bluuebunny/crossref_metadata_2025_split huggingface dataset:
Maternal characteristics in childhood and smoking at age of 15: Findings from the Czech Republic
Authors: Pikhartova J , Andryskova L , Pikhart H 
Published: November 2019

Abstract

Objective
Maternal employment has been shown to influence child’s health, cognitive and behavioural outcomes. There is only a limited number of studies in Central Europe investigating the impact of parental employment on the uptake of smoking in children. The aim of this work is to look at the influence of maternal employment over the whole period of childhood of their children, and other maternal social and behavioural characteristics on the uptake of smoking among children aged 15 in the Czech part of European Longitudinal Study of Pregnancy and Childhood (ELSPAC).

Methods
There were 971 individuals with complete data on smoking behaviour at age of 15, pattern of maternal employment between child ages 3 and 15, and other covariates including gender, maternal age, maternal education and marital status, household income, and maternal smoking. Logistic regression was used to analyse the association between maternal employment and smoking in their children.

Results
37% of adolescents aged 15 years reported trying cigarette more than once. Preliminary results suggest that those whose mothers were in paid work were more likely to be smoking at age 15. When stratified by maternal education, the association between maternal employment and smoking was particularly strong among university educated mothers. Those whose mothers were never employed were 4-times more likely to smoke than those whose mothers were continuously employed between ages 3 and 15. The association between maternal employment and smoking was weaker in other strata of maternal education.

Conclusions
Although maternal employment might have only a limited role in development of smoking behaviour of young adolescents, the association between maternal employment during childhood and young adolescents’ smoking does exist and is particularly strong among those with university educated mothers.

Key messages
More than one third of Czech adolescents self-reported repeated attempt to smoke cigarettes or cigars or pipe at the beginning of new Millennium. Data suggest that adolescents whose mothers had not been employed were more likely to smoke than those of employed mothers.
Vaccination of classmates for an immunosuppressed child’s protection in a school in the LHA Roma 1
Authors: Marino M , Spadea A , Furia G , Frisicale E M , Michelazzo M B , Valentini F , Consoli C , Forte U , Bracci S , Goletti M 
Published: November 2019

Abstract

Issue/problem
One of the duty of a State is to guarantee the protection of the health of all citizens, both safeguarding the sick individual needing care and protecting the healthy individual. An important objective of the vaccination prevention programs is to protect people most at risk of contracting infections because of their health conditions.

Description of the problem
In April 2019 the District 14 of Local Health Autority Roma 1 was asked by a father of an immunosuppressed child (6 years old), worried about infectious diseases, to verify the safeness of his child school attendance (the first class of primary school). First, a list of the class mates was asked to the school, in order to check their vaccination status by interrogating the web based regional vaccination register. Then, the District asked to the school to plan a meeting with classmates’ parents and teachers, in order to inform about the importance of a complete immunization both for the classmates and the immunosuppressed child protection.

Results
Preliminary results show that, among 18 classmates, 77.8% had full vaccination coverage for the second dose measles and fourth dose whooping cough (not mandatory for children aged less than 7 years), 22.2% were immunized for chicken pox. Among the parents attending the meeting, 15 agreed to complete their children vaccination cycle, all the teachers agreed to undergo whooping cough and chicken pox vaccination in order to allow a safe school attendance to the immunosuppressed child. Parents and teachers were given an appointment in a vaccination center for the week following the meeting.

Lessons
It is important to promote a real ’vaccination culture’ starting from the school, in order to develop greater citizenship awareness about the potential of vaccinations and to contrast fake news and ignorance leading to dangerous prejudices.

