bluuebunny/crossref_metadata_2025 huggingface dataset:
Level of literacy and clinical outcomes in patients with Chagas disease: SaMi-Trop project
Authors: Quintino N , David G , Sabino E , Silva J L , Ribeiro A L , Ferreira A , Oliveira L , Oliveira C , Cardoso C
Published: October 2020

Background

Chagas disease (CD) is a neglected tropical disease that affects mainly vulnerable population, whose majority has low ability to understand health information. This study aimed to assess the prevalence of health literacy (HL) and its association with sociodemographic, quality of life, health care aspects and worse clinical outcomes.

Methods

This is a cross-sectional study developed inside a cohort study (SaMi-Trop) including 1959 patients. It has been conducted in an endemic region to CD in Brazil. The eligible criteria for HL evaluation was the ability to read. The HL was assessed with SALPHA-18 scale and literacy was categorized in inadequate HL; adequate HL and; illiterate. Multiple models were adjusted using binary logistic regression, multinomial and beta regression models using the gamlss framework.

Results

Of the patients included, 1136 (74.1%) are illiterate. For HL assessment, only 397 managed to complete the HL evaluation. The prevalence of inadequate HL was 85.1% (338), only 59 patients (14.9%) had adequate HL. Our results are as following: 1) being illiterate increases the chance of using more drugs when compared to individuals with adequate HL - 1 or 2 drugs (OR: 1.96; CI: 1.06-3.62) and 3 to 4 medications (OR: 3.06; CI:1.44-6.52), to have hypertension (OR: 2.24; CI: 1.29-3.90), report an average self-perceived health (OR: 2.97; IC: 1.63-5.42) and report poor self-perceived health (OR: 3.67; CI: 1.71-7.89); 2) inadequate literacy increases the chance of using 3 to 4 medications (OR: 2.26; CI: 1.04-4.93) and report an average self-perceived health (OR: 2.48; CI: 1.34-4.62); 3) Illiterate patients present worst quality of life scores in Physical (OR: 0,730; CI: 0,583-0,914), Psychological (OR: 0,671; CI: 0,544-0,828) and Environmental (OR: 0,727; CI: 0,601-0,880) domains.

Conclusions

We found a high prevalence of inadequate HL; it was associated with worse clinical outcomes and poor self-perceived health.

Key messages

Our findings reinforce the importance of improving health communication in CD patients seeking to avoid unfavorable outcomes. A high prevalence of inadequate health literacy was observed in our study, which can impact the self-care ability of patients with CD.
Will mild atypical pneumonia remain underdiagnosed and undertreated in primary care setting?
Authors: Gatsura S , Deriushkin V , Gatsura O , Ulyanova E
Published: October 2020

Background

Non severe community acquired pneumonia (CAP) is a common problem in primary care. So called “walking” CAP is frequently caused by atypical intracellular pathogens Chlamydia pneumoniae and Mycoplasma pneumonia which are resistant to beta-lactams and can be transmitted from an infected person to a healthy one. Taking into account medical and epidemiologic importance of this problem we aimed to estimate appropriateness of the antimicrobial agent (AM) choice for outpatient treatment of mild CAP by current and future primary care providers with regard to atypical pathogens coverage.

Methods

Total 240 final year medical students of A.I.Yevdokimov Moscow State University of Medicine and Dentistry (Group 1) and 206 Moscow primary care physicians (Group 2) were surveyed in 2019. Respondents were asked to specify in writing what particular AM they would recommend to 35 year old previously healthy male patient with subfebrile body temperature (37.3 °C), non-productive cough and documented CAP. Chi-square test was used to compare the data obtained in both groups.

Results

Group 1 respondents returned questionnaires with 271 recommendations, Group 2 participants named 230 items. AMs with atypical pathogens coverage (macrolides, fluoroquinolones and doxycycline) accounted for just 33.2% in Group 1 versus 20.0% in Group 2 (p=.0009). Amoxicillin/clavulanate was the leading choice equally popular both in students and physicians (42.1% and 40.9% respectively). The rest of recommendations in both Groups included amoxicillin and various cephalosporins.

Conclusions

Only one of three students and one of five physicians made the right choice in offered clinical scenario. A majority of respondents in both groups hastily recommended beta-lactams instead of clinical estimation of atypical CAP probability in given situation, but students indicated appropriate AMs more often. This problem obviously persists and requires action from both academics and healthcare managers.

Key messages

Medical students and primary care physicians’ awareness of atypical CAP presentation and treatment is not quite satisfactory. Resulting undertreatment of atypical CAP may harm the patient and promote further spread of causative pathogen within the community.
Tuberculosis at Public Health Unit of Santa Maria da Feira and Arouca (Portugal)
Authors: Fernandes D , Reina L
Published: October 2020

Introduction

In the last decade Portugal has seen a decrease of about 40% in the notification and incidence rate of tuberculosis, with incidence values below 20/100,000 inhabitants since 2015. In 2018, a notification rate estimated at a national level was 16,6/100,000 inhabitants and an incidence rate of 16.4/100,000 inhabitants. With this investigation we intend to I) determine the notification and incidence rate of tuberculosis at the Public Health Unit (PHU) of Santa Maria da Feira and Arouca (Portugal); II) analyze the clinical and sociodemographic characteristics.

