bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation of Acute Flaccid Paralysis Surveillance in Emilia-Romagna, Italy: 2018-2019 analysis
Authors: Morgado M , Palandri L , Colucci M E , Affanni P , Zoni R , Pasquarella C , Righi E , Veronesi L 
Published: October 2020

Abstract

Problem
Acute flaccid paralysis (AFP) active surveillance is the gold standard in polio eradication process. Italy was classified in 2017 at intermediate risk of poliovirus reintroduction based on suboptimal poliovirus surveillance. The aim of this study was to restore an adequate level of AFP surveillance in Emilia-Romagna Region.

Description of the Problem
The Emilia-Romagna's Reference Centre for AFP surveillance, in collaboration with the regional Public Health Service identified a collaborative network for AFP Surveillance by analysing the 2015-2017 Hospital Discharge Registers in all region's hospitals. The surveillance protocol was reviewed with the development of a computerized system of Active Surveillance-Zero Reporting sent by e-mail to doctors in the network every 15 days since October 2018. The goal was to restore the AFP notification system to meet WHO requirements sensitivity, completeness of case investigation, completeness of follow-up and to monitor the active surveillance program adherence.

Results
The active surveillance network was composed by 49 doctors from both hospital administrations and clinical wards from 4 University Hospitals and 7 Local Health Authorities throughout the region. By the end of 2019, the mean response to each e-mail was 48.5% (SD 7.5%); 7 AFP cases have been reported; 85.7% received a full clinical and virological investigation and 83.3% completed the 60 day's follow-up. The final diagnosis of the cases was: 3 Guillain-Barre, 1 transient polyneuritis after HAV vaccination, 1 neuromyopathy from chronic disease, 1 acute myelitis in patient with DADA2. In 2 cases the paralysis persisted after 60 days.

Lessons
In 2019, the active surveillance system reached sensitivity, completeness of case investigation and follow-up required. Intervention had no expenses, is easily reproducible, created a direct collaboration between clinical colleagues in the network and the reference center which restored adherence to AFP surveillance.

Key messages
This work proposes how to improve AFP surveillance in a setting with low polio risk perception due to the absence of cases. Additionally, it reinforces the importance of direct collaboration/teamwork between institutions, regional reference centres and clinicians.
Attitudes of Marmara university third grade students towards dating violence
Authors: Daştan B , Sunman Ş , Demircan B , Işıldak S , Aydoslu C , Dogan E , Hıdıroglu S 
Published: October 2020

Abstract

Introduction and Objective
The definition of dating violence is “All of the words, mimics and behaviors that involve the use of painful or hurtful physical, psychological force and threats against the partner”. In the studies conducted, it was determined that one of the groups most at risk in terms of exposure to violence is the adolescent and young adult age group. Prevention of violence in the dating period mayal so prevent many types of violence that may occur in the future. Therefore, it is important to determine the attitudes of individuals in the age group at risk towards violence. The aim of there search is to investigate the attitudes of students studying in the 3rd grade in the Medicine, Pharmacy and Dentistry departments at Marmara University against the dating violence and their relationship with various variables.

Methods
The study is qualitative and there search is cross-sectional. There search population consists of students studying in the third grade in the departments of medicine, pharmacy and dentistry at M.U. As a data collection tool, a 15-question questionnaire with sociodemographic variables and attitude scales for dating violence were used.

Results
Participants: 40.5% consist of Medical faculty, 25.90% Pharmacy faculty and 33.5% Dentistry faculty students. Male participants 'attitudes cores towards psychological violence by men in flirting were higher than female participants' attitudescores towards psychological violence by men. When the attitude scales of the participants towards flirting violence were evaluated according to the faculty they studied, no significant difference was found.

Conclusions
This research has revealed that, like many studies in the literature, men's attitude scores towards dating violence are higher than women. While there is a statistically positive relationship between violence attitude scores towards cigarette smoking;there is a negative relationship between the duration of flirting and violence attidue scores.

Key messages
The dating violence is preventable health problem. The dating violence is silent war.
E-cigarette use among youth in Lebanon: Findings from Waterpipe Dependence in Lebanese Youth ‘WDLY’
Authors: Nakkash R , Tleis M , Asfar T , Maziak W 
Published: October 2020

Abstract

Introduction
E-cigarette use is becoming popular among youth worldwide and represents an emerging threat to public health. No previous study has looked into the prevalence of e-cigarettes use in the Eastern Mediterranean region. We report here on the prevalence of e-cigarette use in a cohort of 496 school and university students from Lebanon (62% males; 17 - 23 years) and differences in perceived harm between e-cigarette smokers and nonsmokers. We used data from Wave 8 of an ongoing cohort study that started in 2015 investigating the development of nicotine dependence symptoms in waterpipe smokers compared to cigarettes in Grades 8 and 9.

