bluuebunny/crossref_metadata_2025_split huggingface dataset:
The food environment in school’s vicinities of Sao Paulo, Brazil
Authors: Barata M F , Leite M A , Levy R B 
Published: October 2020

Abstract
The school environment plays an important role in the eating patterns of students. The quality of food available in the school vicinities can influence the health and diet outcomes of this population. The study aims to analyze the food environment in the school vicinity of the city of Sao Paulo, focusing on stores selling ultra-processed products. The association between presence and characteristics of schools and density of stores will be investigated. Schools information was obtained from the 2016 School Census, provided by the National Institute of Educational Studies and Research Anísio Teixeira (INEP). The 2016 Annual Social Information List (RAIS) database was used to characterize the school vicinity. Eleven types of stores selling ultra-processed products were identified through the National Classification of Economic Activities (CNAE). Initially, schools and stores were georeferenced by the Postal Address Code in the city street map; this information was attached to the Human Development Units (UDH). Descriptive analyzes (absolute numbers and density per 10.000 inhabitants) were carried out to investigate the distribution of food stores by each category of Municipal Human Development Index (IDHM) present in the city. The influence of the schools on the presence of stores was verified by comparing stores densities in areas with and without schools, considering IDHM categories. The results show that food stores densities are smaller in areas with lower IDHM (8.79/10.000 inhabitants) and bigger in areas with higher IDHM (79.19/10.000 inhabitants). Comparing areas with and without schools, areas with schools present higher food stores densities in every category of IDHM. Furthermore, the study results are relevant and necessary to fill gaps in current literature and may support the formulation of recommendations and intervention proposals for promoting healthy food environments for children and adolescents.

Key messages
The results assist in the understanding of how different determinants can modulate food choices and practices of children and adolescents. Food environments investigations and monitoring provide important subsidies for designing and directing accurate public policies that promote healthier food environments and choices.
Occupational Eye Trauma: a major public health issue in France
Authors: El Harrak Y , Naoum S , Khawaja O , Salhi Y , Laib S , El Sanharawi M 
Published: October 2020

Abstract
Occupational Eye Trauma (OET) is a global cause of visual morbidity. According to the WHO, 55 million ocular lesions occur each year, and 1.6 million cases of total blindness caused by trauma. The objective of our work is to evaluate the frequency of OET per projectile in France, to compare results to other similar studies, and therefore to encourage the reinforcement of safety measures. This is a cross-sectional descriptive study, carried out in the Ophthalmic Emergency Department, at the Intercommunal Hospital of Villeneuve-Saint-Georges, France, including all patients who presented to the same doctor's consultation, between June 2019 and December 2019.
The study involved 1730 patients, 700 women and 1030 men, with an average age of 40. In 7 months, 600 are victims of ocular trauma and 346 are victims of projectile during professional practice, a prevalence of 20% of all emergencies, or 57% of all trauma. The prevalence is higher within males, reaching 33% of all emergencies. The average age was 39, 99% of males. The average consultation time was 3 days after the accident. Besides, 66% of consultants already have a previous history of OET; and 59% were not using a safety protection.
The study shows that 58% of patients had a corneal foreign body; 25% a corneal ulcer; 10% a conjunctival foreign body; while 2 cases (0.5%) presented a corneal wound requiring surgical management. Therefore, eye trauma is a real public health problem. They account for 35% of consultations, half of which are associated with professional activities, mainly affecting young and active men. The high rate of recidivism and non-respect of safety measures highlights the lack of awareness of the target population. Compared to the findings of a previous study lead in Morocco, the outcomes are almost identical, 20/18% in prevalence, 66/75% in recidivism.
Results of this work shows that OET, avoidable circumstances, are however frequent, causing potential severe lesions, with a reserved prognosis.

