bluuebunny/crossref_metadata_2025_split huggingface dataset:
HIV-targeted health promotion: Can we learn from the experience in Tanzania?
Authors: Gross M 
Published: October 2020

Abstract
The overall rise in deaths from preventable communicable diseases in the African Region is of utmost concern from a public health perspective. Sub-Saharan Africa (SSA) is home to a severe generalized HIV epidemic with the value of targeted health promotion only recently gaining momentum. The transport sector and transport corridors represent a major transmission route for HIV, fueled by unemployment, multiple sexual partnerships, gender-based violence (GBV), migrant workers and poor access to quality health information and services. In Tanzania, targeted sensitization and health promotion interventions spanning two major road corridors and their large-scale construction projects led to improved knowledge and behavior change among the road construction workers, community leaders and local residents in the communities along the road project as measured during a baseline and end line survey. Taking a comprehensive approach to health promotion the road project in Tanzania focused on: Educational and behavioral change campaigns, aimed via road shows at creating awareness on HIV and AIDS, STI, TB and GBV and encouraged people to know their sero status at mobile outlets of the HIV Counselling and Testing Services (HTS) during community bonanzas, featuring edutainment.Training peer educators from communities and road construction workers on basic knowledge and communication skills to transfer information along the roads, within the communities and in the nearby schools.Establishing village multi-sectoral HIV/AIDS committees.Development of SBCC materials with targeted messages to road construction workers and community members, developed jointly with multiple stakeholders.HIV Testing Services in collaboration with districts and health facilities along the roads.Capacity development of health workers and relevant stakeholders.
Lessons learnt can provide guidance for similar settings in SSA and stimulate also a fresh view on promotive activities in Europe.
Interprofessional health education and its impact on integral healthcare
Authors: Silva C , Abreu L , Santos K , Santos S , Figueiredo A 
Published: October 2020

Abstract

Background
Interprofessionality is a tool for optimizing the human resources available towards the consolidation of a resolutive healthcare. However, applying it is a challenge due to the fragmented training of health professionals.

Objective
to describe the experience of planning and executing an interprofessional health education activity.

Methods
An educational workshop was developed aiming at interprofessional health practice. A clinical case was distributed, which addressed the story of an elderly person who suffered a stroke and lived with the sequels of this episode in addition to emotional trauma from the experience. Each professional was asked to define a therapeutic proposal for the case and one of them was invited to present his proposal and complement it based on the suggestions of the other members.

Results
the workshop enabled the perception that, in isolation, no profession would be able to fully contemplate the patient's needs. Therefore, it encouraged the use of integrated action between different professionals by demonstrating that punctual and disjointed actions would not be sufficient to act effectively in the care and needs related to the individual's health.

Conclusions
the final product of this workshop resulted in a consistent activity contemplated by multiple perspectives, experiences and knowledges which would not be so successful if planned in isolation by a single professional group.

Key messages
Due to its low cost, interprofessional action responds to the new health needs of contemporary times and its implementation is of great value in combating the fragmented trend in health training. The interprofessional view is a common ground to health not only where the study took place but worldwide, consolidating itself as a valuable asset to the construction of integral healthcare.
Improving pertussis vaccination in pregnant woman. A new pathway in an Italian Local Health Authority
Authors: Massetti L , Saracino S , Scaccia F , Rossetti R , Moroni V , Marcolini P , Fiacchini D , Cimini D , Branchesi E , Poscia A 
Published: October 2020