Key messages
The active collaboration between institutions (sanitary and school) allows, through the integration between different competences, to achieve health objectives to protect the community. Talking to pupils’ parents about infectious diseases and their prevention makes it possible to increase knowledge and therefore awareness of the importance of adult and children health protection.
Identifying binge-eating disorders in obese young people living in vulnerable areas of Marseille
Authors: Pinto S , Rotily M , Dany L , Négre V , Galinier A 
Published: November 2019

Abstract

Background
While anxiety, depression and self-esteem have been identified as contributors to obesity, binge-eating disorder (BED) also requires attention to avoid worsening obesity. However, handling obese young people living in vulnerable neighbourhoods is rather difficult both in terms of psychosocial representations of obesity and the poor care offer. The objective of our exploratory research is to study the impact of a dedicated multidisciplinary management program on anxiety and depression of obese young adolescents presenting with, or not, a binge-eating disorder.

Methods
Twelve patients (7 girls, 5 boys; mean age: 12.8 +/-1.3 years, range: 11-17) participated so far in this ongoing study. The mean body mass index was 36.5 +/- 7.2 (range: 27-53.4) for the group. They were all residents of vulnerable neighbourhoods of Marseille (France). They were evaluated at inclusion and 3 months after the 6-weeks program with the following self-questionnaires: Adolescent Binge Eating Disorder scale (ADO-BEDS), Hospital Anxiety Depression (HAD), 6-item Kutcher Adolescent Depression Scale (KADS-6), Self-esteem Measurement Scale for Adolescent (EMESA).

Results
So far, only 3 patients were evaluated pre- and post-management. For two patients with ADO-BEDS scores at inclusion and post-management showing the presence of a BED, the KADS-6 and EMESA (general and physical appearance items) scores improved at 3 months. The remaining patient, without any depression signs at both inclusion and after 3 months, experienced a decreased self-esteem while a BED, not assessed at inclusion, was clearly revealed at 3 months. BMI did not change from pre- to post-management.

Conclusions
Our clinical impression is that participating to the management program failed, at least for our first patients, to make them engage in a psychiatric/psychological therapy. Nevertheless, the program contributed to provide a motivating support system allowing them and their parents to become involved in their care.

Key messages
A multidisciplinary management program could potentially have a beneficial impact on depression and self-esteem in obese young adolescents presenting with a binge-eating disorder. The management program seemed to provide a motivating support system allowing obese young adolescents living in vulnerable neighbourhoods, and their parents, to become involved in their care.
Trends in physical activity and overweight among adolescents and their parents in Russian population
Authors: Denisova D , Scherbakova L , Berezovikova I 
Published: November 2019

Abstract

Background
Unhealthy lifestyle, including physical inactivity and overweight, typically begins in adolescence. Familial aggregation of the factors aggravates the predictive risk. During the 1990s Russian population has been exposed to major political, economic and social changes.

Methods
Seven cross-sectional surveys of representative samples of school children aged 14-18 in 1989-2019 were carried out in Novosibirsk. Total sample was 4677 (45% males). To define overweight in adolescents the sex- and age-specific BMI cut-offs of the IOTF were used. Information about parents physical activity (&lt;150 min/week), height and weight was obtained by mail questionnaire. Parents overweight registered if BMI≥25.

Results
Levels of low physical activity in adolescents were stably high during all the period in boys (49-55%) and girls (83-73%) with a rising trend in recent years. In 2009 average amounts of weekly screen time were 18 hours in boys and 15 hours in girls, In 2019 - 35 and 33 hours respectively. Their parents had low levels of physical activity: 2,5 hrs/w in men and 1,5 hrs/w in women without any trends. The prevalence of overweight among adolescents during the 30-year period showed U-curve characteristic with significant decreasing (4,0%) at the end of 90s and rising since 2003 particularly in boys (17.6% in 2019, P &lt; 0,01). Overweight prevalence among parents was high: from 25% in 1989 to 38% in 2019 (P &lt; 0,05) and from 32% in 1989 to 28% in 2019 among fathers and mothers respectively. Familial associations between parents and children were found for overweight but not for levels of physical activity.

Conclusions
Levels of physical activity in Siberian adolescents and their parents were low during 30-year period. Trends in the prevalence of overweight in this groups were differed. Familial aggregation of overweight indicates necessity of preventive actions at a family level.
Supported by grant No. 19-013-00800 of RFBR.

