bluuebunny/crossref_metadata_2025 huggingface dataset:
Chronological trends of cardiovascular diseases in Southern Tunisia over a fourteen year -period
Authors: Maamri H , Ben Ayed H , Ketata N , Baklouti M , Yaich S , Karray R , Feki H , Dammak J
Published: October 2021

Introduction

Cardiovascular diseases are the leading cause of death worldwide and in Tunisia. In fact, as a result of progressive urbanization and westernization of lifestyle the spectrum and pattern of cardiovascular diseases CVD along with their risk factors are changing. The aim of this study was to describe the epidemiological profile of CVD hospitalizations, to evaluate their chronological trends and to estimate their future projected trends.

Methods

We retrospectively collected data from the regional morbidity registry of the University Hospital of Sfax, Tunisia, between 2003 and 2016. We included patients with ischemic heart disease (IHD), heart failure (HF) and rhythm and conduction disorder (RCD). Join-point regression analysis was performed to study chronological trends of CVD (Annual Percentage Change (APC); p).

Results

The mean age-standardized hospital incidence rate (ASHIR) was 94.8, 20.6 and 14/100000 inhabitants/year for IHD, HF and RCD, respectively. Trends analysis of CVD showed a significant increase in the ASHIR of IHD from 54.3/100000 inhabitants in 2003 to 123/100000 inhabitants in 2016, with an Annual Percentage Change (APC) of 3.59% (95% confidence interval (CI):0.4-6.7%; p < 0.001). An upward trend was observed for HF, with ASHIR rising from 8.6/100000 inhabitants in 2003 to 22.6/100000 inhabitants in 2016, with an APC of 8.29% (95%CI:4.1-12;p<0.001). For RCD, no significant change in ASHIR was found. Projections showed that the estimated ASHIR would attend 131 and 36.5/100000 inhabitants for IHD and HF, respectively, while RCD would decline to 19.6/100000 inhabitant in 2026.

Conclusions

IHD and HF were rising at an alarming rate and were expected to continue up to the next 10 years. Primary and primary prevention of cardiovascular risk factors, therapeutic education and early management would have a positive impact in the short and long term.

Key messages

The importance of the bidder of cardiovascular diseases. The necessity of primary prevention.
Comparison of two home-based polysomnography tools for OSAS diagnosis: a cost-minimization analysis
Authors: Sapienza M , Nurchis M , Di Pumpo M , Urbano M , Hart JG , Sommella L , Pascucci D , Riccardi MT , Casale M , Damiani G
Published: October 2021

Obstructive sleep apnoea syndrome (OSAS) is an underdiagnosed chronic disease with a high prevalence in adults. It is becoming an important social problem since it is associated with a significant adverse impact on quality of life and life expectancy. Overnight polysomnography, performed in a sleep laboratory (LabPSG), is considered the diagnostic standard. Home complete PSG (HoPSG) could represent an alternative to LabPSG for patients who want to avoid the overnight stay at a sleep center. The aim of this study was to assess the economic impact of two alternative HoPSG diagnostic techniques in the diagnosis of OSAS: the standard one versus the telemonitoring approach. The observational study was designed as a cost-minimization analysis adopting a healthcare perspective. The time horizon was 6 months (January 2021 - June 2021), thus no discounting was necessary. Direct medical costs, expressed in 2021 euros, were estimated through a micro-costing method while indirect costs were quantified adopting the Human Capital Approach. To explore the uncertainty of critical parameters, a one-way sensitivity analysis was run. Considering the direct costs, the telemonitoring HoPSG was estimated to cost around €55 less than the standard approach. The cost savings sharply increases taking into account the indirect costs that amounted to €90 million and €365 million for the telemonitoring and the standard approach, respectively. Sensitivity analyses results did not significantly differ from the base-case scenario. The diagnosis of OSAS is presently time-consuming, labor-intensive and costly. The adoption of digital health solutions as telemedicine has the potentiality to ease the diagnosis, to improve the access to health services, to reduce both direct and indirect costs, and to enhance the efficiency of healthcare facilities becoming a crucial tool in addressing the actual public health challenges.

Key messages

The telemonitoring Home complete polysomnography is cost-saving compared with the standard approach. Telemedicine has the huge potential to overcome public health challenges as increases in chronic disease in an ageing society and the associated burden in healthcare costs.
Aligning Diet, Health and Planet in the Older Population
Authors: Leydon CL , Harrington JM , McCarthy SN
Published: October 2021

Background

The global food system faces incessant and complex challenges of providing food for a growing population while remaining within planetary boundaries. Agriculture and food production depletes finite resources such as land, water and fossil fuels, and contributes to climate change. GHG emissions occur at every stage in the life cycle of a food from primary production through to processing, packaging, distribution, consumption, and waste. This results in approximately 34% of anthropogenic GHGEs globally. Thus, the aim of this study is to determine the levels of and contributors to dietary carbon footprint among older Irish adults.