Key messages
The results of this work prove that occupational ocular trauma, avoidable circumstances, are however frequent. Workplaces with a high risk of eye trauma should strengthen their protective measures and training programs should be put in place for both workers and occupational physicians.
Free Health Care in Niger
Authors: Genovese E , Beck L B , Ganflef M G 
Published: October 2020

Abstract

Issue
To reduce financial barriers to accessing health care, Niger introduced Free Health Care for: family planning, antenatal care, caesarian section, extra uterine pregnancy, uterine rupture, treatment of gynecological cancers, all preventive and therapeutic care for children &lt;5.

Description of the Problem
Implementation has been challenging due to limited funding for pre-payment reimbursements, stock-out of medicines and other pharmaceutical products, and limited traceability up to the end-users. Health Sector partners have provided stock support.

Results
Relevance: stock-outs of medicines and other pharmaceutical products were mitigated, but challenges related to limited funding and traceability up to the end-users were not addressed. Effectiveness: utilization of first antenatal care consultations increased with stock support (88% Intermittent Presumptive Treatment; (50% iron/folic acid supplementation). Utilization of health services for children &lt;5 did not increase despite stock support (reported cases: malaria 35%, diarrhea 60%, pneumonia 20%). Efficiency: not measurable due to lack of reporting on stock support utilization, though representing 16,5% of all expenses for Free Health Care. Equity: not measurable due to lack of information on stock support utilization. Traceability: stock support was received in conformity with delivery bills (in 100%-97%). Cost-effectiveness: not measurable, as health sector partners had to put in place their own logistics, due to weakness of the national procurement and supply management system, and information to compare the two systems is not available. Externality: stock support was deemed not sustainable, as dependent on parallel systems for financing as well as procurement and supply management.

Lessons
Utilization of antenatal care increased, but attribution to stock support is challenging, due to multiple confounding factors and limited measures to support Free Health Care management.

Key messages
Supporting Free Health Care through procurement and supply management of medicines and other pharmaceutical products alone may provide a partial mitigation to stock-outs, yet effects are limited. Free Health Care requires a comprehensive approach: governance (resource planning, management), pharmaceutical stock availability, human resources performance, and control systems up to the end-users.
Heat, heatwaves and cardiorespiratory hospital admissions in Helsinki, Finland
Authors: Sohail H , Tiittanen P , Kollanus V , Lanki T 
Published: October 2020

Abstract

Background
There is a lack of knowledge concerning the effects of heat on morbidity in Northern Europe. Therefore, this study aimed to evaluate the relationships of daily summer-time temperature and heatwaves with cardiorespiratory hospital admissions in Helsinki, Finland.

Methods
Time-series models adjusted for potential confounders such as air pollution were used to investigate the associations of daily temperature and heatwaves with cause-specific cardiorespiratory hospital admissions, during the summer months of 2000-2017. Daily number of hospitalizations was obtained from the national hospital discharge register, weather information from the Finnish meteorological institute.

Results
Heatwave-days were associated with an increased risk of pneumonia (RR: 1.17, 95%CI: 1.04-1.31), any respiratory disease in some age groups, and myocardial infarction (RR: 1.54, 95% CI: 1.12-2.12) among person 65-74 years of age. In addition, high effect estimates were observed for many types of cardiorespiratory diseases in association with heatwaves in some age-groups. In contrast, risk of arrhythmia was decreased during heatwaves (RR: 0.81, 95% CI: 0.70-0.93).

Conclusions
We found no associations and even protective associations between daily mean temperature and cardiorespiratory hospital admissions. However, our results suggest that heatwaves are a serious health threat affecting the morbidity even in the Northern climate

Key messages
Heatwaves are associated with increased risk of cardio-respiratory hospital admissions. There is a need to adapt to climate change in the public health sector also in Northern Europe to protect vulnerable population groups.
Knowledge, attitudes and behaviours towards vaccination: a survey of university students in Europe
Authors: Callegaro A , Chinenye Ilogu L , Lugovska O , Mazzilli S , Prugnola A , Van Damme P , Vojtek I 
Published: October 2020

Abstract

Background
Immunisation programs are still facing substantial challenges in achieving target coverage rates. This has been attributed to the growing negative individual vaccination attitudes and behaviours. Most of the current studies assessing vaccination knowledge, attitude and beliefs targets adults. However, young people represent future parents and health care professionals. The objective of this study was to investigate vaccination knowledge attitudes and behaviours among university medical and non-medical students in Europe.

