bluuebunny/crossref_metadata_2025 huggingface dataset:
A scoping review of the EU's impact on access to medicines in low- and middle-income countries
Authors: Perehudoff K , Durán C , Demchenko I , Mazzanti V , Parwani P , Suleman F , de Ruijter A
Published: October 2021

The European Union (EU) has a potential major influence on patients' global access to medicines. Historically, this influence most notably came through the EU's trade and aid agendas that intentionally targeted foreign markets. Now, the EU's own internal pharmaceutical policy appears to indirectly shape global access to medicines (ex. EU's large-scale Covid-19 vaccine procurement and export bans). To understand the ways the EU's internal and external policies impact on global access to medicines, this Scoping Review synthesises evidence of the EU's global regulatory influence and its impacts on access to medicines in non-EU low- and middle-income countries (LMICs). By searching 8 databases and grey literature, documents published in English, Spanish, Portuguese, or Russian between 1995-2021 that addressed an EU law, regulation, or policy in relation to access to medicines in LMICs were included. This review identifies three mechanisms through which EU action impacts on medicines in LMICs. One, the EU's external, treaty-based agreements with LMICs can affect their pharmaceutical trade, sales, and use. Two, EU's internal market regulation, standards, and methods are used as models or sources of inspiration for pharmaceutical governance in LMICs. Three, ‘soft' forms of EU influence manifest through the EU's technical assistance, its research and development (aid) funding, and its ‘capacity building' activities towards LMIC actors in the field of pharmaceuticals. Examples of impacts of EU action ranged from the development of new medicines primarily for LMICs, to changes in the availability of generics and on medicines spending in LMICs, and the potential for a more efficient yet less autonomous local market approval process. Most evidence of impact was not peer reviewed. This study raises the question of how to support resilient and efficient global pathways for drug development and regulation while still being responsive and accountable to the local public interest.

Key messages

There are 3 mechanisms through which EU action impacts on medicines in LMICs: treaty-based agreements, EU internal market regulation, and ‘soft' EU influence. EU decision makers need a reliable understanding of how the EU’s internal and external policies impact on pharmaceuticals globally.
In Silico Preliminary evaluation of Cx601 as new therapeutic approach in hospital clinical paths
Authors: Rubba F , Luglio G , Castiglione F , Rispo A , Tropeano FP , Pagano G , Vozzella EA , De Palma GD
Published: October 2021

Crohn's disease is a chronic inflammatory bowel disease characterized by transmural inflammation and fistula formation. Perianal fistulas are a common complication of Crohn's disease and are estimated to affect up to 28% of patients in the first two decades after diagnosis, particularly those with colonic disease and rectal involvement. Complex perianal fistulas in Crohn's disease are challenging to treat, severely impair patients' quality of life and cause substantial morbidity. Allogeneic, expanded, adipose-derived stem cells (Cx601) are a promising new therapeutic approach, although their high cost is often discouraging. We aimed at assessing the safety and efficacy of this treatment in patients with complex perianal fistulas in patients with Crohn's disease. Therefore, we conducted a meta-analysis in order to evaluate this new therapeutic approach before introducing it as standard of care. We examined 8 studies published in the last 10 years, 5 of which were selected for the final analysis. The primary outcome assessed was the combined fistula remission (clinical + imaging) assessed through the clinical examination and MRI, the control being the traditional medical strategies (ie, antibiotics, immunomodulators and anti-tumour necrosis factor agents). We registered a total of 128 events (lack of remission) in the control group vs 94 in the experimental one (Confidence Interval for OR of 0,12-0,31, P < 0,001). Our “in silico” assessment is reliable, being the introduction of (Cx601) an innovative and effective treatment. Further insights will be provided by the INSPIRE registry, a multinational post-marketing study whose main objective is the evaluation of the real-world clinical effectiveness and safety of (Cx601) in patients affected by Crohn's disease with complex perianal fistulas for a duration of 36 months, to which our University “Federico II” is actively taking part.

Key messages

Disability reduction is an important goal in cronh therapeutic path of care. Our “in silico” assessment may support the introduction of (Cx601) an innovative and effective treatment.
Health Technology Assessment for COVID19: an approach for the Horizon Scanning of health innovations
Authors: Cadeddu C , Ruggeri M , Roazzi P , Mandolini D , Grigioni M , Marchetti M
Published: October 2021

Background

The COVID-19 pandemic definitely changed the approach to technologies evaluation, firstly in terms of timeliness. In order to answer to this need, a new methodology was proposed, joining the elements of horizon scanning with the Multi-Criteria Decision Analysis (MCDA). In this work we describe the results of 2 case studies of application.