Methods

Diet quality metrics explore associations between dietary patterns and health outcomes. A Food Frequency Questionnaire was used to assess dietary intake of participants in the Mitchelstown Cohort Study. To determine carbon footprint, foods were linked to CO2eq emission factors from life cycle assessment studies. The DASH and Mediterranean diet scores were used to determine if higher adherence to these recommended diets was associated with improved health outcomes and lower dietary GHGEs.

Results

Preliminary results suggest that the daily CO2eq is similar to a previous Irish study, which found that the daily dietary intake was 6.5 kg of CO2eq per person. As expected, consumption of red meat was the highest contributor to dietary carbon footprint. Fruit and vegetable consumption was low despite these foods having a lower carbon footprint.

Conclusions

The environmental impacts of current dietary patterns are substantial, threatening ecological integrity. Greater adherence to well-characterized diets has been associated with lower diet-related GHGE. Transforming our diets is required to build a resilient and sustainable food system, while safeguarding planetary health. However, nutrition and long-term health must remain a key component of any dietary change particularly in vulnerable and nutritionally compromised populations.

Key messages

Food systems and diets thereof are inextricably linked with nutrition, health and environmental issues. Dietary transitions are needed to reduce global burden of disease and environmental degradation. Consideration on the feasibility of adopting sustainable diets among older populations to ensure healthy ageing is required. Trade-offs arise between protein requirements and environmental impacts.
COVID-19 International Horizon Scanning – informing a response and recovery in Wales and beyond
Authors: Stielke A , Bowles C , Couzens L , Cotter-Roberts A , Allen J , Van Eimeren M , Bainham B , Dyakova M
Published: October 2021

Issue

The rapidly evolving nature and uncertainties of the COVID-19 pandemic have led to unprecedented challenges for health systems, as well as to wellbeing, social and economic impacts for individuals and communities across the globe. Effective, dynamic, innovative and evidence-based solutions are needed to address these challenges.

Description of Problem

The World Health Organization (WHO) Collaborating Centre on Investment for Health and Well-being, Public Health Wales, has initiated and continues to perform International Horizon Scanning work to inform the evolving COVID-19 public health response and recovery plans in Wales by learning from best practices from other countries. The learning and intelligence is systematically synthesized in rapid regular reports published every week/two weeks. The focus and scope vary, depending on the COVID-19 situation and public health and policy needs.

Results

The work stream has provided Welsh Government, the National Health Service (NHS), Public Health Wales and other key stakeholders with continuous and timely learning from the experience of other countries along with emerging evidence and guidance, provided by key international organisations. This includes international evidence, epidemiological data, experience, measures and recovery approaches, to understand and explore solutions. Reports have given a consistent overview of approaches across countries such as a comparative analysis of the vaccine roll-out or a systematic overview of the R-value and measures implemented accordingly.

Lessons

To understand, mitigate and address the impacts of the pandemic in Wales and beyond, a timely, dynamic and evidence-informed actionable intelligence has proven to be essential to inform and support decision-making on government and health system level to address the pandemic and mitigate harms from COVID-19.

Key messages

International learning has and continues to inform the evolving COVID-19 public health response in Wales. Public Health Wales is contributing to an evidence-informed inclusive recovery from the pandemic in Wales and beyond.
Genomic persistence of Listeria monocytogenes strains in dairy and meat processing plants in Italy
Authors: Acciari VA , Del Matto I , Antoci S , Di Marzio V , Torresi M , Iannetti L , Marfoglia C , Centorotola G , Pomilio F
Published: October 2021

Background

Persistence of Listeria monocytogenes (Lm) in food processing plants (FPP) is still considered the major source of food contamination during processing. Correlations among different Lm strains and evaluation of the isolates persistence in FPP environments is an essential tool to improve food safety. The aim of this study was to investigate the genomic characteristics of persistent Lm strains (e.g. Metal and Detergent Resistance, SSIs and genomic island).

Methods

Totally 221 strains isolated from 10 FPP in the Abruzzo and Molise regions, Italy, were enrolled (4 of dairy products FPP - DP - and 6 of meat products FPP - MP). Sampling was performed in 6 sessions, from March 2017 to May 2018. Strains were sequenced using Illumina platform. The CCs, cgMLST analysis and Metal and Detergent Resistance, SSIs and genomic island (GI) detection was carried using the Pasteur scheme.

Results

Results returned 13 CCs and 2 singletons. cgMLST clustering showed two persistent clusters DP and 9 clusters in MP. In DP CC3 and CC9 were persistent. While in MP CC5, CC8, CC9, CC37, CC121 and CC155. The presence of SSI-1, was detected in 100% of the persistent strains from DP and 80% from MP, in particular in all strains of CC155, CC5, CC8 and CC9. In CC121 and CC37 it was absent. The presence of loci of Lm GI3, was in 100% of persistent strains of DP and in 52.3% of MP plant, in particular in 100% of CC121, CC8, CC5 and 16.3% of CC9. The 100% of CC121 in DP and MP plant harboured Tn6188 and SSI-2. The inlA PMSC mutations were detected in 100% of CC9 and CC121 strains.