Methods
We performed a cross-sectional online survey between April and July 2018. The study participants were students attending different faculties at the University of Antwerp, Belgium and the University of Pisa, Italy. We described sample characteristics. The effect of risk factors was tested with univariate and multivariate logistic regressions.

Results
A total of 2079 participants completed the survey including 873 medical students and 1206 from other faculties. The average of vaccination knowledge, attitudes, and confidence was respectively 5.51 (SD: 1.41), 4.66 (SD: 0.14) and 5.28 (SD: 0.57) on the 6-points scale. Our respondents demonstrated a high level of awareness with respect to their vaccination history. In total, 67.7% (n = 1407) reported to have received at least one vaccine in the previous five years; only 6.0% (n = 35) did not receive any vaccine in the previous 10 years. According to logistic regression analysis Italian students had significantly higher knowledge, attitude and confidence scores than Belgium respondents. Students of medicine scored significantly higher compared to non-medical students.

Conclusions
In order to reduce the gaps in vaccinations knowledge between non-medical and medical students we should plan educational interventions. In this way the number of future sceptical parents could be decreased. Further studies are required to explain the differences between countries.

Key messages
Young adults are the parents and the health care professionals of the future, for this reason their vaccination knowledge attitudes and behaviours should be carefully monitored. European non-medical students have lower vaccinations knowledge, attitudes and confidence compared with medical student. In order to fill these gaps, we should plan educational interventions.
Vaccination and immunization status among healthcare students: results from the SAVES survey
Authors: Rivolta S , Letzgus M , De Nard F , Gaiazzi M , Principi N , Margherita M , Florio E M , Gervasi F , Castaldi S 
Published: October 2020

Abstract

Background
Adequate vaccination coverage among healthcare workers, including students in healthcare professions (SHPs), is crucial in order to prevent spreading of infections within healthcare facilities. However, vaccination coverage among SHPs is often inadequate. We aimed to describe the vaccination/immunization status of SHPs of the University of Milan.

Methods
We spread an e-survey to the academic e-mail addresses of postgraduate medical residents and to first- and last-year undergraduate SHPs. The questionnaire covered sociodemographic data (age, sex, education, municipality of residence, internship in high-risk wards) and the reported vaccination/immunization status for Influenza (previous flu season), Varicella, MPR and DTaP vaccines.

Results
Among 5743 invited SHPs, 884 participated in the survey. The study sample comprised 462 medical residents and 422 undergraduate SHPs (medicine 176, nursery 186, midwifery 4, healthcare assistance 32, prevention techniques 24). Median age was 27 years (IQR 7); 68.4% participants were female; 91.3% had attended high school in a lyceum, while others in a professional (2.9%) or technical (5.8%) institute; 36.7% lived in municipalities of &lt; 20.000 inhabitants, while 26.1% of &gt; 250.000. Traineeships took place in high-risk wards for 46% of participants. Reported vaccination coverage for Influenza was 33,7% (with higher coverage for pediatric nursing and midwifery students, medicine students and medical residents). Participants reported immunity (either vaccine or natural immunity) to Varicella in 93,3% cases. Declared vaccination coverage for Hepatitis B was 94,1%; 91,7% participants reportedly completed the MPR schedule, 76,2% the recommended DTaP booster.

Conclusions
Influenza vaccination coverage was suboptimal in our sample of SHPs, suggesting the need of specific educational programs and targeted vaccination campaigns, which may help shaping a positive vaccination attitude for future healthcare professionals.

