bluuebunny/crossref_metadata_2025 huggingface dataset:
Scanning 2d barcodes on vaccine vials to link vials to immunized child, a pilot study
Authors: Ali Khan A , Siddique M , Abdo M , Pearman J , Prusik T , Chandir S
Published: October 2021

Background

Vaccine stockouts contribute to millions of children missing their routine immunizations globally. This is often due to inadequate forecasting and management of vaccine stocks, especially in low and middle-income countries, such as Pakistan, already characterized by suboptimal coverage. Tracking vaccines via 2D barcodes on each vial, could improve management of vaccine stocks. Vial level data can then be linked to Electronic Immunisation Registry (EIR) data (2D Bar codes already used), facilitating data quality improvements which could unlock programmatic gains. Our aim was to test feasibility and acceptability of scanning vaccine vials in a “live” setting.

Methods

We conducted a pilot in 12 vaccination sites in Karachi/Pakistan. Vaccinators were divided into 3 groups and allocated to use one of the following: their existing android phone (government of Sindh's Zindagi Mehfooz [Safe life; ZM-EIR]); a Zebra touch computer; a handheld scanner. The box of dummy vaccine vials of pneumococcal conjugate vaccine (PCV) and oral polio vaccine (OPV) each with a 2D barcode on it, was scanned by the stockroom manager prior to deployment. Vaccinators were required to scan the corresponding dummy vial and immunization cards while working. We integrated the OneScanTM API on the ZM-EIR to link vial to child data and evaluated the vaccinator's experience through thematic analysis of interviews.

Results

2,310 vaccine vials were scanned and linked to immunized children (Zebra Touch Computer 72.6%, Android phone 19%, Handheld device 8.4%). Overall, vaccinators gave positive feedback and highlighted that scanning vials would simplify their work and save time, contingent on the program going paperless. Likewise, managers outlined digitally tracked vials would greatly reduce stock mismanagement.

Conclusions

Linking vaccine vial to child is a feasible and effective solution for vaccine stock management, acceptable by both vaccinators and stock managers.

Key messages

Linking vial to child is an acceptable method for accurate vaccine stock management and usage, improving forecasting and reducing stock outs. Linking vial to child will better facilitate rapid tracking of reported adverse events from vaccinated child back to the exact vaccine vial.
Noncommunicable disease incidences in 2012-2017, Turkey
Authors: Ergor G , Sakarya S , Sozmen K , Dinc Horasan G , Ekinci B , Arıkan A , Sis S , Unal B
Published: October 2021

Background

Globally, 88% of deaths are caused by noncommunicable diseases (NCD) and they are increasing in our country as in many parts of the world. Effective control, prevention and treatment of NCD, can begin from knowing the disease incidence by age, sex and regions.

Methods

This study aimed to determine the incidence of chronic diseases (coronary heart disease, stroke, diabetes, hypertension and cancer) by record linkage of the data from the Turkey Chronic Diseases and Risk Factors Prevalence Study 2011 (TCD-RFS) with health service databases, which are Family Medicine Information System, Medulla- E-Pulse and Death Notification System. The cohort (18.477 people above age 15) from TCD-RFS is followed up to determine the incidence of coronary heart disease, hypertension, diabetes, stroke and cancer, from the electronic health record systems for the period between 2012 and 2017 (6 years). Cumulative incidences were calculated, age and sex standardized incidences were given with 95% CI.

Results

The age and sex standardized cumulative incidences are, 5939 (95% CI 5933-5945) for CHD 1378 (95%CI:1369-1388) for stroke, 2254 (95% CI 2 253 -2 255) for cancer, 4200 (95% CI 4194-4204) for diabetes and 20788 (95% CI 1369-1388) for hypertension (per 100,000). The annual incidences are approximately 990 for CHD, 229 for stroke, 375 for cancer, 700 for diabetes and 3464 for hypertension (per 100,000). CHD and cancer incidences are higher in men, while diabetes, hypertension and stroke incidences are higher in women.

Conclusions

Regardless of the difficulties in comparing incidence of NCD with other countries, we think our results show that hypertension, diabetes, stroke and CHD have higher incidence than Western European countries. We also showed that these metrics can be obtained through data linkage of National Health Records for the first time in Turkey.

Key messages

The NCDs needs to be monitored by surveillance using the current data sources for health services. This data can provide very useful information regularly to monitor and control NCDs if necessary actions are taken to adjust data management.
Disparities in the control of Diabetes type 2 and incidence of cardiovascular events. The APNA study
Authors: Guillen Grima F , Guillen Aguinaga S , Brugos Larumbe A , Forga Llenas L , Guillen Aguinaga L
Published: October 2021

Background

In Spain, the care of patients with DM2 is carried out in primary care by General Practitioners (GP) in Primary Health Care Centers. There is considerable variability among GPs following these patients. The objective of his study is to analyze the influences of variability in the control of the cardiovascular risk factors in DM2 patients in t cardiovascular events.