Conclusions

The persistence of strains inside FPP was confirmed using NGS data, most of the strains were characterised by the presence of genes involved in resistance and adaptation. NGS is confirmed to be a powerful tool to study Lm persistence in FPP, looking also at strains' ecology.

Key messages

Most of persistent strains showed genes involved in resistance and adaptation in the food processing environment. NGS could help in facing Lm persistence in food producing plants giving new insights on the genomic characteristics of persistent strains.
Citizens' knowledge and educational needs in the omics sciences field: results from an Italian survey
Authors: Calabrò GE , Sassano M , Moccia F , Gaudioso A , Ricciardi W , Boccia S
Published: October 2021

Background

Progress in genomics has crucial implications for public health. Therefore, a strategic line to define the promotion and governance of omics related innovation is necessary. In this context, citizens education is essential to allow appropriate decisions about their own health.

Objectives

As part of a project funded by the Italian Ministry of Health, we carried out in collaboration with an Italian civic organization (Cittadinanzattiva) a survey on citizens' attitude, knowledge, and educational needs in omics sciences field. On the basis of the results of two our literature reviews and of a survey with experts of the Italian Network of Genomics in Public Health (GENISAP), we developed an ad hoc questionnaire for citizens. It was developed in order to assess the current state of information on omics field in the Italian population. The survey was launched, through the Cittadinanzattiva channels, on October 29, 2020 and it was closed on April 15, 2021.

Results

As of April 2021, 359 responses have been collected. The average age of the participants was 46.04 ± 15.77 years. 73.5% of the participants had no knowledge of omics sciences and 66.6% of DTC-GTs. As regards the citizens' attitudes, 88.6% would change their lifestyle on the basis of the genetic tests results. 89.2% expressed doubts about the reliability of the information received through the media. Almost all believe that citizens are not adequately informed about omics sciences and DTC-GTs and that more training initiatives are necessary on these topics (omics sciences: 95.5%, DTC-GTs: 95%).

Conclusions

The omics sciences progress is linked to the need to develop a solid literacy of citizens. For this reason, effective tools of knowledge on the omics sciences field will have to be identified and implemented to improve citizens' literacy and engagement in this rapidly changing field.

Key messages

The progress of the omics sciences is related to the need to develop a solid literacy of citizens in order to enable them to make appropriate decisions about their own health. The current challenge is to identify effective methods of improving citizens' literacy and implementing them.
Contribution of research-based pharmaceutical companies in Germany to personalised medicine
Authors: Turulski E , Matusiewicz D
Published: October 2021

Background

The term Personlised Medicine (PM) was introduced to the public more than 20 years ago and was related to tailor-made medicines and a treatment considering the individual human genome. In the meantime, the term PM can be found with various definitions in several different contexts. Considering this, the aim of this research is to analyse the current status of PM in Germany, especially with regard to scientific articles and the pharmaceutical industry.

Methods

First, a systematic literature review was conducted in PubMed and Web of Science. Each search strategy was adapted to the database conditions and consisted of the search terms personalised medicine or the MeSH term precision medicine, additionally pharmaceutical industry and Germany in topic, title or abstract (the Boolean operator AND was applied). Only results in German or English with an available abstract were considered. Second, the websites of all 47 members of the German association of research-based pharmaceutical companies (vfa) were systematically screened referring to their position and communication in terms of PM.

Results

The literature research yielded a total of only 4 results. The scope of the papers is nanomedicine, an interview study and gene disorders. The second research part shows differences on the company websites: More than half of the companies have no relation to PM or an analysis was not possible (n = 25). Some were categorized with indirect relation (n = 3) and on 19 websites PM was communicated in different ways.

Conclusions

The literature research clearly shows that although PM is not a new topic and furthermore, the research of pharmaceutical companies in this area is widely required, the number of scientific articles found is very low. The screening of company websites underlines this result as only 19 of 47 companies take a position to PM here and the scope varies greatly. Nevertheless, it is necessary to examine the reasons and how Germany compares to other countries.

Key messages

Although introduced more than 20 years ago, the appearance of PM by German pharmaceutical companies in scientific articles is quite low. The difference in companies’ communication should be examined.
Which managers make which work accommodations for employees with common mental disorders?
Authors: Bertilsson M , Niederberger R , de Rijk A
Published: October 2021

Background

Work accommodations (WAs) can promote employees' decreased work capacity and work participation. However, little is known about how managers make WAs for employees with common mental disorders (CMD). The aim was to investigate managerial determinants for making WAs for employees with CMD.

