bluuebunny/crossref_metadata_2025_split huggingface dataset:
Personas of young adults and substance use
Authors: de Jonge M C , van Leeuwen L , Onrust S A , Bukman S 
Published: October 2020

Abstract

Background
To develop targeted interventions for (young) adults who use drugs, developers need a better understanding of how different subgroups engage with substances. Personas - archetypes describing distinct patterns of goals, attitudes and behaviours of subgroups - may contribute to this understanding. No substance use-related personas have yet been developed. The purpose of this project was to develop evidence-based personas of young adults, based on their involvement with alcohol and drugs.

Methods
Data was collected among young adults (18-25 yrs) through in-depth interviews (N = 43) and a questionnaire (N = 4182). The questionnaire was based on the insights from the interviews. Participants answered questions about their experiences and intentions with substance use, expectations, descriptive norm and intention to quit. For developing personas from the quantitative and qualitative dataset, we combined Goodwin's methods for persona development with latent class analyses.

Preliminary Results
Ten personas are distinguished: a non-user, moderate alcohol user (no drugs), social bingedrinker without druguse intentions, social bingedrinker with druguse intentions, drug-starter, drug-stopper, stimulant-user, hallucinogens-user, coping user and actual quitter. Each persona has a detailed profile that describes their distinct pattern, supported with illustrative quotes from the interviews.

Conclusions
The personas lead to a better understanding of different perceptions and experiences of young adults regarding substances. Currently, the personas are presented among professionals working with the target group in order to validate the personas and to determine suitable health promoting strategies for each persona. Eventually, the personas will be used to improve the development and implementation of interventions that aim to reduce (risks associated with) substance use.

Key messages
The developed personas provide a better understanding of the perceptions and experiences of young adults and their involvement with substances. In the current phase of the project, health care professionals are involved, matching health promoting interventions and communication strategies to each persona.
Family life stress, maternal depression and child behavioral health in industrialized Italian cities
Authors: Bansal E , Renzetti S , Xhani N , Cagna G , Conversano M , Patrono A , Claudio L , Lucchini R , Placidi D 
Published: October 2020

Abstract
Although family life stress adversely impacts child health, few tools measure its relationship to child outcomes in the setting of maternal variables. This study validates the Italian version of Crisis in Family Systems-Revised (CRISYS-R) and characterizes relationships between family life stress, maternal depression and child behavior in two Italian cities.
This cross-sectional study was nested in current research on health impacts of neurotoxic environmental exposures in children. 101 mother-child pairs (child age=9.91±2.17yrs; 53% female) and children's teachers were enrolled in Taranto (south Italy) and Brescia (north Italy). Mothers performed the Italian CRISYS-R and PHQ9; teachers completed Child Behavior Checklist (CBCL/6-18). Spearman's rank correlation coefficients showed associations of family CRISYS-R, maternal PHQ9 and child CBCL/6-18. Wilcoxon Rank-Sum test compared groups of continuous variables.
Mothers with depressive symptoms (PHQ9≥5) reported higher ongoing stress and proportion of negative stressors on CRISYS-R than non-depressed mothers (p &lt; 0.05). Children of depressed mothers performed worse in all CBCL/6-18 domains: Internalizing Problems, Externalizing Problems and Total Problems (p &lt; 0.01). Specifically, children of depressed mothers scored higher on subscales of Anxious-Depressed (p &lt; 0.05), Withdrawn-Depressed (p &lt; 0.01), Rule-Breaking (p &lt; 0.01) and Aggressive Behavior (p &lt; 0.05). Maternal depressive symptoms correlated with ongoing stress (rs = 0.27; p &lt; 0.01), child Internalizing Problems (rs = 0.34; p &lt; 0.001), Externalizing Problems (rs = 0.28; p &lt; 0.01) and Total Problems (rs = 0.35; p &lt; 0.001).
This study describes links among maternal depression, family life stress, and child behavioral health. It is first to validate Italian CRISYS-R and to explore these factors conjointly in Italian contexts with known neurotoxic exposures. Findings support considering maternal depression and family life stress in child behavioral and environmental health research and policy.