Methods

By means of an assessment matrix, a multidisciplinary expert panel gave a score based on a Likert scale and related to potential value and perceived risk for each technology. Economic, clinical and ethical criteria were considered as a summary of Health Technology Assessment (HTA) main domains. The final scores were then weighted by the MCDA and a scatter plot defined 4 positioning scenarios according to the balance of values and risks resulted, each conducting to an appropriate recommendation (full HTA report or reject). A Monte Carlo simulation was also carried out for the assessment of variability of results.

Results

An individual protection device for COVID-19 and a contact tracing app were assessed. The first technology was placed in the “Danger Zone” of the graph, because of its high costs and organizational complexity. The second one was placed in the “Comfort Zone” of the graph, due to low costs and easiness of implementation and management. For this innovation a recommendation for a full HTA and a pilot testing was given. In both cases, the Monte Carlo simulation confirmed the results of previous analyses.

Conclusions

The implementation of this new tool presented for the large amount of innovations created in response to COVID-19 could be supportive for decision makers, especially in pandemic times when a rapid answer is necessary. Improvements in the subjective judgement process, by introducing an objective approach, is now ongoing as it could enhance the strength of the final decision.

Key messages

In a pandemic time as the current, HTA should be as rapid as possible without losing scientific robustness. The methodology described could be an answer in support to the decision-making process, allowing an adequate and quick priority setting.
Tumescent liposuction for lipoedema: A systematic review of clinical effectiveness and safety
Authors: Walter M , Goetz G , Gassner L
Published: October 2021

Background

Tumescent liposuction is an established method for surgical therapy of lipoedema - a chronic, progressive, and painful fat distribution disorder. We aimed to assess the clinical effectiveness and safety of liposuction in patients with lipoedema (stage I-III) compared to any conservative treatment, concerning patient-relevant outcomes, such as reduction of pain, reduction in the size of extremities, improvement in quality of life (QoL), and safety events.

Methods

A systematic review was conducted, and five databases were searched. In-/exclusion criteria were predefined according to the PICOS scheme. The internal validity of the included studies was assessed using the IHE checklist; strength of evidence for safety outcomes by the GRADE approach.

Results

Six prospective uncontrolled trials (467 patients) were included for assessment of clinical effectiveness. Pain outcomes (patient-reported) statistically significantly improved at six-months follow-up and up to 12 years after liposuction (six studies). Reduced sizes of patients' extremities before-and-after liposuction were reported in three studies regarding reduced leg volume and circumference of lower extremities. Statistically significant improvements in lipoedema-related QoL outcomes were reported in four studies. Seventeen post-operative adverse events occurred overall (492 patients, one additional retrospective study), including five serious adverse events. Other reported procedure-related adverse events comprise, e.g., post-operative wound infections and bleedings. Studies were judged with moderate/high risk of bias. Strength of evidence for safety outcomes was judged to be very low.

Conclusions

The current evidence is insufficient to prove that tumescent liposuction as safe as und more effective than conservative therapy for lipoedema. However, based on the limited evidence of the included uncontrolled studies, liposuction may potentially reduce lipoedema-associated clinical symptoms and improve the QoL.

Key messages

Based on the limited evidence of identified uncontrolled studies, liposuction may potentially reduce lipoedema-associated clinical symptoms and improve the quality of life of affected females. High-quality comparative studies need to be awaited. The results may support and influence the effect estimates considerably.
Implementation of Mental adjustment to cancer scale in psycho-oncology practice in Bulgaria
Authors: Tzvetkova S , Tschilingirova N
Published: October 2021

Background

Theoretically there are several insufficiently confirmed statements based on evidences that underline the important role of psychological assistance to patients with malignant neoplasms. Since April, 2021, Mental Adjustment to Cancer Scale (MAC) is translated into Bulgarian and it was introduced to psycho-oncologic practice in Bulgaria.

Methods

The concise variant of MAC - Mini Mental Adjustment to Cancer Scale (Mini-MAC) has been implemented evaluating the degree when the patients perceive their adaptation to the diagnosis and cancer treatment. It comprises 29 items and measures four inner scales: determination, helplessness, anxiety, cognitive negligence and fatalism. It has been applied in compliance with strict confidentiality, voluntary principle and objectivity to 30 patients - 14 male and 16 female.

Results

MAC scales have good consistency - alpha coefficient from 0.56 to 0.74. The age correlates moderately with disease type (r=.35, p = 0.05). Helplessness is in positive relation to anxiety (r=.63, p = 0.000) and fatalism (r=.30, p = 0.05), and in negative one to determination (r=-.35, p = 0.05). The determination is in statistic positive relation to cognitive negligence (r=.44, p = 0.02).

Conclusions

The malignant disease type does not influence the scale results. They are influenced by inner factors as morbid experience, sensitivity to the disease, psychological protections that are frequently demonstrated by cognitive negligence and determination. MAC has been successfully implemented in the clinical psychological counseling in Bulgaria.

