bluuebunny/crossref_metadata_2025_split huggingface dataset:
Addressing childhood obesity - Are we doing enough?
Authors: Borg M , Cauchi D , Calleja N , Gauci C 
Published: October 2020

Abstract

Background
The prevalence of childhood overweight and obesity is increasing worldwide, with Malta having one of the highest rates among European countries. Childhood obesity is likely to track into adulthood, and can have multiple physical and psychological health outcomes. It also causes a substantial economic burden on society. A cross-sectional study that aimed to identify barriers to maintaining a healthy weight among children attending primary school, and to assess the level of support for a range of policies aimed at addressing childhood obesity as expressed by their parents/guardians, was conducted in Malta.

Methods
Data were collected using a paper-based questionnaire that was distributed to a stratified random sample of parents whose children attended free State schools, subsidised Church schools and fee-paying Independent primary schools in Malta and Gozo in 2018. Data were analysed using SPSSv25.

Results
Responses from 1169 parents were received. There was a dissonance between the most common barriers identified, that were primarily related to the food environment, and the policies that received the most support. Providing more spaces for safe physical activity was the most supported policy (94% in favour). Participants were least supportive of taxation policies, a phenomenon also observed in other countries. The level of support for policies varied significantly by various demographic and socioeconomic factors.

Conclusions
Recommendations were developed to inform future policies and strategies to address obesity. Policymakers need to take bold, possibly controversial decisions to mitigate against the barriers faced by the population in accessing healthy food and being physically active. Given the globalised nature of media advertising and the food system, a joint international effort is necessary to address this epidemic, such as stricter audio-visual media advertising regulations, food reformulation and mandatory standardised food labels.

Key messages
The majority of participants supported most of the proposed policies to address obesity. Taxation policies received the least support. Most policies supported are trans-sectoral, therefore a health-in-all policies approach and international collaboration are necessary.
Health research saves lives
Authors: Higgins C 
Published: October 2020

Abstract
This presentation will argue that increased investment in health research is a significant public health imperative. It will use New Zealand as an illustrative case study and also draw upon international experiences.
Over the last ten years New Zealand government investment allocated to health research has stood at between 0.6% and 0.8% of government health care costs. Health research advocacy organisation New Zealanders for Health Research (NZHR) argues that the level of investment should be increased to at least 2.4% in order to align with international norms, improve the population's health and well-being and save lives. New Zealand's annual amenable and non-amenable premature mortality currently stands at about 5000 and 7000 deaths respectively. Increased investment in health research holds the key to significantly impacting these figures and should be regarded as an important public health issue.
NZHR is one of five similar health research advocacy organisations globally, the others being Research America, Research Canada, Research Sweden and Research Australia. All consistently demonstrate strong public support for their governments to be more actively committed to achieving increased investment in health research. New Zealand is scheduled to have a General Election in September 2020, so the results of NZHR's own polling, supported by that of our sibling organisations, are of particular relevance as NZHR seeks to make health research investment an election issue.
The presentation will include comparative information from the five health research advocacy organisations globally, and will note that health researchers irrespective of where they are based are part of an international community where knowledge is shared to the benefit of all nations globally. The presentation therefore will challenge all countries, including New Zealand, to examine, and where necessary address, the adequacy of their own levels of health research investment.

Key messages
Health research saves lives. Health research investment is a public health issue.
Environmental pollution as a risk factor for autism spectrum disorders in children and adolescents
Authors: Szponar L , Matczuk E , Pietraś E 
Published: October 2020

Abstract
Autism spectrum disorders caused, inter alia, by environmental pollutions have been in focus of public health leaders, doctors (paediatricians, perinatologists, nutrition experts). Based on the data from 2016 Demographic Yearbook, it has been established that among children and adolescents in the age below 17, the population of boys is 3155000 and girls 3994000. In USA in recent decades the CDC studies have shown that the incidence of ASD has increased from 1 case per 150 children in 2000 to 1 case per 59 children in 2014 i.e. it more than doubled. Three groups of factors modifying the risk of ASD development in children and adolescent populations, being more common in boys population, were identified: the declining environmental chemical pollution by POP, probably reduces the inflammation status of microglia cells in the central nervous system. Significant gender distinction of the microglia cells of the mouse brain, caused probably by steroid hormones at the transcriptome level, results in a different behaviour of the microglia in female individuals. The microglia cells of this gender reduce the level of microglia damage caused by acute focal ischemia. It seems likely that the lower prevalence of ASD in girls may be due to the effective protective activity of female sex hormones, at this level. Meanwhile the elimination of chemical pollutants from the discussed substances on the gastrointestinal tract - white part of the brain axis strengthens the proper functioning of the intestinal microbiome - brain axis. Demographic data, it has been estimated that the number of boys at risk of ASD in Poland may be approximately 30000 and girls fourfold less, i.e. approximately 7500. A definite absence of epidemiological data collected through representative studies on the prevalence of ASD in children aged 3-17 years in Poland indicates a need for a proper diagnosis in order to develop a more effective health care system for population in question compared to the existing one.