Key messages
Family life stress, maternal depressive symptoms, and preadolescent behavioral health were highly interrelated in two industrialized Italian cities. The Italian version of CRISYS-R is a useful instrument for assessing and understanding family life stress, a crucial yet under-explored contributor to child behavioral health outcomes.
Improving cultural competence in medical curricula of Algarve University to reduce health disparities
Authors: Pinto de Oliveiraa A , Nunes S , Marreiros A , Palmeirim I 
Published: October 2020

Abstract
The increasing diversity of the Portuguese population and the globalization of health care require advance practice physicians to be culturally competent. Greater appreciation exists for the impact of culture on health care: health seeking behaviors are affected by cultural mores. The field of 'cultural competence' has emerged as one strategy to address these disparities.
The Integrated Master of Medicine at the University of Algarve realized that the development of culturally responsive clinical skills is vital to the effectiveness of behavioral health services. To achieve this realization, Cultural Competence Seminars were included as obligatory course in medical curricula, since 2017. Although some cultural competence topics were addressed at different moments of master, in PBL approach and electives.
The seminars offered in Year 6 were structured in 3-h interactive lectures per week covering the following topics: gipsy ethnicity, vulnerable groups, Jehovah's Witnesses, Islamic Culture and Ethics in different cultural contexts. These thematic areas were taught by social scientists and interested “experts” or inviting personal testimonys. The learning objectives are related to knowledge-based that focus on information, such as definitions about culture and related concepts; attitudes that seeks to improve provider awareness of the impact of socio-cultural factors on patients' values and behaviors and skills that focus on learning communication regarding the context.
The integration of seminars in the medical curricula has been a successful project as it has been well received by students. Reflecting on the conceptualization and implementation of the cultural competence seminars, there are still some challenges to address. That is, cultural competence needs to be further integrated in the curriculum by incorporating in additional clinical communication and clinical skills sessions.

Key messages
It is a model that can be applied regardless of the meaning a school of medicine attaches to the notion of cultural competence, and can build on existing strengths within the organization.
Collaborative strategies for knowledge translation: the African-German CEBHA+ research network
Authors: Sell K , Pfadenhauer L M , Jessani N , Schmidt B M , Levitt N , Chapotera G , Akiteng A R , Mpando T , Ntawuyirushintege S , Rehfuess E A 
Published: October 2020

Abstract

Background
The Collaboration for Evidence-based Healthcare and Public Health in Africa (CEBHA+) is an NCD research consortium that seeks to engage policy-makers and practitioners throughout the research process in order to build lasting relationships, enhance evidence uptake and build long-term capacity among partner institutions in Ethiopia, Malawi, Rwanda, South Africa and Uganda. This integrated knowledge translation (IKT) approach includes the formal development and implementation of country-specific engagement strategies.

Methods
An early-stage evaluation is taking place in Mid-2020. Online surveys and qualitative interviews with researchers and policy-and-practice partners will inform adaptation of country-specific strategies, advance the initial programme theory and contribute to the science of IKT.

Results
We present three pertinent observations based on the development and implementation of an overarching CEBHA+ IKT approach and five country-specific strategies over the last two years: Despite being informed by an overarching IKT programme theory, the site-specific strategies and resulting partnerships vary markedly, representing the whole continuum of integrated knowledge translation.The diversity of approaches is due to different understandings of IKT, discontinuity of staff, lack of IKT training, and perceptions of usefulness (compared to ongoing research activities) among CEBHA+ researchers.The individual, dynamic and often pre-existing relationships of researchers and partners from policy and practice are central to IKT, but capturing these within the programme theory and monitoring them remains challenging.

Conclusions
These observations are useful to guide further evaluation and cross-country comparison. Close examination of relationships and conceptualisation of IKT as a continuum may provide valuable insights into the circumstances that make IKT efforts worthwhile.

Key messages
Translating evidence into policy and practice is reliant on partnerships between researchers and policy-and-practice partners. These can be formalised but the relationships remain complex and dynamic.
Tai Chi and workplace wellness for health care workers: a systematic review
Authors: Dorelli B , Cocchiara R A , Gholamalishahi G , Longo W , Musumeci E , Mannocci A , La Torre G 
Published: October 2020

Abstract

Background
Several studies show positive effects of new non-medical therapies known as complementary and alternative medicines, such as the discipline of tai chi. As healthcare professions are among the most vulnerable for work-related stress, this systematic review aims to investigate the relationship between tai chi practice and wellness of healthcare workers.

Methods
Cinahl, Scopus, Web of Science and PubMed were searched in September 2019. Full-text articles, written in English and published after 1995, were recruited if they focused on positive effects of tai chi on the psychophysical wellbeing of healthcare workers, in comparison with alternative techniques (such as yoga or traditional care). Outcomes were reduced work-related stress, better physical and psychological function, improvement in attention and/or productivity; no restrictions about study design were applied. Quality assessment was performed with the Newcastle-Ottawa Scale on cohort/cross-sectional studies, the Jadad scale for randomized clinical trial, AMSTAR for systematic reviews and CASE REPORT scale for case study.