Key messages

Mental Adjustment to Cancer Scale identifies patients' adaptation to cancer and is introduced in Bulgaria. The methodology shows the established cognitive mechanisms for personal understanding and behavior in the course of treatment.
Suberosis at Public Health Unit (PHU) of Santa Maria da Feira/Arouca (F/A) (Portugal)
Authors: Fernandes D , Paiva Monteiro G , Barroso Travassos S , Miguel Carvalho J
Published: October 2021

Introduction

Santa Maria da Feira (SMF) is currently one of the largest producers of cork in Portugal. Suberosis is an occupational disease of workers in the cork processing industry, associated with repeated exposure to moldy cork dust, usually presenting itself as a disease of the pulmonary interstitium (Hypersensitivity Pneumonitis). This study aims to assess the impact of occupational health interventions on the cork industry, in terms of health promotion and risk prevention.

Methods

We assessed 10 different cork companies distributed in 10 parishes of SMF.

Results

With regard to health promotion, we highlight the development of healthy workplaces and the strong commitment to training health professionals with regard to the correct use of personal protective equipment (PPE). Regarding the prevention of risks, emphasis is placed on the two areas that imply greater professional risks: storage and the process of drilling and boring. The storage of cork is done most of the time in dark and humid places, providing ideal conditions for the development of mold and the process of drilling and boring exposes workers to large amounts of moldy cork dust. In these settings, investing in PPE namely protective gloves and mask, as well as collective prevention measures, namely effective ventilation systems and regular control of humidity conditions, are essential to health protection of workers.

Conclusions

SMF has a prevalence of Suberosis well above the national average. In order to respond to this issue, the cork industry must reinforce the investment in terms of PPE, with the use of uniform, cuffs, safety shoes and visor, variable with the specific production process. In terms of collective protection, the signaling of the main hazards and the information available in the workstations regarding mandatory/recommended PPE, isolation of the areas with the most dangerous tasks as well as the maximum possible turnover between tasks are essential in terms of Occupational Health.

Key messages

Suberosis is an occupational disease of workers in the cork industry, associated with repeated exposure to moldy cork dust, usually presenting itself as a disease of the pulmonary interstitium. The development of healthy workplaces, the correct use of PPE and the investment in effective ventilation systems and control of humidity, are essential to health protection of cork workers.
Occupational prestige and sickness absence inequality in Sweden: a registry-based study
Authors: Nwaru C , Berglund T , Hensing G
Published: October 2021

Background

Socioeconomic position has been linked to sickness absence (SA). However, less is known about the role of occupational prestige, a measure of social status afforded by one's occupation, in SA. To expand knowledge on socioeconomic determinants of SA and on gender differences in SA, this study aimed to investigate the association between occupational prestige and SA and the distribution of the association in women and men. The study also aimed to analyze the effects of intersections of gender and occupational prestige on SA.

Methods

The study was based on data of 97 397 employed individuals aged 25-59 years selected from the 2004, 2007 and 2010 waves of the Swedish Labour Force Survey. Baseline occupational prestige was measured with the Standard International Occupational Prestige Scale. Information on SA was retrieved from the national register. Two measures of SA were defined: the number of SA days in any particular year during a 3-year follow-up and long-term (>120 days) SA based on data of participants with at least one sick leave spell during the follow-up.

Results

Working in lower prestige occupations was associated with increased SA among women and men. The association was independent of other socioeconomic indicators, such as income, education, and occupational class. In the intersectional analysis, women regardless of prestige level and men in lower prestige occupations had higher probability of SA compared with men in high prestige occupations. Women in high prestige occupations had the highest absenteeism rates (IRR, 2.25, 95%CI, 2.20-2.31), while men in medium prestige occupations had the lowest rates (IRR, 1.17, 95%CI, 1.13-1.20). Compared with the rest of the groups, men in low and medium prestige occupations had higher odds for long-term absence.

Conclusions

Women, regardless of occupational prestige level, and men in lower occupational prestige had an increased risk of sickness absence.

Key messages

Occupational prestige was associated with sickness absence in women and men. There is need to pay close attention to occupational prestige as a factor that may influence health and labor market participation.
Can a UV-C box help cinema industry by hygienizing video-cameras?
Authors: Messina G , Limaj S , Amodeo D , De Palma I , Petri C , Cevenini G
Published: October 2021

Background

UV-C has proven to be an effective microbiocide method for disinfecting objects in domestic and work environments. Aim of this study was to test the biocidal efficiency of an UVC box on a real video-camera.

