bluuebunny/crossref_metadata_2025_split huggingface dataset:
A vaccination campaign in a Roma community in Rome: an experience of the Local Health Autority Roma1
Authors: Spadea A , Marino M , Valentini F , Furia G , Frisicale E M , Michelazzo M B , Consoli C , Forte U , Bracci S , Goletti M 
Published: November 2019

Abstract

Issue/problem
About 8,000 Roma and Sinti live in the city of Rome, distributed in 33 settlements. This population is particularly at risk of health problems, due to social marginality and reduced access to health and social services. An important challenge for public health is therefore to guarantee and improve the right to health and the availability of health care. In Italy, a new vaccination law was approved in July 2017 and 10 vaccinations became mandatory for minors attending schools.

Description of the problem
In 2018 the District 14 of the Local Health Authority Rome1 (LHA Rome1) organized a vaccination campaign for the Roma and Sinti community being in its area. The aim of the campaign was to analyse the vaccination status of children under-18 living in the camp, based on the local police census data, crossed with the web based regional vaccination registry, to offer free vaccination for those without a regular status, in order to allow school attendance.

Results
Among 109 children living in the targeted Roma and Sinti camp, only 6 (5.5%) had a regular vaccination status according to the Italian law. Two different vaccination opportunity were offered to the community during 2018: a dedicated vaccination session in the local vaccination center, during which 6 children were vaccinated; four vaccination days offered directly at the Roma camp (a total of 53 children were vaccinated). At the end of 2018, the new Police census identified 114 minors resident in the camp instead of 109; of these, 48 (42.1%) had reached a regular vaccination status.

Lessons
Addressing hard-to-reach communities in order to improve the access to health and social services is one of the LHA objectives. The intervention performed in the Roma camp was also an opportunity to promote the importance of vaccination and to inform the target community about various LHA services, in particular maternal and infant services, including those for Temporarily Present Foreigners.

Key messages
The interventions performed straight into communities living in unfavorable health and social conditions are useful to improve the access to health and social services. Vaccination of people living in a social marginality is an important challenge for public health in order to guarantee specific protection measures and promoting the right to health.
What are the determinants of body image distortion and dissatisfaction among Tunisian teenagers?
Authors: Ben Ayed H , Jedidi J , Cheikhrouhou F , Ayadi A , Yaich S , Damak J 
Published: November 2019

Abstract

Background
Body image (BI) is considered as central to many aspects of human functioning including emotions, thoughts, behaviors and relationships. This study aimed to investigate the prevalence and the main determinants of distortion and dissatisfaction among teenagers.

Methods
This was a cross-sectional school-based study using a self-administered questionnaire, conducted among a randomized sample of 1300 school-adolescents in Southern Tunisia, 2018. BI perception was assessed by the Stunkard Figure Rating Scale.

Results
Among 1210 respondents (93%), BI distortion and dissatisfaction prevalence were 44.8% and 42.4%, respectively. Multivariate analysis showed that 16-18 years age group (Adjusted Odds Ratio (AOR)=1.28; p = 0.046), low family financial situation (AOR=1.88; p = 0.014), as well as high frequency of eating pasta (AOR=1.3;p=0.04) and fast-food consumption (AOR=1.7;p=0.042) were independently associated with under-estimated BI. Skipping breakfast (AOR=1.9; p = 0.017) and having one obese parent (AOR=1.9;p=0.01) were independently associated with higher frequency of over-estimated BI. For BI dissatisfaction, independent factors associated with desire to lose weight were female gender (AOR=1.53; p = 0.007), high family financial situation (AOR= 2.1,p=0.008) and having one parent obese (AOR=2.21,p&lt;0.001). Frequent fast-food consumption (AOR=1.9, p = 0.038) and eating between meals (AOR=1.57,p=0.01) were associated with higher desire to gain weight.

Conclusions
Our study highlighted a substantially high prevalence of BI distortion and dissatisfaction among adolescents. Their determinants included socio-demographic factors and lifestyle behaviors. Increased awareness among parents and public health planners may help adolescents improve accuracy of BI attitudes.

