bluuebunny/crossref_metadata_2025 huggingface dataset:
Knowledge, attitudes and behaviours towards vaccination: a survey of university students in Europe
Authors: Callegaro A , Chinenye Ilogu L , Lugovska O , Mazzilli S , Prugnola A , Van Damme P , Vojtek I
Published: October 2020

Background

Immunisation programs are still facing substantial challenges in achieving target coverage rates. This has been attributed to the growing negative individual vaccination attitudes and behaviours. Most of the current studies assessing vaccination knowledge, attitude and beliefs targets adults. However, young people represent future parents and health care professionals. The objective of this study was to investigate vaccination knowledge attitudes and behaviours among university medical and non-medical students in Europe.

Methods

We performed a cross-sectional online survey between April and July 2018. The study participants were students attending different faculties at the University of Antwerp, Belgium and the University of Pisa, Italy. We described sample characteristics. The effect of risk factors was tested with univariate and multivariate logistic regressions.

Results

A total of 2079 participants completed the survey including 873 medical students and 1206 from other faculties. The average of vaccination knowledge, attitudes, and confidence was respectively 5.51 (SD: 1.41), 4.66 (SD: 0.14) and 5.28 (SD: 0.57) on the 6-points scale. Our respondents demonstrated a high level of awareness with respect to their vaccination history. In total, 67.7% (n = 1407) reported to have received at least one vaccine in the previous five years; only 6.0% (n = 35) did not receive any vaccine in the previous 10 years. According to logistic regression analysis Italian students had significantly higher knowledge, attitude and confidence scores than Belgium respondents. Students of medicine scored significantly higher compared to non-medical students.

Conclusions

In order to reduce the gaps in vaccinations knowledge between non-medical and medical students we should plan educational interventions. In this way the number of future sceptical parents could be decreased. Further studies are required to explain the differences between countries.

Key messages

Young adults are the parents and the health care professionals of the future, for this reason their vaccination knowledge attitudes and behaviours should be carefully monitored. European non-medical students have lower vaccinations knowledge, attitudes and confidence compared with medical student. In order to fill these gaps, we should plan educational interventions.
Vaccination and immunization status among healthcare students: results from the SAVES survey
Authors: Rivolta S , Letzgus M , De Nard F , Gaiazzi M , Principi N , Margherita M , Florio E M , Gervasi F , Castaldi S
Published: October 2020

Background

Adequate vaccination coverage among healthcare workers, including students in healthcare professions (SHPs), is crucial in order to prevent spreading of infections within healthcare facilities. However, vaccination coverage among SHPs is often inadequate. We aimed to describe the vaccination/immunization status of SHPs of the University of Milan.

Methods

We spread an e-survey to the academic e-mail addresses of postgraduate medical residents and to first- and last-year undergraduate SHPs. The questionnaire covered sociodemographic data (age, sex, education, municipality of residence, internship in high-risk wards) and the reported vaccination/immunization status for Influenza (previous flu season), Varicella, MPR and DTaP vaccines.

Results

Among 5743 invited SHPs, 884 participated in the survey. The study sample comprised 462 medical residents and 422 undergraduate SHPs (medicine 176, nursery 186, midwifery 4, healthcare assistance 32, prevention techniques 24). Median age was 27 years (IQR 7); 68.4% participants were female; 91.3% had attended high school in a lyceum, while others in a professional (2.9%) or technical (5.8%) institute; 36.7% lived in municipalities of < 20.000 inhabitants, while 26.1% of > 250.000. Traineeships took place in high-risk wards for 46% of participants. Reported vaccination coverage for Influenza was 33,7% (with higher coverage for pediatric nursing and midwifery students, medicine students and medical residents). Participants reported immunity (either vaccine or natural immunity) to Varicella in 93,3% cases. Declared vaccination coverage for Hepatitis B was 94,1%; 91,7% participants reportedly completed the MPR schedule, 76,2% the recommended DTaP booster.

Conclusions

Influenza vaccination coverage was suboptimal in our sample of SHPs, suggesting the need of specific educational programs and targeted vaccination campaigns, which may help shaping a positive vaccination attitude for future healthcare professionals.

Key messages

Immunization status for VPDs is suboptimal among Italian students in healthcare professions. The monitoring of the immunization status should include healthcare students actively involved in healthcare activities.
Influenza vaccination among pregnant women: increasing awareness and coverage
Authors: Carini E , Bruno S , Di Pilla A , Beccia V , Di Pumpo M , Damiani G , Carducci B , Masini L , Lanzone A , Laurenti P
Published: October 2020

Influenza is a serious public health issue and pregnant women are one of the categories at higher risk of complications. Vaccination represents a safe and effective tool for prevention but the importance is not well perceived and the coverage is low (ECDC: 25% median in 2016/17). A program of education and free vaccination has been proposed to pregnant women following birthing classes. The aim was to increase pregnant awareness and to increase vaccination coverage of both parents. Classes about vaccinations, their timing and efficacy were given and a dedicated ambulatory operating twice a month during the flu season was set up. After the classes, the women were addressed to the ambulatory to be vaccinated. Vaccination was offered to the partners of the pregnant as well. General data, anamnesis and data about previous vaccinations were asked and then entered into a database.