Methods

An online survey was sent to 4,737 Swedish managers, aged 20-65 years (response rate 71%). Only managers who stated having had employees with CMD in the last two years responded to questions on WAs, and were included in this study (n = 1779). The 15 WAs in the survey were condensed to seven WA types using principal component analysis. We calculated odd ratios (95% confidence intervals) for the association of person- (n = 5), knowledge- (n = 2) and work-related (n = 10) determinants in relation to WA types with multivariate logistic regression, adjusting for managers' personal experience of CMD, medical training, treating people with CMD, type of industry and organizational size.

Results

Greater confidence in how to support employees with CMD was associated with five different WA types, the strongest OR was found for changes in working conditions (OR 1.87 95% CI 1.48 - 2.38). Female manager was associated with three WA types, the strongest OR was found for changes in working conditions (OR 2.09 95% CI 1.60 - 2.73). Managerial training including knowledge about how to support employees with CMD was associated with four WA types, and the strongest OR was found for accommodating work tasks (OR 1.76 95% CI 1.35 -2.28). Only work sector was associated with more than two WA types, where managers in the private sector were less likely to make three WA types.

Conclusions

Greater confident in how to support these employees, being female, managerial CMD-training and working in the public sector were associated with making WAs more often. The findings suggest directions for training managers in making WAs in order to support and improve work capacity of employees with CMD.

Key messages

Managers’ confidence in and knowledge about how to support employees with CMD were essential in order to make work accommodations. Work-related factors were less associated than expected. Training managers to accommodate the work of employees with CMD might be effective.
Work-Life Balance Inequalities among Veterinary and Allied Professionals: A Qualitative Review
Authors: Ikpeme M , Omotoyinbo F , Toluwade T , Ryan M
Published: October 2021

Background

This study aimed to review qualitative psychological and non-psychologically based literature for work-life balance (WLB) inequalities within the veterinary and other allied professions.

Methods

The PECO framework includes qualitative studies published in any language but with an English translation involving adult workers in the veterinary or allied profession and outcomes around work-life balance. Seven relevant electronic databases EMBASE, PsycARTICLES, PsycINFO, MEDLINE, Social Policy and Practice, HMIC Health Management Information Consortium, and Global Health, were used. The retrieved hits were exported to Endnote Desktop (Version 7.7.1) for sorting and management.

Results

Of the 3610 hits, 31 studies were eligible for narrative synthesis. The studies were published from 1980-2017 and came from 15 countries. 9(29%) of the 31 studies were from the USA. 22 of the 31 studies (71%) focused on a mix of professions. Data were collected in six different ways, with the most common being interviews (17 (54.8%) of 31 studies). Twenty-three questions were used to assess WLB. The most common ones focused on women becoming mothers, maternity leave, and return to work (five (16.1%) of 31 articles). Secondly were attitudes of ethnic minorities concerning education, employment, role-family conflict, etc., and family commitments (three (9.7%) of the 31 papers). Findings came under 74 different topics. Nineteen (25.7%) of the 74 topics occurred more than four times and were allocated under the appropriate sub-theme. The nine sub-themes include pregnancy, breastfeeding, motherhood, job/life satisfaction, age/gender/ethnic inequalities, return to work (RTW), health and lifestyle, dual-earning couples/family, workplace support, and work-family/family-work conflicts.

Conclusions

The review suggests that women, ethnic minorities, older staff, and those with health concerns are negatively impacted by inequalities around WLB in veterinary and allied professions.

Key messages

The findings from the review were used to support the development of psychological measures of work-life balance and gender differences. The results were used in online questionnaires/surveys for future participants within the veterinary profession in addressing inequalities.
Process evaluation of care scale up for hypertension in diabetes in Belgium, Slovenia and Cambodia
Authors: Martens M , Wouters E , Stjepanovič TK , Stojnic N , Chham S , Por I , van Olmen J , Klipstein-Grobusch K , Boateng D ,   SCUBY consortium
Published: October 2021

Background

Effective integrated care interventions for hypertension (HT) and type 2 diabetes (T2D) exist and need to be scaled-up. The ‘SCale-Up diaBetes and hYpertension care' SCUBY project aims to facilitate scale-up of integrated care for HT and T2D through the implementation of contextualised scale-up roadmaps in Cambodia, Slovenia and Belgium and co-creation in policy dialogues. We herewith describe the plan for the process and scale-up evaluation of the SCUBY project, including the development, adoption and implementation of the roadmaps. The specific goals of the process evaluation are to (i) analyse how the reality of scale-up adheres to the developed roadmaps and (ii) assess how the different contexts can influence the implementation process of the scale-up strategies.