Methods

The confirmed cases of tuberculosis between January 1, 2015 and December 31, 2019 were analyzed.

Results

105 cases of tuberculosis were identified, most of them male (67%), aged between the 1 year and 94 years age (median: 52 years). About ⅓ of the patients were retired. Among the co-morbidities that constitute a risk for tuberculosis, we highlight COPD (7.6%), alcohol abuse (5.7%) and HIV (3.8%). The pulmonary location prevailed (81.9%). We emphasize that 52 cases had positive smear microscopy and 42 cases cavitation. From 2017 to 2019 we have a median of 61 days from the onset of symptoms to diagnosis. From 2015 to 2019, 4 cases with poly-resistance to isoniazid and streptomycin were identified. In 2019, the incidence rate tuberculosis was 12.5/100,000 inhabitants and the notification rate of 16.3/100,000 inhabitants.

Conclusions

The incidence and notification rate like the median between the onset of symptoms and the diagnosis, by the public health unit (PHU), are below the national average. Regarding these results, we recommend that the strategy adopted by the PHU should be maintained.

Key messages

In the last decade Portugal has seen a decrease of about 40% in the notification and incidence rate of tuberculosis, with incidence values below 20/100,000 inhabitants since 2015. In 2019, the incidence rate tuberculosis at PHU was 12.5/100,000 inhabitants and the notification rate of 16.3/100,000 inhabitants.
Assessment of changes in efficacy of antimalarials: a systematic review and network meta-regression
Authors: Youdom S W , Tchouenkou R S , Ndong-Nguema E-P , Basco L K
Published: October 2020

Background

The fight against diseases such as malaria requires the synthesis of evidence from existing studies to inform decision makers. Indeed, at a cross road of antimalarial drug resistance, several artemisinin-based combination therapies (ACT) with multiple doses are available to fight uncomplicated malaria. However, little is known on how these combinations are combined as well as how different formulations are tested.

Methods

A systematic review was performed to identify randomized trials. Articles were sought by hand-searching and scanning references. Additional covariates effect on treatment outcome was assessed, and a modeling approach to reduce heterogeneity among trials was evaluated. We explored one single interaction effect for all treatment with age as the main covariate in a meta-regression. A Bayesian analysis was used to implement the consistency and inconsistency models under the WinBUGS software. Ranking measure was used to obtain a hierarchy of the competing interventions.

Results

In total, 77 articles meet the inclusion criteria with 15 combinations tested in 36,000 patients. Results were compared to that of frequentist approach and presented according to the Prisma NMA checklist. The consistency model showed a good performance than the inconsistency model under the hypothesis of homogeneity. It was found that compared to artemether-lumefantrine, the dihydro-artemisinin-piperaquine was more effective before (B, OR = 1.83; 95% CI = 1.31-2.56) and after (A, OR = 1.70; 95% CI = 1.20-2.43) covariate adjustment, and occupied the top rank.

Conclusions

The application of the methods described here may be helpful to gain better understanding of treatment efficacy and improve future decisions in malaria programs. Based on the available evidence, this study demonstrated the superiority of DHAP among currently recommended ACT in preventing as well as treating uncomplicated malaria.

Key messages

Choosing the best therapy requires data triangulation and data science. Network meta-analysis could be a solution but need more methodological studies.
HIV/AIDS: a 30 year history at the Northern Region of Portugal
Authors: Neves L Reina , Santos M , Oliveira A
Published: October 2020

Since 1981, when the first cases of human immunodeficiency virus (HIV) infection were diagnosed, the need to monitor what emerged shortly afterwards as an epidemic arose. Portugal was not immune, and over the years different measures have been taken to control the national epidemic. The goal of this research is to contribute to the previous knowledge about the trend of HIV infection at the regional level that allows adequate planning focused on controlling the epidemic. This is an observational, descriptive and cross-sectional study, whose data were anonymized at the source, based on the analysis of cases notified by doctors. The data were analyzed using the software Microsoft® Excel version 16.16.4 and IBM® SPSS® Statistics version 25. To check if there is a proven statistical relationship between the variables, the Chi-Square independence test (X2) was used. The results obtained revealed 14512 accumulated cases, in the different stages of infection, 76.7% of which are male, with a higher incidence between 25-29 years of age. Type HIV-1 covers 97.1% of all cases. From 2013 to 2017 it was observed that 74.2% lived in urban areas. Late diagnosis was found in rural areas, particularly in heterosexual transmission. It was concluded that there are several similarities between data at regional and national levels, such as the occurrence of late diagnosis in the category of heterosexual transmission. Regarding legislative changes, no conclusion can be inferred, although hypotheses were raised that can should be discussed in future studies.