Methods

APNA is a dynamic cohort study that includes all the inhabitants of Navarra, a region of Spain with a population of 661.023 inhabitants. We studied 385 GPs and selected all DM2 patients over 17 years of age-old and performed 5 years follow-up. We collect clinical variables, visits to GPs, and analytical data from the clinical records, hospital admissions for cardiovascular events and stroke for each patient and GP we computed 4 indicators of DM2 quality of care, HbA1c < 7% (I1); % HbA1c > = 9% (I2); % BP < 140/90 mmHg (I3); % cLDL <100 mg/dl (I4). Using K-means cluster analysis GPs were classified in 2 groups according to their performance in the indicators. We computed Cox regression.

Results

At the beginning of the follow up we identified 19603 DM2 the prevalence of DM2 was 4.14% (95% CI 4.08- 4.20). The average for I1, I2, I3 and I4 was 51.7%, 9.0%, 46.8% and 35.3%. The coefficient of variation of GPs for I1, I2, I3 and I4 were 24.3, 60.6, 26.7 and 33,1. In the Cox regression model, the risk of hospital admission for a cardiovascular event adjusting by age, gender, income, smoking, BMI, antecedents of cardiovascular events, I1, I2, I3, and I4 was higher when the patient was cared by a GP in the worst cluster of HbA1C > 9% control with a HR of 1.15 (CI 95% 1.03-1.29)

Conclusions

Adjusting by risk factors, and control variables for type 2 diabetes mellitus being attended by GP in the worst indicator cluster adds an additional 15% risk of having a cardiovascular event requiring hospitalization. Efforts should be made to improve quality of DM2 care and to reduce the disparities among GPs.

Key messages

There is great variability in the quality of health care for patients with type II diabetes specially in the proportion of diabetics with HbA1c higher or equal to 9% that differs greatly among GPs. Diabetic type 2 patients cared for by general practitioners in the worst quality group have a 15%.higher likelihood of having a cardiovascular event.
Amigo – A win-win for climate & health
Authors: Brettenhofer M , Dietachmair J
Published: October 2021

Background

Overburdened roads and traffic jams are daily routine in the cities of the Alpine Rhine Valley. At the same time, active travel is increasingly recognised as an important source of promoting physical health. Therefore, the interdisciplinary and cross-border project AMIGO aims to promote active commuting at the workplace. Approach: The goal of AMIGO is to integrate active commuter mobility into health programmes of organisations. Pilot companies across the entire region implement programmes to animate commuters to switch to active mobility modes, improve their own health and maintain sustainable behaviour. Together with an advisory board of psychologists, health experts and mobility experts the project establishes solutions to connect people's individual commuter choice with the mobility and health management of companies. A cross-border approach has been applied as commuters also significantly cause congestions across the border. Hence, the project team consists of organisations based in Austria, Liechtenstein, Switzerland and Germany, which covers the entire Lake Constance area. This enables cross-border knowledge transfer and joint action to achieve political awareness.

Methods

AMIGO uses qualitative and quantitative research methods. An employee survey as well as mobility analyses were used for needs assessment to identify employers who may be susceptible to changing their long-term travel patterns. In addition, focus groups provided detailed insights into the needs and obstacles of the employees. Techniques of behavioural science are applied for designing the interventions.

Results

A bundle of measures is required to create an enabling environment for sustainable and active commuting. Companies investing in active mobility make an impact for public health and environmental health.

Key messages

Companies investing in active mobility make an impact for public health and environmental health. Active commuter mobility should be integrated into health programmes of organisations.
Inequalities in diabetes type 2 prevalence in the multicultural city Malmö, Sweden
Authors: Rämgård M , Zdravkovic S , Grahn M , Schölin T , Nagorny Holmberg C , Annersten Gershater M
Published: October 2021

Background

Type-2 diabetes is a progressive disease and very much linked to health equity prerequisites and poverty. Its long-term complications include cardiovascular diseases, blindness, amputation and kidney failure. The aim of the study was to explore diabetes type 2 (T2D) prevalence in Malmö, a socioeconomically diverse and multicultural city with a relatively young population.

Methods

The study is a part of the Cities Changing Diabetes project related to the 14 geographical developing areas CTC (Community That Care) in Malmö. The whole city has been divided into 14 areas based on socioeconomical homogeneity as well as shared local area affiliation. Results are obtained from the Patient Administrative System (ICD E11 code) in regional health care as well as from Statistics Sweden.

Results

The prevalence of T2D was 4.3% in 2018. It has increased since 2011 mostly noticeable for residents between 18 and 64 years of age. There are considerable differences in T2D prevalence by CTC-areas where the highest observed prevalence rate was 6.4% and the lowest was 2.6%. The areas with the lower prevalence rates have a high level of education as well as high average household income. The opposite is observed in the areas with the highest prevalence rates where the residents have lower educational level as well as low average income. Two of the three CTC-areas with the highest T2D prevalence rates consists of a younger population as compared to the city in general whereas the third consists of the oldest population in the city.

Conclusions

The prevalence of T2D has increased during the last decade in Malmö. There are significant differences in T2D prevalence within the city related to contextual and socioeconomic factors. The highest T2D prevalence occurs in the area with the lower income and lower level of education.