Methods

In February 2021, a descriptive study on a parallelepiped-shaped UVC box, produced by Cartoni S.p.a., was conducted at the University of Siena. The box has 10 UV-C lamps (254 nm at 0.9 Watt/each) and all six mirrored reflective walls. It was specifically engineered for disinfecting equipments for film makers. A real professional camera was used to assess the level of disinfection. Contamination was obtained inoculating 1.5x107CFU/mL of S. Aureus ATCC 43300 on five 20 cm2 plastic carriers positioned in five different spots (referred as spots A, B, C, D, E), both directly (spot A), and indirectly (by reflected light, spots B, C, D, E) exposed to a UV-C light source. After a cycle of 3 minutes' exposition to UV-C: all carriers were transferred on empty Petri dishes; 10 mL D/E medium was added, transferred into a 50 ml Falcon and spun for 40 minutes at 4500 rpm; the supernatant was then removed and 100 µl of it was incubated into a Petri dish (with a generic growth medium) at 36 °C for 48 h. The experiment was run in triplicate. The mean logarithmic reduction and its 95% confidence interval were calculated from the replicates data and compared with positive controls (1.5x107CFU/mL).

Results

Mean logarithmic reduction compared to positive control was in spot A: 6.33 log10(C.I. 5.90-6.75), spot B: 4.74 log10(C.I. 4.11-5.33), spot C: 4.83 log10(C.I. 4.75-4.91), spot D: 4.89 log10(C.I. 4.12-5.65), spot E: 5.00 log10(C.I. 4.79-5.21).

Conclusions

These experiments showed that after 3 minutes of UV-C exposure there is a significant reduction in the bacterial load, 4 to 6 log10 (99.99% to 99.9999% reduction), on the carriers. The results also highlight the ability of the UV-C box to disinfect all infected spots, including those irradiated by reflected light.

Key messages

UV-C Box devices are effective in decreasing bacterial contamination on shared work tools in cinema industries, regardless of the direct or indirect exposition to the UV-C source. UV-C box's speed in hygienizing shared work tools can help cinema industry professionals to work in a safer and cleaner environment.
What motivates patients to change general practitioners in the Pleven region, Bulgaria?
Authors: Karcheva M , Vasileva B
Published: October 2021

Problem

The World Health Organization's 2008 World Health Report, entitled ‘Primary care now more than ever,' clearly states the need of knowledge about primary care not as one of the ordinary structures of the national health system, but as its leading priority.

Description of the problem

Since the start of health reform in Bulgaria, the choice and change of a GP by patients is most often spontaneous, random, and without enough specific information about the qualities of the GP. This reduces the effectiveness of the free choice of a doctor. The purpose of this study was to analyze the patient's motives for changing their GP. A survey was conducted among respondents in the period from September 1st to 30th, 2018 in the Pleven Region, Bulgaria. Patients who visited their GPs during the study period were interviewed. The results were processed using Microsoft Office Excel 2007.

Results

It was established that 830 (78.8%) of the 1053 respondents in the territory of Pleven Region have changed their personal doctor. The three leading motives were: long waiting times in front of the GP's office - 30.2%, change of residence - 19%, and lack of sufficient referrals from a physician to the specialist - 11.7%. Most of the surveyed patients assessed their GP as having a positive attitude toward them. 132 (12.6%) of the participants rate their personal doctor as rude, always being in a hurry, and nervous or not giving them any answers at all.

Lessons

When choosing a GP, the patient's prior information about the qualities and competencies of the personal physician of his\her choice is very low. It is necessary to create a system for the informed choice of a personal physician which will have a double effect, 1) a more adequate and more critically justified choice of a GP by the patient, and 2) a clearer, more stable commitment and responsibility of the GPs to the patients who chose them.

Key messages

It is necessary to improve the overall organization of the work of GPs. Healthcare is a type of interaction between the doctor and the patient during the diagnostic and treatment process.
Socio-economic analysis of AED use
Authors: Pogorzelczyk K , Robakowska M , Basiński A
Published: October 2021

Background

In the Pomorskie Voivodeship (Poland), there are statistically 1,379 out-of-hospital cardiac arrest cases. Not all affected people receive help. Despite the continued installation of AEDs in public spaces, the public is reluctant to use them. Sudden cardiac arrest has a high mortality rate.

Methods

The following aims were assumed in the study:

Estimation of the level of risk of cardiac arrest in outpatient conditions among the population of the Pomorskie Voivodeship according to national and global data, CBA and CUA for three options - current, zero and 100% AED use. During the research, an original questionnaire was used. The answers were collected during direct interviews with the respondents and by making the form available via the Internet. 20,971 responses were included in the analysis. Data collected in registers and inventories of major public administration offices (ie 123 municipalities) regarding the location of devices in public space were used to assess the degree of AED prevalence. Cost data was taken from information databases and directly from medical entities. The economic analysis was based on the use of the CBA and CUA pharmacoeconomic analysis.

Results

Pharmacoeconomic analysis showed a level of investment unprofitability. There is a significant difference between the profitability results made for the levels of current, zero and 100% AED use. Statistical analysis showed relationships between gender, place of residence, education level and knowledge about AED among the inhabitants of the Pomeranian Voivodeship.

