bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vaccine hesitancy and Health Literacy: we need to change our paradigm
Authors: Casigliani V , Arzilli G , Menicagli D , Scardina G , Lopalco P L 
Published: October 2020

Abstract

Introduction
The vaccination coverage decline and the re-emergence of vaccine preventable diseases draw attention to the problem of vaccine hesitancy (VH). Many studies demonstrated that the current vaccine education is not very effective. We analysed the problem of VH in relation to Health Literacy (HL) and the perception of vaccine preventable diseases-related risks in a sample of parents.

Methods
We conducted a survey among parents between February and November 2018. We collected data on demographic, main sources of information, vaccination attitude (using the Vaccine Confidence Index (VCI) adapted from Larson HJ 2016), HL levels(using an adapted version of IMETER and knowledge of signs and symptoms of diphtheria, tetanus and measles.

Results
The study included 772 parents, 620 women (mean age 39 years), 48.2% had diploma. The main source of information was the doctor (85.5%) followed by the web(24.2%). The average VCI was 3.78(range: 0.1-10) with lower values among parents informed through social networks (2.05-2.78). Analysing the IMETER test, 90% had a good or acceptable level of HL. No significant correlation between VCI and HL was found. For parents who identified at least 3 specific elements of selected diseases, the average VCI was significantly higher(Measles 4.32,Tetanus 4.64,Diphtheria 5.84).

Conclusions
The HL level did not correlate with the VCI. A low VCI was associated with poor knowledge of selected diseases: this confirms the importance of a correct risk perception. This study in accordance with the literature suggests to amplify the model used to analyse the VH taking into account cognitive biases (i.e. ambiguity aversion and omission bias) as important factor affecting the parents' decision making. We aim to expand our work building a survey to categorise parents according their main cognitive bias. This may be useful to understand the better communication strategies to effectively have an impact on each parents' behaviour.

Key messages
This study in accordance with the literature suggests to amplify the model used to analyse the VH taking into account cognitive biases. The Health Literacy is not enough to explain the problem of the Vaccine Hesitancy.
Influenza vaccination coverage in patients with diabetes mellitus afferent to an Italian hospital
Authors: Cocciolo G , Salvati S , Allora A , Molinari C , Burini A , Scavini M , Odone A 
Published: October 2020

Abstract

Background
Patients with type 1 (T1DM) and type 2 (T2DM) diabetes are at increased risk of vaccine-preventable diseases and their complications. The National Vaccinal Prevention Plan 2017-2019 includes specific recommendations for patients with diabetes, which in 2018 have been included in the standards of care of the Italian Diabetes Society (SID) and Italian Association of Clinical Diabetologists (AMD).

Methods
Adult diabetic patients attending the Diabetes clinic at the San Raffaele Hospital, a large teaching hospital in Milan, Italy, were surveyed with a questionnaire to investigate self-reported vaccinal history, knowledge, attitudes and practice on the recommended vaccinations, vaccinal hesitancy and information sources on the topic.

Results
Between May 16 and November 11, 2019 N = 222 T1DM and N = 57 T2DM patients were enrolled. 25.2% of T1DM and 26.3% of T2DM patients did get vaccinated annually against the flu in the past 3 year. 85.0% of T2DM patients were vaccinated at the General Practitioner's (GP) clinic, while 54.9% of T1DM patients were vaccinated by their GP and 24.4% from territorial vaccinal clinics. 54.5% of T1DM and 50.0% of T2DM patients chose not to be vaccinated because they didn't consider the vaccine useful, while the second most common reason was that they have not been advised by healthcare personnel.

Conclusions
We documented a low coverage and knowledge about influenza vaccination. Patients with diabetes trusted information and advice of diabetologists and GPs about vaccination and claimed that they would be more likely to vaccinate if vaccination were offered in the diabetes clinic. Implementing training programs for professionals and educational campaigns for patients with diabetes may improve vaccinal coverage.

Key messages
Vaccination coverage in T1DM and T2DM patients is low due to vaccination hesitancy. A strong action from care givers, in order to raise vaccination awareness in this at-risk population, is needed.
Twitter monitoring evidence of Covid-19 infodemic in Italy
Authors: Calamusa A , Tardelli S , Avvenuti M , Cresci S , Federigi I , Tesconi M , Verani M , Carducci A 
Published: October 2020

Abstract

Background
Risk communication is essential for risk management, especially during alarming events, in order to create a balanced risk perception. The tweets follow up can be useful to timely evidence “media storms” or “infodemics” thus suggesting corrective interventions. The spread of Covid-19 has been the occasion to observe the evolution of tweets about this topic, with the aim of evidence peaks of fear

Methods
On 30th January 2020 we started a large collection of Italian and English tweets containing the following keywords: “coronavirus”, “2019-nCov”, “CoronavirusOutbreak”, “CoronavirusWho”, “WuhanCoronavirus”, “coronaviruschina”, “coronavirusitalia”, “virus cina”, “virus cinese”, “virus mascherine”, “virus paura”, “virus polmonite” and “virus vaccine”. “Covid-19” and “SARS-CoV-2” were added later. For the data collection Twitter Streaming API was used.