Key messages

Promotive actions need to be specifically targeted at younger populations in the city of Malmö to prevent the increase in type-2 diabetes and its complications. Contextual factors need to be taken into consideration in the development of sustainable primary and secondary preventive actions for type-2 diabetes in community care and the health care system.
The prevalence of post-traumatic stress disorder increased in refugees after long-distance migration
Authors: Eiset AH , Aoun MP , Stougaard M , Gottlieb AG , Haddad RS , Frydenberg M , Naja WJ
Published: October 2021

Background

Refugees are forced migrants but there is a large variation in the distance that refugees cover. This may importantly affect their health needs. Previous studies suggest an inverse association between long-distance migration and self-rated health in the general population, possibly related to difficulty in acculturation but there is a knowledge gap in the health effects of migration in refugee populations. Here, we estimate the association between long-distance migration and post-traumatic stress disorder (PTSD), a severe mental health disorder associated with deteriorating psychiatric and somatic health and highly prevalent in refugees.

Methods

Included were 712 adult Syrian refugees and asylum seekers in Lebanon and Denmark arriving no more than 12 months prior to inclusion. The Harvard Trauma Questionnaire was used to assess PTSD and the estimate of association was obtained by multiply imputing missing data and adjusting for confounding by propensity score-weighting with covariates age, sex, socioeconomic status, trauma experience, and WHO-5-score, reporting the bootstrap 95-percentile confidence interval (CI). Additionally, a number of sensitivity analysis were carried out.

Results

The prevalence of PTSD was high in both Lebanon (55%) and Denmark (60%). After adjusting for biases the prevalence difference increased from 5 percentage point (95-percentile CI [-5; 15] percentage point) to 9 percentage point (95-percentile CI [-1; 19] percentage point). All sensitivity analysis produced estimates of the same direction and magnitude, except when grossly violating the assumption of multiple imputation which halved the magnitude of the association.

Conclusions

We found that long-distance migration was associated with an increase in the prevalence of PTSD among newly arrived Syrian refugees and asylum-seekers. This is a first step in examining the effects of migration in refugee health.

Key messages

Long-distance migration was positively associated with prevalence of post-traumatic stress disorder in Syrian refugees. This is a first step to investigate the impact of migration in refugee health.
Inequalities in Utilisation and Provision of Dental Services: A Scoping Review
Authors: Ghanbarzadegan A , Bastani P , Luzzi L , Brennan D
Published: October 2021

Background

To explore the main determinants of inequality in both provision and utilisation of dental services in OECD countries.

Methods

Four databases were searched up to 8 Aug 2020 applying the relevant keywords. Thematic analysis was used for synthesizing and extracting data. Trend analysis was applied to determine the trends of the inequality determinants.

Results

Thematic analysis led to 53 sub-sub-themes, 13 sub-themes and 6 main-themes. The main themes represent the main inequality determinants for both utilisation and provision of dental services. The streamgraph illustrates that fewer studies have been conducted on social and cultural determinants, and in almost all determinants the trend of published articles has been increasing since 2007 except for health policies.

Conclusions

Inequality in the utilisation and provision of dental services is addressed by various factors including individual, social, cultural and economic determinants, health policies and availability of services. The first four determinants are related to utilisation and the last two are related to the provision of services. All these aspects must be considered to reduce inequality in dental services.

Key messages

Service Utilisation, Provision and access to service int the dental literature should be distiguished and redefined. Researchers and policymakers should pay attention simultaneously to all structured determinants of inequality in the dental services.
Evaluation of ZnO-NPs in canned seafood by single particle ICP-MS determination
Authors: Copat C , Grasso A , Arena G , Cristaldi A , Oliveri Conti G , Ferrante M
Published: October 2021

Zinc is a well-known essential micronutrient, widely used as a food supplement, antimicrobial agent and food preservation. NOAEL was established at 50 mg/person per day and an upper limit of 25 mg/person per day was recommended. ZnONPs are GRAS substances approved by FDA. Nanotechnology is an emerging issue because of the industrial widespread use of ZnO nanoparticles and their potential toxicity and bioaccumulation. Aim of this study is to provide information regarding the quantification of ZnO-NPs, which may be intentionally or unintentionally added, in different brands of canned tuna (CT) and canned clam (CC), and to provide a first esteem of dietary exposure. Canned seafood was subjected to an alkaline digestion with TMAH. Assessment of ZnONPs was performed using a NexION 350D with the Syngistix Nano Application software (Perkin Elmer), allowing to identify number of particles, size and size distribution of metal NPs with the simultaneous quantification of the dissolved elemental concentration. Estimated Meal Intake was evaluated for adults by assuming a meal size of 227 g, 70 years old and 70 Kg of b.w. Results revealed a comparable mean size range between the considered food item (CT 69-80 nm; CC 75-83 nm). Concentration of ZnONPs are significantly higher in CC versus CT (CT 3.2-9.8 µg/Kg; CC 7.7-11.3 µg/Kg). The same we found for dissolved Zn concentration (CT 19.1-28.4 mg/Kg; CC 27.4-39.2 mg/Kg). For CT it was estimated an EMI of 0.018 µg/Kg bw for ZnONPs and 79.9 µg/Kg bw for dissolved Zn. For CC it was estimated an EMI of 0.031 µg/Kg bw for ZnONPs and 109 µg/Kg bw for dissolved Zn. Our findings revealed that ZnO-NPs have the potential to bioaccumulate in marine organisms, and seafood could be an important uptake route of ZnONPs. These results are a first important step to understand the ZnONPs human dietary exposure, but the characterization and quantification of ZnONPs is necessary for a large number of food items.