Conclusions

The low level of AED equipment operation and the unsatisfactory level of knowledge among the inhabitants of the Pomeranian Voivodeship contribute to a very low level of investment profitability.

Key messages

Education is the key to optimizing public spending. The level of profitability of public investment depends on various social factors.
Effectiveness of Personalized Cardiovascular Risk Score on Employee Smoking Behavior: An RCT
Authors: Wanitchatchawan W , Tadadej C , Pongpirul K
Published: October 2021

Background

Based on the Nudge Theory, an individual could make better decisions by offering small changes to the choices offered that could lead to dramatic changes in their behaviors. A cardiovascular risk score could be added to the employee health checkup report and become a good nudge for smoking employees. This study aimed to compare the effect of various personalized cardiovascular risk score reports on employee smoking cessation.

Methods

This three-arm randomized controlled trial recruited smoking employees of a 600-bed hospital in Bangkok, Thailand, and was conducted during January-April, 2020. The cardiovascular risk score of each participant was calculated by using the 2013 American College of Cardiology and American Heart Association guidelines. While a conventional annual checkup report was provided to all participants, intervention group A also received both smoking-positive and smoking-negative risk scores whereas intervention group B also received a smoking-positive risk score. The number of cigarettes was collected at weeks 0, 4, 8, and 12. The changes in the number of cigarettes were analyzed by using repeated measure ANOVA.

Results

Thirty-six smoking employees were recruited (mean age 35.67±10.54 years; male 97.2%). Two-third (66.7%) had a low cardiovascular risk. The participants smoked 53.03±47.88 cigarettes per week and 66.7% did not have the intention to quit smoking. For Group A, the number of cigarettes significantly reduced by 19.58 (p = 0.04), 28.92 (p = 0.00), and 35.50 (p = 0.00) at weeks 4, 8, and 12, respectively. For Group B, the number of cigarettes reduced by 14.25 (p = 0.13), 21.35 (p = 0.03), and 18.08 (p = 0.06) at weeks 4, 8, and 12, respectively. For Group C, the number of cigarettes increased by 0.42 (p = 0.96), 5.89 (p = 0.54), and 12.44 (p = 0.20) at weeks 4, 8, and 12, respectively.

Conclusions

Cardiovascular risk score in an employee checkup report could be a simple yet effective intervention for smoking cessation.

Key messages

Based on the Nudge Theory, an individual could make healthier decisions by offering small changes to the choices offered that could lead to a reduction in cigarette consumption. Cardiovascular risk score in an employee checkup report could be a simple yet effective intervention for smoking cessation.
Overcoming social distancing in interventions with older adults by using digital media?
Authors: Foitzik E , Kaiser V , Pentner C , Zastrow F , Hassel H
Published: October 2021

It was shown that older adults' health literacy has deteriorated in course of the COVID-19 pandemic. Two ongoing interventions aiming to improve health and food literacy as well as self-management by regular in-person meetings with working groups for persons aged 60 and older were put on hold. To help orientating in an information flood, to stay rooted in social networks, and to counteract intervention drop-out, a bridging program was developed. Telephone interviews with peer-moderators on technical equipment for digital communication, media literacy and relevant topics were conducted. The peer-moderators were trained in performing video and phone conferences as well as phone chains. A total number of 23 moderators leading 15 groups with 170 participants were involved in the interventions before the lockdown. It was found that the majority of participants were not able or equipped to perform video or telephone conferences. Based on these findings, health information and exercises were sent periodically by post and each group implemented a phone chain. Both measures were well-accepted by all groups. Conference calls with the moderators were conducted only twice due to low acceptance. Despite training for video conferences, none of the groups managed to use digital media alone for communication. Nevertheless, only four groups, nine moderators and 94 participants, quit the program during the lockdown. The acceptance of the moderators is key to introduce the participants to new communication channels. Due to insufficient digitalized homes, lack of digital devices or technical affinity, the distribution predominantly took place via postal dispatch. Even though the bridging program was well accepted, participants still rather waited until in-person meetings were allowed again instead of swapping to digital communication. A regular, participatory developed, multichannel intervention can help to engage older adults and maintain intervention research in times of crisis.

Key messages

Multichannel and participatory developed interventions can help group programs with older adults surviving a crisis. Mere digital communication, lacking knowledge and equipment can discourage older adults to stay socially active.
Providing mammography in workplaces improved screening rates: cluster randomized controlled trial
Authors: Shima A , Tanaka H , Okamura T , Nishikawa T , Godai K , Kimura T , Tatsumi Y , Morino A , Kawatsu Y , Miyamatsu N
Published: October 2021

Background

Despite sufficient evidence on the importance of breast cancer screening, the screening rate has remained less than 50% in Japan. To promote behavioral change of individuals, it is important to reduce barriers to taking screening. The purpose of this study was to examine the effect of an environmental approach providing opportunities for mammography (MMG) in workplaces.