Results
6/111 papers were included: 3 clinical trials, 1 observational study, 1 systematic review and 1 case report. The methodological quality was of medium level. 2/3 trials found a significant increase in individuals' wellbeing and improvements in stress levels and nursing staff’s motivation in their work. In the observational study tai chi was a prevalent mind-body practice to reduce stress. The systematic review suggested that tai chi could be a useful tool to reduce stress-related chronic pain. In case report the effectiveness was observed in medical students.

Conclusions
This study highlights the full potential and possible beneﬁts derived from tai chi but its application to improve health professionals' wellbeing is still limited, and the absence of a standardized intervention impacts on the methodological quality and reduces the robustness of the retrieved evidence.

Key messages
Tai chi can improve many pathological conditions and reduce work-related stress. Further research is needed to gain robust evidence of its efficacy for wellbeing of healthcare workers.
Risk of nasopharyngeal cancer in productive sectors and formaldehyde exposure in bakeries industry
Authors: Miligi L , Massari S , Paredes Alpaca R I , Piro S , Airoldi C , Ranucci A , Romeo E , Scondotto S , Cenni A , Aprea M C 
Published: October 2020

Abstract

Background
The International Agency for Research on Cancer evaluated formaldehyde (F) as carcinogenic for human in association with Nasopharyngeal Cancer (NPC). Occupational exposure to F occurs in many industrial sectors also in those non-traditional. For example in Tuscany F was detected in a bakery where a NPC case had ever worked.

Methods
In this study a) A case control approach (OCCAM) was used for monitoring occupational risks based on current information sources. Three Italian Regional Operating Centres, collected NPC cases from cancer registries and/or hospital discharge records. Controls were randomly sampled from the regional health service population data. Occupational histories were available through record linkage with the social security pension database (INPS). Study results were reported by industrial sectors, area and gender. b) A specific study on F exposure was conducted in bakeries and pastry industry carrying out measurements to determine the concentration of F in specific tasks and positions.

Results
717 cases linked with INPS database. Increased ORs for several industrial sectors such as iron and steel, wood and plastic were observed. In two regions also health and veterinary services and hairdressers were at increased risk, but based on few cases of exposed workers. In the non traditional sector of bakeries and pastry industries, where workplaces were monitored, high levels of F in personal air samplings were found, in particular in processes that involve a strong leavening.

Conclusions
Many productive sectors, in which F exposure could occurred, were observed to be at higher risk. The measurements performed in the non traditional sector monitored, confirmed the F exposure in some phases of the work process. With this study we contributed to increased knowledge on the risk of NPC within the monitoring system of occupational risks, and to deepen exposure to F in a non traditional productive sector such as bakeries and pastry industries.

Key messages
The epidemiological method used (OCCAM) in this study provides further information on the role of occupational exposure in the development of nasopharyngeal cancer. The measurements performed in the bakeries and pastry industries provide new additional information on the exposure to formaldehyde in some work process phases of a non-traditional productive sector.
Addressing lead exposure in children in Georgia: challenges and successes of a multi-agency response
Authors: Ruadze E , Khonelidze I , Sturua L , Lauriola P , Crabbe H , Marczylo T , Leonardi G S , Gamkrelidze A 
Published: October 2020

Abstract
The national response for reducing lead (Pb) exposure in Georgia is coordinated by the National Centre for Disease Control and Public Health (NCDC&PH) and implemented as a multi-agency (CDC, UNICEF, WHO, University of Emory) response. Given concerns about the extent of Pb exposure, in 2018 Multiple Indicator Cluster Surveys (MICS) of representative samples of children have been conducted to study several demographic and health aspects, including a study of the prevalence of blood Pb levels among 2 to 7 years old children (n = 1578). This survey was conducted in collaboration with the Italian Instituto Superiore di Sanita' (ISS), UNICEF and NCDC.
The laboratory analyses were conducted at ISS in Italy. Initial results showed that in 41% of all children, blood Pb concentration was ≥ 5 µg/dl, a challenge which motivated public agencies to establish an initial public health action plan to assess environmental samples (paint, dust, water, soil, selected food items such as spices and imported sweets) in families where Pb concentrations were ≥ 10 µg/dL. A State intervention programme, monitoring Pb blood concentration among MICS children and their family members, provided relevant information on exposed households and led to a reduction of Pb blood concentration across the most exposed households.
In collaboration with Public Health England, NCDC has conducted a small Pb isotope ratio study aimed at identifying the most relevant sources of Pb exposure contributing to elevated blood Pb in MICS children. It is expected that these data will support the design of more detailed public health interventions to reduce exposure to key sources of Pb, thus leading to further reduction of Pb-induced health effects in Georgia.
In addition, this experience will clarify elements of an ongoing monitoring of environmental factors such as an Environmental Public Health Tracking system, to support national capacity to manage the risks to public health.

