bluuebunny/crossref_metadata_2025_split huggingface dataset:
Definition of a novel vaccination pathway in PLWHA: experience of a Southern University Hospital
Authors: D'Amato S , Pellicanò G F , Genovese C , Mazzitelli F , Nunnari G , D'Andrea F , Squeri R 
Published: October 2020

Abstract

Background
At the end of 2018 across the globe there are ∼37.9 million people with HIV/AIDS also thanks to the use of HAART which led to an increase in life expectancy. The Italy Immunization Plan 2017-19 recommend vaccines to these patients but a protocol still isn't present. Moreover, despite the availability of effective vaccines, coverage remained very low for many reasons including problems with privacy. The objectives of this study were a) the appliance of a shared clinical pathway between the “Immunization Center of Hospital Hygiene Operating Unit” and the “HIV/AIDS Disease Prevention, Diagnosis and Treatment Center of Infectious Diseases Operating Unit” b) the increase in vaccination coverage and the evaluation of side effects.

Methods
A prospective study was conducted from Oct 2019 to Feb 2020 at the G. Martino University Hospital of Messina. In particular, of the 138 patients followed by the Infectious Diseases OU, after evaluation of their immune status, 62% were enrolled in this study. Following the acquisition of informed consent, we collected socio-anagraphical data and we started the free administration of vaccines by providing an hoc calendar in the Immunization Center. Statistical analysis was performed with R software.

Results
The sample was represented by 86 patients (74% males and 26% females, 21% foreigners and 79% Italian, mean age=40±13.6 SD). We didn't observe drop out and no differences were observed for local/systemic AEs generally reported. We obtained an increase of vaccination coverage with a total of 74 doses administered for flu (+164%) and 240 for other vaccines (+172%). In particular, we immunized a total of 74% of patients for HPV (2% in 2018), 42% for HAV (28% in 2018), 37% for HBV (28% in 2018), 58% for pneumococcal (21% in 2018), 54% for meningococcal ACWY and B (0% in 2018).

Conclusions
The undertook clinical pathway showed the relevance of specific management of these patients and the need to increase the vaccination offer.

Key messages
The immunization in people living with HIV is priority to reduce the risk of infectious disease. It’s important to implement a shared clinical pathway to increase vaccination rates of these patients. The application of the protocol had an high impact in patients' adhesion to vaccination also thanks to the chance of accessing to the service in a comfortable setting and suitable to protect privacy.
HIV incidence fall in Italy: a –20% fall in 2018 to be explained
Authors: Salvati S , Croci R , Odone A , Signorelli C 
Published: October 2020

Abstract

Background
HIV is still a critical public health threat in Europe, especially in some at-risk populations. Stigma keeps undermining access to prevention, diagnosis, and care. Treatment as Prevention (TasP) and Pre-Exposure Prophylaxis (PrEP) have spread heterogeneously across the continent. The study aimed to compare recent HIV incidence trends in five European countries (Italy, Spain, Germany, France, UK), and to speculate about TasP and PrEP's relative contribution as preventive measures in Italy.

Methods
We collected incidence data by consulting the ECDC HIV/AIDS Surveillance Report 2019, and a preliminary Italian 2019 report issued by the National Institute of Health. We used the latest ECDC Continuum of HIV care data to appraise European trends in HIV viral suppression.

Results
All the considered European countries reported a decreasing trend in 2018, compared to 2017. In Italy, according to raw preliminary data, the number of new HIV infections dropped from 3,561 (5.9/100,000) to 2,847 (4.7/100,000), thus resulting in a -20% fall. Interestingly, Spain shows an even sharper decrease of -22%, dropping from 3,795 new cases in 2017 to 2,527 in 2018, that is from a rate of 8.2/100,000 to 6.4/100,000.