Key messages
Immunization status for VPDs is suboptimal among Italian students in healthcare professions. The monitoring of the immunization status should include healthcare students actively involved in healthcare activities.
Influenza vaccination among pregnant women: increasing awareness and coverage
Authors: Carini E , Bruno S , Di Pilla A , Beccia V , Di Pumpo M , Damiani G , Carducci B , Masini L , Lanzone A , Laurenti P 
Published: October 2020

Abstract
Influenza is a serious public health issue and pregnant women are one of the categories at higher risk of complications. Vaccination represents a safe and effective tool for prevention but the importance is not well perceived and the coverage is low (ECDC: 25% median in 2016/17). A program of education and free vaccination has been proposed to pregnant women following birthing classes. The aim was to increase pregnant awareness and to increase vaccination coverage of both parents. Classes about vaccinations, their timing and efficacy were given and a dedicated ambulatory operating twice a month during the flu season was set up. After the classes, the women were addressed to the ambulatory to be vaccinated. Vaccination was offered to the partners of the pregnant as well. General data, anamnesis and data about previous vaccinations were asked and then entered into a database.
The number of women participating to the birthing classes from October 2019 to January 2020 was 119. Of those, from the beginning of the vaccination sessions on November 14th 2019 until January 16th 2020, 46 were vaccinated in the dedicated ambulatory (plus 2 in the resident ambulatory of the hospital). The compliance to vaccination was 40.34%. An additional number of 39 partners was also vaccinated. November was the month with the highest number of people vaccinated (20 women and 14 partners), while January had the lowest (7 women and 8 partners).
As expected a higher number of people got vaccinated at the beginning of the flu season. A considerable number of partners decided to vaccinate, showing the parents understanding of the importance of herd immunity. Sensitising the women towards vaccination and increasing their awareness is crucial to improve women and new-borns' health status. Even though the compliance was considerable, a lot of work has to be done to improve vaccination coverage and to make the importance of vaccination clear.

Key messages
Providing a programme of sensitisation could improve influenza vaccination coverage. The compliance, although satisfactory, can be further improved providing different and steady educational strategies.
Vaccine-preventable diseases screening and vaccination programs for healthcare professions students
Authors: Letzgus M , De Nard F , Gaiazzi M , Rivolta S , Grimoldi L , Magnoni P , Gervasi F , Carrer P , Castaldi S 
Published: October 2020

Abstract

Background
Students in Healthcare Professions (SHPs) present an increased risk of contracting and transmitting Vaccine-Preventable Diseases (VPDs). Our study aimed to investigate the organizational strategies (screening and immunization for VPDs and vaccination promotion among SHPs) implemented by the healthcare facilities accredited with the University of Milan.

Methods
we sent an e-survey by e-mail to medical residents and first- and last-year students in nursing, midwifery and healthcare assistance.

Results
among 3397 invited SHPs, 645 participated. We included in the analysis 522 SHPs, distributed in 24 facilities across the Lombardy region (mean age 27,4 years; 69,5% female; 69% medical residents, 28% nursing, 2% healthcare assistance, and 1% midwifery students). Although most participants underwent occupational health visit before the traineeship start (47,5%) or within 6 months (29,5%), others hadn't undergone yet (15,1%). The visits included the collection of vaccination history (72,6%; 64,6% from written documentation), serological tests for VPDs (hepatitis B 76,1%, measles and rubella 58,4%, varicella 54,4%), and screening for latent TB (69,7%). Vaccinations were recommended to 226 participants, but only 173 fully (76,5%) or partially (8%) complied. Full compliance was associated with nudges like in-hospital (Chisq. 18,7; p = 0.00) and free vaccinations (Chisq. 31; p = 0.00). Reported facility vaccination policies included campaigns (posters 37,4%, intranet 39,5%, social media 11,5%, general/personalized letters 30,3%/11,5%), time-off incentives (7,7%), on-site (30,5%) and opinion leaders' vaccinations (9,8%). However, SHPs were often unaware of those strategies (mean 48,6%), and intra-facility answers were sometimes discordant (agreement &lt;70% for facilities with &gt;30 respondents).