Key messages
BI distortion and dissatisfaction are pervasive problems that increased negative affect in adolescents. Promotion of healthy lifestyle including balanced diet and physical activity is warranted.
Prevalence of Italian children living in food insecure households and their health status
Authors: Zace D , de Waure C , Teleman A , Reali L , Di Pietro M L 
Published: November 2019

Abstract

Background
Food insecurity poses a major threat to population’s health status. Children, if affected, are particularly vulnerable to the possible sequels of food insecurity. Considering that, we aimed to assess the prevalence of children (born in Italy, from Italian parents) living in food insecure households and the association with their health and socio-economic conditions.

Methods
The study was conducted from January 2017 to December 2018 in pediatric offices. Parents answered to the 18-items of the Household Food Security Index, 8 of which specifically concern children. Households were classified in 4 categories: very low, low, marginal and high food security, creating then a dichotomized variable (food secure and insecure). Pediatricians answered a dedicated questionnaire on children’s health status. We used logistic regression to assess the socio-economic variables predicting food insecurity and chi2 test to evaluate the association between food insecurity and children’s health status.

Results
Based on parents’ answers, among 573 households with children, 15.4% were food insecure. Food insecurity was associated to lower parent’s education and employment, worse household’s economic condition, higher number of children within a family and geographic location (living in south Italy rather than north). There was a significant association between food insecurity and the presence of visual, relational, psychomotor, dental and physical impairments in children.

Conclusions
Almost 1 Italian child in 7 lives in food insecure households. Children living in food insecure households have higher probability of having physical, mental and social health problems. Considering the impact on children’s health, food insecurity emerges as a public health issue and should be addressed through the appropriate measures.

Key messages
Food insecurity among children represents a public health issue even in a developed country such as Italy, affecting children’s present and future health. Policy makers should consider screening children for food insecurity and taking appropriate actions, especially for the at-risk population.
Association between maternal factors and appropriate medication for nursery school children in Japan
Authors: Yanagi N , Satoh H , Sawada Y 
Published: November 2019

Abstract

Background
Inappropriate medication use for children by caregivers has been reported in Japan. We focused on the factors which could be associated with health literacy (HL) and knowledge of medication (KM). We aimed to examine the association between appropriate use for nursery school children and maternal socioeconomic status (SES) or behavior related to medication adherence among mothers in Japan.

Methods
The data regarding the conditions of medication for children (aged from six months to six years old) at home and in nursery school by the online survey from April to May 2019 was used. Maternal SES, such as education, occupational status, and economic conditions, were asked via a self-administered questionnaire. Maternal behaviors were measured using a 5-point Likert scale and classified into two groups. HL and KM were scored and divided into two categories. Appropriate medication use was evaluated using a 5-point Likert scale for the statement “I give my child medicine as per instructions,” and the answers were classified into two groups. Poisson regression was employed to investigate the association. Age, maternal SES, chronic disease of children, birth order, HL, and KM were used as covariates.

Results
A total of 233 (38.8%) of 600 mothers aged 24-48 years, reported appropriate medication use for children. None of the maternal SES was statistically significant. After adjustment, the individuals, who consent to prescribed medications for children, were 2.16 times (95% confidence interval [CI]:1.64-2.86) more likely to use medicine appropriately compared with their counterparts. ’To be able to consult with pharmacists’ were also statistically significant (Prevalence Ratio=2.14, 95% CI:1.63-2.81).

Conclusions
The mothers, who consent to prescribed medications for children, who consult with pharmacists were more likely to use medicine appropriately. Community pharmacists could support those to improve their skills.