Conclusions
Since 2008, when the coordinated ECDC/WHO Regional Office for Europe HIV/AIDS surveillance system was set up, Italy has never witnessed such a sharp yearly fall in incident cases, thus representing, together with Spain, an epidemiological peculiarity in the European context. TasP could have played a major role in Italy. Indeed, Continuum of HIV care data show a positive trend in viral suppression in European countries. PrEP has been introduced in the Italian guidelines in 2016 and is nowadays adopted in a few urban areas, as a co-pay, on-demand service for high-risk populations with limited diffusion. It is thus plausible that PrEP carries a much lower epidemiologic weight in the Italian 2018 incidence reduction.

Key messages
We need to spread PrEP, TasP and screening programs, especially in at-risk populations. We must search for a causal association between preventive measures and decreasing incidence.
Young men’s discourses of health service utilization for Chlamydia infection testing in Stockholm
Authors: Briones-Vozmediano E , Stjärnfeldt J , Larson F , Nielsen A , Eriksson M , Salazar M 
Published: October 2020

Abstract

Background
Chlamydia Trachomatis (CT) infection is the most commonly reported sexually transmitted bacterial disease in Sweden, other European countries, as well as globally. CT is often asymptomatic and if it goes untreated it can cause severe reproductive health issues. In Sweden, men test for CT in a much lesser extent than women. The aim of this study is to identify factors influencing Swedish young men to use Health care for CT detection.

Methods
Qualitative study based on 18 semi-structured interviews with young men (18-30 years old) in Stockholm during 2018. A Situational Analysis was conducted (a development of Constructivist Grounded Theory) of the interviews' transcriptions, using Open Code as the software for qualitative analysis in order to code and organize the information obtained. We constructed a situational map to illustrate the positions taken by Swedish young men according to their discourses.

Results
Three ideal types of Swedish young men with different discourses and behaviors towards CT testing were identified: unconcerned men are indifferent about CT and other sexual transmitted infections (STI) and therefore not testing; ambivalent men only test when suspect suffering from an STI and/or are influenced by their social network; Whereas, proactive men test regularly as a way to know they are healthy. The differences between the ideal types are explained by their risk perception, the role of health services, and the positive or negative influence of their social network.

Conclusions
The ideal types of young men identified in this study show a range of discourses linked to their risk perception, the role of health services, and the influence of their social network, which in practice is translated into different behaviours adopted for CT testing. Testing should be encouraged as an important part of CT prevention by educating groups of unconcerned young men about both the consequences of untreated CT and the free testing options available in Sweden.

Key messages
Swedish young men have different discourses towards CT testing depending on their risk perception, the strategies adopted to test and the positive or negative role of their social network. The role of health services and the social support emerged as key factors to promoting testing among Swedish Young men.
Experiences of maternal weight management services among women with a raised body mass index
Authors: Fair F , Soltani H 
Published: October 2020

Abstract

Background
Obesity is associated with increased maternal morbidity and mortality. Maternal weight management services (MWMS) are a good opportunity to influence lifestyle behaviours of mothers. To understand what constitutes the most suitable service, women's views on MWMS are paramount.

Methods
A purposive sample of 13 women with a BMI≥40kg/m² were interviewed at 36 weeks gestation. A semi-structured interview schedule explored their experiences of MWMS provision and advice, awareness of services and the barriers and facilitators to antenatal weight management. Interviews were recorded and transcribed verbatim. Inductive thematic analysis was undertaken.

Results
Four themes emerged. 'Understanding where I am at' showed women's readiness and motivation varied, from being avoidant or unaware of weight as an issue to already making changes. 'Getting information' revealed while a few women felt that they received good information during pregnancy most reported a lack of information or minimal information provided in a 'tick-box' fashion. Women particularly wanted practical advice. 'Difficulties I face' identified physical, emotional and financial barriers and the strategies some women used to overcome these. 'Encountering professionals - a mixed experience' demonstrated women wanted to be treated with respect and sensitivity and that how weight management information was addressed was more important than who provided it. The fine line professionals need to tread was evidenced by women thinking they had received inadequate information and yet that there was too much focus on their weight and its related risks during pregnancy.