The number of women participating to the birthing classes from October 2019 to January 2020 was 119. Of those, from the beginning of the vaccination sessions on November 14th 2019 until January 16th 2020, 46 were vaccinated in the dedicated ambulatory (plus 2 in the resident ambulatory of the hospital). The compliance to vaccination was 40.34%. An additional number of 39 partners was also vaccinated. November was the month with the highest number of people vaccinated (20 women and 14 partners), while January had the lowest (7 women and 8 partners).

As expected a higher number of people got vaccinated at the beginning of the flu season. A considerable number of partners decided to vaccinate, showing the parents understanding of the importance of herd immunity. Sensitising the women towards vaccination and increasing their awareness is crucial to improve women and new-borns' health status. Even though the compliance was considerable, a lot of work has to be done to improve vaccination coverage and to make the importance of vaccination clear.

Key messages

Providing a programme of sensitisation could improve influenza vaccination coverage. The compliance, although satisfactory, can be further improved providing different and steady educational strategies.
Vaccine-preventable diseases screening and vaccination programs for healthcare professions students
Authors: Letzgus M , De Nard F , Gaiazzi M , Rivolta S , Grimoldi L , Magnoni P , Gervasi F , Carrer P , Castaldi S
Published: October 2020

Background

Students in Healthcare Professions (SHPs) present an increased risk of contracting and transmitting Vaccine-Preventable Diseases (VPDs). Our study aimed to investigate the organizational strategies (screening and immunization for VPDs and vaccination promotion among SHPs) implemented by the healthcare facilities accredited with the University of Milan.

Methods

we sent an e-survey by e-mail to medical residents and first- and last-year students in nursing, midwifery and healthcare assistance.

Results

among 3397 invited SHPs, 645 participated. We included in the analysis 522 SHPs, distributed in 24 facilities across the Lombardy region (mean age 27,4 years; 69,5% female; 69% medical residents, 28% nursing, 2% healthcare assistance, and 1% midwifery students). Although most participants underwent occupational health visit before the traineeship start (47,5%) or within 6 months (29,5%), others hadn't undergone yet (15,1%). The visits included the collection of vaccination history (72,6%; 64,6% from written documentation), serological tests for VPDs (hepatitis B 76,1%, measles and rubella 58,4%, varicella 54,4%), and screening for latent TB (69,7%). Vaccinations were recommended to 226 participants, but only 173 fully (76,5%) or partially (8%) complied. Full compliance was associated with nudges like in-hospital (Chisq. 18,7; p = 0.00) and free vaccinations (Chisq. 31; p = 0.00). Reported facility vaccination policies included campaigns (posters 37,4%, intranet 39,5%, social media 11,5%, general/personalized letters 30,3%/11,5%), time-off incentives (7,7%), on-site (30,5%) and opinion leaders' vaccinations (9,8%). However, SHPs were often unaware of those strategies (mean 48,6%), and intra-facility answers were sometimes discordant (agreement <70% for facilities with >30 respondents).

Conclusions

SHPs are often unaware or discordant regarding vaccination policies carried out by traineeship facilities, suggesting the need of inclusive communication strategies.

Key messages

About half of students in healthcare professions are screened for VPDs after the start of the traineeship. Students in healthcare professions are often unaware of vaccination promotion strategies.
Climate change and health: time for action!
Authors: Marrauld L , Cucchi M , Lainey E , Depoux A
Published: October 2020

Issue

For several weeks, prophylactic messages against the extension of Covid-19 have saturated the public space. To protect populations, efficient measures have been rapidly put to limit the movement of people and manufactured goods. These policies have reduced global greenhouse gas emissions as well as air pollution, especially in China.

Problem

If climate change were an epidemic, we would probably have already restored it. But it results directly from the thermo-industrial activities linked to the consumption society. For Friel (Lancet, 2020), the dramatic consequences of this disturbances have to be considered as an essential health issue. She advocates for 'climate change and health alliances'.

Results

Within such alliances, health professionals have the responsibility (1) to describe the morbidity inherent in our thermo-industrial societies (2) to alert populations, and (3) to work with allies to tackle climate change and protect human populations, starting with the most vulnerable. This type of alliance is underway in the battle against air pollution, as it has been for years for fighting smoking. Alliances are intended to extend to all population health issues, with a complete decompartmentalization of minds and practices at large scale.

Lessons

Health professionals have to be mindful not to cause any harm while practicing. The health system alone produces up to 8% of global greenhouse gas in developed countries (Pichler, 2019; HCWH, 2019). There is room for action. Since 2009, the British health care system (NHS) has adopted an efficient decarbonation policy, reducing global emission from 8 to 4%, but this outstanding initiative remains an exception worldwide.