Key messages

The extensive use and discharge of ZnONPs will probably expose human population to concentration higher than the recommended upper limit 25 mg/person per day. The quantification of ZnONPs dietary exposure will be useful for risk assessors in developing provisional tolerable daily intake.
Resistance to veterinary antimicrobials of Staphylococcus aureus from mastitic milk
Authors: Rossi F , Marino L , Pomilio F , Centorotola G , Cornacchia A , Perilli M , Scattolini S , Telera GC , Del Matto I
Published: October 2021

Background

Use of antimicrobials in veterinary medicine for prophylactic and therapeutic purposes is one of the main culprits for the selection of antimicrobial resistant bugs that currently threaten human and animal health. Therefore, surveillance on antimicrobial resistance (AMR) selection trends in animal husbandry is of utmost importance to prevent the spread of resistant bugs to humans. The species Staphylococcus aureus (Sa), that is of particular concern for the spread of methicillin-resistant (MRSA) strains, often causes mastitis in milk producing animals, thus requiring antibiotic treatment that can impact on the AMR status of this pathogen. With the aim of elucidating the current evolution of AMR in Sa involved in mastitis and the threats posed by the consumption of raw milk or inadequately pasteurized dairy products, data from antimicrobial susceptibility testing carried out on Sa strains from mastitis in years 2013 - 2019 in Molise region, Italy, were analyzed.

Methods

Sa isolates were tested by disk diffusion and inhibition halo sizes were converted in Minimum inhibitory concentrations (MIC) according to the EUCAST standards for the antibiotics there included. One isolate per AMR profile per farm was considered to define the percentage of the antibiotic resistant on the total number of isolates per year.

Results

The number of diagnosed Sa infections per year ranged between seven and nineteen, with a total of 78 isolates from 70 farms. The percentages of those resistant to aminoglycosides kanamycin, neomycin and paromomycin, to the macrolide tylosin and the multi drug resistant (MDR) isolates increased since 2015. The latter ranged between 26.3 and 85.7%.

Conclusions

AMR and MDR Sa in milk producing animals pose a serious risk to public health and needs stricter surveillance.

Key messages

Limiting use of antibiotics is needed to revert the trend. AMR Sa strains in dairy products, need to be kept under control for the strict connection with human health.
Evaluation of a tele-expertise experiment for skin cancer detection: the perspective of GPs
Authors: Terenzi Seixas C , Marrauld L , Bourgueil Y , Sicotte C
Published: October 2021

Background

The incidence of skin cancer has shown an increasing trend in the world and in France over the last four decades. In this context, the delay to access a specialist opinion strongly impacts the patient outcomes. However, the medical demographics of dermatologists in France have been decreasing over the past years. Hence, a tele-expertise (TLE) experiment for skin tumors detection, which allows general practitioners to obtain feedback from a dermatologist within 7 days using a smartphone application, has been set up in the Hauts-de-France region since 2015. Thus, this study aims at understanding the advantages and drawbacks of TLE in the detection of skin tumors perceived by general practitioners.

Methods

Exploratory study carried out with 15 general practitioners participating in the experiment in the Hauts-de-France region. Semi-structured interviews were conducted between february and april 2021 and analyzed after transcription.

Results

The main advantages perceived by general practitioners are: (i) fast access to a specialized feedback; (ii) formalization of the request and commitment of the dermatologist; (iii) ease of regulating patients to a specialist; (iv) lower travel frequency and stress for patients; (v) ability to send medical information securely. The drawbacks are most related to the lack of functionalities and the graphical user interface of the application.

Conclusions

Tele-expertise is a well accepted technological innovation in dermatology among general practitioners, which enables the best use of the scarce medical resources available in the region and to address the needs of patients. The sustainability of TLE in dermatology and its extension to other territories is possible and desirable.

Key messages

Tele-expertise in dermatology has its place in enabling the early management of malignant skin tumors. The qualitative approach makes it possible to understand general practitioners visions after the introduction of a technological innovation into their practices.
Health status and labour force participation among older workers: a growth curve analysis
Authors: Feer S , Lipps O , Dratva J , Baumann I
Published: October 2021

Objectives

We investigate how individual trajectories of health status and labor force participation among older workers in Switzerland are interrelated and how this relationship varies by occupation.

Methods

We use data from the Swiss Household Panel (SHP) to analyze the long-term trajectories of older workers, measured in terms of working hours and general health status. The sample includes more than 7,000 workers aged 50 to 65(men)/64(women). We run a bivariate response multilevel model for growth that allows examining between- and within-individual changes over time.