Methods

Female employees aged 40 years or older were eligible. Supermarket stores were randomly assigned into two groups, the intervention arm (leaflet and MMG) and the control arm (leaflet). From May to July 2018, participants in the intervention arm were given a leaflet informing the subsidies for breast cancer screening and were provided the opportunity to have MMG in their workplace. Participants in the control group were given the same leaflet, but they had to take the screening outside the workplace as usual. The primary outcome was the breast cancer screening rate in 2018, evaluated using self-administered questionnaires. The odds ratio (OR) and 95% confidence intervals (CIs) for the screening rate in the intervention arm compared with the control arm was estimated using multilevel logistic regression.

Results

We analyzed 1624 participants (mean age was 53 years) from 25 supermarket stores (intervention: 578 patients in 8 stores, control: 1046 patients in 17 stores). The screening rate in the intervention arm was 312 (54%) and was 125 (12%) in the control arm. The OR (and 95% CIs) was 7.81 (5.03-12.12) in the final model adjusted store level effects (i.e., stores and screening rate in 2017 at each store) and individual age and current smoking.

Conclusions

In a worksite-based cluster-randomized controlled trial conducted in a Japanese population, an environmental approach providing MMG opportunities in workplaces significantly increased the self-reported breast cancer screening rate within one year. (UMIN000030465)

Key messages

Providing the opportunity of mammography in Japanese supermarket stores improved the breast cancer screening rate. An environmental approach reducing barriers to screening may be more effective than conventional approaches in improving breast cancer screening rate.
Knowledge on sexually transmitted diseases: results from a survey among Italian university students
Authors: Tocco Tussardi I , Mazzi M , Benoni R , Astorino G , Fila A , Tardivo S , Majori S , Busch IM , Rimondini M , Moretti F
Published: October 2021

Background

Sexually transmitted diseases (STDs) are one of the most pressing public health concerns in many countries. Adolescents and young adults are the most affected population. Given that risky sexual behaviors are a growing trend, awareness must be increased. To identify the most important issues contributing to STDs spreading in the young population, we designed a project aimed to explore knowledge, attitudes, and behaviors related to STDs among students from an Italian University. As part of this bigger project, the present study focused on data regarding knowledge, information/education sources, and awareness on non-sexual ways of transmission.

Methods

A descriptive, cross-sectional study was carried out at the University of Verona, Italy. An ad-hoc questionnaire was developed based on existing literature and expert consensus and was administered to the students from December 2, 2020 to January 7, 2021. The project was approved by the Committee for Human Research of the University of Verona.

Results

A total number of 2258 individuals (76% women) answered the survey. Results were not quite satisfactory, especially regarding the knowledge on ways of STD transmission and carcinogenic viruses, and students showed misperceptions about general knowledge related to STDs. The study also demonstrated that students collect information on STDs primarily from the internet but would turn to a specialist in case of doubt. Misbeliefs regarding non-sexual ways of transmission were observed. Regarding differences between genders, the female population was tendentially more aware of the link between Papilloma Virus infection and cancer.

Conclusions

This study indicates that current educational efforts to disseminate knowledge on STDs and thus contain infections are not sufficient. To prevent future spreading of STDs, information activities regarding STDs should be increased and health education in schools and universities promoted.

Key messages

Early information and education are among the pillars of controlling the spread of STDs, but at the moment they still seem to need better implementation. Assessing which areas of knowledge must be improved in different groups can facilitate the development of targeted interventions to achieve better results in terms of disease awareness and prevention.
Women’s knowledge, awareness and prevention of cervical cancer and infection from HPV in Greece
Authors: Giota B , Kitsou KS , Bakola M , Kallianezos P , Charalambous G , Jelastopulu E
Published: October 2021

Background

Cervical cancer prevention can be obtained by regular screening with Papanicolaou test. However, in recent years HPV DNA test and mRNA HPV test are available for the screening for cervical cancer. The HPV vaccine helps protect against HPV- related cancers. Our aim was to investigate the beliefs and knowledge of women living in a city in northwestern Thessaly, Greece, regarding the prevention of cervical cancer.

Methods

A cross sectional study was conducted among 119 women, 18-65 years old and living in Trikala, Greece. They completed a 45-item self-administered questionnaire, investigating their knowledge, perceptions, and behaviors regarding the prevention of cervical cancer, the infection with HPV, the Papanicolaou test and vaccination. Furthermore, associations between knowledge and behaviors as well as with various demographic factors were explored.