Abstract
Pertussis is quite common in adolescents and adults, but it is especially dangerous in new-borns. The national immunization plan (NIP) 2017-2019 recommended a Tdap booster for every pregnancy at 28-36 weeks, but adherence is still far from the optimal level. This work aims to evaluate the effectiveness of a dedicated pathway organized by the department of prevention to improve the Tdap coverage among pregnant woman attending antenatal class.
The women attending from November 2019 to October 2019 the public antenatal class organized by the local health authority have been evaluated for their Tdap coverage in pregnancy. From May 2019, public health experts have been involved for 30 minutes during the first lesson to explain the NIP with a focus on vaccination in pregnancy. Then the eligible women (28-36 weeks not yet vaccinated) who voluntarily agree were accompanied to the ambulatory to be vaccinated. Pre-post Tdap vaccination coverage and pregnancy weeks at vaccination have been evaluated respectively by chi2 and t-test.
90 pregnant women have been included in the study. Their mean age was 32.3 (SD 5.2) and the overall Tdap coverage was 44.4%. The Pre-post Tdap coverage was 26.7%(12/45) before May 2019 and 62.2% (28/45) after the introduction of the new pathway (p = 0.001). 50% of the vaccinated women decided to receive the booster the same day of the antenatal lesson, while the remaining 50% delayed the vaccination till a maximum of 30 days. We observed a clinical, but not statistically, significant anticipation in the pregnancy week in which they received Tdap booster (32.4 weeks before and 31.3 after May 2019; p = 0.150).
The introduction of a short intervention on vaccination in the antenatal class followed by the opportunity to receive the booster in a dedicated time and without waiting list significantly improved the Tdap coverage in pregnancy. This study encourages the cooperation among the different public health actors involved in the field of antenatal care.

Key messages
Antenatal class represents a great opportunity to improve vaccine confidence in pregnant women. Intervention aimed to ameliorate vaccine convenience could improve Tdap coverage in pregnancy.
Root internalization of Salmonella Typhimurium in basil plants
Authors: Scattolini S , D'Angelantonio D , Di Lollo V , Mancini V , Serio A , Centorotola G , Di Marzio V , Olivieri S , Pomilio F , Aprea G 
Published: October 2020

Abstract

Background
Foodborne pathogens present in soil or irrigation water have the potential to internalize via root into edible parts of the plants and survive, representing a serious hazard for consumer's health (1). The present work assesses the ability of Salmonella Typhimurium (ST) to enter basil plants (Ocimum basilicum L., cultivar “Napoletano”) from roots. This situation may represent a risk in food safety since that vegetable is largely used raw/undercooked, in the Mediterranean diet.

Methods
Sixteen basil plants were cultivated in hydroponics, from the seeds. Roots from 14 plants at 4 leaves-stage were individually immersed in liquid media contaminated with a suspension of ST isolated from Aterno river in Abruzzo region, Italy (9 log10 cfu/mL final concentration). Two plants were used as negative controls (no ST challenge); surface swabs were taken from leaves and stems to exclude external contaminations. After 24 hours, plants were tested for detection (UNI EN ISO 6579-1:2017) and enumeration (in-house method) of ST in leaves and stems.

Results
ST detection gave positive results in 14/14 plants; in particular, ST was present in 14/14 plants in the leaves and for 9/14 plants also in the stems. The internalized ST strains were also enumerated in 10/14 plants. In particular, 3/14 plants gave positive results both in the leaves and stems, 2/14 only in the stems and other 5/14 only in the leaves. The average ST counts were of 4 log10 cfu/g in leaves and stems. All negative ctr/surface swabs were negative to ST.

Conclusions
Even though antimicrobial properties of basil plants have been described (2), this study demonstrated the potential of ST to internalize, survive and spread to edible parts. The findings highlight the risk of human infections by ST in plant following root uptake, suggesting the importance of applying appropriate preventive pre-harvest strategies.

Biblio
EFSA. E. Jour. (2014);12(3):3600 Tenore et al. (2017). Natural product research, 31(17), 2067-2071

Key messages
The ability of Salmonella Typhimurium to internalize, survive and spread to edible parts of basil plants. Pathogenic bacteria root uptake represents a potential risk for human health.
Roma socioeconomic status has higher impact on smoking behaviour than genetic susceptibility
Authors: Merzah M A , Pikó P , Ádány R , Fiatal S 
Published: October 2020

Abstract

Background
Prevalence of smoking in Hungarian Roma (HR) population is two to five times higher than in Hungarian general (HG) population. Our study aims to examine genetic susceptibility and other possible determinants associated to smoking behaviours in these populations.