Key messages

A review of public health strategies is necessary to meet the energy, environmental and health issues, both in terms of health risks due to climate change and of decarbonation of care activities. Health professionals have the responsibility to alert populations and to work with allies to tackle climate change and protect human populations.
Knowledge, Attitudes And Behaviors Of Faculty Members On Childhood Vaccine Refusal A University
Authors: Yigit E , Boz G , Gokce A , Aslan M , Ozer A
Published: October 2020

Introduction

Vaccines stimulate the immune system and provides protection against a large number of diseases. Although there is a lot of scientific evidence that the benefits of vaccines are higher than their risks, concerns can occur in every segment of the community about the safety of vaccines.In this study, we aimed to examine the knowledge, attitudes and behaviors of the faculty members working at Inonu University regarding vaccine rejection.

Methods

This study is a descriptive cross-sectional study, conducted between July and August 2019. The universe of this study consists of 799 faculty members working at Inonu University. Sample size was calculated as 258 with 95% confidence interval and 80% power. The questionnaire used in the study consists of the questions including the sociodemographic characteristics of the faculty members and their knowledge, attitudes and behaviors about childhood vaccine rejection. Chi-square test was used for statistical analysis. p < 0.05 was determined to be significant.

Results

99.1% of the faculty members had their children vaccinated during their childhood. 31.8% of faculty members stated that they were worried about childhood vaccines.As a source of information about vaccines, faculty members stated the scientific articles in highest rate (49.4%).It was found in comparison that parents who applied alternative medicine for their children were more worried about vaccines than those who did not, and those who did not read scientific publications about vaccines were more worried than to those who read (p < 0.05).The levels of anxiety are significantly lower in those who do not think that vaccines cause autism and infertility, and those who trust vaccine producing companies (p < 0.05).

Conclusions

Almost all of the faculty members have their children vaccinated, but their level of anxiety about vaccines is high. In our study, we observed that those who obtained their knowledge about vaccines from scientific articles were less anxious.

Key messages

Faculty members, who are among the most educated groups of the society, have a high level of anxiety about childhood vaccination. By keeping faculty members informed about the scientific publications about vaccines, their concerns about the vaccine can be eliminated.
Preparing health professionals to practice environmentally sustainable healthcare
Authors: Madden D L , McLean M , Horton G L , Canny B , Haq B , Roiko A , Capon A , Alsop-ten Hove B , McKay I , Hankinson A
Published: October 2020

Background

In 2019 the WHO identified climate change and air pollution as the top global threat to health. This was illustrated by the health consequences of the catastrophic 2019-20 Australian bushfire season. Health-care systems also contribute to climate change and environmental degradation. For Australia, health care contributes 7% of total carbon emissions and produces considerable clinical and non-clinical waste which is either incinerated or sent to landfill. Despite these threats to health there is a limited response by health professions education to include climate change and environmentally sustainable healthcare in curricula.

Methods

Medical Deans of Australia and New Zealand (MDANZ) is the peak body for professional medical education in Australasia. MDANZ formed a Climate Change and Health Working Group to develop curriculum and learning resources. The Group comprises representatives of Australasian medical schools and student representative organisations. The scope for curriculum was defined by searching the literature, reviewing teaching experience, and benchmarking against relevant courses developed for medical students by peers.

Results

Five broad areas of learning were identified; graduate outcome statements and learning objectives were developed aligned with these. Once endorsed by MDANZ these were circulated to all medical schools to inform curriculum review. A resource repository is being developed to support curriculum change. Ways to measure and monitor inclusion in medical programs are being researched.

Conclusions

We must prepare future practitioners for their role in transforming health care to become carbon neutral. Using a public health approach, system level change in medical education is being supported in Australasia. All health professions have a role in providing environmentally sustainable health care. The Group provides a model that can be used by other health professions to create change at the necessary pace and scale.

Key messages

The health education sector must prepare graduates for climate change and environmentally sustainable healthcare. By working collaboratively at a systems level, change can occur at pace and scale.
CO levels in waterpipe cafes of Karachi, Pakistan
Authors: Baloch R , Pervez M
Published: October 2020

Background

The dangers of water-pipe smoking have been documented, but data from water-pipe (WP) cafés is lacking. Assessing carbon monoxide (CO) levels in the air inside WP cafés may aid the understanding of the toxins and exposure of the employees. The results can provide novel information regarding WP's effect on air quality which may help generate regulatory efforts to protect the café employees against WP smoke. We wanted determine the air quality through measurement of CO levels in closed room cafés and restaurants of Karachi, Pakistan.

Methods

It was a cross sectional study design. 3 WP cafes in the city of Karachi, Pakistan were surveyed during June 2015. All cafés were indoors and air-conditioned. Carbon Monoxide (CO) air samples were collected from the included cafés using CO USB Data logger. The Sampling device was left with café admin managers and was left for 30 hours at venue #1, for almost 7 hours at venue #2, and for 70 hours at venue #3 to measure the CO levels in cafés. The average sampling duration was around 36 hours. The graphs were automatically generated by the device.

Results

Overall, readings of the CO monitoring samples from all included venues were within / lower than threshold limit value (TLV) of 25 ppm, and MAK maximum workplace value of 30 ppm.