Key messages
Levels of physical activity in Siberian adolescents and their parents were low during 30-year period. Trends in the prevalence of overweight in adolescents and their parents were differed: the shaped curve in children and linear - in parents. However familial associations of overweight were found.
Beyond the diabetes epidemic – a public health challenge
Authors: Cuschieri S , Mamo J 
Published: November 2019

Abstract

Introduction
Various factors pertain to the development of type 2 diabetes (T2DM). While exploring the risk factors and links to T2DM at a population level, certain unexpected relationships were identified in a cross-sectional study representative of adults in Malta (2014-6).

Methods
A health examination study was conducted among a representative sample of adults in Malta (18-70 years). Validated medical data was collected for fasting glucose (FBG) and lipid profiles. Self-reported Diabetes (T2DM) and a fasting glucose level(FBG) &gt;7mmol/L were labelled as T2DM. Regression analysis explored T2DM and components of the lipid profile while adjusting for confounding factors (age, gender, residing locality, education level, employment status, use of statins). Separate analysis compared non-diabetic and metabolically healthy sub-populations as a reference to T2DM population respectively.

Results
A negative association was found between an increase in LDL-C (OR: 0.76 CI 95% 0.65 - 0.89, p = &lt;0.01) and a diagnosis of T2DM when the non-diabetic sub-population was the reference category. A negative association was also present for total cholesterol (OR: 0.79 CI 95% 0.69 - 0.91, p = &lt;0.01). On the contrary, a positive relationship with T2DM was present for both parameters (LDL-C OR: 4.15 CI 95%: 2.79 - 6.17, p = &lt;0.01 and Total cholesterol OR: 2.45 CI 95%: 1.84 - 3.33, p = &lt;0.01) when the metabolic healthy sub-population was the reference category. Similar results were present after adjusting for confounders.

Conclusions
Individuals without an established diagnosis of T2DM but with a biochemical and/or anthropometric abnormality are still at metabolic risk. Hence, preventive policies targeting metabolically at-risk persons at the community level need to be explored in order to target the health inequalities gap.

Key messages
Health inequalities are present in individuals with normoglycemia but with biochemical and/or anthropometric abnormality. Preventive policies need to target metabolically unhealthy population irrelevant of their glucose status.
Lifestyle related risk factors of coronary artery disease patients in Nepal
Authors: Gaudel P , Kaunonen M , Neupane S , Joronen K , Koivisto A M , Rantanen A 
Published: November 2019

Abstract

Background
Coronary Artery Disease (CAD) is a leading cause of morbidity and mortality and serious health problem worldwide. It is important to observe lifestyle related risk factors in patients with CAD for effective planning and implementation of secondary prevention strategies. The aim of this study is to describe the prevalence of lifestyle related risk factor habits among the patients with CAD.

Methods
A cross-sectional study was conducted among CAD patients in a tertiary care national heart center in Kathmandu, Nepal. Six lifestyle related factors (dietary habit, smoking, alcohol consumption, stress, physical activity and adherence to medication) and Body Mass Index were used as the risk factors of CAD in this study. Individual face-to-face structured interview was conducted using culturally validated standard instruments. The descriptive characteristics were presented as frequencies and percentages for categorical variables and as mean ± standard deviation (SD) or median and interquartile range (IQR) otherwise.

Results
In total study population, the mean age of the patients was 59.9 years and 76% were male. Patients having any three risk factors out of seven were the most common (36%) followed by two risk factors (25%) and four risk factors (22%). About 32% of study population were current smokers, whereas 29% were former smokers. Likewise, 31% of the total were physically inactive. Majority of the patients 95% had perceived moderate stress.

Conclusions
The prevalence of lifestyle related risk factors is high among CAD patients in study population. Combination of any three lifestyle related risk factors were the most common among patients. Therefore, studies focusing on lifestyle risk factor modification intervention on particular groups is recommended.