Key messages
The maternal behaviors related to adherence were associated with appropriate medication for children among Japanese mothers, although none of the maternal SES was statistically significant. Community pharmacists could support mothers and contribute appropriate medical treatment for children.
Environmental Health: Knowledge and Practice of Perinatal Health Professionals in Southern France
Authors: Sunyach C , Antonelli B , Tardieu S , Marcot M , Perrin J , Bretelle F 
Published: November 2019

Abstract

Background
The exposure of adults of reproductive age as well as of pregnant women and children to environmental contaminants is of particular concern, as it can impact fertility, in utero development, pregnancy outcomes and child health. Although worrying, this knowledge provides an opportunity to enforce interventions during these critical reproductive/developmental times, when they may have the greatest effect. Consequently, the World Health Organization (WHO) and international societies advocate including Environmental Health (EH) in perinatal care.

Objectives
Our aim was to paint a picture of the current attitudes, representation, knowledge, and training expectations among Perinatal Health Professionals in south-eastern France.

Results
In 2017, a cross-sectional study was performed in a large panel of perinatal HPs. Quantitative and qualitative information was collected via auto-questionnaire. Questionnaires were completed by 962 participants, mainly midwives (41.1%), physicians (25.6%) and nursery nurses (11%). Indoor/outdoor air quality and endocrine disruptors were the best-mastered topics, whereas electromagnetic fields and diet gave rise to unsure responses. Overall, perinatal HPs were ill-trained and -informed about the reproductive risks linked to daily environmental exposure. HPs reported scarce knowledge, fear of patient reaction and lack of solutions as the main barriers to providing information regarding EH to the public.

Conclusions
In South-eastern France perinatal Health Professionals are eager to incorporate EH in their current practice. Our findings highlight the need to set up EH training programs focused on scientific knowledge and to provide simple messages and tips to help perinatal HPs deliver advice to populations to mitigate exposure to environmental toxicants.

Key messages
In South-eastern France perinatal Health Professionals are eager to incorporate EH in their current practice but ask for training. We are currently providing training programs combining practical sessions as well as basic and advanced scientific training adapted to the demand of medical and non-medical professional groups.
Surveillance of transient congenital hypothyroidism using the French newborn screening programme
Authors: Barry Y , Mandereau-Bruno L , Bonaldi C , Guseva-Canu I , Delmas D , Cheillan D , Roussey M , Coutant R , Léger J , Regnault N 
Published: November 2019

Abstract

Introduction
Congenital hypothyroidism (CH) is a condition of thyroid hormone deficiency present at birth. Untreated CH results in severe mental impairment. An increased incidence of CH has been reported in France and worldwide that could be explained by an increase in transient forms of CH (TCH). We aimed to estimate the proportion of transient eutopic gland based on the characteristics of children at birth.

Methods
A probabilistic matching data from French CH neonatal screening program and French national health data system (SNDS) of children born between 2006 and 2012 (1, 763 with CH) allowed to linking 484 (68.8%) among 703 children with eutopic gland. Infants with six months or greater discontinuation of levothyroxine (LT4) treatment before the 31th December 2017 were classified transient CH. We used the Cox model to examine the predictors of TCH.

Results
Among infants with eutopic gland, 52.9% were female, 14.9% were preterm and 14, 1 % had low birth weight, 11.8 % had a first degree family history of thyroid diseases, 48.1% of mild CH (TSH&lt;50mU/L) at diagnosis and 30,0μg/j median dose of LT4 treatment. The probability of transient CH at five years of follow-up was 25.3% [IC95%:21.6% -29.4%] and 36.7% [31.7% -42.2%] after ten years. In a cox multivariable analysis, neonates with a TSH&lt;50mU/L (adjusted Hazard Ratio=4.1 [2.8-6.2]) and preterm 1.9 [1.1-3.4] had more risk to be transient.

Conclusions
Prematurity and TSH level were predictors of transient CH. Additional analyses are ongoing to determine whether the occurrence of transient forms of TCH is increasing over the study period.

Key messages
Transient congenital hypothyroidism represent a significant part of HC at 10 years of follow-up. This finding has important implication on medical practices and should trigger research on the etiology of these transient forms.
VBAC or not VBAC? Improvement of performance and outcome indexes with the promotion of care safety
Authors: Nasi G , Parrocchia S , Mastromatteo A M , Triggiani A , Miraglia B A , Ferrazzani S , Moscato U , Metastasio P , Piscicelli C , Distefano F A 
Published: November 2019

Abstract

Background
In a multidisciplinary approach to Quality Management System and humanization of care, we aimed at evaluating the characteristics that influence the request of women to carry out Vaginal Birth after Cesarean (VBAC).