Methods
A questionnaire based cross-sectional study was designed in HG (N = 412) and HR (N = 402) populations. Ten Single Nucleotide Polymorphisms (SNPs) were genotyped known to be robustly linked to smoking behaviours. Risk allele frequencies were compared. Additive genetic risk scores (unweighted GRS and weighted GRS) were constructed to compare genetic load from SNPs in genes NRXN1, CHRNA5/4, AGPHD1, MAOA, TRPC7, KCNJ6, GABRA4, and CYP2A6. Smoking behaviour were associated with GRSs and confounders (age, gender, BMI, socioeconomic status-SES) in several regression models. SES was calculated based on Modified Kuppuswamy scale 2019.

Results
Risk allele frequencies of four SNPs were found to be different between populations (p &lt; 0.01). Median of GRS was equivalent among in populations; whilst wGRS median was slightly higher among Roma (5.2 compared to Hungarian 4.9; P = 0.02). In Roma both genders were more likely to be heavy smoker (OR = 2.05, 95%CI: 1.47-2.86; OR = 1.89, 95%CI: 1.58-2.25, for males and females, respectively) compared to counterparts from general population. GRS were higher among heavy smokers of both populations compared to other smoking behaviours (ORRoma= 1.06, 95%CI:0.98-1.15; ORHungarian=1.05, 95%CI=0.91-1.2). Strong reversible relationship was found between SES and smoking behaviours among study populations (p &lt; 0.0001). Heavy, moderate, and former smokers were having lower SES compared to never smokers of both populations (SES β=-0.037, P = 0.04 for Hungarian; β=-0.039, P = 0.02 for Roma).

Conclusions
Socioeconomic status was shown as a priority indicator based on multifactorial regression analysis. The highest efforts should be focused on improving the SES of Roma population.

Key messages
Result of this study indicate the priority impact of SES instead of genetic susceptibility on Roma smoking behaviours variations. Interventions on improving socioeconomic status of the Roma might result in decreasing their cigarette consumption.
Trends in mortality due to noncommunicable diseases in Brazil and the sustainable development targets
Authors: Carvalho Malta D , Felisbino-Mendes M S , Teixeira R , Machado ÍE , Duncan B B , Ribeiro A L P , Velasquez-Melendez G , Passos V , Glenn S , Nagavi M 
Published: October 2020

Abstract

Background
Monitoring premature mortality due to noncommunicable diseases (NCDs) is a global priority, as part of the Agenda 2030.

Objective
The current study aims to describe the mortality trends and disability-adjusted life years (DALYs) lost due to NCDs between 1990 and 2017 for Brazil and states, projections for 2030.

Methods
We analyzed the following NCDs: cardiovascular diseases, chronic respiratory diseases, neoplasms, diabetes mellitus, comparing deaths and mortality rates between 1990 and 2017, for Brazil and states. The study used the concept of premature mortality used by the World Health Organization (30 to 69 years). The absolute number of deaths, mortality rates, DALYs, years of life lost (YLL), were used, comparing 1990 and 2017. We also analyzed the premature death fraction (YLL) for NCDs attributable to risk factors.

Results
There was a reduction of 35,3% from 509.1 deaths/100,000 inhabitants (1990) to 329.6 deaths/100,000 inhabitants due to NCD in 2017. DALYs rate decreased by 33.6% and the YLL rate by 36.0% in the same period. There was a reduction in the NCD rates in all 27 states. The main risk factors related to premature deaths by NCDs in 2017 among women were - high body mass index, diet risks, high systolic blood pressure, tobacco, and among men, diet risks, high systolic blood pressure, tobacco, high body mass index. Trends in mortality rates due to NCDs were declining in the period, however, after 2015, the curve reversed and fluctuation and tendency to increase rates were observed.

Conclusions
Trends of mortality rates by NCD were declining in the period, however, after 2015, the curve was inverted and the fluctuation and trend of increasing rates was observed, which can compromise the SDG goals in 2030.