Results
The total number of tweets collected till 26th February was approximately 20M, 2M in Italian and 18M in English. The trend of the volume of tweets gathered shows a first small peak between Jan 30th and Feb 1st, but a second, higher, peak is visible after the 21st February, following the report of the Covid-19 clusters in Italy. Italian tweets account for 6% of the first peak and for 22% of the second. The Italian word “paura” firstly appeared on Feb 5th, with a peak after Feb 21th.

Conclusions
”infodemics” or “media storms”, are situations of uncontrolled diffusion of news and opinion, frequently leading to irrational and counterproductive behaviors. The Italian evolution of tweets indicate since the first day of cluster report, a clear escalation of fear, that suggests timely corrective actions to facilitate the disease control.

Key messages
With the twitter monitoring we demonstrate that since 21th February an infodemic is spreading in Italy. The twitter follow up can be used to timely evidence a public alarm, motivate corrective interventions and. evaluate the efficacy of them.
Transforming food retail for better health: The Healthy Stores 2020 trial
Authors: Brimblecombe J , McMahon E , De Silva K , Ferguson M , Miles E , Wycherley T , Peeters A , Minaker L , Greenacre L , Mah C 
Published: October 2020

Abstract

Background
How food is promoted in food retail settings impacts population diet. Foods high in sugar, fat and/or salt are promoted by retailers to attract impulse purchases. To combat the high burden of chronic disease and associated conditions confronting society we examined the impact of restricted retail merchandising (promotion and visibility) of discretionary food and beverages on sales and business outcomes.

Methods
We conducted a pragmatic randomised controlled trial in partnership with a retail organisation operating stores in remote communities of Australia (the Arnhem Land Progress Aboriginal Corporation). Twenty consenting stores were allocated to the 12-week intervention (7-point Healthy Stores 2020 strategy) or to usual retail practice. Four intervention stores with retail competition implemented a modified 6-point strategy. Weekly sales data were used to assess intervention impact on free sugars (g) to energy (MJ) (primary outcome) derived from all purchased food and beverages. Impact on gross profit and sales of targeted food and beverages was also assessed. Managers of intervention stores were interviewed to determine their views on customer response and impact on retail practice.

Results
Free sugars were reduced by a relative 2.8% (95% CI -4.8, -0.7). There were significant reductions in free sugars from targeted beverages (-6.4%; -11.1, -1.5) and soft drinks (-12.5%; -18.1, -6.5). Gross profit was not impacted adversely. Managers mostly viewed the strategy favourably and of benefit to the community.

Conclusions
The public health and business relevant gains demonstrated by this novel trial have resulted in ALPA converting their stores to the Healthy Stores 2020 strategy and integrating the strategy in to their nutrition policy. Retail competition impedes complete implementation of the 7-point strategy. Tackling this will require collective agreement by retailers to implement the full strategy and/or government policy power.

Key messages
Restricting merchandising of unhealthy foods can achieve both public health relevant and business relevant gains. Working in partnership with retailers is critical to testing real-world interventions to impact population diet.
Swedish teens' comprehension of sexting and explicit sexual images and consequences for well-being
Authors: Dahlqvist H , Gillander Gådin K 
Published: October 2020

Abstract

Background
Sexting and dissemination of explicit sexual images (ESI) through social media have become a common practice in teen peer culture in the past decade. Even though sexting is not a problem per se, it is regarded as a risk factor for e.g., sextortion and adverse mental health. The dissemination of ESI may be with or without consent, and the difference between (unwanted) sexting/ESI and online sexual harassment may be difficult for teenagers to assess. Therefore, it is important to delve deeper into how young people understand these practices.

Aim
The aim was to deepen the understanding of how young people comprehend sexting with a focus on ESI.

Methods
We conducted ten group interviews (3-7 participants each) with adolescent girls and boys in Sweden in 2019. There were two male and two female groups with 12-14-year-olds and four male and two female groups with 15-19-year-olds. Parental written consent was obtained for participants &lt;15 years. Data was analyzed using qualitative content analysis.

Results
One overarching theme was found for both genders: “Sexting and ESI - a means to many ends and an everyday hassle”. The understanding of sexting and ESI dissemination was however only partly overlapping between genders. One difference was that boys expressed that often, the non-consensual dissemination of ESI was a means to 'mess with' or harass (most often) girls and not as a means to express romantic or sexual interest. In contrast, girls interpreted the motives behind boys sending unwanted ESI in various ways but not directly as a means of harassment. Furthermore, ESI often had adverse effects on girls' well-being.