Methods
Skills have been improved, with the use of tests on dummies and case by case assessments. For the psychological-motivational study we have adopted: Informed consent, Semi-structured interview and Big Five Questionnaire. The women were recruited by both Gemelli and Cristo Re Hospital: the women following the counseling decided to undergo a second Caesarean Section (CS) (41, control group) and women who decided to complete a VBAC (22, experimental group).

Results
The analysis of the data shows that the women of the VBAC group are in the average between 31-35 years (57%), 80% has an education = or &gt; at the 3rd level and the choice of the VBAC was conditioned by the partner (64%). The women of the control group are in average &gt; 35 years (51%), 60% have a higher average education and the influence on the choice is oriented by the gynecologist/obstetrician (64%). From the personality test a statistically significant difference emerges between the dimensions Energy and Mental Opening. Past experience influences the choice of the next birth: women who are inclined to a second CS considered the previous CS as a positive event (66%) while only 36% in the VBAC group; 64% of this was the recovery of the painful post-surgery and a certain type of difficulty in the care of the child, in breastfeeding, of having suffered from post-partum mood alterations, which is why they chose to undertake a Trial of Labor After Cesarean.

Conclusions
The deeper knowledge of women as well as the preparation and safety of the same operators has shown that it is possible to perform a greater number of VBACs, with the sharing, participation and satisfaction of women and the entire team, leading to an improvement in outcomes and performance indexes.

Key messages
The promotion of care safety also improves the performance indexes through continuous training to the operators and the study of psychological aspects that lead to the choice to carry out a VBAC. Good Clinical Practice shown that it is possible to perform a greater number of VBACs, with the sharing, participation and satisfaction of women and the entire team.
Potential effective elements in combined lifestyle interventions for overweight children
Authors: Saat J J E H , Fransen G A J , Naumann E , van der Velden K , Assendelft W J J 
Published: November 2019

Abstract

Background
Combined Lifestyle Interventions (CLIs), offered in primary care, aim to prevent childhood overweight/obesity. Combined means the intervention focuses on optimalising nutrition behaviour, physical activity and mental health, provided by a multidisciplinary team. Although the effectiveness of CLIs is still not clear, CLIs are already implemented in daily practice in the Netherlands. These CLIs are not uniformly designed and have variations in protocols to suit the needs of their community. Due to the many different CLIs it is difficult to investigate their effectiveness. To be able to investigate effectiveness of GLIs, we first need to unravel the ’black boxes’ of CLIs and identify their (potential) effective elements.

Methods
First, we carried out a literature study on elements that may contribute to the effectiveness of a GLI (the so called potential elements). Next, we organized an online brainstorm session, where experts such as researchers and paramedics could add or specify potential elements. We made all elements measurable, with help of experts. These elements were incorporated into a tool to check presence of potential elements in CLIs. This tool was tested on reliability by comparing the results of four researchers who assessed protocols of six CLIs.

Results
42 experts participated in the brainstorm session. The literature study and brainstorm session together resulted in 54 potential elements for CLIs for overweight/obese children, categorized in four themes: organization, content, role of parents and role of experts. For all six protocols, a minimum of 85% of the potential elements in the tool have been scored the same by the four assessors.

Conclusions
We developed a reliable tool to determine potential effective elements in a CLI. In future studies, this tool can be used to identify specific elements that are effective in CLIs for overweight/obese children by comparing the tool with health effects of CLIs.