Methods

A comprehensive framework was developed to include context, process, scale-up and impact evaluation that is embedded in implementation and political theory. A diverse range of mostly qualitative tools - including a policy dialogue reporting form, a stakeholder follow-up interview and survey, project diaries and policy mapping - will be used to assess how stakeholders perceive the scale-up implementation process and adaptations to the roadmap. Key implementation outcomes include acceptability, feasibility relevance, adaptation, adoption and cost of roadmap activities. The role of context is relevant, and barriers and facilitators to scale-up will be continuously assessed.

Conclusions

The SCUBY project presents a comprehensive framework to guide the evaluation of scale-up of complex interventions. We describe three contextualised roadmaps, for Belgium, Slovenia and Cambodia, each adopting their own (horizontal/diversification/vertical) scale-up strategy(ies) as a basis to monitor adaptations through a co-creation process. This study protocol will be a guide for other scale-up interventions making use of knowledge translation and co-creation activities.

Key messages

Process evaluation is needed to keep track of complex interventions including scale up. The SCUBY project developed an evaluation plan to comprehensively monitor the scale-up of HT and T2D care.
The perceptions of construction workers on designing a workplace nutrition intervention in the UK
Authors: Wronska M , Coffey M , Robins A
Published: October 2021

According to the European Commission, construction is an important industry providing the EU with 18 million jobs and contributing to 9% of the EU's GDP in 2020. Construction workers struggle with healthy food choices due to lack of knowledge, long working hours, remote site locations, poor food facilities on site, and temporary accommodation. Yet, nutrition interventions in construction are rare, with no UK studies. This is an exploratory study designed to investigate workers' perceptions of a workplace intervention to facilitate healthy nutrition choices. Engaging participants in the intervention design showed positive results on behaviour change. Five internally homogenous focus groups were conducted on three different construction sites (in three companies); two with managers (n = 11) and three with workers (including subcontractors) (n = 27). Sites differed in size (14; 50-100; and 300 workers); two were temporary. Framework Analysis was used to analyse data. The main themes uncovered in the focus groups were; 1) the need for workers to learn about food to sustain good energy levels, as deemed crucial for their job 2) the desire to get an understanding about portion sizes, food labels, impacts of food on mood and practical ideas of healthy snacks and meal planning and 3) the importance of intervention accessibility for everybody on site (including subcontractors), convenient scheduling and location, and managers support to encourage participation. A participatory approach was used to explore workers' suggestions on the content and delivery of the nutrition intervention. Education and practicality of recommendations were of the essence to workers, who suggested that individual characteristics, the nature of construction jobs (e.g. busy schedules, transient jobs), and resources available (e.g. storage) need to be considered when designing the intervention. Inclusivity, accessibility and managerial support were regarded as valuable in the intervention delivery.

Key messages

This research produced recommendations to encourage the development and implementation of inclusive nutrition interventions in construction, to improve the health and wellbeing of workers. This research invites public health consultants and senior leaders in construction to invest in supporting healthy behaviours of workers, with a consideration of job and workplace characteristics.
Effect of a community-based lifestyle intervention programme on quality of life among German women
Authors: Kranz RM , Englert H
Published: October 2021

Background

Quality of life is an important concept in the field of health, which can be influenced by various lifestyle factors. The objective was to test if a community-based lifestyle programme would beneficially affect the health-related quality of life of German women.

Methods

The controlled intervention study had a total duration of 24 months. Quality of life (EQ-5D-3L), anthropometrics, vital and blood parameters as well as diagnosed diseases and health economic parameters were collected at baseline (t0), after 10 weeks (t1) and after 6 months (t2). For the intervention group (n = 65) a 10-week intensive lifestyle programme followed by monthly alumni meetings were conducted. The intensive phase consisted of 14 consecutive seminars about a healthy lifestyle, which focused on a plant-based diet, physical activity, stress management and community support. The control group (n = 35) received no intervention.

Results

The first descriptive health profile results of the subgroup analysis showed that 59% women of the intervention group at t0 (t1: 37%; t2: 48%) and 60% of the control group at t0 (t1: 54%; t2: 49%) reported problems in at least one of the EQ-5D dimensions (mobility, selfcare, activities, pain, and anxiety). A significant difference in EQ VAS change between women in intervention (7,15 [95% CI 4,32; 9,98]; EQ VAS t0: 75,35 [SD 13,71]) and control group (-2,63 [95% CI -5,40; 0,15]; EQ VAS t0: 78,80 [SD 18,51]) from t0 to t1 was observed (p < 001; adjusted for baseline). No significant differences in mean EQ VAS change from t0 to t2 and in mean EQ-5D index change from t0 to t1 and t0 to t2 between the groups were observed (p > 0,05; adjusted for baseline).

Conclusions

The preliminary results suggest that the lifestyle intervention programme can have a positive short-time effect on some aspects of quality of life, such as the health profile and EQ VAS. However, the long-term results will be shown in the future.