Key messages

Late diagnosis in rural areas. Late diagnosis in heterosexual transmission.
Investigation of flagellates in sandfly guts by microscopic observation
Authors: Mansour C
Published: October 2020

Background

The identification of natural Leishmania infection, observing the location of flagellates in the gut and development stages of promastigotes, helps to incriminate a certain species as vector and to assess the infection risk in host populations, thus contributing with leishmaniasis surveillance.

Objectives

To document with photos, videos and description of the dissection process of sandfly females for observation in their digestive tract of Leishmania infections of Leishmania and Viannia subgenera (suprapillary and peripillary distribution, respectively), to produce a manual to assist in leishmaniasis surveillance actions.

Methods

For the documentation of suprapillary infection, Lutzomyia longipalpis females fed on hamsters infected with Leishmania (L.) infantum and for peripillary infection, Pintomyia fischeri and Nyssomyia neivai fed on hamsters infected with L (V.) braziliensis were used. The dissection of the females was performed at intervals of 12 hours after infectious repast, until completing 120 hours, to observe the different phases of the parasite's evolutionary cycle in the gut.

Results

A manual was produced with description and photos of the entire process, from field sandfly collection, transportation, laboratory maintenance and dissection, as well as the complete cycle of the parasite's evolution inside the vector. Videos were also produce.

Conclusions

This project sought to contribute with the leishmaniasis surveillance as regards the sandfly natural infection investigation by Leishmania to assess the transmission risk of parasites. Although the identification of the Leishmania species depends on molecular techniques, this initial screening may reduce its costs.

Key messages

This study enabled the elaboration of a support manual for technicians from the Entomology laboratory networks. This study enabled with information to identify infected sandflies and thus colaborate with the leishmaniasis epidemiological surveillance programs.
Tuberculosis in a township in southern Bahia: epidemiological and operational indicators
Authors: GAS Jesus , Silva M R , Miranda M L , Reis I M
Published: October 2020

Tuberculosis is an important public health problem of global magnitude. Although it has had diagnostic and therapeutic support for decades, its control requires attention in several points from the health system. In this context, epidemiological and operational indicators allow evaluating the effectiveness of the Tuberculosis Control Program. A retrospective epidemiological study was conducted with a quantitative approach, referring to the period from 2014 to 2018, in the township of Ilhéus, using secondary data from the Information System of Notifiable Diseases of the State Secretariate of Bahia (SINAN/SESAB). During the analyzed period, 678 cases of tuberculosis were identified in the information system, with an average annual incidence coefficient of 71.32 cases/100,000 inhabitants and a mortality coefficient with an average of 4.45 deaths/100,000 inhabitants. The test rate of these HIV patients was 56.64%. Regarding the directly observed treatment (DOT), the annual average was 10.19% cases that underwent this follow-up, with a reduction of 28.57% of cases in 2014 followed up with DOT for only 8.11% of cases in 2018. Regarding the closure situation, in 2018 there was a higher proportion of individuals who presented cure (77.61%), lower proportion of treatment abandonment (18.30%), as well as a lower number of cases with closure due to death (2.99%). Thus, it is perceived that tuberculosis in the township of Ilhéus presents values far from what is recommended and remains an important public health problem. In view of this scenario, highlights the importance of decentralization of the service, with its management guided by the evaluation of indicators and the consolidation of primary health care.

Key messages

This study is relevant because it allows the assessment of the tuberculosis profile. The analysis of the indicators makes it possible to adopt appropriate prevention and control strategies.
Syphilis: A Cohort Study on prevalence, among recently HIV diagnosed in São Paulo, Brazil
Authors: Gomes J O , Teixeira S S S , Müller P R , Luiz O C , Nogueira R S
Published: October 2020

Introduction

The Sexually Transmitted Infections (STIs) are a Public Health problem concern Worldwide. They not only have a direct, but also an indirect impact on sexual Health in afflicted person's life, as they facilitate the sexual transmission of Human Immunodeficiency Virus (HIV). In 2016, the World Health Organization (WHO) estimated 6,3 million new Syphilis infections out of 376 million STIs (95% CI: 5,5-7,1 million). The worldwide prevalence of Syphilis is 0,5% (95% IC: 0,4-0,6). WHO is also concerned about Brazilian syphilis rates infection, since its sexual transmission increased from 59,1 cases in 2017, to 75,8 cases out of 100.000 persons, in 2018.

Objectives

Demographic analysis, incidence and prevalence rates of syphilis among recently HIV diagnosed Adults in a Center of São Paulo, Brazil

Patients and Methods

A Cohort Study in a population of 576 persons recently HIV diagnosed from September/2013 to July/2019. The rates were obtained by performing a nontreponemal test: Venereal Disease Research Laboratory (VDRL)

Results

Epidemiological analysis from 576 persons: 53,3% were Caucasian, 80% were Men who have sex with Men (MSM), 49% had more them 3 occasional partners, the average age was 30 y.o. and the median age was 28 y.o.18 - 65). Prevalence of Syphilis: 16,3%. Incidence rate: 9,6 persons/year.

Conclusions

considering that the STIs including syphilis, facilitate HIV transmission and also other STIs, we need to perform a stricter ISTs surveillance in the sexually active population, mainly in MSM to reduce all the STIs including HIV.