Methods
In 2019, we added questions to examine e-cigarette use patterns, risk perceptions, dependence, and susceptibility for future use among this population. Results were described and compared by gender status, e-cigarette users vs. non-users and other modes of tobacco use.

Results
Overall, 14.5 % reported ever use of e-cigarette and 8 % reported current use (use in the last month). Most ever e-cigarette users were cigarette smokers (32.8%), waterpipe smokers (34.3%), or dual smokers (10.45%). Compared to ever users, non-users were more likely to perceive e-cigarettes as more harmful (42% vs. 27% respectively, p= .007) and more addictive (41 % vs. 36% respectively, p= .013) than conventional cigarettes. Among current users, 28 % used e-cigarettes within 5 minutes of waking up. Among non-users, males were more open than female to try e-cigarettes if offered by a close friend (28.8% vs. 17.1%).

Conclusions
Our study suggests significant nicotine dependence among current users. Qualitative studies are needed to better understand why youth are drawn to this new emerging tobacco product. Our preliminary results point to the need to monitor e-cigarette use nationally by introducing questions on e-cigarette use in national school wide surveys such as Global Youth Tobacco Survey or the Global School Health Survey.

Key messages
E-cigarette use is spreading among youth in Lebanon. Results reveal significant nicotine dependence among youth in Lebanon users of e-cigarette.
Menopause, multisite pain and work ability among municipal workers
Authors: Kausto J , Kaila-Kangas L , Lallukka T , Leino-Arjas P 
Published: October 2020

Abstract

Background
A rising number of women will go through menopause while working. We aimed to examine the association of menopausal status with multisite pain and pain interfering with work ability.

Methods
We analysed cross sectional data collected in the Helsinki Health Study. Female full-time municipal employees aged 45, 50, 55 or 60 years and of at least normal weight were studied. Premenopausal group included 2420 and postmenopausal group 1364 participants. First, we examined the associations between menopausal status and multisite pain. Second, among those with pain (n = 1481), the association between menopausal status and change in work ability due to pain was studied. Age, health behaviour (including the use of hormone replacement therapy) and work-related factors were controlled for.

Results
Postmenopause was associated with multisite pain (OR 1,44; 95 % CI 1,11 − 1,87) as compared with premenopause. Postmenopause was also associated with a large change in self¬-perceived work ability caused by pain (OR 1,53; 95 % CI 1,01 − 2,32).

Conclusions
The results underline the importance of menopause to the experience of multisite pain and its contribution to the change in self¬-perceived work ability.

Key messages
This study adds evidence to the underresearched topic of menopause and work. Support for women in menopause and further attention in work issues of women in midlife are necessary.
Work ethic and societal norms influence sick leave and return to work: Tales of transformation
Authors: Moldvik I , Ståhl C , Müssener U 
Published: October 2020

Abstract

Background
Evidence of a positive association between work and health has been gathering up for years and can be explained by social status, contributions to society and the self-worth that work provides. This is maintained through the ideal of work ethic, where working is seen as the moral way of life. Not living up to the morally worthy identity can cause feelings of inadequacy, shame and stigmatisation. Considering this, it is relevant to investigate how people on sick leave manage societal norms and values related to work, and how this influences the sick leave and rehabilitation process. The literature on return to work is extensive and has investigated the issue from different perspectives. How norms influence the return to work process and how individuals and other stakeholders relates to such norms are less commonly explored, which is the focus of the present study.

Methods
This was a longitudinal interview study with a narrative approach, comprising 38 interviews with 11 individuals on long-term sick leave. Data collection was conducted in two phases and analysed iteratively through content analysis.

Results
The results suggest that work ethics and societal norms influence individuals' views of themselves and the sick leave and rehabilitation process. Conforming one's personal values to the work norm can create internal conflicts and cause feelings of shame for not being able to live up to the established norm. The strong work norm may create unrealistic expectations, which in some cases may result in constraining the return to work process.

Conclusions
To transform a sick leave narrative into a positive one, societal norms and their influence on identity needs to be recognised. Stakeholders involved in the process can contribute to a positive transformation by not only supporting return to work, but also to acknowledge and help people manage their self-image as having a disability that limits their ability to work.

Key messages
Full return to work is not always the best option from a quality of life and well-being perspective. Treatment and support from stakeholders should be viewed as meaningful and legitimate, even if it does not lead to return to work.
Development of an online intervention to improve sustainable employability of low-educated employees
Authors: Hazelzet E , Bosma H , Houkes I , de Rijk A 
Published: October 2020

Abstract

Background
Although low-educated employees are more at risk of poor health, they participate less often in workplace interventions, and when they do participate, they tend to profit to a lesser extent than high-educated employees. When developing sustainable employability (SE) interventions, the perspectives of the low-educated employees are often lacking, leading to a mismatch between the intervention and the needs. This group should be included when developing SE interventions in work organizations. The paper describes the development of a web-based intervention for employers to improve the SE of their low-educated employees using the Intervention Mapping (IM) approach.