Conclusions
The line between (unwanted) sexting/ESI and sexual harassment is problematic, and boys seem often to be using ESI to cross this line. Both girls and boys recognized the adverse mental health effects of ESI. These findings can inform internet safety educators, legal guardians, and school staff as well as other adults working with young people.

Key messages
For boys, the dissemination of ESI was often a means to ‘mess with’ others. In contrast, girls did not interpret the motives behind boys sending unwanted ESI as a means of harassment. Both girls and boys recognized the adverse mental health effects of unwanted ESI.
Examining the governance and structure of the global health financing system using network analyses
Authors: Fergus C A 
Published: October 2020

Abstract

Background
Development assistance for health (DAH) has been a vital in achieving the improvements in health since the year 2000. This was facilitated through the distribution of financial and in-kind resources, valued at over $37 billion in 2017, from a group of global health and development entities to low- and middle-income countries. The resources from these organisations originated from a variety of sources, including national treasuries, philanthropic foundations, and private corporations. The allocation of these resources are also governance arrangements, in many cases with disease and intervention priorities determined outside the recipient localities.

Methods
The structure of global health financing was investigated using network analyses of DAH actors in the context of disease/health area-specific funding. The dataset utilised in the analyses, assembled by the Institute of Health Metrics and Evaluation, consisted of 27 years of annual estimates (1990-2017) of DAH flows tracked from sources through channels to 177 recipient countries, disaggregated by health area.

Results
The number and diversity of organisations involved in global health financing saw a rapid expansion since 1990. The most prominent structural changes were the recession of large multi-laterals and the emergence of non-OECD and private entities. Amongst these, unofficial partnerships were detected. This study identified several weaknesses in the global health financing system pertaining to specific diseases as well as child and maternal health.

Conclusions
To provide sustainable, efficient, and effective health intervention implementation in DAH-recipient countries, it is important to understand the structure of the global health funding system. These results will be used to develop potential future financing scenarios, and to understand the impact of the global health financing structural characteristics on the improvement of targeted health outcomes in developing countries.

Key messages
Global health financing has undergone substantial structural changes since 1990, with multi-laterals scaling back proportionally and the emergence new types of entities. The governance and delivery arrangements within global health are linked to the financial arrangements, potentially causing structural weaknesses that threaten the sustainability of the system.
Can incorporating behaviour change principles make clinical practice guidelines and health policies more impactful in change public health?
Authors: Bacon S 
Published: October 2020

Abstract

Background
We now live in world of ever-increasing amounts of evidence and information. In spite of the use of high-quality methods to synthesise this information, clinical practice guidelines and health policies often fail to impact public health. Canada has started to develop a series of guidelines and policies which have incorporated a behaviour change perspective into their development to fast track their implementability and their impact on public health. For example, the Canadian Association of Cardiovascular Prevention and Rehabilitation (CACPR)'s new Cardiovascular Rehabilitation Guidelines are being built using key integrated knowledge translation and behaviour change theories to develop recommendations which not only target the what to do but, who, and how this needs to be done. Another example is Canada's new Food Guide, which is unique in the fact that it has taken a behaviour-oriented perspective, rather than a macro and micronutrient path. Both of these examples leverage basic behaviour change principles to get multiple stakeholders to increase their uptake and usage of these knowledge products.

Results
Both the CACPR guidelines and the Food Guide are still relatively new, so their uptake and impact is not currently measurable. However, there is a monitoring plan which will evaluate these aspects. That being said, there is some evidence that both of these products have been well received by their respective communities.

Conclusions
Taking a behaviour change perspective in the development and delivery of guidelines and policy, especially health policy, has the potential to positively engage more stakeholders in the process, and fast track their impact on public's health. Ultimately, more evidence is needed to define the optimal way to do this.
Preeclampsia and the risk of chronic kidney disease: a national registry-based cohort study
Authors: Barrett P M , McCarthy F P , Evans M , Kublickas M , Perry I J , Stenvinkel P , Khashan A S , Kublickiene K 
Published: October 2020

Abstract

Background
Preeclampsia is associated with increased risk of future cardiovascular disease, but evidence for associations with chronic kidney disease (CKD) has been inconsistent to date. We aimed to measure associations between preeclampsia and long-term CKD in a population-based sample of parous women, and to identify whether the risk differs by CKD subtype.

Methods
Using data from the Swedish Medical Birth Register, singleton live births from 1973-2012 were identified and linked to data from the Swedish Renal Register and National Patient Register (up to 2013). Preeclampsia was the main exposure of interest and was treated as a time-dependent variable. The primary outcome was maternal CKD, and this was classified into 5 subtypes: hypertensive, diabetic, glomerular/proteinuric, tubulo-interstitial, other/non-specific CKD. Cox proportional hazard regression models were used for analysis. Women with pre-pregnancy comorbidities were excluded.