Key messages

Demographic analysis, incidence and prevalence rates of syphilis among recently HIV diagnosed Adults in a Center of São Paulo, Brazil. The Sexually Transmitted Infections (STIs) are a Public Health problem concern Worldwide.
Physical activity among parents during pregnancy and 8 months postpartum compared to pre-pregnancy
Authors: Sjögren Forss K , Stjernberg L
Published: October 2020

Background

As there is incontrovertible evidence of the essential prerequisite of regular physical activity it is also important to understand how different life change events may impact individual's participation in physical activity. Pregnancy and the transition to parenthood have been found to be life change events associated with decreased physical activity among women however, the examination of changes of physical activity in the male parent during this major life change event has been largely neglected in scientific literature and a significant research gap can be found. In the light of this, this longitudinal study aimed to follow changing physical activity patterns among women and med during pregnancy and eight months postpartum compared to pre-pregnancy.

Methods

The study involved 123 women and 112 men (partners of the women) from the municipality of Karlskrona, Sweden. We measured the self-reported amount of physical activity performed outdoors and indoors before pregnancy (calculated from one month before pregnancy), throughout the entire pregnancy, and eight months postpartum.

Results

We found similar trends among both women and men in decreasing frequency of physical activity during pregnancy and eight months postpartum as compared to pre-pregnancy, however, overall physical activity levels did not change.

Conclusions

Our findings contribute new knowledge about changes in men's physical activity patterns from pre-pregnancy to pregnancy and postpartum and is an important contribution in research, as the area is very limited. As couples seem to change activity patterns similarly, it is important to promote family-based physical activity initiatives and encourage couples to be active together during pregnancy and postpartum.

Key messages

Couples seem to change physical activity patterns similarly during pregnancy and postpartum. as compared to pre-pregnancy. It is important to promote family-based physical activity initiatives and encourage couples to be active together during pregnancy and postpartum.
Study of induced abortion based on the Georgian Birth Registry
Authors: Kandelaki D , Kereselidze M , Skhvitaridze N , Lobjanidze T
Published: October 2020

Among the countries of the WHO European region, Georgia has the highest numbers of abortion and comprise 420 per 1 000 live births. According the national law and regulation it is necessary to have a mandatory waiting period for five days before the induced abortion. In this study, we aim to assess the usability of different methods and evaluate the effectiveness of mandatory waiting period of induced abortions.

We provided retrospective study of secondary data based on cases, extracted from the Georgian Birth Registry. The main variables used for the descriptive statistics were: demographic information of selected cases, parity, gestational age, mode of abortion, real length of mandatory waiting period from registration till the induced abortion.

In 2018, was registered 13 612 cases of induced abortion before gestation week 12. Of these, most cases were observed in two age groups: 27.6% was performed among women aged 25-29 and 27.5% among women aged 30-34. From total reported induced abortion cases, 5.4% were provided by dilatation and curettage (from these, 12.6% occurred before 6 weeks gestation), 41.4% was performed by aspiration (from these, 6% occurred at 10-11 weeks of gestation), and 53.2% provided using medical drug-induction (from these, 1.2% occurred at 10-11 weeks of gestation). Of all cases, 14.5% were primiparous women. In 29.3% of cases there were not observed obligatory waiting period before the abortion. 68% of total cases changed the geographical location for the performing induced abortion.

According our results, the application of methods of induced abortion is not fully in line with the international recommendations. Additionally, there is violation of national law for keeping mandatory waiting period before induced abortion. The mandatory waiting period before the induced abortion is less effective in Georgia. Moreover, the share of induced abortions performed during the first pregnancy is high.

Key messages

Health promotion educational activities should be concerned on providing proper information about negative aspects of induced abortion and promote other ways of contraception. Medical personnel should have continues education to be well aware about application of different methodologies of induced abortion.
Safe driving is cool – Project on young driver road traffic injury prevention, Croatia, 2018-2019
Authors: Bocina I , Hasukic J
Published: October 2020

Road traffic injury (RTI) is the leading cause of preventable death among youth in Split-Dalmatia County (SDC), Croatia, particularly males. The most of those who died in road traffic crashes in SDC are young novice drivers (18-24 years). The alcohol was key factor in young driver fatal crashes, often in combination with the drug abuse, driving inexperience, distractions and speeding.

Adolescents lack sufficient knowledge about RTI prevention and reducing hazards. They are occupied with technical details and compliance with traffic rules and don't pay attention to importance of reducing their own risky behaviour. Our goal was to provide a better understanding of factors affecting driving safety among adolescents. The main outcome measure was rating of alcohol and/or drug abuse as main risk, understanding that injuries are preventable as well as RTI.