Key messages

A healthy lifestyle can affect the quality of life in a positive way. The community-based lifestyle programme had a short-time influence on the descriptive health profile and EQ VAS of German women, whereby the EQ index didńt change significantly between the groups.
A systematic review of the determinants of the nutritional quality of food for homeless populations
Authors: Ravikumar D , Nic Gabhann S , Kelly C
Published: October 2021

Introduction

Studies assessing the nutritional quality of food provided to homeless population show deficiencies in micronutrients and excess fat, sugar and salt. The availability of cheap, energy-dense and nutrient poor food has changed the profile of people living with homelessness from primarily underweight to obese in western countries. Many factors influence the nutritional quality of food provided to the homelessness population such as budget and time constraints, food donations and limited equipment. Nutrient intakes in this population are unlikely to be met outside of charitable meal programmes, making the nutritional quality of these meals crucial. This review will synthesise qualitative literature with the aim of understanding of the determinants of the nutritional quality of food provided to the homeless population.

Methods

This qualitative evidence synthesis will include English language primary research empirical studies from Europe, North America and Oceania. Searches will be conducted on Web of Science, CINAHL, Embase, Scopus, PsycINFO, Google Scholar, OpenGrey and ProQuest. Quality appraisal will be conducted using the Standards for Reporting Qualitative Research tool. Two independent reviewers will be included in study selection, data extraction and quality appraisal. A third reviewer will resolve conflicts.

Results

Demographic data on study participants and findings and quotations will be extracted. Thematic synthesis will be employed. Results will be organised based on a determinants of health model, to highlight areas where change may be effective, thereby making it more likely to be useful to practitioners and researchers. The iterative steps in the systematic review process will be the focus of this presentation.

Conclusions

Findings from this review will be used to develop best-practice guidelines for policy makers and service providers to improve the nutritional quality of food provided in the homeless sector.

Key messages

The determinants of the nutritional quality of food provided to the homeless population are influenced by multiple factors. This review will provide a comprehensive assessment of these determinants. This presentation will detail the iterative steps undertaken to conduct this systematic review.
Assessing health literacy among migrants and associated socioeconomic factors
Authors: Marques Maria J , Gama Ana , Mendonça Joana , Fernandes Adalberto Campo , Osborne Richard H , Dias Sónia
Published: October 2021

Health literacy, the ability to understand, access, appraise, remember and use health information and health services, has great potential to reduce health inequalities and improve access to and quality of health care, particularly among groups that experience vulnerability, including migrant groups. Across Europe, including in Portugal, little is known about the health literacy strengths, needs and preferences among migrants. We aimed to assess the health literacy of diverse migrants living in Portugal and identify if health literacy needs differ across sociodemographic subgroups. A cross-sectional survey was administered to migrants living in Portugal. Data were collected using the Health Literacy Questionnaire (HLQ), an internationally tested and robust multi-dimensional measurement tool with nine scales, and a demographic and socioeconomic questionnaire. Associations were tested using Welch's ANOVA. In total, 1126 adult migrants were surveyed: 53.4% female, mean age of 35.8 years (range 18-77), 48.9% from African countries, 29.5% from Middle East/Asian countries, 21.6% from Brazil. Low scores on most HLQ scales were clearly associated with sociodemographic characteristics such as lower levels of education: 1. Feeling understood and supported by healthcare providers (p = 0.045); 2. Having sufficient information to manage health (p < 0.001); 3. Actively managing health (p = 0.036); 4. Social support for health (p = 0.001); 5. Appraisal of health information (p < 0.001); 7. Navigating the health system (p = 0.031); 8. Finding health information (p = 0.007). Similar patterns were found for participants who were unemployed and with lower income (<650€). Health literacy needs of migrant communities should be taken into account when designing interventions aiming to mitigate health inequalities and to promote health literacy. This is even more pertinent in the current context of the COVID-19, where its adverse social and economic impacts are likely to aggravate health inequalities.

Key messages

Lower health literacy is related to lower socioeconomic status. Mapping health literacy needs can inform interventions to mitigate health inequalities among vulnerable migrant groups.
Life skills training to promote health and well-being at school: an evaluation
Authors: Cattaneo C , Giovannelli I , De Nigris N , Russo E , Buoncristiano M , Rosa B , Ripoli G , Parenti I , Indorato E ,   “Life Skills” Working Group
Published: October 2021

Background

In educational settings, health promotion refers to a whole-school approach to help individuals realize their potential, cope with the everyday stresses of life, work productively and fruitfully, and contribute to their community. In these regards, it is essential to enhance a vast repertoire of knowledge, skills, attitudes, and values, a narrower set of psychosocial skills (Life Skills - LS). The Local Health Unit of Palermo, the Centre of Training and the National Institute of Health (ISS) developed the project “Life Skills and resilience: effective strategies to promote health at school”.