Results

Most of the women had at least university education (77%). More than 90% declared to visit an obstetrician-gynecologist at least once a year and 68.4% regularly have a Pap smear once a year. 95.8% were aware of the importance of a Pap smear and 82% declared a positive attitude regarding HPV vaccination. Higher knowledge regarding examination and vaccination, was associated with marital status (married) (p = 0.002) and educational level (higher educational level) (p = 0.001).

Conclusions

The majority of women in our sample know why they should do the Pap test; however, they need to be further informed with additional details about the diagnostic test. Although most of the women were aware about the importance of testing, one third of them were not regularly tested for cervical cancer detection or had lacked knowledge about vaccination.

Key messages

A high percentage of women is aware about the benefits of cervical cancer screening. However, information campaigns and establishment of national screening programs are required to facilitate the access to such programs for all women.
Identification of key determinants to reduce alcohol consumption among young adults
Authors: Wolf A , Alberternst C , Hößelbarth S , Scheibe M , Hassel H
Published: October 2021

Background

Hazardous drinking is a widespread problem and has serious effects on public health. Young adults (aged 18-25) in particular are at increased risk of heavy alcohol consumption, especially binge drinking. At the same time, they are difficult to reach by prevention programs. Using the intervention mapping approach (IM), the community-based prevention program IDEAL will be developed in Northern Bavaria and Southern Thuringia until the end of 2021. As one of the first planning steps, a comprehensive literature search was required to identify the determinants of heavy alcohol consumption among young adults.

Methods

A systematic literature research was performed using three databases including reviews published in English or German between the years 2011 and 2021 with focus on community-based interventions for reducing alcohol consumption.

Results

The search yielded 33 reviews meeting the inclusion criteria with the majority of interventions targeting students. 12 determinants were identified, of which seven were individual factors, three environmental and two social factors. Most of the studies address the perception of drinking peer norms in combination with other individual factors like knowledge of alcohol consequences or coping-skills. Furthermore, important data exist, on whether gender-specific distinctions have impact on the efficacy of these factors.

Conclusions

Based on the research, interventions targeting the perception of peer norms in combination with other developmental factors are effective in reducing young adult's hazardous drinking. But the efficacy of these factors may differ depending on gender. In addition, it is difficult to expose which factor was responsible for the behavior change and thus for the efficacy. Therefore, future research is needed to focus on single gender-specific intervention components.

Key messages

The combination of addressing perceived peer norms with developmental factors in interventions is a successful approach to reduce alcohol consumption among young adults. But it seems essential to consider gender in the implementation in order to change drinking behavior.
The involvement in health promotion in the setting of daycare centres - Description of access
Authors: Kuchler M , Rauscher M , Quilling E
Published: October 2021

Background

For health promotion and prevention in childhood, e.g. overweight, the daycare setting enables particularly early access to the target groups. The aim is to address not only children, but more explicitly also their parents and the wider social environment, and to involve them in the planning and implementation of measures. The project is developing participative and demand-oriented offers in different institutions throughout Germany. Scientific monitoring aims to generate recommendations for action for participatory health research from these various experiences.

Methods

Access takes place via day care centres and family centres. The participatory research design starts with the Search Conference method. With this method, institution-specific needs are identified on a local level and goals are defined that determine the further processes. The participatory procedure is accompanied by interviews and focus group discussions which are analysed according to Mayring.

Results

Due to lockdown, access to the target groups via the institution is difficult. Families and network partners are hardly accessible and heavily burdened. Nevertheless, it has been possible to establish digital participation in some institutions. The evaluations show that parents have a great interest in the health of their children. On the one hand, the results indicate that the current conditions lead to a wait-and-see attitude on the part of the institutions, while at the same time the topic of health is gaining in importance among all those involved.

Conclusions

Participatory methods pose a particular challenge during lockdown and must be adapted to the current situation. Especially when moving participation into the digital space, daycare centres (and similar institutions) play a key role as gatekeepers.

Key messages

Covid 19 highlights the central role of families and the immediate social environment for children. It is essential to involve them in health promotion to enable children to grow up healthily.
Healthy diet and lifestyles assessment using a mEMA approach: protocol of the HEALTHY-UNICT study
Authors: Barchitta M , Maugeri A , Favara G , Magnano San Lio R , Riela PM , Guarnera L , Battiato S , Agodi A
Published: October 2021

Background

Dietary intake, physical activity and other lifestyle factors, behaviors known to change in college students, may affect long-term health outcomes. The mobile Ecological Momentary Assessment (mEMA) methods represent an innovative, detailed and valid approach to capture the complexity of food intake and behaviors and to overcome limitations of traditional dietary assessment methods. The main aim of the HEALTHY-UNICT study is to characterize heating habits, including Mediterranean Diet adherence, and others lifestyle factors, and their relationship with anthropometrics and emotions in a sample of college students of the University of Catania, using real-time mEMA methods and an innovative custom mEMA application.