Conclusions

The findings of this study provide evidence that the air quality in water-pipe cafes is potentially hazardous to the health of its employees, which is critical to inform tobacco control policies and regulations for such venues. The study findings indicate a clear need to extend research to not only focus on the indoor air quality of water-pipe cafes, but also the biological monitoring of employees in water-pipe cafes.

Key messages

Employees working in waterpipe cafes are exposed to toxic substances that can potentially manifest adverse health effects. Air quality of indoor waterpipe cafes should be assessed to protect employees.
The three paradigms on urban health
Authors: Kim J , de Leeuw E , Harris-Roxas B , Sainsbury P
Published: October 2020

Background

While public health and urban planning share a historical connection in the mid-19th century, when public health and sanitation became a key guiding principle for urban planning, the two disciplines evolved in separate ways after major technological and social developments such as the development of germ theory and the ascent of biomedicine. Recently, urban planners and public health experts globally are calling for a reconnection between the health and urban planning spheres. However, there are different schools of thought around how to address health in the urban context that originates from different worldviews and epistemological traditions of the disciplines.

Methods

This study is a narrative review that explores the core beliefs and assumptions of the different research traditions that are observed around health in the urban context.

Results

The study identifies three main traditions. The 'urban health science' tradition is characterized by the pathogenic and epidemiological analysis of urban problems, suggesting predominantly technological solutions to these issues. Scholars of this tradition emphasize that urban health requires straight Cartesian causal thinking to inform interventions to promote the health of urban populations. The 'healthy cities movement' tradition is based on the principles of the Ottawa Charter for Health Promotion with strong roots in social movements, and takes a value-based approach to solutions that embraces the principles of solidarity, equity, sustainability and empowerment. While these two traditions originate from the discipline of public health, the third 'healthy urban planning' tradition emerged from the urban planning discipline and proposes to include health as objectives in the spatial development of cities.

Conclusions

This study identifies the core beliefs and assumptions of the paradigms of urban health and highlights areas where beliefs and assumptions epistemologically or practically overlap and interface.

Key messages

Scholars from different epistemological traditions possess different worldview on the problem definition and solution to urban health. The three paradigms on urban health are not mutually exclusive, rather each could learn from each other to promote the health of urban citizens.
Air pollution and rhinitis in the Constances cohort
Authors: Savouré M , Lequy E , Vienneau D , de Hoogh K , Nadif R , Jacquemin B
Published: October 2020

The prevalence of rhinitis has increased in the past decades. We aim to study the effect of air pollution, as one of the environmental factors that may explain the increase of rhinitis prevalence. A total of 21507 (80%); of the 26737 participants included until December 2013 in Constances, a large French population-based cohort, answered standardized questions on rhinitis in 2014. Ever rhinitis was defined by a positive response to “Have you ever had a problem with sneezing or a runny or a blocked nose when you did not have a cold or the flu?”. Current rhinitis was defined among those reporting ever rhinitis and nasal symptoms in the past 12 months. Annual exposure to nitrogen dioxide (NO2), particulate matter ≤2.5 µm (PM2.5) and black carbon (BC) was estimated at the participants' residential address by extrapolating European land-use regression models for 2010 to year 2014. Associations between annual exposure to air pollution and rhinitis were estimated using a logistic model adjusted for age, gender, smoking and education level.

After exclusions, 18506 participants were included (mean age: 52, 45% men, 13% ever asthma). Ever and current prevalence of rhinitis were 58% and 41% respectively. Significant and positive associations were found between each pollutant and current rhinitis. Adjusted ORs were 1.26 [1.16-1.36] per 15 µg.m-3 increase in NO2, 1.28 [1.17-1.41] per 5 µg.m-3 increase in PM2.5, and 1.36 [1.22-1.51] per 10-5.m-1 increase in BC. Results were similar for non-smoking participants and those whose address had not changed since inclusion.

Exposure to air pollution is associated with current rhinitis in adults in the general population. In view of the high prevalence of rhinitis and its costs, these findings have an important public health impact and reinforce the need to reduce the population's exposure to air pollution.

Key messages

Exposure to air pollution is associated with current rhinitis in adults in general population. These results contribute to a better understanding of health effects of air pollution.
The impact of heatwaves on ED visits at Ljubljana University Medical Center, from 2013 to 2017
Authors: Percic S , Hojs A , Cegnar T , Pohar M , Mozina H
Published: October 2020

Background

Morbidity increases during the summer heatwaves globally. Despite increasing heat load, public health efforts probably improve public awareness and behavior. Our study aimed to assess whether ED visits during heatwaves in Slovenia decreased in the last years.

Patients and Methods

We analyzed data from the Ljubljana University Medical Centre database for consecutive patients arriving at ED, covering the Osrednjeslovenska region (around 650.000 people) in the summer period 2013 to 2017. We estimated relative risks for a number of ED visits for the observed diagnoses, sex, and age, as well as 95% confidence intervals and excess ED visits associated with heatwaves occurring in all observed years.