Key messages
Need to improve awareness about lifestyle related risk factors among CAD patients. Highlight the importance of lifestyle counselling.
Ketoacidosis admission rate in type 2 diabetes mellitus patients from 2006 to 2015 in Abruzzo, Italy
Authors: Meo F , Di Giovanni P , Cedrone F , Di Martino G , Scampoli P , Staniscia T 
Published: November 2019

Abstract

Background
Diabetic ketoacidosis (DKA) is a potentially life-threatening but largely preventable complication of diabetes and is associated with significant health care utilization and expenditure. Whereas DKA is mostly related to type 1 diabetes, over recent years an increasing number of hospital admissions for DKA have been reported in adult subjects with type 2 diabetes. The aim of this study was to assess the trend of hospitalizations for DKA in adult patients with type 2 diabetes and its associated factors.

Methods
A retrospective cross-sectional study was performed from 2006 to 2015 in Abruzzo region. Data were collected from hospital discharge records (HDRs) of type 2 diabetes adult patients with either primary or secondary diagnosis for DKA. Age-adjusted hospitalization rates were computed by gender and standardized on the regional population in 2006. A logistic regression model was implemented using the presence of DKA as dependent variable.

Results
We identified 160,366 HDRs with type 2 diabetes. Out of them, 1611 (1.00%) were due to DKA. The hospitalization rates for DKA increased both for male +115.9 and female +142.8%, from 2006 to 2015. Associated factors of DKA were age ranging from 18 to 44 (adjOR=4.17; 95%CI:3.27-4.31), uncontrolled diabetes (adjOR=1.79; 95%CI:1.60-2.01), trauma (adjOR=1.38; 95%CI:1.13-1.68), any infection (adjOR=1.68; 95%CI:1.22-.2.33), liver disease (adjOR=1.29; 95%CI:1.09-1.53), fluid and electrolyte disorders (adjOR=2.09; 95%CI:1.09-1.53), psychosis (adjOR=1.69; 95%CI:1.25-2.30).

Conclusions
Hospitalization trends for DKA in adult patients with type 2 diabetes have been increasing and are associated with some comorbidities. Early screening, appropriate patients, families and communities education remain an important aspect of preventing an acute diabetic complication such as DKA. Moreover, multimorbidity complicates the disease management and remains an open challenge for public health.

Key messages
This study addresses hospitalizations for DKA in adult patients with type 2 diabetes, an occurrence increasing worldwide for unclear reasons. For preventing DKA in type 2 diabetes patients, it is useful taking into consideration the known trigger factors, but it is also worthwhile improving the management of comorbidities in outpatients.
Management of COPD in Anhui Province: compliance with GOLD guidelines
Authors: He S , Zha L , Li Y , Yang G , Zhou Y , Villanueva E V 
Published: November 2019

Abstract

Background
COPD is a major public health concern of global scope, especially in China. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines are international and national recommendations to manage COPD. Little is known about level of adherence of COPD management among exacerbated COPD inpatients to GOLD guidelines in China. The current study aimed to compare COPD management (vaccination and treatment of COPD exacerbation) among hospitalized patients in Anhui Province with GOLD guidelines and identify risk factors influencing vaccination coverage and guideline-compliant care.

Methods
A retrospective clinical audit of medical records was conducted in a hospital in Anhui Province in China, involving 1132 patients hospitalized with exacerbated COPD within 2016-2017. Descriptive analysis was conducted to evaluate compliance to GOLD recommendations (version 2017). Logistic regression was conducted to detect the association between guideline-consistent care and variables.

Results
Extreme deficiency in the vaccination coverage (0%) was found. Regarding pharmacological management, some adherence to prescribing short-acting bronchodilators timely (43.5%) and prescribing long-acting bronchodilators (55.0%) was observed; nonetheless, only 26.1% of patients received systemic corticosteroids or antibiotics for the recommended duration (&lt;7 days) and only 17.0% did not receive methylxanthines. Age, education level, occupational status and disease severity were independently associated with guideline-consistent treatment.

Conclusions
The implementation of GOLD recommendations in Anhui Province was unsatisfactory. Interventions to increase the vaccination coverage among COPD patients and to optimize the treatment of COPD exacerbation are imperative, requiring efforts at the hospital and policy levels.