Methods

Data will be collected using a mEMA tool administered via a web-based application. mEMA data collection will be carried out in two waves during the second semester of the academic year. During each wave, participants will receive prompts via the text messages to complete the surveys during four selected days, eight times per day.

Results

This abstract describes the protocol of the study. The HEALTHY-UNICT study aims to follow university students from a large university. A total of 100 students will be enrolled in the pilot phase. Expected results are the characterization of dietary behaviors, including Mediterranean diet adherence, food choices and others lifestyle factors, including smoking habits and physical activity and their relationship with anthropometrics and emotions in the sample of college students of the University of Catania.

Conclusions

The project idea should be relevant since results of the study could be useful to identify targets for the improvement of health and the promotion of healthy lifestyles in young adults. The HEALTHY-UNICT project will contribute to Sustainable Development Goals (SDGs) in the area of food and nutrition, to improve nutrition and lifestyle, through actions that combine tradition and innovation.

Key messages

The study will provide a better understanding of the food choices that college students make and insights for individual and population level prevention interventions. Findings of this study could be used to develop targeted interventions that encourage healthy food choices and healthy habit and ultimately reduce the risk of overweight and others adverse outcomes.
Co-producing in the everyday meeting with residents from a deprived neighborhood
Authors: Termansen T , Vardinghus-Nielsen H , Bloch P , Tørslev M
Published: October 2021

Background

Many community interventions struggle to involve and engage the most vulnerable groups in co-production processes. The purpose of this study is to provide knowledge concerning ways of ensuring participation and co-production in a community restaurant with residents from a deprived neighborhood. The study is part of the initiative Tingbjerg Changing Diabetes and the purpose of the restaurant is to engage residents and mobilize resources through participation in cooking workshop, social dining and co-production processes.

Methods

The study is based on Community Action Research (CAR), combining 1) in depth ethnographic fieldwork in the neighborhood Tingbjerg from January 2020 to August 2021, 2) participatory methods engaging residents in the development process and 3) interviews with stakeholders (n:7) and residents (n:9). The study is ongoing, but most data has been gathered and preliminary analyses have been conducted.

Preliminary Findings

Results show that co-production in the community restaurant is characterized by a flexible approach to participation. Furthermore, the study illustrates that co-production processes are be build up over time. Conventional approaches to co-production, e.g. as a facilitated process did not fit well into the context. Rather, for co-production to become valuable, practitioners had to let co-production happen in the everyday meeting with residents.

Conclusions

The engagement of residents was a prerequisite for valuable co-production processes, and co-production in the everyday meeting provided value for both residents and practitioners who managed to build sustainable relationships and mobilize resources to take ownership of the restaurant. Main message: There is potential in moving co-production away from facilitated processes and into the everyday meeting with residents from deprived neighborhoods. This will potentially lead to more sustainable interventions and ownership.

Key messages

Co-production can be executed in the everyday meeting with residents from a deprived neighborhood. Flexible and fluid approach to participation can ensure attendance and engagement from the seemingly ‘unengageable'.
Home-based exercise program for women with osteoporosis: focus on adherence
Authors: Pinelli E , Barone G , Benvenuti F , Audino G , Zinno R , Bragonzoni L
Published: October 2021

Exercise program is important for maintaining or increasing bone mineral density in people with low bone mass. The home physical activity was the only alternative to keeping active people with osteoporosis during covid-19 pandemic. This study aims at investigating the adherence to an exercise program specifically designed for women with postmenopausal osteoporosis when administered as individual home training (IHT) or online group training (OGT). 40 women, aged between 67 ± 6,5 years, were recruited for the study. A randomization was performed to divide the women into two groups: IHT or OGT. The OGT group was supervised by the trainers during exercise session utilizing a video conferencing software. The IHT group received a book with the exercises explained, a diary and a training program. Every 6 weeks the program was changed and the IHT group met the trainers in order for them to explain on video call the new excercise the group had to perform. They were also monitored by call every 15 days. Both groups performed 24 weeks of training, twice a week for 1-hour session. The training sessions was 48 in total (100%). The adherence was registered with a diary for the IHT and with a register for the OGT. The adherence in both groups was 65% (26 women), while 35% was not adherent (14 women:7 OGT and 7 IHT). The causes of not adherence depend on family problems 50%, health issue 14%, work duties 14% and IT ability and possibility to have broadband connection 21% (only OGT).The relationship between trainers and participants is important in maintaining adherence to a physical activity program. When physical contact is not allowed, as happened during the pandemic period, frequent contact by telephone or other appropriate technological tools can help to maintain adhesion. Despite the home environment often prevents participation in a physical activity program, online training promotion represents an indispensable opportunity to reach elderly people who are unable to go to the gym.

Key messages

The relationship between trainers and participants is important in maintaining adherence to a physical activity program. online training promotion represents an indispensable opportunity to reach elderly people who are unable to go to the gym.