Results
The dataset included 1,924,591 unique women who had 3,726,819 singleton pregnancies. The median follow-up was 20.7 (interquartile range 9.9-30.0) years. Overall, 90,964 women (4.7%) experienced preeclampsia and 18,146 (0.9%) developed CKD. Women who had preeclampsia had higher risk of developing any CKD during follow-up (aHR 1.88, 95% CI 1.79-1.98). The risk differed by CKD subtype, and was higher for hypertensive CKD (aHR 3.76, aHR 3.09-4.57), diabetic CKD (aHR 3.45, 95% CI 2.83-4.21) and glomerular/proteinuric CKD (aHR 2.08, 95% CI 1.90-2.29). Women who had preterm preeclampsia, recurrent preeclampsia, or preeclampsia complicated by pre-pregnancy obesity were also at greater risk of any CKD.

Conclusions
Women with a history of preeclampsia are at increased risk of long-term CKD. The risk is most marked for hypertensive CKD, diabetic CKD, and glomerular/proteinuric CKD. The absolute risk of CKD related to preeclampsia is substantial, and these women may warrant systematic renal monitoring in the years following delivery.

Key messages
Preeclampsia is an independent predictor of long-term risk of chronic kidney disease in otherwise healthy parous women. Women with a history of preeclampsia may warrant systematic renal monitoring through additional blood pressure, blood glucose, and proteinuria checks.
Economic evaluations of public health interventions for physical activity and diet: systematic review
Authors: Gebreslassie M , Sampaio F , Nystrand C , Ssegonja R , Feldman I 
Published: October 2020

Abstract

Background
Physical inactivity and unhealthy dietary habits are associated with an increased disease and economic burden. Despite the prevalence of different public health programs, decision-makers encounter a multitude of challenges in prioritizing interventions for optimal resource allocation. The aim of this systematic review, therefore, was to identify economic evaluations of public health interventions targeting physical activity and healthy diet, and assess the quality and transferability of the findings to the Swedish context.

Methods
A search of published economic evaluations was conducted through electronic databases including PubMed, Web of Science, PsycINFO, National Health Service Economic Evaluation Databases (NHS EED) and the Health Technology Assessment Database (HTA). An additional search was done using references of relevant systematic reviews and, websites of relevant organizations were checked to find grey literature. Quality and transferability of the economic evaluations were appraised using a quality assessment tool developed by the Swedish Agency for Health Technology Assessment.

Preliminary Results
Thirty-two economic evaluations of 178 interventions were included; thirteen studies targeting physical activity, thirteen targeting healthy diet and six targeting both. The interventions varied in terms of their content, setting, mode of delivery and target populations. A majority of the economic evaluations reported that the interventions were likely to be cost-effective; however, considerable variations in the methodological and reporting qualities were observed. Only half of the economic evaluations were rated to have a high probability of transferring to the Swedish context.

Conclusions
Most of the interventions were reported to be cost-effective. However, a variation in quality and transferability of the available evidence to the Swedish context were observed.

Key messages
Public health interventions targeting physical activity and dietary habits have a high potential to be cost-effective. Decision makers should consider transferability and suitability of findings of economic evaluation from a different context to a decision problem at hand.
Designing for Growth and Development – A co-designed course for homeless people
Authors: Kroll T , Frazer K 
Published: October 2020

Abstract

Background
In many developed countries, homelessness remains an intractable challenge for intersectoral policies. People who are homeless struggle with a myriad of problems. They frequently experience stigmatisation and social marginalisation. Physical and mental health may be severely compromised, and it could be challenging to retain a sense of personal agency.

Objectives.
To co-design a personal and organisational development training course, in collaboration with clients and staff of a homeless service provider. To ensure that homeless individuals develop strategies and supports to help them navigate complex life circumstances. 6 three-hour workshops, informed by design-thinking. Each workshop session was co-designed (2 clients of a homeless charity, one staff member of staff, and two academics) in Ireland. Workshops followed the design cycle, starting with empathy exercises, then moved to define specific life challenges related to homelessness. Solution-focused ideation sessions followed. The team proceeded then to build a testable 'prototype'.

Results
The team jointly developed a high degree of creative confidence and shared responsibility for different sessions. The team developed a 'peer-support programme' as a tangible output. Academic team members gained deep insights into the lived experience of homelessness; client members deployed skills and experiences and gained renewed confidence in their abilities. The homeless charity proceeds with testing the 'peer-support' programme prototype.

Conclusions
We expect the Access and Life-Long learning programme at the university will offer the programme as a credit-bearing course. Its acceptability and usability will be tested.

Key messages
Homeless individuals can be meaningfully involved in designing services that empower them to navigate complex systems. Design thinking yields personal and organisational benefits.