Key messages
We were able to develop a reliable instrument to better analyze the factors that contribute to positive health effects of combined lifestyle interventions for children with overweight or obesity. the developed tool with potential effective elements must be filled in for more CLIs, where after we can find corresponding elements in the most effective CLIs.
School bullying among Tunisian adolescents: prevalence and psychosocial outcomes
Authors: Sahli J , Limam M , Mellouli M , El Ghardallou M , Ajmi T , Zedini C , Mtiraoui A 
Published: November 2019

Abstract

Background
Bullying is a serious public health concern affecting the emotional well-being of pupils. We conducted this study to examine the prevalence of bullying, its psychosocial associated factors and the perceived involvement of parents, teachers, and classmates to counteract this behavior.

Methods
This is a cross-sectional study conducted in 2015 among a representative sample of pupils enrolled in 14 colleges in Sousse using the revised Olweus Bully/Victim Questionnaire.

Results
We included 1584 students aged between 11 and 15 years. The prevalence of bullying and victimization was 16.0% [95% CI: 14.2%, 17.8%] and 11.3% [95% CI: 9.7%, 12.9%] respectively. Four groups of students were identified, 11.7% were classified as pure victims, 7.8% as pure bullies, 3.2% as bully-victims and 75.5% as bystanders. Compared to other groups, the bully-victims were less likely to report a feeling of empathy (38.3%, p &lt; 10-3) and liking school (30.0%, p &lt; 10-3). They were more likely to be aggressive (56.2%, p &lt; 10-3) and disintegrated in the class (30.6%, p = 0.002). Among the victims, 11.1% reported that their parents contacted the school several times to stop their victimization. The majority of the middle school students perceived that their classmates (54.1%) and teachers (39.5%) did nothing to counteract the bullying behavior.

Conclusions
The school institution is expected to be for pupils a highly meaningful space for social, emotional and academic development. Parents, teachers and students should learn effective ways to handle the bullying problem since it has been emphasized that the most effective programs are comprehensive targeting students, schools, families, and the community.

Key messages
This is the first study conducted in Tunisia to highlight the extent of school bullying. Our findings can help to raise awareness of parents, school staff and policy makers about bullying.
Analysis of coordinating capacities in schools of grades 10 and 11 in a public school of Bogotá
Authors: Morales Eraso N , Riveros Medina M , Gutiérrez Galvis A , Alvarado Melo J , Rubiano Espinosa O , Acosta Rodríguez E , Melo Moreno C 
Published: November 2019

Abstract

Studies that address the problem of excess weight and inactive behaviors such as television and video games in children and adolescents have focused on chronic noncommunicable diseases, with few studies about the effects of sedentary lifestyle on coordination capacities (balance, precision and movement capacity).
The objective of the study is to analyze the coordinative capacities in school children of grades 10 and 11 in a public school in Bogotá. This analytical cross-sectional study was conducted on 63 schoolchildren (30 men and 33 women) with an average age of 16.24 ± 0.689. The motor quotient was evaluated by means of the KTK test with the authorization of the institutional ethics committee, assent signature and informed consent. Descriptive statistics were obtained (mean SD frequencies, percentages). Data were tested using Kolmogorov-Smirnov test and independent t-test was applied to measure the significant difference among the variables. P-value less than 0.05 was considered a significant difference.
The motor quotient showed the following qualifications: symptomatic 11.1% (n = 7), normal 58.7% (n = 37) and good 30.2% (n = 19). Statistically significant differences (p &lt; 0,05) were found in the motor quotient between boys (37,048) and girls (34,374), with girls being mainly in the symptomatic category. It can be concluded that girls need to increase motor experiences to improve their coordinative abilities. The importance of this study consisted in the possibility of identifying the effects of sedentarism on coordination capacities, as well as the impact produced by the current government by reducing hours of physical education in schools, leading to an increase in sedentarism. For this reason, it is essential to develop research aimed at stimulating coordination capacities in schoolchildren as a strategy to reduce public health problems.

Key messages
For this reason, it is essential to develop research aimed at stimulating coordination capacities in schoolchildren as a strategy to reduce public health problems. Promotion of public policy as a Determining factor in the reduction of sedentarism in children, through Strategies that include assessment of Coordinating Capacities of schoolchildren.