Key messages
The female sex hormones protect the majority of girls against ASD, probably at a brain microglia level. Brain microglia, may be key to mitigation of the risk of asd health disorder in the population of girls and women.
Systematic review on citizens’ literacy in omic sciences and web search of initiatives to improve it
Authors: Sassano M , Calabrò G E , Tognetto A , Federici A , Ricciardi W , Boccia S 
Published: October 2020

Abstract

Introduction
We are assisting to a progressive change in the classical approach to patient care toward so-called personalized medicine, mainly driven by the development of omic sciences. To implement omic sciences into practice it is important to address healthcare professionals', policy makers', leaders', and citizens' literacy

Methods
As part of a project funded by the Italian Centre for Disease Prevention and Control (CCM), we carried out a systematic review (SR) on citizens' attitude, knowledge, and educational needs in omic sciences. The search was carried out on Pubmed, Web of Science, and Embase. We also conducted a separate web search on Google, Yahoo, and Bing on initiatives published in Italian and English aimed at improving citizens' literacy in the same field. Websites of retrieved initiatives were examined to identify additional resources

Results
Forty-nine studies were included in the SR. Most studies (n = 26, 66.7%) reported low levels of knowledge in omic sciences among citizens, and conflicting attitudes related to potential risks and benefits of omic sciences. Eleven studies (22%) evaluated citizens' educational needs, and most (n = 9, 82%) reported a clear knowledge gap. As for the web search, 13 initiatives were identified in Italy, 4 in Europe, and 22 in non-European Countries. Overall, 33% of them required in-person attendance, while 67% were web-based resources. The former included exhibitions, seminars, courses, symposia, information stands in public places, guided visits at research laboratories, and interactive laboratories; the latter included web-pages for reading, online lessons and courses, web portals for information, videos and short movies, animations, apps for mobile devices

Conclusions
Results show a clear need to improve citizens' literacy. To achieve this goal, the implementation of effective strategies and initiatives is crucial, hence this effort to summarize the existing ones will be essential for future plan developments.

Key messages
The current challenge is to identify effective methods of improving citizens' literacy and implementing them. Only through citizens’ empowerment the implementation of omic sciences in the Health System will be possible, since citizens are increasingly active in the health context.
Genetic variants associated with the early onset of type 2 diabetes in the Hungarian population
Authors: Werissa N , Pikó P , Fiatal S , Sándor J , Ádány R 
Published: October 2020

Abstract

Background
It is generally accepted that early detection of type 2 diabetes mellitus (T2DM) is important to prevent the development of complications and comorbidities, as well as premature death. In addition to the environmental risk factors, genetic factors may also contribute to the development of T2DM. The aim of our study is to identify single nucleotide polymorphisms (SNPs) which have an effect on the early onset of T2DM in the Hungarian population.

Methods
This study included 891 T2DM patients (438 males and 453 females). The onset of T2DM varied between 25 and 90 years of age. Pearson correlation analysis was carried out for 16 SNPs to define how they are associated with the patient's age at onset of T2DM and genetic risk score was calculated for each patient by computation of alleles identified as risk ones. Linear regression analyses were used to estimate the effect of GRS on the early onset of T2DM independently of conventional risk factors (sex, BMI and TG/HDL-C ratio).

Results
Six SNPs (rs111875 in HHEX gene, rs560887 in G6PC2 gene, rs11071657 in the C2CD4B gene, rs5219 in KCNJ11 gene, rs10830963 in MTNR1B gene and rs11671664 in GIPR gene) were identified as risk polymorphism in the correlation analysis and GRS was calculated by defining their number/subject. The GRS showed significant association (β=-0.486, p = 0.008) with younger age at onset of T2DM. The correlation of GRS with the risk of earlier onset of T2DM was significant in the male population (β= -0.581, p = 0.024) and close to significant in female one (β= -0.471, p = 0.068).

Conclusions
Our findings indicate a considerable genetic predisposition for early onset of T2DM, which is mainly attributed to the cumulative effect of 6 SNPs presently known to be susceptible alleles. This set of SNPs and the genetic risk score calculated can be used for estimating the risk of earlier onset of T2DM on individual and population levels.