Conclusions
SHPs are often unaware or discordant regarding vaccination policies carried out by traineeship facilities, suggesting the need of inclusive communication strategies.

Key messages
About half of students in healthcare professions are screened for VPDs after the start of the traineeship. Students in healthcare professions are often unaware of vaccination promotion strategies.
Climate change and health: time for action!
Authors: Marrauld L , Cucchi M , Lainey E , Depoux A 
Published: October 2020

Abstract

Issue
For several weeks, prophylactic messages against the extension of Covid-19 have saturated the public space. To protect populations, efficient measures have been rapidly put to limit the movement of people and manufactured goods. These policies have reduced global greenhouse gas emissions as well as air pollution, especially in China.

Problem
If climate change were an epidemic, we would probably have already restored it. But it results directly from the thermo-industrial activities linked to the consumption society. For Friel (Lancet, 2020), the dramatic consequences of this disturbances have to be considered as an essential health issue. She advocates for 'climate change and health alliances'.

Results
Within such alliances, health professionals have the responsibility (1) to describe the morbidity inherent in our thermo-industrial societies (2) to alert populations, and (3) to work with allies to tackle climate change and protect human populations, starting with the most vulnerable. This type of alliance is underway in the battle against air pollution, as it has been for years for fighting smoking. Alliances are intended to extend to all population health issues, with a complete decompartmentalization of minds and practices at large scale.

Lessons
Health professionals have to be mindful not to cause any harm while practicing. The health system alone produces up to 8% of global greenhouse gas in developed countries (Pichler, 2019; HCWH, 2019). There is room for action. Since 2009, the British health care system (NHS) has adopted an efficient decarbonation policy, reducing global emission from 8 to 4%, but this outstanding initiative remains an exception worldwide.

Key messages
A review of public health strategies is necessary to meet the energy, environmental and health issues, both in terms of health risks due to climate change and of decarbonation of care activities. Health professionals have the responsibility to alert populations and to work with allies to tackle climate change and protect human populations.
Knowledge, Attitudes And Behaviors Of Faculty Members On Childhood Vaccine Refusal A University
Authors: Yigit E , Boz G , Gokce A , Aslan M , Ozer A 
Published: October 2020

Abstract

Introduction
Vaccines stimulate the immune system and provides protection against a large number of diseases. Although there is a lot of scientific evidence that the benefits of vaccines are higher than their risks, concerns can occur in every segment of the community about the safety of vaccines.In this study, we aimed to examine the knowledge, attitudes and behaviors of the faculty members working at Inonu University regarding vaccine rejection.

Methods
This study is a descriptive cross-sectional study, conducted between July and August 2019. The universe of this study consists of 799 faculty members working at Inonu University. Sample size was calculated as 258 with 95% confidence interval and 80% power. The questionnaire used in the study consists of the questions including the sociodemographic characteristics of the faculty members and their knowledge, attitudes and behaviors about childhood vaccine rejection. Chi-square test was used for statistical analysis. p &lt; 0.05 was determined to be significant.

Results
99.1% of the faculty members had their children vaccinated during their childhood. 31.8% of faculty members stated that they were worried about childhood vaccines.As a source of information about vaccines, faculty members stated the scientific articles in highest rate (49.4%).It was found in comparison that parents who applied alternative medicine for their children were more worried about vaccines than those who did not, and those who did not read scientific publications about vaccines were more worried than to those who read (p &lt; 0.05).The levels of anxiety are significantly lower in those who do not think that vaccines cause autism and infertility, and those who trust vaccine producing companies (p &lt; 0.05).

Conclusions
Almost all of the faculty members have their children vaccinated, but their level of anxiety about vaccines is high. In our study, we observed that those who obtained their knowledge about vaccines from scientific articles were less anxious.

Key messages
Faculty members, who are among the most educated groups of the society, have a high level of anxiety about childhood vaccination. By keeping faculty members informed about the scientific publications about vaccines, their concerns about the vaccine can be eliminated.