Objectives

The project's general aim was to provide headteachers and teachers with methodologies and tools to develop and promote LS in educational settings. Through the participatory approach, training was structured in 5 modules of 16 hours each. The training activities began in October 2019 and ended online due to the Covid-19 emergency in July 2020. The evaluation plan provides the assessment of learning, satisfaction, monitoring and assessment of attitudes and behaviours using a validated questionnaire. The aim was to identify improvements in relationships inside and outside the school context and increase self-efficacy and job satisfaction among teachers. Data analysis is currently being processed.

Results

169 Teachers, 12 Healthcare workers attended the training. The preliminary results show that: i. there is an improvement in relationships between colleagues, students and parents; ii. there is a slight improvement in the perceived self-efficacy in managing negative emotions; iii. there is an improvement in the personal and collective effectiveness perceived in the school environment and job satisfaction.

Conclusions

The project was designed for implementing sustainable interventions. The advent of COVID-19 has allowed further reflection on the usefulness of this approach for promoting resilience and protective factors and managing the consequences of the pandemic.

Key messages

The training improved personal and professional skills on design and methods to apply LS. The use of qualitative/quantitative assessment made it possible to illustrate the entire training process.
Web content and social media analysis on children's lifestyles even during the Covid-19 pandemic
Authors: Nardone P , Sampaolo L , Cattaneo C , Buoncristiano M , Carletti CV , Pani P , Menzano MT ,   Peer Education Working Group
Published: October 2021

Background

One of the main aims of the project ‘Peer education as a tool to reach and involve families and schools in the promotion of healthy lifestyles of children' - funded by the Italian Ministry of Health - is the web & social media (SM) content analysis relating to children's eating habits, physical activity and sedentary behaviours. By discovering which influencers deal with health topics, when, how, and through which channels they do it, countermeasures can be planned, if needed, foreseeing better users' health literacy. This ‘web and social listening' and its analysis are even more relevant now at the pandemic, as the parents' use of the web and SM has increased.

Methods

Four areas of interest were selected: nutrition, physical activity, sedentary lifestyle and overweight. For each, keywords were defined to search for relevant content (mention). The data were collected between May and December 2020.

Results

The mentions collected were 38.146. Of these, 29.666 were used to contruct the panel of 3.100 citations subjected to qualitative analysis. The main Preliminary Results:

- Source type: social media 48%, web 52%. 45% of SM content were from Twitter, Instagram (40%), Facebook (14%) and YouTube (0.3%). Facebook accounts had the largest audience

Audience profile: 62% women and 38% men; 51% of these were 45-54 and 30% 35-44 years old The most relevant words were: physical activity, children, children's snack, correct nutrition References to the topic ‘COVID-19' in the mentions collected concerned 14% of the analysed content The main organisations, by volume of citations, were: World Health Organisation (12%); National Institute of Health (6%); Italian Food Union (6%); Istat (5.5%); Doxa (5%); OKkio alla Salute (5%); Ministry of Health (4%); Coldiretti (4%); UNICEF (3%).

Conclusions

The results will contribute to producing indications for health promotion and increasing Internet users' health literacy.

Key messages

Women are the main users of the topics investigated. Children and adolescents’ health was the central theme in the mentions collected relating to Covid-19.
Factors associated with the quality of life among paramedical students in Sousse governorate
Authors: Ben Nasrallah C , Ghammem R , Mihoubi A , Ben Rejeb M
Published: October 2021

Background

The process of paramedical education has been proved to be a challenging scenario that threatens students' physical and psychological health. Compared with students of the same age, paramedical students must be at higher occupational stress in adapting to their lifestyle. The academic pressure, severe daytime somnolence, lack of physical exercise and social interaction, can lead to a decreasing quality of life (QOL). The aim of our study was to assess the health-related quality of life (HRQOL) of paramedical students in Sousse governorate and to find the associated factors that caused the variations among these students.

Methods

A cross-sectional study was conducted in the governorate of Sousse including a randomized sample of the nursing students during the 2017/2018 school year. The data were collected using an anonymous self-administered questionnaire including the 36-item short form survey (SF-36).

Results

A total of 448 students was included in the study with an average age of 20.74 (SD = 1.25) years and a sex-ratio of 0.70. The overall QOL score was 49.8 (SD = 11.6) with a significantly higher mental score impairment (45.3 (SD = 12.1)) than the physical score ((54.2 (SD = 15.6)). The independent associated factors with a decreasing HRQOL were: socioeconomic level, living away from family, means of transport, exams stress and insecurity in everyday life.

Conclusions

Our study showed a low score of QOL among health sciences students. HRQOL was influenced by socio-demographic, behavioral and environmental factors. Future interventions and programs should focus on these influencing factors in order to improve the quality of life among paramedical students.