Key messages
This is the first clinical audit study investigating the COPD management among hospitalized COPD patients in China. The implementation of GOLD recommendations in Anhui Province was unsatisfactory.
The analytic hierarchy process as a holistic model for the assessment of dialysis centres
Authors: Kaziuk M B , Kosiba W 
Published: November 2019

Abstract

Introduction
Haemodialysis is one of the methods of renal replacement therapy which is most frequently used in Poland and in the world in patients with chronic and acute renal failure. Purpose: An attempt was made to have patients undergoing regular haemodialysis assess the results of activity of dialysis centres.

Methods
64 patients (30 women, 34 men, age: 50.2 +/- 11.9 years) undergoing dialysis therapy in three selected dialysis centres in Poland were included in the study. A questionnaire correlated with the analytic hierarchy process (AHP) was employed for the assessment. The dialysis centres were assessed by the patients in the context of availability of services, communication between the medical staff and the patient and the treatment used. Two sub-criteria were connected with each criterion, for which significance (priorities) indicating a dependent impact on the assessment of the quality of dialysis centres was calculated.

Results
From amongst four domains of the assessment of dialysis centres, the patients rated medical care and nursing care the highest (w = 0.386), where medical care had significance equal to 0.455, and nursing care had significance equal to = 0.545. The next important part of the assessment of dialysis centres was communication between the medical staff and the patient (w = 0.321) and the treatment used (haemodialysis) (w = 0.155). Availability of services had the lowest significance (w = 0.138), including performance of examinations for kidney transplant and medical transport for haemodialysis.

Conclusions
The assessment of dialysis centres using the AHP method should be part of the therapeutic process where one needs to emphasise the role of the patient in chronic nephrological care which translates into the quality of services provided by dialysis centres.

Key messages
The assessment of dialysis centres using the AHP method should be part of the therapeutic process. The patient’s role and its good assessment in the treatment process is very important.
Nutritional and Rehabilitation goals in Acquired Brain Injury patients: a new decannulation protocol
Authors: d’Angelo M , Michelutti A , Biasutti E , Quattrin R , Brusaferro S 
Published: November 2019

Abstract

Background
One of the first goals for the rehabilitation of patients with Acquired Brain Injury (ABI) is the removal of the tracheocannula: the aim is not only to allow respiration by airways and reduce respiratory complications but also to obtain rehabilitation of dysphagia and verbal communication: for this purpose from July 2017 the ABI unit of the Institute of Physical and Rehabilitation Medicine ’Gervasutta” adopted a new decannulation protocol, recommended by the Italian Society of Physical Medicine and Rehabilitation (SIMFER).

Methods
Clinical data of ABI patients with tracheal cannula from May 2014 were collected as both process and outcome indicators associated with the adoption of the new protocol were defined. ABI patients were therefore divided into two groups depending on whether they were treated with or without the new procedure. Data have been processed with “Simple Interactive Statistical Analysis” (SISA) software.

Results
A sample of 141 patients with tracheocannula was analyzed; among these 57 (40.4%) were treated with the new decannulation protocol. No statistical significant differences were found between the two groups in terms of systemic or respiratory complications, Functional Independence Measure (FIM) or Level of Cognitive Functioning (LCF) at the entrance as well as for both the time (days) between entry or tracheotomy and decannulation. However decannulation rate is significantly higher when the new protocol is applied (OR = 1.8; 95% CI = 1.2- 9.8; p = 0.01) as the time (days) between entry and oral feeding resumption (p &lt; 0.001; 95% CI = -10 - -34 days).

Conclusions
The introduction of the new protocol has allowed the achievement of both nutritional and rehabilitation goals with a significantly faster oral feeding resumption and an increase of decannulation rate and. Further efforts are needed to support its use in the future, with the aim of further improving of either process or outcome performances.

Key messages
Promising prospects for the decannulation of patients with acquired brain injury. Achievement of nutritional and rehabilitation goals.