The pilot project was realized in SDC during 2018-2019 through collaboration between Public Health Institute, Police Department and two high schools. The project included 122 students with an average age of 18.5 year. Initial survey results showed that students tended to take unnecessary risk in road traffic, furthermore 77.0% used cell phones, 62.3% earphones, and only 27.0% helmet while riding bike or motorcycle. Even 39.2% was driving intoxicated or was driven by intoxicated driver once (19.6%) or more times (19.6%). After conducting project, feedback survey results showed that students demonstrated better recognizing of hazards. They accepted injuries (94.3 vs 80.3%) and RTI (99.1 vs 72.9%) as preventable and understood the importance of traffic rules obey (92.6 vs 63.9%). Students understood the danger of intoxicated driving (74.6 vs 56.6%).

Promoting safe-driver behaviour and providing new educational opportunity can encourage responsible driving behaviours among adolescents. Strengthening inter-sectoral collaboration is a key of success in achieving the reduction of mortality and morbidity among young drivers.

Key messages

Adolescent adapted method developed by joint effort is vital in promoting safe driving practice. Projects aiming to minimize risks in young drivers contribute to saving lives, they deserve to grow up.
Pregnancy and childbirth in Mozambique: men as decision makers and women as caretakers?
Authors: Galle A , Cossa H , Osman N , Roelens K , Griffin S , Degomme O
Published: October 2020

Background

Increasing male involvement during pregnancy is considered an important, but often overlooked intervention for improving maternal health in sub-Saharan Africa. This study explores the attitudes and beliefs of health policymakers, health care providers and local communities regarding men's involvement in maternal health in southern Mozambique.

Methods

Ten key informant interviews with stakeholders were carried out to assess their attitudes and perspectives regarding male involvement in maternal health, followed by 10 days of semi structured observations in health care centers. Subsequently 16 focus group discussions were conducted in the community and at provider level, followed by three in depth couple interviews. Analysis was done by applying a socio-ecological systems theory in thematic analysis.

Results

Results show a lack of strategy at policy level to stimulate male involvement in maternal health. Invitation cards for men are used as an isolated intervention in health facilities but these have not lead to the expected success. Providers have a rather passive attitude towards male involvement initiatives and women accompanied by a husband are often put in a submissive position. In the community however, male attendance at ANC is considered important and men are willing to take a more participating role. Main barriers are the association of male attendance at ANC with being HIV infected and strong social norms and gender roles. On the one hand men are seen as caretakers of the family by providing money and making the decisions. On the other hand, men supporting their wife by showing interest in their health or sharing household tasks are seen as weak or as a manifestation of HIV seropositivity.

Conclusions

A clear strategy at policy level and a multi-level approach is needed. Gender-equitable relationships between men and women should be encouraged in all maternal health interventions and health programs should step away from linking male involvement to HIV prevention.

Key messages

Linking the promotion of gender equality to male involvement is the key for success. Step away from linking HIV prevention to male involvement in maternal health.
Fears for the future among Finnish adolescents in 2019
Authors: Lindfors P , Lahti L , Kinnunen J , Rimpelä A
Published: October 2020

Background

Adolescents' images of the future emerge from knowledge built on experiences of the past and present and their age-related developmental tasks. Images of the future direct adolescents' decision-making, choices, and behavior. The images of the future can act as a mirror of our times, reflecting the political values and ethos of society. The aim of this study was to examine the fears for the future among Finnish adolescents in the era of climate change.

Methods

Data from a nationwide survey on the health and health behavior of 12-, 14-, 16-, and 18-year-olds (n = 3520, the response rate 37 %) in 2019 in Finland. An open-ended question on fears for the future was employed as a final question on the survey. The data was analyzed first by inductive content analysis and then by statistical methods. Altogether 7829 fears were reported. These were constructed into 12 main categories.

Results

Fears for the social relationships and loneliness were the most common (35 %). Fears related to death (33 %), physical health and wellbeing (25 %), life management and success (19 %) and working life (17 %) were next common. Only 9 % of the adolescents reported climate and the environment related fears. In age group comparisons, 12-14-year-olds reported more global and social fears, while 16-18-year-olds reported more personal fears, such as study, working life and relationships. The most common fears among boys and girls were similar in all age groups.

Conclusions

The most common fears among Finnish adolescents are related to personal life and less to global issues. Against our hypothesis, climate and environmental related fears were not among the top fears, even these topics are figured prominently in media and other research has also reported high proportions of climate change related fears among adolescents. The inconsistencies might be explained by the differences in the research methodologies: whether open-ended questions or structured questions are used.

Key messages

Most common fears for the future are related to personal issues like relationships, health and work. Fears for climate change were not among the most common ones when open-ended questions were used.
The impact of physical activity on children with adolescent idiopathic scoliosis from Varna, Bulgaria
Authors: Marinov D , Dimitrova T , Najdenova D
Published: October 2020

Background

Adolescent idiopathic scoliosis (AIS) is one of the most common chronic conditions in teenagers. There is an increasing amount of evidence suggesting that AIS is associated with low body mass, but the link between the condition and the nutritional status of the adolescents has not been well researched. This ongoing study aims to access the relationship between AIS and all the aspects of the nutritional status in-depth, including factors such as physical activity (PA).