Results

All occupational groups become more heterogeneous in terms of health status with increasing age. At the same time, working hours decrease in all occupational groups with increasing age. A look at the individual level indicates that the working hours of manual workers seem to be more dependent on their health status compared to those of non-manual workers and that this dependence increases over time. This result confirms our hypothesis that the labor market participation of manual workers is more sensitive to their health status.

Conclusions

Our findings contribute to the debate about the importance of older workers' health in the context of working life extension.

Key messages

All occupational groups become more heterogenous in terms of health status with increasing age, however working hours of manual workers seem to be more dependent on their health status. Manual workers experience a stronger effect of health on working hours and that this effect increases over time, therefore prevention of ill health may be particularly beneficial in manual workers.
The women in situation of gaslighting – risk identification in the work environment
Authors: Dimitrova D
Published: October 2021

Background

As a contemporary form of “workplace harassment' (WH) is reported gaslighting. Preston Ni, defines it as ‘A form of constant manipulation and brainwashing…' The phenomenon is presented as mainly affecting the woman in the workplace. The aim of the study is to determine and identify the risk of subjecting a woman in the workplace in Bulgaria to this form of psychological pressure gaslighting, in favor of building a risk reduction program cause.

Methods

Empirical sociological research (ESR) among working women for period of 10 years in Sofia (around 2 million citizens), Bulgaria. An anonymous survey of 2,000 working women between the ages of 30 and 65 was conducted. The questionnaire of the respondents with only more than 5 years of work experience are included.

Results

Of the surveyed 25% are between 30-40 years, about 47% are 41-50 years, about 25% are 51-60 years and about 3% are 61-65 years. The result of the study indicates that mostly women between 41 and 50 years are subjected to psychological pressure by a man at work (about 45%), about 15% - are 51-60 years, only about 5% of women 31-40 years, and less 2% over 61. All of them are described as introverted. Mostly women with a high level of education have remained mentally resistant to gaslighting - about 35% of respondents, and less than 5% of them have shown higher creativity against the background of psychological pressure. In almost 1/3 of those subjected to prolonged mental harassment, were diagnosed for the first time, including: Hashimoto's thyroiditis (5%); arterial hypertension (about 10%); ischemic disease (about 15%). Half of them are presented with depression.

Conclusions

Gaslighting is a hidden psychological violence against a female person based on hate speech and demonstration of power. Gaslighting is defined as a real risk among women, mostly of the introverted type. Emotional plasticity based on knowledge and smart has a positive effect in situation of gaslighting.

Key messages

Gaslighting can lead to lack of confidence, clinical depression, distress and related physical illnesses. Early risk detection provides advantages for early reduction and optimization of the corporate culture of the department and the institution and in favor of building a risk reduction program.
Burnout among health care workers during COVID-19 pandemic: prevalence and risk factors
Authors: Maamri H , Ben Ayed H , Ben Hmida M , Baklouti M , Ktata N , Yaich S , Feki H , Damak J
Published: October 2021

Introduction

During COVID-19 pandemic, health-care workers (HCW) have been exposed to multiple psychosocial stressors. Although the problem of burnout, which overlaps with the symptoms of depression, remains urgent, few studies have addressed it comprehensively. The objective of this study was to determine the prevalence and the factors associated with burnout among HCW.

Methodes

We conducted a cross-sectional study on March-April 2021 using a self-administered questionnaire distributed to HCW who were involved in COVID-19 management patients. The 22-item Maslach burnout inventory was performed to measure the prevalence of burnout defined as follows: high score of emotional exhaustion (≥27) plus high score of depersonalization (≥13) or low score of personal accomplishment (≤31).

Results

Overall, 250 HCW were included in this study. The sex ratio was 0.17. Their median age was 34 years (interqurtile range (IQR) = [30-40 years]). The average number of work experience was 11.1±3.4 years. There were 46 cases (18.4%) with a chronic disease. Among the study population, 131 HCW (51.4%) were infected with covid-19. The overall burnout prevalence was 45.6%. Female gender (Odds ratio (OR)=4.3; p < 0.001) and unmarried status (OR = 3.3; p < 0.001) were statistically associated with burnout. Participants in the burnout group had statistically higher number of working hours per day (≥6 hours) (OR = 3.2; p = 0.003), of night shifts per week (4±1 vs 3±1; p = 0.04), but lower number of working experience years (7±0.6 vs 12±1; p = 0.017). History of chronic diseases (OR = 1.8;p=0.021), witnessing a COVID-19 death while working (OR = 3.1; p < 0.001) and suffering from sleep deprivation (OR = 1.9; p = 0.034) were statistically more frequent in the burnout group of HCW.

Conclusions

The findings of this study indicated that the burnout syndrome was highly prevalent among HCW. More psychological support should be provided for this population in order to provide a high-quality of care for patients.