Key messages
The austerity policies adopted and the economic crisis in Brazil after 2015, resulted in increased poverty and worsening NCD mortality indicators. With the NCD indicators worsening in 2015, SDG targets may not be achieved.
The prevalence of neutropenia in chemotherapy cancer patients at a provincial hospital, Thailand
Authors: Suwannapong Y , Chinwong D , Niamhun N 
Published: October 2020

Abstract

Introduction
Cancer patients with neutropenia (&lt;1500 cell/mm3 absolute neutrophil count [ANC]) are at high risk of febrile neutropenia and serious complications which can cause the delay treatment, reduction of chemotherapy dose, leading to morbidity and mortality. We lack of information of the prevalence of neutropenia in Thailand and its' consequences. Thus, this cross-sectional study aimed to investigate the prevalence of neutropenia at a provincial hospital in northern Thailand.

Methods
We retrospectively reviewed electronic medical records of cancer patients with solid tumor and receiving chemotherapy from September 2018 to October 2019.

Results
A total of 248 cancer patients (79 men, 169 women, mean age of 58.36±12.03) were included. The top 3 cancers were colon, breast and lung cancer (50.53%, 34.33%, 6.88%). They received chemotherapy 1,803 cycles of treatment. The top 3 regimens of treatment were FOLFOX (oxaliplatin/ fluorouracil/ leucovorin), AC (doxorubicin/ cyclophosphamide) and paclitaxel (42.65%, 17.75%, 9.67%). The prevalence of neutropenia (&lt;1500 cell/mm3) was 264 episodes: 64 episodes of ANC 1,000-1,500 cell/mm3 (3.55%); 172 episodes of ANC 500-1,000 cell/mm3 (9.54%); and 28 episodes of ANC &lt;500 cell/mm3 (1.55%). Most of them were postponed the treatment, but 16 episodes were still received chemotherapy. The dose of chemotherapy in 78 episodes were decreased and 16 episodes were related to the treatment of febrile neutropenia. The treatment of febrile neutropenia chemotherapy patients was 8 + 3 days with an average of US$ 400 per person, per cost of treatment.

Conclusions
We found that the effects of neutropenia in chemotherapy patients were delayed treatment, dose reduction and a major risk factor of febrile neutropenia. This decreased the efficiency of chemotherapy in patients with cancer. The result should be informed and encouraged our patient care team to develop practical action for prevention and management of serious neutropenic events.

Key messages
The result should be informed and encouraged our patient care team to develop practical action for prevention and management of serious neutropenic events. If we can manage cancer patients with neutropenia, the cost of treatment for serious febrile neutropenia and other complications will be reduced.
The association between secondary care multimorbidity in mid-life and premature mortality
Authors: Johnston M , Black C , Mercer S W , Prescott G J , Crilly M 
Published: October 2020

Abstract

Background
Multimorbidity (MM) is the co-existence of two or more health conditions. Whilst its prevalence is higher in older adults, in absolute numbers there are more multimorbid young people. Recently, the trends for increasing life expectancy observed in high income countries have stalled or reversed. The relationship between MM and premature mortality requires exploration. We assessed the prevalence of secondary care MM in mid-life and its association with premature mortality in the Scottish Aberdeen Children of the 1950s (ACONF) cohort.

Methods
Prospective cohort study. ACONF members were linked to electronic hospital records and mortality records. Secondary care MM was assessed using hospital records in 2001 when participants were aged 45-51 years. The association between MM and mortality over 15 years (to age 60-66 years) was assessed using Cox proportional hazards regression. There was adjustment for key covariates: age, gender, social class at birth, childhood intelligence, educational attainment, alcohol, smoking, body mass index and adult social class.

Results
Of 9,625 participants (51% male), 3% had MM. Higher childhood intelligence and adult social class were associated with reduced MM. In relation to the reference group (no MM), those with MM had a mortality hazard ratio of 4.5 (95% CI 3.4-6.0) over 15 years. The association remained when adjusted for the covariates (2.5 [95% CI 1.5-4.0]).

Conclusions
Secondary care MM prevalence was 3% in mid-life and associated with premature mortality. Younger adults with MM are an important group at risk of premature mortality which should be the focus of public health action. This includes reducing the impact of social inequality and reconfiguring secondary care services to offer comprehensive management of younger multimorbid adults.