Results

Statistically significant were: in 2013: all, all causes (RT 0.78 (95% IZ, 0,72-0,85)); male, all causes (0.78 (0.70-0.88)); female, all causes(0.77 (0.68-0.87)); 75+ years, all causes (0.79 (0.70-0.91)); all, circulatory system (0.74 (0.63-0.86)); male, circulatory system (0.74 (0.60-0.91)); female, circulatory system (0.74 (0.59-0.93)) and all, digestive system (0.7 (0.35-0.91), in 2014: all, all causes (1.17 (1.07-1.28)); male, all causes (1.14 (1.01-1.29)); female, all causes (1.2 (1.06-1.35)) and all, 75+ years, all causes (1.21 (1.06-1.38)), in 2015: all, all causes (1.08 (1.01-1.16)); female, all causes (1.1 (0.01-1.22)); all, endocrine diseases (1.47 (1.03-2.1)), in 2016: all, all causes (0.92 (0.86-0.98)) and all, 75+ years, all causes (0.9 (0.81-0.99), in 2017: all, 75+ years, all causes (0.89 (0.81-0.97)), all, circulatory system (0.86 (0.77-0.96)), female, circulatory system (0.83 (0.7-0.97)); all, digestive system (0.76 (0.32-0.93)) and all, endocrine diseases (1.38 (1.02-1.85)).

Conclusions

The scientific evidence shows that it is possible to influence heat-related outcomes with proper public health interventions. The results of our research show a decrease in ED visits during heatwaves and support the hypothesis that public behavior is changing.

Key messages

ED visits due to heatwaves can be preventable. In Slovenia we are on good way with public health interventions. Heatwaves will become more frequent, more intense and will last longer, so we must continue with public health efforts.
An evaluation of the global health security agenda steering group governance interventions
Authors: DeShore N E , Johnson J A , Malone P , Greenhill R , Wuenstal W
Published: October 2020

Background

Member States lack of compliance with 2005 IHR implementation led to the launched of the Global Health Security Agenda. This research will provide an understanding of how the Global Health Security Agenda Steering Group (GHSA SG) governance interventions impact health system performance and global health security. This will enhance the understanding of a Steering Group's governance interventions in complex Global Health initiatives. Research questions: To what extent have GHSA SG governance interventions contributed towards enabling health system performance of WHO Member States? To what extent have GHSA SG governance interventions contributed towards the implementation of global health security among WHO Member States?

Methods

Correlational analysis using Spearman's rho examined the relationship between governance, health system performance and global health security variables at one point in time. A convenience non-probability sample consisting of eight WHO Member States was used. SPSS Statistics generated the bivariate correlation analyzes.

Results

Governance and health system performance analysis indicated a statistically significant strong positive effect size in 11 out of 18 and moderate positive effect size in the remaining seven out of 18 health system performance indicators. Governance and global health security analysis concluded three of the governance indicators had strong and moderate positive coefficients. Global health security variables demonstrated weak effects in the remaining three governance indicators.

Conclusions

This study presents a case for health systems embedding in global health security. Health system performance is only as effective at protecting populations when countries achieve core capacities of preparedness and response to global health threats. The associations provide stakeholders information about key characteristics of governance that influence health system performance and global health security implementation.

Key messages

This study provides an argument for the continued support of the GHSA 2024 Framework with implementation of global health security capabilities and meeting 2005 IHR requirements. The GHSA SG governance role remains profoundly important in establishing sustainable efforts internationally towards achieving the objectives of the GHSA in support of the 2005 IHR standards.
Gender-specific violence and/or abuse: strategy for dealing with a hidden phenomenon
Authors: Dei S , Marchetti C , Monti G , Pifferi A , Moscatelli C , Pagliara C , Erba F , Michelangeli L , Lelli S , Doretti V
Published: October 2020

Background

Exposing episodes of violence against women or hate crimes was extremely difficult in the past, due to a lack of awareness in emergency departments, the absence of a social, institutional and health network, and poor communication by Anti-Violence Centers. Until about 10 years ago, professional skills employed to address this kind of episodes were strictly related to the specificity of the trauma reported (gynecological, orthopedic, surgical and psychiatric).

Purpose

introduce a necessary holistic approach, that takes into account all aspects of the issue that normally are completely overlooked.

Methods

The “Codice Rosa” project began in the Grosseto Health Department (Tuscany) on 2009. It ensured reserved access to the emergency room for victims of violence, in particular women, children and discriminated persons. Later, it evolved into a regional network for women who have suffered from gender-based violence and for victims of hate crime violence. The project currently includes all victims, no matter whether they access the sanitary service through the emergency room, ambulatory or ordinary hospitalization. It follows a precise alert procedure triggering subsequent steps over the territory, with the goal to ensure ongoing support and a global care scheme.

Results

from 2010 up to July 2019 in the Grosseto Health Department 3483 “Codice Rosa” (mistreatment, abuse, stalking) have been admitted, 3088 adults and 395 minors respectively. In Tuscany from 2012 up to July 2019, the Codice Rosa patients were 20162, 17305 adults and 2857 minors respectively.