Methods

Data is collected from 101 participants with AIS from Varna, Bulgaria using anthropometric measurements, clinical examination to determine the severity of the spinal curvature and questionnaires including a standardized questionnaire for PA of adolescents - PAQ-A. Participants were categorized into 3 groups of AIS severity according to Cobb Angle: mild (10°-19°), moderate (20°-39°) and severe (>40°).

Results

Out of 101 participants, 81 had mild, 15 had moderate and 5 had severe scoliotic curvatures. None of the participants reported reduced PA due to impaired or restricted physical functions related to AIS. Only 40% of all subjects with AIS had PAQ-A score over 2.75, which corresponds to the international recommendations of > 60 mins of daily moderate-vigorous PA. There was a strong negative correlation between PAQ-A score and AIS severity (Spearman's Correlation Coefficient = - .433, p < 0.001). The mean PAQ-A score was 2.73 in mild curvatures compared to 1.98 in moderate and severe ones. Subjects with AIS were 4.8 times more likely to have mild severity if they met the PA recommendations (OR = 4,815 (95%CI, 1.268-18.279)). Those are preliminary results and data will be further compared to a control group.

Conclusions

The level of daily PA might have an impact on the severity of AIS. PA recommendations could be given to patients with AIS as a way of secondary prophylaxis against this chronic idiopathic disorder.

Key messages

This ongoing study is the first to investigate in-depth the association of all the aspects of nutritional status including PA with the incidence and severity of AIS. PA shows a significant negative correlation with AIS severity. PA recommendations might be a useful addition to the secondary prophylaxis of AIS.
Acceptability of assisted reproductive technologies in Hong Kong, a very low fertility Asian city
Authors: Kim J H , Wong S Y S , Chan R , Chan R Y , Sumerlin T S , Chan L Y
Published: October 2020

Background

Although advances in medical technologies now allow greater reproductive options, the social acceptance of assisted reproductive technologies (ART) has not been examined in East Asian countries which currently have the lowest fertility rates in the world and highly prohibitive regulations.

Methods

A cross-sectional telephone surveys interviewed 990 among Hong Kong Chinese adults (>18 years of age) in 2015 who were asked about their knowledge and attitudes towards various ART and their inclination to use ART. A focus group was conducted (n = 30) on physicians to examine the perceived barriers and benefits of integrating ART as routine offerings.

Results

Although nearly all adults (>92.0%) were familiar with ART procedures such as in vitro fertilization, sperm banking, and gestational surrogacy, attitudes supporting the use of these services and the inclination to use these services varied widely by socio-demographic attributes. Nearly one-third (31.5%) of women said that they would consider cryopreservation of their oocytes or embryos if they could afford it and 21.9% would encourage their female family members to do so. Although respondents considered sperm donation and embryo preservation to be well-accepted practices, support for these services was noticeably lower than in Western countries for unmarried individuals and homosexuals. Also, the vast majority of respondents were much more disinclined to use anonymous donor gametes than in Western countries. Among medical practitioners, the primary barriers to routine offering of these services to their clients was the perceived lack of cultural acceptance of these types of services.

Conclusions

Public support of assisted reproductive services for genetic offspring is well-accepted for heterosexual couples. Main Messages: Asian countries with sub-replacement fertility levels may consider integrating ART into their mainstream health services and updating their regulatory frameworks.

Key messages

Public support for assisted reproductive technologies is high for married couples only in Hong Kong. Given the sub-replacement fertility levels, cities in East Asia should consider updating regulatory frameworks to allow expansion of ART services.
Screening for retinoblastoma: an evidence review of the validity and use of the red reflex test
Authors: Kelly C
Published: October 2020

Background

Retinoblastoma is the most common intraocular malignancy of childhood, the most common presenting signs of which are leucocoria and strabismus. In Ireland, there are on average less than 5-7 cases annually. Early detection of this sight and life-threatening malignancy is important to enable urgent specialist ophthalmology referral for assessment. An evidence review was sought by the Health Service Executive Steering Group for the Revised Child Health Programme to examine the validity and use of the red reflex test in Ireland and internationally as a screening test for retinoblastoma.

Methods

An electronic literature search was conducted to identify relevant peer-reviewed publications using the database Pubmed. A hand search of reference lists of suitable articles was conducted to check for additional material. Publications pertaining to national and international retinoblastoma screening practices were sourced via internet searches using Google. The relevant grey literature was explored.

Results

There is very limited data on the validity of the red reflex test as a screening test for retinoblastoma. Despite potentially raising a high proportion of false positive results, it is a low-cost, non-invasive, quick and acceptable test. In Ireland and the UK, retinoblastoma is universally screened for using the red reflex test within 72 hours of birth and at 6-8 weeks of age. Detection of a white, absent or asymmetrical red reflex prompts urgent referral to a specialist ophthalmology service. Many cases of retinoblastoma in developed countries are brought to clinical attention after an eye abnormality is noticed by a parent.

Conclusions

The red reflex test is a valuable screening tool which is used internationally as part of newborn screening for eye pathology including retinoblastoma. The evidence synthesised in this review will inform educational initiatives in Ireland to improve awareness and detection of this malignancy among healthcare providers and parents.