Key messages
Environmental health response requires extensive research and multi-agency approach. If State implements adequate intervention it is possible to reduce blood lead (Pb) level.
Mediterranean diet and mental health in university students: an Italian cross-sectional study
Authors: Corezzi M , Bert F , Lo Moro G , Buda A , Gualano M R , Siliquini R 
Published: October 2020

Abstract

Background
Well-being is essential for positive mental health among university students, influencing their later attitudinal and career outcomes. Many factors contribute to endanger students' mental health, including academic stressors, as well as unhealthy lifestyles. Following a Mediterranean diet (MD), widespread in Europe, is proved to have a protective role for mental health. Our aim was to investigate mental well-being and adherence to the MD in university students.

Methods
In 2019, a cross-sectional study was performed in Turin, Italy. Totally, 502 university students were enrolled. A socio-demographic form, the Mediterranean Diet Adherence Screener (MEDAS) and Warwick-Edinburgh Mental Wellbeing Scale (WEMBS), were used. Mainly, multivariable linear and logistic regressions were performed to investigate potential predictors of adherence to the MD and of psychological well-being (p &lt; 0.05 considered significant).

Results
The 24% of the sample resulted at high risk of depression (WEMWBS score&lt;40) and the 22.7% at high risk of psychological distress (WEMWBS score 41-45). The median MEDAS score was 6 (IQR=2, non-normal distribution) in a possible range between 0 and 14 (the higher is the score, the higher is the adherence). Preliminary results showed that a MEDAS score ≥6 was associated to a lower risk of depression (OR = 0.78, p = 0.006). Not being on time with university exams (OR = 2.65, p = 0.002) and not having an excellent health status (OR = 1.94, p = 0.23) led to a higher depression risk instead. The main variables that had a negative association with MD adherence were WEMWBS&lt;40 (coef=-0.65, p = 0.001) and not cooking personally (coef=-0.30, p = 0.04).

Conclusions
Students who reported greater adherence to the MD were those with the lowest risk of depression. The potential protective role that MD has for mental health in young adults could be used to help developing more comprehensive intervention strategies of health promotion among European university students.

Key messages
Adherence to the Mediterranean diet and good mental health seem to be related in a sample of university students analyzed through multivariable regressions. European policies and strategies addressing unhealthy lifestyles and encouraging Mediterranean diet adherence could be useful to improve well-being and mental health of university students.
Use of dietary supplements among male fitness club members in Nis, Serbia
Authors: Ramic M , Jovanovic M , Nikolic M , Ramic M , Nikolic K 
Published: October 2020

Abstract

Background
Dietary supplements use continues to increase in many countries. They are often used without a full understanding of the potential benefits and risks associated with their use, and without consultation with a health care professional. This study aimed to explore health beliefs and patterns of dietary supplement usage among fitness club participants.

Methods
This cross-sectional study was conducted in fitness clubs of the city of Nis, Serbia. Male adults, age 18-45 years, participated. Data from participants were collected through an original structured, self-administered questionnaire describes the prevalence and type of supplements used, the reasons for using and the information source.

Results
The prevalence of dietary supplement intake among participants was 85.86%. Most participants were between the age of 20 and 40 years, had a college degree (57.1%), non-smokers (80.5%), without chronic disease (86%), perform exercise at least thrice weekly (76.2%) and 63% had at least1 hour. The percentage of participants who had favorable health views on dietary supplements was significantly higher among the supplement users than among the non-users (P &lt; 0.0001). Most participants (76.19%) perform exercise from 3 to 5 times weekly and 82.85% had from 1 to 2 hours exercise duration. The percentage of subjects who think supplements have side effects was significantly higher among the supplement non-users than among the users (p &lt; 0 .05). Proteins (83.33%), amino acids (63.09%) and creatine (52.38%) were the most commonly reported supplements used. The places of buying dietary supplements most mentioned were specialized supplement store (78.57%), online (11.9%) and pharmacy (9.52%).

Conclusions
Male fitness club member are large consumers of dietary supplements. Public health campaigns could be useful to educate Serbian population regarding using dietary supplements during fitness activities.

Key messages
Male fitness club members are large consumers of dietary supplements in Serbia. Public health campaigns are needed to educate fitness participants about using dietary supplements.