Key messages

Highly prevalent of burnout syndrome. Psychological support should be provided.
Digital screening tool (Health Catch-UP!) to promote multi-disease screening in migrants
Authors: Hargreaves S , Carter J , Knights F , Deal A , Goldsmith L , Crawshaw AF , Hayward S , Zenner D , Wurie F , Hall R
Published: October 2021

Background

The ECDC has called for innovative strategies to deliver multi-disease screening (TB, LTBI, HIV, hepatitis B/C, Chagas, Strongyloidiasis and schistosomiasis) and catch-up vaccination (MMR, DTP) to adult migrants within the primary care context. We did a UK i qualitative study to explore current practice and seek views on a novel integrated digital tool to support delivery of screening recommendations for migrants https://emishealth.vids.io/videos/a49ad1bb1a18e4c72c/health-catch-up-with-requested-edits-mp4).

Methods

Phase 1 was conducted via telephone with clinical primary care practitioners (PCPs) (phase 1) and informed data collection and analysis for phase 2 with administrative staff. Data were analysed iteratively, informed by thematic analysis (Ethics no.20/HRA/1674).

Results

64 participants were recruited in Phase 1 (25 general practitioners [GPs], 15 nurses, 7 healthcare assistants, 1 pharmacist); Phase 2 comprised administrative staff (11 Practice-Managers, 5 receptionists). There was lack of consistency in delivery of screening and vaccination. Most GP practices adopted a practice-specific approach, or had no system in place; screening only for HIV and hepatitis B/C. Barriers to screening were perceived lack of knowledge/training and limited financial resources. Facilitators included having an infectious disease/migrant-health champion, incentivisation, and clear protocols. Participants responded positively to the integrated Health Catch-UP! tool, confirming that it would increase screening and vaccination, reduce missed opportunities for preventative healthcare, and raise awareness of migrant health.

Conclusions

Infectious disease screening and catch-up vaccination is not currently delivered well in primary care in high-migrant receiving European countries. Innovative digital tools like Health Catch-UP! could aid clinical decision-making and facilitating improved health outcomes for migrants. Further work is needed to evaluate this intervention.

Key messages

Infectious disease screening and catch-up vaccination is not currently delivered well in primary care in high-migrant receiving European countries. Innovative digital tools could aid clinical decision-making and facilitating improved health outcomes for migrants.
Assessment of the Relationship between Religious Officials' Vaccine Acceptance and Health Literacy
Authors: Caliskan Pala S , Ocal EE , Arslan Torba T , Ay A , Onsuz MF , Metintas S
Published: October 2021

Background

Vaccination, which is the most effective protective measure from infectious diseases, has not been able to achieve the desired success in recent years.Religious officials, who have an important effect on the community, can play an important role for the vaccine acceptance. The study was aimed to assesment of vaccine acceptance and health literacy(HL) among religious officials.

Methods

This cross-sectional study, 72%(n = 328) of the religious officials in the city were reached. The questionnaire consisted of sociodemographic characteristics, Vaccine Acceptance Instrument (VAI) and Chew Health Literacy Scale(CHLS) which was developed by Sarathchandra et al. The instrument,which language validity and reliability were made by the researchers, consisted of 16 items and one dimension. The Cronbach alpha coefficient was 0.841. The cut off score the scale was determined by ROC analysis according to the variable of getting vaccinated. Those who scored above 54 points were determined as those who accepted the vaccine. It is accepted that HL decreases as the score on the CHLS increases.

Results

The mean age(SD) study group was 41.9(9.2), and the 76.8% were male. The vaccine acceptance frequency of religious officials was 58.8%. The CHLS score was lower in those who accepted the vaccine(p = 0.001). The HL level of 43.9% was below the mean score. 33.8% of the study group reported that they were advising the community about vaccination. According to multiple logistic regression analysis, vaccine acceptance was 2.16(OR;95% CI,1.15-4.08) higher in males, 3.01(1.73-5.25) higher who had information, 6.14 times(1.57-23.94) higher who had their children vaccinated, and 0.8 times(0.74-0.91) lower with who had low HL.

Conclusions

Vaccine acceptance among religious officials was found to be insufficient. The frequency of vaccination acceptance was higher in male, those who had high knowledge about the vaccine, those who had their children vaccinated, and those with high HL.

Key messages

Increasing the acceptance of vaccines among religious officials is an important issue as it affects the community. It would be beneficial to increase their knowledge level on this issue. Health literacy is important in increasing the acceptance of vaccines among religious officials as it affects the community.
Exploring children breakfast habits using Zoom8-questionnaire: Results from the I-MOVE Study
Authors: Scrimaglia S , Esposito F , Sanmarchi F , Marini S , Masini A , Melis A , Sacchetti R , Dallolio L
Published: October 2021

Background

Scientific evidence widely argues that consuming breakfast daily is considered a good habit which positively affects health and academic performance, especially in children. In order to be adequate, according to national requirements, breakfast should include a portion of milk or yogurt and one grain based product, providing about 15-20% of the daily recommended energy intake. The aim of this study was to analyse breakfast habits in a convenience sample of primary school children inside the Imola Active Breaks Study.

Methods

A cross-sectional study was conducted in a sample of children, aged 6-10, recruited in a primary school of Imola (Emilia Romagna region, Italy). The Zoom8 self-reported questionnaire, which investigates dietary habits and lifestyle aspects were administered to parents to explore the children's breakfast habits.