Key messages

Early detection of retinoblastoma is important to enable urgent specialist ophthalmology referral for assessment. The red reflex test is a valuable screening tool which is used internationally as part of newborn screening for eye pathology including retinoblastoma.
Cyberbullying and Electronic Media Communication problematic use in Piedmont. Data from HBSC study
Authors: Marengo N , Borraccino A , Caputo M , Dalmasso P , Lemma P
Published: October 2020

Background

Cyberbullying seems to be an emerging public health issue worldwide. Several mental health problems have been reported in adolescents exposed to it. Spreading of smartphones and social networks in youths, requires to explore the eventually Electronic Media Communication (EMC) problematic use, in order to identify potentially negative health consequences in adolescents. This study aims to illustrate cyberbullying and to investigate whether an EMC inappropriate use could implicate an increased cybervictimization risk.

Methods

Data were collected as part of the Italian 2018 Health Behaviour in School-aged Children (HBSC) study for the Piedmont region, which involved 3022 children of 11, 13 and 15 years old. Prevalence of cybervictimization, cyberbullying and EMC problematic use were estimated in subgroups defined by age and gender. The link between EMC problematic use and cyber-victimization/bullying was examined through a multivariate logistic regression.

Results

The average frequency of cybervictimization in Piedmont was low (7,4%), in line with the average distribution in Italy. 13 years old girls reported the highest proportions of both cybervictimization and EMC problematic use (10,30% and 12,08% respectively). Adolescents who reported EMC problematic use showed an increased risk of cybervictimization (OR = 2,45; p < 0,05).

Conclusions

Despite the low prevalence of cyberbullying in Italy, our data showed a greater risk of cybervictimization when the EMC use is inappropriate. Further investigations, starting from the HBSC study, are required to explore the cyberbullying phenomenon in depth.

Key messages

Cybervictimization risk is higher in EMC problematic use. Public health intervention and educational programs are deemed necessary for a more responsible EMC use, in order to prevent cyberbullying and mental health problems in adolescents.
The venom bites in pregnant women: systematic review
Authors: Lorenzini C , Cuccaro C , Nante N
Published: October 2020

Background

The snakebite in pregnancy are rarely reported in literature; they cause mortality and morbidity, the symptoms may be many, such as circulatory collapse, respiratory failure, bleeding, renal failure. The antivenom is the standard treatment, but it can be a potential cause of anaphylaxis and serum diseases; its effects on the fetus are unknown, so doctors may hesitate to apply it. We conducted this study because there are many cases not described in the literature also in Italy. The aim of systematic review is to evaluate the outcomes of the bites for women and newborns and the antivenom treatments in pregnant women, to understand the best behaviour to adopt.

Methods

In January-February 2020, we searched studies in Medline using the key MeSH Terms “snake bites” and “pregnant woman”. We included all case-control studies and letter to editor in English.

Results

The research yielded 22 publications: after title, abstract and full text's analysis, 12 manuscripts were included in this review. The studies were conducted from 2006 to 2019 in Japan, Taiwan, India, Pakistan, Thailand, Burkina Faso, USA, Israel and included a total of 14 pregnant women (1-3 women per study). The mean age was 30.47± 7.34, the average of pregnancy week was 21.50±11.25, 93.33% of mothers was alive as well as 60% of fetuses. The antivenom was given in 66.67% of cases, of these, all mothers were alive and only four newborns were dead (the deaths in studies don't seem to be related to the use of antivenom).

Conclusions

Snakebite during pregnancy could lead to serious complications for mother and fetus. The use of antivenom does not appear to be related to fetal or maternal death, and it should always be species-specific for the type of snake, so as to reduce the risk of adverse effects caused by antivenom or its improper use. It is necessary to implement guidelines for the correct management of therapy and to ensure good maternal and fetal outcomes.

Key messages

It is important to diagnose snakebite in pregnant women quickly in order to begin supportive therapy and identify the species of snake for the administration of the correct antivenom. An improvement of the guidelines is needed for better management of therapy in pregnant women.
Every fifth child and adolescent in Finland is overweight
Authors: Laitinen U , Mäntymaa P , Haapala E , Jääskeläinen S , Sundman J , Ruokokoski E , Nieminen T , Peltomäki H , Lundqvist A
Published: October 2020

Background

Globally, the prevalence of child and adolescent overweight and obesity has increased during the preceding decades leading to childhood obesity being acknowledged as one of the most significant health hazards of the 21st century. Yet, in Finland comprehensive and up-to-date data on the prevalence of overweight and obesity among children and adolescents have been lacking. The aim of this study was to examine the prevalence of overweight and obesity among 2-16-year-old children and adolescents living in Finland in 2018.

Methods

The study was based on height and weight measurements taken at child welfare clinics and school health services between 5.7.2017 and 5.4.2019 (n = 375,561). The data was collected from the Register of Primary Health Care Visits. Child and adolescent overweight and obesity were defined according to international IOTF BMI criteria (age- and sex-specific BMI cut-off points corresponding to adults' cut-off points of 25 kg/m2 for overweight and 30 kg/m2 for obesity) and reported by age group and sex.