Methods
The development builds on the first four steps of IM. A needs assessment (step 1), based on empirical evidence from previous literature and focus groups with employees (N = 11) and with representatives of employers (N = 5), was used to formulate the intervention objective (step 2), followed by selecting relevant theoretical methods and translation to practical applications (step 3). Subsequently, a web-based intervention was developed (step 4).

Results
The needs assessment identified the importance of the active involvement of employees and of a true dialogue between employee and employer. An online toolkit, called 'Healthy HR' (HHR) was developed, with eight steps, each consisting of several tasks, for developing and implementing local SE interventions that are tailored to the organization by the employer and employees themselves. Every task comprises one or more supportive dialogue-based tools. Adapted Intervention Mapping was used as the guiding principle to structure the eight steps.

Conclusions
The systematic development resulted in an easy-to-use online toolkit for employers that supports developing SE interventions tailored to the needs of the low-educated employees and organization. Using IM principles is expected by both the researchers and the employers to improve the effectiveness of HHR.

Key messages
‘Healthy Human Resources’ (HHR), is an online dialogue-based toolkit that facilitates employers to develop tailored SE interventions by involving their low-educated employees via dialogue. The principles of intervention mapping (IM) are used at two levels: to develop HHR, and as the leading principle within HHR.
Prevalence and factors related to burnout syndrome among Italian residents: a cross-sectional study
Authors: Sattarinia D , Caricato M , Bori T , Murgia N 
Published: October 2020

Abstract

Background
Burnout syndrome occurs frequently among physicians and begins early in training, but little is known about burnout among resident physicians. The aim of this study is to explore the prevalence and characteristics of burnout among residents and define factors associated with burnout.

Methods
In 2019, an anonymous questionnaire was sent out to residents of the University of Perugia, Italy (n = 419). We collected socio-demographical, occupational data and burnout level through the Maslach Burnout Inventory Human Services Survey (MBI-HSS), calculating mean level of burnout and proportion of residents suffering from low, intermediate and high degree of burnout. Total scores for Emotional Exhaustion (EE), Depersonalization (DP), and Personal Accomplishment (PA) subscales were calculated. Chi-squared tests were computed for correlations between burnout and the other factors.

Results
The response rate was 81,15%. EE and DP, the major components of burnout, were reported, respectively by 55.29% (n = 188) and 47.60% (n = 162) of the residents. Burnout prevalence was 69,70% (n = 237) among the residents, defined as a severely abnormal level of either EE or DP, with 75.6% (clinical group), 67.0% (surgery group) and 65,20% (healthcare services group). Higher prevalence was reported in early residency, in women and in residents with bad lifestyle (fitful sleep, poor physical activity, unbalanced diet, heavy drinking and low social life).

Conclusions
Our findings suggest that residents are an at-risk population. Specific interventions are urgently needed for the potential impact of burnout on work quality, patient care, residents' professional development and lifestyle.

Key messages
Prevalence of Burnout is higher in medical residents than in other helping-professions. There are differences about risk of burnout among different types and years of residency.
Mortality among the Russian working-age population from suicide: official and actual rates
Authors: Semyonova V , Sabgayda T , Zubko A , Gavrilov L 
Published: October 2020

Abstract
Purpose of the study is to assess suicide-related loss of the Russian working-age population in the 2000s and extent of its possible under-reporting. Analysis is based on Rosstat data on deaths among the Russian working-age population (15-59 years) calculated in FAISS-Potential, as well as data on mortality from suicide in the “old” and “new” European Union (EU) (before and after May 2004) from the European mortality database. Officially, mortality from suicide among the working-age population decreased at 3.4 fold in males and 2.9 in females, far exceeding the rate of decline in the overall mortality from external causes which equaled to 2.6 times in males and 2.5 in females in 2000-2018. Currently, the Russian mortality from suicide is multifold higher than the “old” EU one across all working ages and higher than the “new” EU one among population aged up to 45 years only. The rate of decline in mortality from event of undetermined intent among working-age population was lower compared to suicide, adding up to 14.2% and 11.6% vs 3.4 and 2.9-fold. And the Russia's such loss compared to the “new” EU one was about 10-fold in both males and females across all working ages. With a high degree of probability, “events of undetermined intent” are likely to be latent suicides.