Key messages

Knowledge of associated factors is important to implement appropriate programs. Findings may have important implications for institutions responsible for promoting active lifestyle.
Migration intention of final year medical students
Authors: Sylla AK , El Ouadih S , Barknan K , Hassoune S , Nani S
Published: October 2021

Background

One out of three Moroccan doctors is out of the country, and the ratio doctor per population is 7.3 per 10000 people (recommended 15.3 doctors per 10000 people). The objectives of this study are to estimate the prevalence of migration intention of final year medical student and to describe the profile of student who wants to migrate.

Methods

A cross-sectional study was carried out between 01 January and 31 January 2021. We included Moroccan final year medical students who did their entire medical school curriculum in FMPC. Electronic Self administered questionnaire was used though Google form. The data were described through mean, standard deviation, median, quartiles, frequency and percentage. The khi2 test was used to test the association between migration intention and social-economic variables. The data was processed using R 3.6.3.

Findings

We included 251 final year students. The 70.1% of final year students had intention to leave the country, of which 63.6% were female. The students were attracted by foreign countries because better training (97.6%), better working conditions (99%) and quality of life (97.2%). The students intended to leave the country because they were not satisfied about formation (95.2%) and salary (97%) also the denigrating of doctor in media (83.6%). Germany was the favorite destination (34%). We did not find any significant association between the migration intention and socioeconomic profile of students.

Conclusions

The health policymakers should improve working conditions, training quality and salary of health workers to reduce medical student migration.

Key messages

The migration intention of final medical students is one of the keys indicators about the future of country healthcare system. Reducing the medical students migration is crucial to build and maintain a strong healthcare system.
Health professionals' perspectives on child protection capacities, training and need for action
Authors: Maier A , Fegert JM , Hoffmann U
Published: October 2021

Background

Child maltreatment is because of its prevalence and consequences one of the main reasons for global health inequalities and a major public health problem. The medical field offers many opportunities to support affected children. However, there is often very limited awareness concerning child protection beyond a few engaged professionals. The present work aims to survey the state of knowledge and capacities in view of child protection in the medical field and explores health professionals' perspectives on a potential need for action.

Methods

From 06/2016 until 02/2021 3,360 health professionals were interviewed. Using quantitative and qualitative items the questionnaire gathered demographic and professional background information as well as assessments regarding the awareness of child protection, capacities in child protection among health professionals and training offers in medicine.

Results

The analysis indicated that the topic child protection in medicine is not as present as the high prevalence demands it. The majority (94.0%; n = 3,159) of the probands stated that they need more knowledge and capacities regarding child protection in medicine. More than half of the probands assessed the importance of the issue child protection as low among health professionals. The reasons cited included child protection as being an uncomfortable topic, unwillingness among managers, and a lack of training on the topic.

Conclusions

It turned out that there is too little awareness and importance regarding child protection in the medical field. Hence, it is difficult to ensure an adequate care for those affected. Child protection topics should be made mandatory in the training curricula of all health professionals as well as quality standards for prevention and intervention should be implemented in medical institutions.

Key messages

Too little attention is paid to child protection in the medical field. More training in child protection and quality standards must be established in the medical field.
Ethnic minority women’s interactions with antenatal care providers in Europe
Authors: Sharma E , Puthussery S , Tseng PC , Li L , Harden A , Griffiths M , Bamfo J
Published: October 2021

Background

Ethnic minority women are at greater risk of maternal morbidity and mortality. Antenatal care reduces risks of adverse maternal and neonatal outcomes and supports a positive transition to motherhood. Important components of quality antenatal care are interactions between women and care providers which are supportive and empowering.

Methods

We conducted a systematic review to identify and synthesise qualitative evidence on ethnic minority women's experiences of accessing antenatal care in European countries. Following a comprehensive search of 8 databases and two-step screening process, we included 27 studies from various European countries. Study findings were coded and synthesised using a ‘best-fit' framework approach.

Findings

Overall women expressed satisfaction with their antenatal care, frequently framed in relation to experiences of maternity care in countries of origin. Women highly valued interactions with antenatal care providers which were supportive and trust-inducing, and when there was continuity of carer to facilitate this. However, studies frequently showed a dichotomy between reported satisfaction with antenatal care and experiences of interactions with care providers which could be discriminatory, stigmatising and disempowering. Some women blamed themselves for negative interactions. Language barriers were frequently identified by women as a factor which hindered their communication with antenatal care providers and the subsequent quality of care received, when suitable interpreters were not available. Negative interactions with antenatal care providers could result in a withdrawal from ongoing antenatal care for some women.

Conclusions

This review highlights the importance of quality interactions between ethnic minority women and antenatal care providers. Policy implications: Antenatal care should be provided in such a way as to facilitate trust, support and effective communication between women and care providers.

Key messages

Positive interactions with care providers form an important element of quality antenatal care for ethnic minority women in Europe. Trust, support and the provision of suitable interpreters, where needed, contribute to positive interactions with antenatal care providers for ethnic minority women in Europe.