Results

A total of 155 children were recruited in November 2019. Breakfast was consumed daily by 117 children (75%), 4-6 times/week by 12 (7%), 2-4 times/week by 4 (3%), and 22 (14%) did not answer. Concerning dairy products' consumption: 50 (32%) children reported milk or yogurt, 47 (30%) milk, 6 (4%) yogurt, 9 (6%) neither of them and 43 (28%) gave no answer. Mostly all the children consumed at least one of these products: biscuits, cakes, croissants, industrial snacks or cereals. 108 children (70%) recognised that the consumption of a dairy and a carbohydrate product represent an adequate breakfast.

Conclusions

The findings suggested that the majority of children consumed one grain based product for breakfast, but most of them were high in sugar and fat content (industrial snacks and croissants). Still not every child had breakfast daily nor had a portion of a dairy product. Measurements should be taken to avoid skipping breakfast and to promote a more balanced breakfast. It would be advisable to analyse in detail the frequency of consumption of each food group and their energy intake.

Key messages

Breakfast consumption positively affects children’s health and academic performance. Health Promotion should stimulate daily consumption of breakfast and improve its quality and energy intake.
Health behavior in adolescents from different ethnic groups in the Municipality of Plovdiv, Bulgaria
Authors: Petrova G , Merdzhanova E , Lalova V , Angelova P , Raycheva R , Boyadjiev N
Published: October 2021

Background

The health behavior of modern adolescents is manifested by reduced motor activity. The aim of the present study is to analyze the attitude of adolescents to sports outside of school, as a preventive measure to limit their motor inactivity.

Methods

About 185 adolescents (11-15 years old) from three different ethnic groups in the period of May 2019 - July 2019, have been studied. Also have been developed and used specifically for this purpose an author's questionnaire for students, which contains open, closed, and mixed questions. For the statistical processing, we have used the data analysis software IBM SPSS Statistics v. 25.

Results

Approximately 2/3 of the surveyed boys from the three ethnic groups play sports outside of school. The girls playing sports out of school are mainly of Bulgarian ethnicity 52.27% and in less than Turkish 28.57% and Roma 23.08%. As the most common reason for not playing sports outside of school, the teenagers point out that there is no one to take them and to pick them up after training, especially for girls of Roma 45.45% and Turkish origin 33.33%. Although the distributions of values across children who have a computer or other electronic device (electronic game, smart phone) and who play sports outside of school are not equally likely (Related-Samples McNemar Change Test = 72.01, p = 0.000), the difference between proportions are not that high - 100% (n = 106) own device/s and play sports vs 93.7% (n = 74) own device/s and do not play sports. The distributions of values across children who play sports outside of school and the place where they spend the most time in front of a computer are not equally likely (Related-Samples McNemar Change Test = 47.71, p = 0.000).

Conclusions

Modern adolescents spend most of their time in front of digital devices, which is a prerequisite for reducing their physical activity.

Key messages

Encouraging sports outside of school is a factor for increasing physical activity in adolescents. The promotion of health in the family forms healthy behavior in adolescents of different ethnicities. Acknowledgments: This study was supported by Medical University of Plovdiv, Bulgaria, Project HO-12/2019.
A rapid review of factors influencing food decisions among economically disadvantaged families
Authors: Ravikumar D , Spyreli E , Woodside J , McKinley M , Kelly C
Published: October 2021

Introduction

The importance of external and household family food environments in establishing healthy eating habits during childhood is well reported. Deprived areas are at a nutritional disadvantage due to the high prevalence of fast food outlets and convenience stores. Little is known about the impact of food environments on food-related behaviours of low-income families. This rapid review aimed to synthesise available qualitative evidence on parental perspectives of environmental factors that influence food planning, purchasing and processing among economically disadvantaged families with children.

Methods

This review included qualitative and mixed-methods studies published after 2000 from Europe, North America and Oceania. Search strategies included seven concepts: family, food, perceptions, influences, environment, socio-economic status and study type. Thematic synthesis was employed.

Results

Fourteen articles from the USA, Australia and the UK remained following screening by two reviewers. All parents had a desire to provide healthy food for their children, but they were impeded by child food preferences and beliefs about food behaviours and nutrition. In the external environment, food outlets/availability, cost and marketing influenced food choices amongst parents. Social determinants had a dominant negative influence on food decisions, including hectic daily schedules and time constraints and most importantly limited finances. Social support and support from nutrition programmes and cooking interventions had a positive influence on family food decisions.

Conclusions

This synthesis of qualitative evidence highlights the challenges and opportunities that low-income parents face to feed their families. Improvements in parental food choices and feeding behaviours can only be improved if inequities in health, such as access to affordable healthy food, are addressed.