Conclusions
Official mortality from suicide among working-age population decreased at extremely high rate with linear trends. A significant share of suicide mortality is latent and is counted as events of undetermined intent. With a high degree of probability, latent suicides cover hanging, jumping/falling from a high place, and drug poisoning of undetermined intent. The trend in loss due to latent suicide is negative. The share of latent events among actual suicide-related loss in 2010s steadily increased, exceeding one third in males and reaching 50% in females in 2018. Currently, mortality from suicide is likely to exceed the Rosstat indicators by 60% in males and over 2-fold in females.

Key messages
In the 2000s, the official mortality from suicide among the Russian working-age population decreased at an extremely high rate with linear trends. The share of latent events among the actual suicide-related loss in the 2010s steadily increased, exceeding one third in males in 2018 and reaching 50% in females.
Forgoing health care is associated with insurance deductibles in a consumer-driven health care system
Authors: Sandoval J L , Petrovic D , Guessous I , Stringhini S 
Published: October 2020

Abstract

Background
The Swiss health care system is consumer-driven with universal coverage and good population outcomes. Deductibles of mandatory insurance plans are self-selected, regulated, and unrelated to pre-existing conditions. In a Swiss population, we aimed to determine if forgoing health care was associated with insurance plan deductibles and if the association was dependent on socioeconomic status.

Methods
We used data from the Bus Santé Study; a cross-sectional survey study ongoing in Geneva (Switzerland) since 1993. We included adult participants in the study between 2007 and 2016. We divided participants according to insurance plan deductibles (low, medium, or high). Forgoing health care information was obtained from the study questionnaire. Forgoing dental health care was considered separately as mandatory insurance plans do not cover dental care. Inequalities were quantified using the regression-based relative index of inequality (RII) adjusted for potential confounders (age, gender, income, educational attainment, known comorbidities, cardiovascular risk factors, additional health insurance plans or subsidized premiums)

Results
We included 9081 participants, with 8.9% reporting forgoing non-dental healthcare. Those with a high-deductible insurance plan were younger, more often Swiss and male, with higher income and educational attainment, less known cardiovascular risk factors and comorbidities. Participants with high-deductible plans had a higher probability of forgoing non-dental health care (RII=2.2, p &lt; 0.001) independently of socioeconomic status and known comorbidities or cardiovascular risk factors. As expected, we did not observe inequalities related to insurance plan deductibles in forgoing dental health care (RII=1.0, p = 0.8).

Conclusions
In a population with universal coverage and good health outcomes, insurance plan deductibles are associated with inequities in forgoing health care independently of socioeconomic status and pre-existing conditions.

Key messages
In a highly performant health system, high insurance plan deductibles are associated with inequities in care independent of individual sociodemographic characteristics, risk factors and comorbidities. Uncovering associations between health system design features and inequities in care could inform decision-makers that seek to curtail inequities through improving their current health system design.
Distribution of Manganese-Substituted Magnetites in Dusts from Taranto, Italy
Authors: Peli M , Bostick B C , Barontini S , Placidi D , Giorgino A , Ranzi R , Smith D R , Conversano M , Lucchini R G 
Published: October 2020

Abstract
Elevated exposure to manganese (Mn) in environmental dusts and airborne particulates, particular from ferromanganese alloy steel production and metal working, is associated with a number of negative health outcomes, including Parkinsonism and other nervous system diseases. Manganese contamination and exposure from industrial sources is difficult to identify or quantify, as manganese is naturally abundant in the environment, and means to distinctly identify or fingerprint Mn arising from different industrial and environmental sources are limited. Here, the chemical and mineralogical properties of Mn in dusts from an active steel production facility in Taranto, Italy, were compared with those of indoor and outdoor deposited dust samples and surface soils collected in a series of schools in the nearby town. X-ray absorption spectroscopy revealed distinct chemical forms of Mn in industrial sources from those in typical background soils. Manganese ore from the facility contained abundant Mn(III, IV) oxides, while Mn-substituted magnetites were the most abundant mineral phase in dusts found in areas of the plant where metal was produced or combustion occurred. All school dusts were primarily composed of Mn-substituted magnetites, while most of the soils contained abundant manganese(IV) oxides. Source apportionment of Mn in regional dust and soil samples was estimated using linear combination fitting with representative industrial source materials. Manganese in dusts from the Taranto area community adjacent to the plant was derived primarily from industrially-sourced dusts produced during high temperature coke or steel production rather than re-suspended local soils or ore source material. Soils contained smaller proportion of industrially-derived Mn and are distinct from dusts, indicating that soil is a minor contributor of dust Mn in this area.

Key messages
Manganese speciation gives useful information in investigating Mn toxicology to humans in urban areas. Manganese-substituted magnetites may represent the target compound useful to distinguish toxic and non-toxic Mn-containing elements.