Conclusions

The program operates synergistically with other entities, institutions and overall with the local network of Anti-Violence Centers and Social Services, in line with national and international directives. It has provided a strong contribution to the development of current national guidelines in Italy.

Key messages

Gender specific violence and hate crimes phenomenon have to be specifically addressed. Improving the regional/national networks among the various actors involved in the fight against gender violence and hate crimes.
Differences obesity at subnational levels in Chile and the potential for targeted interventions
Authors: Urquidi C , Cumsille F , Sepulveda A , Garrido M
Published: October 2020

Background

Chile has a high prevalence of obesity (PO), and this has increased even more in recent years. Public health interventions have not impacted, probably because a geographic distribution of the cases at a lower level is unknown. We described the geographic distribution and change of obesity at a sub-regional level in Chile, and to identify targets areas/groups for interventions.

Methods

We did a secondary analysis of the latest two National Health Surveys (2009, 2016), using Regions and Health Service (HS) levels, which are the second and third administrative division of Chile, respectively. HSs were the smallest geographical unit possible to analyze with this data. Logistic regression models were fit to test differences between sex, age, number of children, family income, educational level, regions, and HS, using the lowest value of each variable as the reference group, adjusting by sex and age.

Results

At the national level, PO increased from 25% to 34% from 2009 to 2016. The southern regions have the highest PO in 2016 (Los Rios: 45%, Aysen:44%, Araucania:42%), and the lowest PO is even more than 30%. Although, the highest relative increase was in the north and central regions (Tarapacá:94%, Valparaíso:89%, Coquimbo:62%), as well as their HS. At HS level, in the Metropolitan Region, the PO varies from 21% to 46% in 2016 (OR = 3.3 IC95%1.4-7.9). Likewise, in the Valparaiso Region, it goes from 24% to 44% (OR = 2.9 IC95% 1.2-7). These differences in PO among HS levels in those regions were lower in 2009. Lower family income, educational level, and females with two or more children were associated with obesity in both surveys.

Conclusions

There is a high prevalence and increases in obesity in Chile at national and sub-national levels. The large variability in obesity observed among regions and Health Services suggests that lower geographical areas would be a potential target for effective interventions, complementarity to those at national levels.

Key messages

Analysis and intervention at a subnational level are required for preventing obesity in Chile. The high prevalence of obesity in Chile has a large variability among the subnational levels.
Cuina sense pares / Cooking without parents
Authors: Bertran M , Diaz C , Garcia T , Iglesias M , Martinez F , Polo C , Puigdemont I
Published: October 2020

Issue

Health promotion in Catalunya isn't a mandatory competency for councils; hence fomenting healthy eating habits isn't a priority for many municipalities because they have to destiny the resources in required issues. To revert this situation, Barcelona Provincial Council, a second level local administration, gives both technical and economic support for health promotion which is specially needed for municipalities with fewer inhabitants.

Description of the Problem

Adolescence implies autonomy to eat and often it turns in unhealthy eating habits. For this reason, Barcelona Provincial Council, in 2010 creates the project “Cuina sense pares” to promote a healthy eating and an optimum nutritional state from 14 to 18 teenagers in the province of Barcelona. The project counts on cooking workshops throughout territory and on a website www.cuinasensepares.cat that facilitates resources and cooking proposals adapted to the collective.

Questions

What was the response of the municipalities in the project? How municipalities value the project? Has it been echoed in the media?

Results

In 10 years, 673 workshops have been realised in 154 municipalities from the 311 in the province of Barcelona with a participation of 9.069 teenagers. Additionally, a 60% of the applicant municipalities have less than 10.000 inhabitants. The municipal technicians have rated the cooking workshops with an average of 9.11 among all. It has appeared 126 times in news media. In addition, the website has had more than 94.000 views and the Youtube channel has had 33.400.

Lessons

Involve the young in their eating by the elaboration of easy and healthy recipes. As an innovation, healthy cooking workshops are offered to municipalities complemented by a website.

Key messages

Facilitate tools to municipalities to boost healthy promotion eating programmes between the young. Foment a healthy eating between the young by attractive cooking proposals.
Can animal welfare have an impact on food safety? A study in the poultry production chain
Authors: Iannetti L , Neri D , Torresi M , Acciari V A , Di Marzio V , Centorotola G , Scattolini S , Pomilio F , Di Giannatale E , Vulpiani M Podaliri
Published: October 2020

Background

Animal welfare is a major issue in the production of food of animal origin. A project funded by the Italian Ministry of Health was carried out in order to collect scientific evidence that animal welfare is not only an ethical issue, but should also be related to food safety.

Methods

The project was carried out along an Italian integrated poultry production chain. Animal welfare was measured at farm in 13 broiler chicken batches, including 2 organic, using Welfare Quality®, an animal- and resource-based internationally recognised protocol. Samples for the detection and enumeration of Campylobacter, Salmonella and Listeria monocytogenes were taken at different levels, from the live animal (faeces at farm and after transport) to the end product (caecal content and carcass skin at slaughterhouse), with a total of 2,080 samples. Strains were deeply characterised (serotyping, PFGE).