Results

In 2018, nearly 20% of boys and girls aged 2-16 years were classified as at least overweight while the prevalence of obesity was 5% among both sexes. The prevalence of overweight in pre-school-aged children (2-6 years) was 12% in boys and 15% in girls, in primary school-aged children (7-12 years) 23% in boys and 22% in girls and in adolescents (13-16 years) 25% in boys and 23% in girls.

Conclusions

In 2018, every fifth child and adolescent in Finland was classified as either overweight or obese. The prevalence of overweight and obesity appears to increase with age in both genders.

Key messages

Childhood and adolescent overweight and obesity were comparatively common in Finland in 2018. As overweight and obesity often persist into adulthood, multi-professional interventions targeted at prevention and early detection are essential.
The effects of paternal childcare in early childhood on later behavioral problems in Japan
Authors: Ochi M , Fujiwara T
Published: October 2020

Background

Parenting by primary caregivers in early childhood is important for the psycho-social development of children. Previous studies reported that the effect of maternal childcare on child behavioral problems. However, the research about the paternal childcare was limited. This study aims to clarify the impact of paternal childcare during infant-period on behavioral problems in later childhood, in terms of 1) childcare hours and 2) type of involvement in childcare.

Methods

We used the data of the Longitudinal Survey of Newborns in the 21st Century (2001-2006), which was a population-based survey in Japan. We analyzed 35,082 samples, excluding single parents. Paternal childcare was assessed by the following; paternal childcare hours on weekdays or weekends at 18 months old, and frequency of each type of childcare (feeding, diaper change, bathing, putting the child to sleep, playing at home, and taking the child outside) at 6 and 18 months old. We evaluated child behavioral problems by the caregiver's answer at 5 years old. Multivariate logistic regression was conducted for analysis.

Results

Children with paternal childcare for ≥ 6 hours on weekends at 18 months old were had fewer behavioral problems at 5 years old than children with paternal childcare for < 4 hours (odds ratio (OR): 0.83, 95% confidence interval (CI): 0.77 to 0,89), while there was no clear association between paternal childcare hours on weekdays and child outcomes. Children with frequent paternal childcare at 6 and 18 months old also had fewer behavioral problems than children with less paternal childcare (OR: 0.83, 95% CI: 0.76 to 0.90). Some types of paternal childcare (feeding, playing at home, and taking the child outside) strongly reduced child behavioral problems at 5 years old, and dose-effect relations were observed (p for trend < 0.001).

Conclusions

Paternal childcare for a longer time on weekends in the infant-period could reduce the child behavioral problems at 5 years old.

Key messages

High paternal involvement in childcare during infant age, such as taking the child outside the home on weekends, could have protective effects on behavioral problems in later childhood. The promotion of paternal involvement in childcare in early childhood should be useful for adequate child development.
A latent class analysis of bullying among students: associations with social factors and alcohol use
Authors: Ferreira Júnior V , Yurgel Valente J , van der Meer Sanchez Z
Published: October 2020

Bullying is a behavior highly prevalent in schools worldwide and is associated with several mental disorders later in life. Considering its prevalence and impact in mental health, it is being recognized as a public health problem. We aimed to identify patterns of bullying victimization and perpetration in children and adolescence, and investigated its association with school performance, alcohol use and sociodemographic factors. A latent class analysis was conducted using baseline data collected from a randomized controlled trial conducted to evaluate the effectiveness of the drug prevention program PROERD (the Brazilian adaptation of the the US program 'Keepin it REAL”) carried out among 1.742 students in 5th grade and 2.316 in 7th grade, from 30 public schools of São Paulo city, Brazil. Two models of four latent classes each were identified among the students, in 5th and 7th grade: Low bullying, Moderate bullying victimization, High bullying victimization and High bullying victimization and perpetration. In both grades, we found that alcohol use were associated to all bullying latent classes (e.g High bullying victimization and perpetration (aOR=5,63; 95%CI = [3,05; 10,38] and aOR=3,29; 95%CI = [1,28; 8,43], 5th and 7th grade respectively). In 5th grade, girls were more likely to belong to the “High bullying victimization” class and to “Moderate bullying victimization” (aOR=1,75; 95%CI = [1,02; 3,01] and aOR=1,47; 95%CI = [1,16; 1,87], respectively); students who reported to belonging to black or brown races were more likely to belong to 'High bullying victimization' class (aOR=3,35; 95%CI = [1,34; 8,37]); low and medium school grades were associated to High bullying victimization and perpetration (aOR=10,12; 95%CI = [4,19; 24,41]) and Moderate bullying victimization (aOR=1,63; 95%CI = [1,17; 2,27]). The results show the need to implement school prevention programs that simultaneously address alcohol use and bullying components, besides taking into account race and gender norms.

Key messages

Bullying profiles help us to understand how this type of violence happens among students. And the associated factors indicate which groups are at greatest risk and need more attention. The use of alcohol associated with all latent classes, besides showing the impacts of bullying, it also indicates the importance of bullying prevention programs to address substance use prevention.