Key messages

This review concluded that income, time constraints, food cost and limited food availability/outlets can have a negative effect on family food decisions. Social supports such as cooking programmes play a positive role in ensuring healthy food options for families.
Health and economic impact of a food substitution in the Portuguese diet: methodology overview
Authors: Morgado JN , Sousa Guerreiro C , Peixoto J , Monteiro Pires S
Published: October 2021

The Portuguese Food Based Dietary Guidelines (FBDG), namely Food Wheel Guide, as well as the National Food, Nutrition and Physical Activity Survey 2015-2016, advise the Portuguese population to substitute animal protein for vegetable protein. At the same time, 10,1% of the Portuguese families suffered from food insecurity issues, mainly due to lack of financial resources. This study will be the first to investigate the possibilities of associating the health impacts of different risks and benefits through a Risk-Benefit Assessment (RBA) with different methodologies that estimate the economic sustainability of substituting unprocessed red meat by legumes produced in Portugal, e.g. beans and chickpeas in the Portuguese population. An overview of the current Portuguese diet as well as a literature review of the RBA methodology was performed, with specific reference to substitution studies, as means of promoting healthy and sustainable diets. For a socio-economic analysis, relevant literature of specific authorities (FAO, EFSA, ECDC), and published studies (Public Health and Environment institutes), was evaluated and the different methodologies, such as the Willingness To Pay (WTP), behavioral economics and a cost analysis were compared amongst them as to their advantages and disadvantages. From the literature review it can be concluded that not only income or food prices are the only factors that explain food choices. However, if healthier diets are proved to be unaffordable for many people's households, especially the Portuguese families, then nutrient adequate consumption dietary patterns will not improve, even in their lowest prices form, with nutrition education and behavioral change. This way, associating a RBA with a cost analysis is a valuable approach to evaluate the health impact in relation to the cost of substituting red meat for legumes in a household, giving estimates that support policies that promote nutritious foods for all.

Key messages

Advocate for the substitution of red meat for legumes in the Portuguese population, expected to be both more environmentally-friendly and healthier. Investigate the costs (affordability) of this substitution in the Portuguese households while advocating for healthier foods: methodological overview.
The development of a quality-assured action model for municipal health promotion
Authors: Tollmann P , Dieterich S , Kuchler M , Leimann J , Mielenbrink V , Terhorst S , Quilling E
Published: October 2021

Background

The creation of health-promoting living environments is a key strategy in order to minimise health inequalities, which have been increasing recently. Health promotion in municipalities offers many approaches in this context and is gaining importance on an international level. To structure the process of municipal health promotion, the aim of this research was to create a basis for action and to define requirements in the process.

Methods

A systematic literature research on models, approaches and tasks for health promotion in municipal settings was conducted in five databases such as Web of Science and EBSCOhost, and was supplemented by a manual search. All hits were filtered using inclusion and exclusion criteria. The design and presentation of the results were prepared based on the method of the Integrative Review.

Results

262 publications were screened, sixteen of which were considered for analysis. On this basis, an action model for municipal health promotion was developed. It consists of four phases: Network Planning and Modification, Municipal Profiling, Municipal Strategy Development, Implementation and Evaluation. Other important identified aspects during the process are participation, project and network management, communication, evaluation and quality assurance.

Conclusions

The action model structures tasks and requirements in the process of municipal health promotion. The evidence also shows the importance of central coordination in municipal health promotion, which can be structured by the action model. The created model provides a new framework for a quality-assured and sustainable process and for a central coordinated municipal health promotion.

Key messages

Municipal health promotion should increasingly be established. Thereby, the adherence to a systematic, quality-assured process is important.
Occupational risk perception in Health Education and Research: Better knowledge, better prevention
Authors: Madaleno P , Sousa-Uva A
Published: October 2021

Background

Workers of Biologic Sciences and Health, in the exercise of their occupational activities, are exposed to several occupational hazards.

Objective

To identify the occupational hazards and risks of occupational and “work-related” diseases in a Public Health Education and Research Institution located in Lisbon (Portugal).

Methods

Descriptive study carried out by applying a structured questionnaire to collect information regarding the perception of exposure to occupational hazards, risk perception (cognitive and emotional) and sociodemographic and occupational variables.

Results

95% of workers report exposure to at least one occupational hazard. Exposure to risk factors related to the activity or ergonomic (74%) was reported by all professional categories and work areas. Exposure to physical hazards were perceived by 60% of workers and mainly in laboratory work (78%). Exposure to microbiological agents (51%) and chemical substances (49%) is perceived mainly by professionals who work in the laboratory with 81% and 82%, respectively. Psychosocial risk (33%), mainly career progression, were reported by 84.6% of professionals at general services and by 79% in teaching. However, workers have difficulty perceiving occupational risk, since only 15% of participants considered the probability of having an occupational accident to be high, 15% of acquiring an acute illness and 25% a chronic disease. About 45% of workers were not concerned with the severity and implications of the accident or illness in their lives. Differences were identified in the characterization of risk perception considering the work area and antiquity time in the institution.

Conclusions

Understanding workers occupational risk perception is an indispensable condition for an effective occupational risk management. Only in this way is it possible to define health surveillance protocols and planning effective preventive and health-promoting measures at work on an individual and or collective level.

Key messages

Occupational risk perception evaluation is essential to define health surveillance protocols and planning effective preventive and health-promoting interventions at work. More studies about hazards and risk perception in Health Education and Research is necessary to the definition of adequate preventive policies to improve the protection of their workers’ health.