Key messages
Multimorbidity in mid-life is associated with premature mortality and may be an important influence on reducing life expectancy trends. Much focus is upon multimorbidity in older adults, however younger adults with multimorbidity are at risk of premature mortality, requiring public health action.
Perceived outcomes and SWOT analysis of a virtual community of practice in Burkina Faso
Authors: Lapierre J , Goyer-Pétrin G , Philibert L , Gagnon M-P , Dupéré S , Guillaumie L , Ouellet M , Bationo F , Ouedraogo C , Rouamba S 
Published: October 2020

Abstract

Background
In Burkina Faso, maternity is a risk. Global Affairs Canada funded the initiative PASME-2 with World University Service of Canada, Laval University and Farm Radio International to improve maternal outcomes. A preventative program was co-developed in phases. Phase 3 received funding from Social Sciences and Humanities Research Council in partnership with the Centre for International Cooperation in Health and Development (CCISD) and TIESS, a liaison and transfer expert in Québec, to support local teams towards sustainable practice changes. This research aimed at documenting the partnership experience, digital literacy, perceived direct and indirect outcomes.

Methods
A participative co-design approach, allowed the engagement of several stakeholders in the process. Two active phases where 16 health professionals engaged actively in the VCoP, according to the final agreed-upon Constitutional Chart, are presented. The phases pilot-tested two different technology tools.

Results
16 interviews post-phase 1 and 16 interviews post-phase 2 were conducted. Implementation issues as perceived by users are discussed and include: feasibility, challenges, needs, animation, relevance to care, communication and sharing, use and perspectives. Perceived outcomes focus on professional preventative practice changes, skills, family outcomes, challenges to practice integration, knowledge and practice exchanges.

Conclusions
The phases of experimentation demonstrate that strategies can be put in place to counter the digital literacy challenges and to engage users in new ways of communicating, sharing on the platform about health practices and taking valuable time to do it. Overcoming technology constraints is essential especially in lower resource settings. The most practical life experiences and cases lead to more engagement and innovations. Support from management and upper directorate is significant.

Key messages
Partnership from several stakeholders is key to implementing a VCoP. Experimenting and sharing solutions is influenced by the capacitating environment that the VCoP can provide with recognition from administration and as a professional development activity.
The Functioning of Outreach Programs Of/On the Street and the Work Processes of the Nurse
Authors: Schettino R , Ornelas C , Antônio M , Oliveira T , Soares S , Almeida S 
Published: October 2020

Abstract

Problem
Homeless people (PSR) are a heterogeneous and fragile group. They are among the most excluded ones from health service access because they cannot present a regular home. They are also a population who have great difficulty of accessing the entrance and mostly search only for emergency and urgency services when their lives are at stake. This intervention is important because it aims at decreasing the inequalities to health access and, moreover, it decreases the difficulties to health access.

Description of the problem
A field visit to an outreach program on the street (CR) in Belo Horizonte was made on April, 22nd and on May, 6th in 2019. This program is linked to a Health Center. The objectives were knowing the functioning of outreach programs on the street and understanding the assignments and participation of the team nurse on working with PSR.

Results
By acting with and approaching PSR, the nurse can create contact and humanized listening. This is an attempt to establish user / professional bonds. During this contact, the professional struggles to encourage the user to search the health attention net. This professional also approaches the rupture with home, with the family, with the work, and with others. He/She tries to support users to face the challenges and to stimulate social reinsertion as well. Tests on the street to detect HIV/AIDS and syphilis are made, guaranteeing the individual privacy right. By approaching PSR, it is crucial that the nurse, who is part of the multi-professional team, be free of any prejudice and stigmas which can make the attendance success difficult. The application of health expanded concept was also present because it considers the complexity of health, mainly to those who inhabit the streets.

Lessons
The nurse can succeed in facing inequity. This decreases not only the barriers established by social inequalities but also the organizational barriers PSR are exposed all the time.

Key messages
Attendance prioritizes local care. It not only tries to attend social and health problems but also shared actions with Health Centers. At last, it should be an example to other countries. It is important for health professionals to reinvent their practices, searching partnerships and the acquisition of new knowledge to succeed in decreasing individuals’ demands.