost-effectiveness ratio (ICER) of the proposed strategy using universal genetic testing for Lynch syndrome with systematic CASCADE testing of their relatives is CHF 65,058 per QALY saved, which is cost-effective in Swiss settings where cost-effectiveness threshold is CHF 100,000 per QALY saved. The gained utility is 361,358 QALYs saved. Sensitivity analysis demonstrated cost-effectiveness of the proposed strategies in most of the scenarios.

Conclusions

The overall effectiveness of the universal genetic testing is greatly dependent on willingness of patients and relatives to be tested and compliance with the increased surveillance. Therefore, close cooperation across different stakeholders such as family doctors, oncologists, genetic clinicians, and laboratories is crucial to encourage and educate patients about the importance of the LS screening.

Key messages

Universal genetic testing for Lynch syndrome for all patients with colorectal caner is cost-effective in Swiss settings. Close cooperation across all stakeholders such as family doctors, oncologists, genetic clinicians, and laboratories is crucial to encourage and educate patients about the importance of the LS testing.
Dispensing antibiotics without prescription at pharmacies: barriers and strategies for improvement
Authors: Kazaryan I , Sevikyan A , Vardanyan L , Amirkhanyan A , Melikyan M
Published: October 2021

Background

Antimicrobial resistance (AMR) is a worldwide public health challenge, and non-prudent use of antibiotics is one of key drivers of AMR. In some countries antibiotics are often sold without a prescription at pharmacies. In Armenia this problem is also observed despite national regulation. The objective of this work was to identify perception of pharmacy staff on main barriers for dispensing antibiotics with a prescription at community pharmacies and perceived strategies for improving the situation in Armenia.

Methods

Survey was conducted at community pharmacies in different regions of Armenia. Pharmacists and pharmacy technicians were asked to complete pretested questionnaire. Data were analysed with SPSS statistical software.

Results

Despite most of professionals reported that they are aware about regulation, 78.4% of 241 participants indicated that patients can buy antibiotics at their pharmacy without a prescription from doctor. Most of participants reported that the percentage of patients whom antibiotics were sold without a prescription is high. More than a half of responders indicated the following barriers for dispensing antibiotics with a prescription at community pharmacies: lack of patients' awareness about effectiveness and safety of antibiotics (61.0%), difficulties for doctors to prescribe using approved forms (60.6%), poor prescribing practice (56.4%). More than a half of professionals consider that it is necessary to introduce the following strategies: organizing public awareness campaigns (68.0%), organizing special training courses for physicians and pharmacists (63.9%), introducing Medicines and therapeutic committees at health facilities (54.8%).

Conclusions

Patients can buy antibiotics without a prescription at community pharmacies in Armenia. There are certain barriers for dispensing antibiotics with a prescription at community pharmacies. Educational and organizational strategies can be helpful for improving the situation.

Key messages

Lack of patients’ awareness about antibiotics is a very important barrier for dispensing antibiotics with a prescription at community pharmacies. Most of pharmacy professionals are interested in improving the situation and indicate necessity of appropriate measures.
Health Literacy in Lombardy gambling prevention program: reflections for health promotion policies
Authors: Calloni L , Parisi G , Torri A , Capriulo AP , Celata C
Published: October 2021

Issue/problem

Gambling is a complex public health issue in Italy which has been contrasted by the establishment of a specific Ministerial Fund to implement prevention and treatment actions at regional level (L. 208/2015). Lombardy has implemented these guidelines through a Regional Plan (Dgr 585/2018) declined in Local Operational Plans monitored at regional level. Among the priorities of the Plans, the principle of Health Literacy (HL) assumes a central role in order to facilitate the dissemination of knowledge about gambling and the access to the Territorial Services. What has been achieved on HL allows to orient the programming of the new Regional Plan of Prevention (PRP 2020-25), since it could be transferred to other health promotion policies.

Description of the problem

The survey of what has been achieved in the field of HL was carried out through an ad hoc research form, administered to the Local Heath Protection Agencies, called ATS. The form evaluated actions and processes deployed during 2020, identifying the tools used for specific population targets. On the basis of the data collected, the objective of the contribution is to identify sustainable and effective HL promotion activities.

Results

The actions were developed for specific targets (children, adults and the elderly) on different settings (workplaces, schools, local communities) and concerned training and information measures, communication campaigns, cultural, social, aggregative and action research activities, capable of forming a network of social multipliers.

Lessons

The development of activities and tools on specific settings and targets has allowed to promote the growth of health knowledge in the population (HL), generating new communication channels.

Key messages

HL’s promotion actions regarding gambling can become sustainable and effective tools to raise awareness on other health issues at national and international level. HL's promotion tools should be considered as useful strategies in health policies at both national and international level.
Coping Styles in the SARS-CoV-2 national lockdown: impact on behaviors for cardiovascular prevention
Authors: Lontano A , D'ambrosio F , Marziali E , Galletti C , Mazza E , Boncompagni I , Del Bono C , Urbani E , Galasso V , Mingarelli A
Published: October 2021

Background

Coping styles are the ways in which people deal with different stressor situations. Coping strategies can be categorized into three types: task-oriented, emotion-oriented, and avoidance-oriented. Several studies showed a strong relationship between coping styles and cardiovascular diseases. The aim of the study was to evaluate how much the SARS-CoV-2 national lockdown has impacted the coping strategies on behaviors for cardiovascular prevention.

Methods

62 participants from Rome were recruited to assess the impact of prevention and promotion of health on Individual Cardiovascular Risk. The Coping Inventory to Stressful Situations (CISS, Endler & Parker, 1990) is a self-report questionnaire that measures the three strategies of coping. Behaviors dealing with cardiovascular prevention were evaluated at the beginning of the observation period, and after 6, 12, and 18 months. During 12 (February 2020) and 18 months (July 2020) the SARS-CoV-2 national lockdown enabled us to inquire into coping strategies in stressful situations and cardiovascular risk factors.

Results

The Pearson correlation analysis was used to assess the existence of a correlation between coping strategies and the variation of cardiovascular risk factors and alcohol consumption at 12 and 18 months. Interestingly, results showed relations between Emotional-oriented (r = 0.26 p < 0.05) and Task-oriented (r = -0.33 p < 0.01) coping styles and Differential Cardiovascular Risk Reduction (DCRR). Furthermore, a positive relation between Task-oriented (r = 0.34 p < 0.01) coping style and Differential Alcohol Consumption (DAC) was observed.

Conclusions

We found that the DCRR relates to the Emotional- and Task-oriented coping styles, while DAC is associated with the Task-oriented coping style. The strength of our study consists in the territorial and multidisciplinary dimension of the project, the main critical issue is represented by the small size of the patient sample.

Key messages

A relationship can be described between Differential Cardiovascular Risk Reduction and Emotional- and Task-oriented coping styles. There is a relationship between Differential Alcohol Consumption and the Task-oriented coping style.