Results

Higher welfare scores were reported in organic batches. Transports to the slaughterhouse longer than 1 hour were associated to increased Campylobacter prevalence. Significantly lower Campylobacter concentrations both in faeces and carcass (P < 0.05) were reported in organic batches. Low-welfare batches showed higher prevalence of Salmonella, with statistically significant difference compared to high-welfare batches (43.6% versus 2.9% in carcass; 19.3% versus 0% in caecal content; P < 0.00001). L. monocytogenes was never found in faeces, in contrast with high prevalence in carcases (up to 72.5%) with undistinguishable genetic profiles recurrent in different batches after long time (up to 18 months).

Conclusions

Our results support the hypothesis that poultry meat contamination is influenced by the welfare or stress which broilers experience during their life. Longer transports enhance Campylobacter prevalence. L. monocytogenes in poultry meat should not be linked to increased stress but rather to persistent contamination in the slaughterhouse processing environment.

Key messages

“High-welfare” broiler chicken batches show lower Campylobacter and Salmonella contamination compared to “Low-welfare” batches. Microbiological safety of poultry meat can be improved by the application of high animal welfare standards at farm and during transport.
Consumption of healthy and unhealthy foods in adults according to binge drinking and sex - Brazil 2016
Authors: Pita Ruiz AM , de Assumpção D , Stolses P M , Francisco Bergamo
Published: October 2020

Background

Abusive alcohol intake is associated with noncommunicable diseases that exert a financial impact on public healthcare systems throughout the world. Alcohol affects the absorption of nutrients and plasma levels of fatty acids and exerts a negative impact on food consumption.

Objective

Determine the regular consumption (≥ 5 days/week) of healthy and unhealthy foods in adults (≥ 20 years) according to binge drinking and sex.

Methods

A cross-sectional study was conducted with data from the Surveillance System of Risk and Protection Factors for Chronic Diseases of the 2016 Vigitel telephone survey conducted by the Brazilian Health Ministry. Multiple logistic regression was used to determine odds ratios (OR) and 95% confidence intervals (CI).

Results

Information from 32,195 women and 19,490 men was analyzed, with binge drinking reported in 11.95% and 27.85%, respectively. Lower regular consumption of fruit (OR: 0.80; 95%CI: 0.69-0.92) and milk (OR: 0.82; 95%CI: 0.72-0.94) as well as greater consumption of red meat (OR: 1.27; 95%CI: 1.10-1.46) were found among the men who reported binge drinking. Lower regular consumption of natural juice (OR: 0.79; 95%CI: 0.67-0.93), fruit (OR: 0.64; 95%CI: 0.55-0.75) and milk (OR: 0.70; 95%CI: 0.60-0.82) as well as greater consumption of red meat (OR: 1.35; 95%CI: 1.14-1.59) and soft drinks/artificial juice (OR: 1.55; 95%CI: 1.24-1.94) were found among the women who reported binge drinking. Regarding sex, women consumed more raw vegetables (OR: 1.50; 95%CI: 1.24-1.82), cooked vegetables (OR: 1.79; 95%CI: 1.44-2.21), fruit (OR: 1.28; 95%CI: 1.07-1.55) and sweets (OR: 1.35; 95%CI: 1.05-1.72) as well as less red meat (OR: 0.71; 95%CI: 0.59-0.86) than men who also engaged in binge drinking.

Conclusions

Binge drinking was associated with a lower frequency of the regular consumption of healthy foods, such as fruit, vegetables and milk, as well as a greater consumption of red meat, soft drinks and sweets.

Key messages

Alcohol exerts a negative impact on food consumption. Abusive alcohol intake is associated with noncommunicable diseases.
Every cockroach is beautilful to the eyes of his mother? Parent’s perception of child’s BMI
Authors: Salini C , Tarroni M , Messina D , Balestri C , Nante N , Messina G
Published: October 2020

Background

Childhood obesity is becoming a social health problem in the western world and an important goal is to analyze and correct risk factors. Part of the problem could be determined by a different perception of the weight. We aim to determine the association between children's BMI and the parent's perception of their Health Status.

Methods

In October 2019 we conduced a cross sectional study in which a questionaire was administrated to the parents of primary and secondary schools children in South-East Tuscany, Italy. Eating habits, lifestyle and biometric data were collected from children and their parents. 4324 persons were included. We used Stata for descriptive and inferential analysis. Cohen's Kappa was used to find the correlation between variables.

Results

Analysis was carried out on 1421 complete questionnaires. We found that most of parents have a wrong perception of weight's children. 88.3% of parents who have obese children belive that his child is normal weight or only “a little overweight” and only 11.7% have a perception of their child's obesity. 67.6% of parents who have overweight children, belive that their child is normal weight. While among underweight children, 74.3% of parents belive that their child is normal weight. Cohen's kappa show poor agreement between real and perceived BMI (K = 0.26; p = 0.0001).