Key messages
SNPs were identified to play a role in the early onset of T2DM in the Hungarian population. The genetic risk score calculated by computation of susceptible alleles can be used for risk estimation of early onset of T2DM.
Distance learning training in genetics and genomics practices for Italian healthcare professionals
Authors: Calabrò G E , Mazzaccara A , Carbone P , Barbina D , Guerrera D , Di Pucchio A , Sassano M , Federici A , Ricciardi W , Boccia S 
Published: October 2020

Abstract

Background
Genomics and related fields are becoming increasingly relevant in healthcare practice. Italy is the first European country with a structured policy of Public Health Genomics and dedicated guidelines that focus on three pillars: Health Technology Assessment of omic applications, promotion of citizens' literacy, and promotion of extensive training for all healthcare stakeholders. In January 2019 we initiated a project funded by the Italian Ministry of Health and entitled 'Capacity building and Citizens-Omics'.

Objectives
The project is coordinated by the National Institute of Health and is aimed at implementing the “Italian National Plan for innovation of the healthcare system based on omics sciences” published in 2017.

Results
The project had set-up two distance-learning courses on genetic/genomics: an advanced course for physicians and biologists, and a basic one for the remaining healthcare professionals. The courses focused on genetic/genomic testing in clinical practice, pharmacogenomics and oncogenomic and they were developed according to the main models of andragogical training (Problem-based Learning and Case-based Learning). The courses include audio-video lectures and interactive clinical cases and they will be accessible free of charge for a year (from February 17th 2020). In three weeks, we had 2129 participants (1101 physicians, 1028 biologists) for the advanced course and 10.000 for the basic one.

Conclusions
Genomic literacy among healthcare professionals is essential to ensure optimal translation to healthcare delivery of research. The distance-learning training in genetic/genomic practices represents an effective method to improve healthcare professionals' knowledge in the immediate and mid-term time scale. Our courses represent the third Italian experience in distance training in omic field. The educational effects related with online courses could potentially be relevant internationally and across a wider range of potential audiences.

Key messages
In view of the ongoing rapid developments in genetics research it is important that omic literacy among healthcare providers be enhanced to ensure translation to healthcare delivery of research. E-learning training appears to offer a cost-effective and time-efficient method of improving omic knowledge and it could be relevant across a wider range of potential audiences.
Study of submerged cases of violence on healthcare workers in an emergency department
Authors: Piras I , Piras G , Portoghese I , Azara A , Piana A , Contu P , Galletta M 
Published: October 2020

Abstract

Background
Violence at work has negative effects on both workers and organizations. Among healthcare workers, nurses are the professionals most at risk, especially those who work in emergency departments. However, literature data are estimated to be the tip of the iceberg. The study aims at analyze violence events that are not reported by professionals via common reporting system, in order to measure the real extent of the problem and allow the organizations introducing adequate prevention measures.

Methods
The study took place in November 2016 in an emergency department in Southern Italy. A retrospective analysis was carried out by reviewing both the delivery registers (DR) used by nurses and doctors during the service, and the reports of security guards (RSG), in the period between 2011 and 2015.

Results
The results show that violence frequency was higher than that present in the risk management reporting (only one case). In the DR, 40 violence events were reported, yet in the RSG, 109 cases were registered. More nurses (n = 33) than doctors (n = 8) reported violence events in the DR. In the RSG, guards reported the same number of cases involving nurses, and 26 cases for doctors. In 50 cases, the professional involved was not specified. The violence type was physical (5 DR vs 13 RSG), physical threats or attempted violence (4 DR vs 13 RSG), and verbal (24 DR vs 67 RSG). Weapons (e.g., knife, hammer, syringe) were used in 2 cases as reported in DR and in 4 cases according to RSG. The aggressor was mainly the patient (15 DR vs 83 RSG) and the companion (14 DR vs 16 RSG). The shifts with more frequency of events are afternoon (15 DR vs 40 RSG) and night (12 DR vs 48 RSG).

Conclusions
The data show an amount of submerged cases and highlight a discrepancy between report of professionals and violence events where security guards intervened.

Key messages
Under-reporting violence cases require attention by the organizations. Prevention and protection strategies must be implemented. The use of the reporting system must be improved.
Comparison of fall risk assessment scales in the triage of an Italian emergency department
Authors: Piras I , Murenu G , Piras G , Pia G , Azara A , Piana A , Galletta M 
Published: October 2020

Abstract

Background
Falls in hospital are adverse events with serious consequences for the patient. Fall risk assessment requires easy tools that are suitable for the specific clinical context. This is important to quickly identify preventing measures. The aim of the study is to identify an appropriate scale for assessing fall risk in patients from an emergency department.

Methods
For the fall risk assessment in the emergency department, three scales were identified in literature: Kinder 1, MEDFRAT, and Morse. MEDFRAT and Morse classify the patient in high, moderate, and low risk; Kinder 1 split patients “at risk” (also when there is only one positive item) and “non-risk” (in which all items are negative). The study was carried out in July 2019 in an Italian emergency department. Patients who arrived in triage were assessed for the fall risk using the three scales.