Conclusions

Our results show, among the overweight children, there is a misperception in the weight of the child by the parents, uniformly with the data present in the literature. Acquisition of healty behavior during childhood is extremely important for the state of health in adulthood and for avoiding the onset of associated diseases. Therefore, food education becomes a crucial objective for the future of our country: an essential goal is to create prevention programs addressed to children and parents to increase consciousness of the correct weight and the diseases that can result from bad nutrition.

Key messages

Many parents have a misperception of the weight of their children. It is crucial to educate parents to control their children's weight to avoid the onset of metabolic diseases. Increase consciousness in children and parents of the correct weight should become extremely important to avoid the onset of disease in adulthood.
Mediterranean diet adherence in pregnant women: results of a survey in North East of Italy
Authors: Grillone L , Castriotta L , Antinolfi F , Fasan J , Cortelazzo F , Madia A , Righini M , Savoia A , Brusaferro S , Parpinel M
Published: October 2020

Background

In literature, few studies evaluated Mediterranean diet (MD) adherence in pregnant women, so we decided to conduct a survey to analyze MD and healthy habits in pregnant women living in North East of Italy, in 2018.

Methods

In our monocentric observational study, we enrolled >18 years pregnant women (2nd-3rd trimester) to evaluate MD adherence through “PREDIMED” validated questionnaire. Based on previous studies on MD score, women were classified into High-MD adherence (score >8; range 0-14) and low-MD adherence group (score ≤ 8). Comparisons between groups were performed using a t-test, Wilcoxon-Mann-Whitney test, chi square test and regression models as appropriate. We also investigated BMI (body mass index) and healthy habits before and during pregnancy.

Results

We analyzed 113 questionnaires and MD score, ranging from 3 to 13, had a mean value of 8.04 (SD 1.95), with low MD adherence in 63% (71) of our sample. Women (mean age 32 years; min 22- max 43; SD 1.95) were mostly employed (95; 84%) and alcohol consumers before pregnancy 79 (70%), especially wine 53 (47%). 5 (4%) didn't quit smoking while pregnant. Comparing BMI data before and during pregnancy to international recommendations, we found inadequate weight gain for each BMI category (100% in underweight, 70.7% in normal weight, 35% in overweight, 50% in obese range). Age was associated with MD adherence (β 0.11; 95%CI 0.04-0.17). Employment was also positively associated with higher MD values (p 0.002). Wine assumption before pregnancy was statistically significant associated with high MD group (p 0.0334).

Conclusions

In our study we found MD adherence levels lower than expected and an inadequate weight gain during pregnancy. MD seems also to be age and employment-related. Wine consumption before pregnancy and its positive association with MD need to be further analyzed.

Key messages

Mediterranean Diet adherence among pregnant women studied is not high and weight gain is frequently inadequate. Age and employment status might influence MD adherence in pregnancy.
Monitoring and genotyping of Norovirus in edible shellfish in Northern Italian seas (2018-2020)
Authors: Galuppini E , Filipello V , Galuppini E , Righi F , Rubini S , Losio M N
Published: October 2020

Background

Norovirus is an enteric virus with foodborne transmission. Bivalve shellfish are a main source of infections and outbreaks, which in the last years are showing an increasing trend. Therefore, in Italy a voluntary based monitoring plan to control the safety of bivalve shellfish was set up at provincial level. This study describes the occurrence and distribution of Norovirus in different areas of Northern Italy seas.

Methods

Between the years 2018-2020 622 samples (n = 173 oysters, n = 139 mussels, n = 300 clams, n = 10 other bivalve shellfish) were tested by OneStep RT Real Time PCR for Norovirus GI and GII and quantified according to the ISO 15216:2017. Positive samples were further analyzed to determine genotype by sequencing of the ORF1/ORF2 junction of the Norovirus genome.

Results

A total of 111 (18%) samples were positive for Norovirus (mussels 22%; oysters 18%; clams 16%, other molluscs 20%), positive samples were found mainly in the winter season. The mean contamination was 103 ge/µL and ranged 100-105 ge/µL. Thirty-two samples were typeable (GI n = 10; GII n = 22) with GI samples belonging to four genotypes and GII samples belonging to five genotypes. GII.4, particularly Sydney 2012 subtype (found in three oysters and three clams samples), was the most prevalent, followed by GII.3. Often more than one genotype was found in samples collected simultaneously in the same sampling site. The virus was found with relatively high occurrence both in samples collected close to the coast (38%) and in those harvested from farms located 3-6 nautical miles offshore (73%).

Conclusions

The overall prevalence of Norovirus in edible shellfish, particular those to be eaten raw, is moderately high (18%). No difference in contamination was highlighted among the different species or different sampling sites. One of the most prevalent variants found (i.e. GII.4 Sydney 2012) is a leading cause of infections worldwide.

Key messages

Given the moderately high proportion of positive samples (18%), oysters (which are often eaten raw), regardless of the origin, represent the main risk of infection. The presence of genotypes frequently involved in human infections strengthens the need for ongoing monitoring, which should be extended to all provinces involved in shellfish farming.