Results
On a sample of 318 patients, the used scales show different levels of fall risk. For Kinder 1, 83.02% is at risk and 16.98% is not at risk; for MEDFRAT, 14.78% is at high risk, 15.09% moderate, and 70.13% low risk; for Morse, 8.81% is at high risk, 35.53% moderate, and 56.66% low risk. As Kinder 1 implies as “high risk” that all items of the questionnaire are positive, to compare Kinder 1 to the other scales with three measurements, we assumed only one positive response as “moderate risk”, all negative responses as “low risk”. Thus, Kinder 1 shows no cases at high risk, 83.02% moderate risk, and 16.98% low risk. All the scales show that the moderate-high risk increases with age. MEDFRAT and Morse have concordant percentages for young (13.6%), elderly (61.2%), and long-lived (66.6%) people. Kinder 1, 59%, 96.7%, and 100%, respectively.

Conclusions
The comparison between scales shows inhomogeneity in identifying the level of risk. MEDFRAT and Morse appear more reliable and consistent.

Key messages
An appropriate assessment scale is important to identify the fall risk level. Identifying accurate fall risk levels allows for implementing specific prevention actions.
Control Policy of RF electromagnetic field in Bulgaria. Practical approach
Authors: Zaryabova V , Shalamanova T s , Petkova H r , Israel M 
Published: October 2020

Abstract

Problem
Public concern about the possible health risk of the impact to electromagnetic fields (EMF) is growing strongly. International organizations propose specific policy approach to be implemented. Bulgaria has very restrictive legislation concerning EMF which further complicates the implementation of these recommendations.

Description of the Problem
Legislation in Bulgaria implements two-stages of control: on the base of documentation for calculation of the safety zone, measurements of the EMF values.

Many problems arise
Exposure assessment; Implementation of new technologies, even more the new 5G standard; Problems standing in front of experts, control bodies and administration.

Results
Following steps are taken to resolve the Issues: A proposal for changes in the legislation has been prepared.A communication program of establishing a dialogue with the population has been developed and implemented.An Expert Consultative Body has been created by the Ministry of Health which includes experts, industry and administration.An electronic information system of the telecommunication sources located on the territory of the country has been established. Its purpose is to provide detailed information on the EMF values for the population and to support the expert evaluation of the sources and the control.Annual monitoring of the telecommunication sources is carried out, providing data for the electronic information system.

Lessons
Combined efforts of experts, industry and administration lead to successful solving the problems and decision-making for implementation of the European practices and policies to protect the public health. Implementing the date of the monitoring carried out by the control bodies into electronic system, we manage to provide information of the population.

Key messages
Implementation of the European legislation in the country in line with the contemporary challenges of new technologies and ensuring public health. Providing information of the EMF exposure to population.
20-year trends in overweight, nutrition and physical activity habits among Lithuanian population
Authors: Kriaucioniene V , Petkeviciene J 
Published: October 2020

Abstract

Background
Changes in diet and physical activity can affect the prevalence of overweight. The study aimed to evaluate trends in overweight and lifestyle factors among Lithuanian population considering socio-demographic factors.

Methods
The data were obtained from eleven cross-sectional postal surveys of Lithuanian Health Behaviour Monitoring, carried out in 1994-2014. For every survey, a nationally representative random sample of 3000-4000 individuals aged 20-64 was drawn from the National Population Register. In total, 8738 men and 11822 women participated in these surveys. Self-reported body weight and height were used to calculate BMI. Questions about food consumption and physical activity were included in questionnaires.

Results
Between 1994 and 2014, the proportion of men with overweight (BMI≥25 kg/m2) increased from 47.5% to 58.6 and the proportion of men with obesity (BMI≥30 kg/m2) - from 10.7% to 19.5%. The increasing trends were observed in all socio-demographic groups. In women, the prevalence of overweight decreased from 51.7% in 1994 to 46.0% in 2014; the prevalence of obesity has not changed significantly and was 17.3% in 2014. The most remarkable decrease in BMI was observed in women of the youngest age group and with university education. Socio-demographic differences in the trends in nutrition habits were in line with changes in BMI. The highest decrease in fatty meat and milk products consumption and an increase in fresh vegetable consumption were reported by younger, highly educated and living in city women. Since 1994, the proportion of men and women having leisure-time physical activity at least four times a week has increased, however, only to 29.1% of men and 24.5% of women. Older people and those with lower education were less physically active.

Conclusions
Over 20 years, the prevalence of overweight increased in Lithuanian men and decreased in women. These trends were related to trends in diet and physical activity habits.

Key messages
Over 20 years, the increasing trends in the prevalence of overweight were observed in all socio-demographic groups of men and decreasing trends in the youngest age group and high-educated women. Positive changes in BMI were associated with improvement in food habits and physical activity level.