Conclusions
MWMS should not be seen as a 'tick box' exercise but should be woman-centred to assist women to move forward in their weight management journey, no matter what their starting point. Women desired practical advice provided in a sensitive, respectful manner not just the continual repetition of the risks of being obese during pregnancy.

Key messages
Maternal weight management services require a woman-centred approach to enable women to move forward on their weight management journey. Women want practical, sensitive advice not just the continual repetition of the risks of being obese during pregnancy.
Seroprevalence of anti-pertussis antibodies and immunization status of pregnant women in Turin, 2019
Authors: Rainero E , Garlasco J , Scacchi A , Giacomuzzi M , Ditommaso S , Zotti C M 
Published: October 2020

Abstract

Background
Pertussis is an acute respiratory infection caused by B. pertussis. An acellular vaccine is available, but the protection it confers is estimated to wane after 5 years. Infants under 6 months have the highest risk of complications and mortality. In Italy, the first dose of vaccine is administered in the third month of life and maternal vaccination is recommended in the final weeks of pregnancy. This study aimed to evaluate the seroprevalence of IgG antibodies to pertussis toxin (IgG anti-PT) among pregnant women as a potential source of transplacental transfer of antibodies, which may reduce neonatal risk of disease.

Methods
An observational cross-sectional study was conducted. Two hundred women between the 33rd and 37th weeks of pregnancy were recruited among patients undergoing routine pregnancy check-up at the S.Anna Hospital of Turin, from May to December 2019. Participants were interviewed on their immunization status and a serum sample was collected. Anti-PT levels were assessed using ELISA “NovaLisa B. Pertussis toxin (PT) IgG”. Lacking a correlate of protection, we have distinguished contact with microorganism (10-39 IU/mL), exposure in the previous 2-3 years (40-99 IU/mL), recent infection or immunization &lt;12 months ( &gt; =100 IU/mL).

Results
The median age of participants was 35. Women who had anti-PT titers &gt; =10 IU/mL were 120 (60%) (10-39 IU/mL: 26%, 40-99 IU/mL: 14%, &gt; = 100 IU/mL: 20%). Around 70.5% of women declared previous vaccination (42.5% during pregnancy). Among women vaccinated in the previous 12 months, 7% presented antibodies titer &lt;100 IU/ml. Two women not vaccinated had a titer &gt; 100 IU/ml, indicative of recent pertussis exposure.

Conclusions
This study found 40% of women with antibody titers under cut-off (&lt;10 IU/mL) and 1% prevalence of recent exposure. Despite the late introduction of vaccination against pertussis during pregnancy, a good adherence to the program offered is evident.

Key messages
40% of pregnant women in this study were lacking in antibodies against Pertussis and could not transfer anti-PT to their newborn for early protection. Improving maternal vaccination coverage against pertussis should be a public health priority in Italy; a good adherence to intervention was reported.
Educational aspiration mismatch and depressive symptomatology among Taiwanese mother-child dyads
Authors: Huang L-H , Chiang Y-L , Lin W-H , Chiao C 
Published: October 2020

Abstract

Background
International studies emphasize the importance of depression for women and adolescents. Yet few researchers have used family-based surveys to explore depressive symptomatology of mother-adolescent dyads, and less is known about this aspect in Asian community where education is highly valued. The present study builds upon an inter-generational framework by investigating the effect of educational aspiration mismatch on depressive symptomatology in mother-child dyads.

Methods
A total of 1108 Taiwanese mother-child dyads were surveyed when the child was 13 years old, and followed up to two years later. Depressive symptomatology is measured by Symptom Checklist-90 Revised for both mother and child. Comparisons of mother and child's educational aspiration are categorized into three groups: mothers' aspirations are equal to, lower, or higher than their children.

Results
Results from multivariate logistic regression shows that, when mother's education aspiration is higher than that of her child, both mother and child have lowered risks of being depressed (mothers: AOR = 0.60, p &lt; 0.1; children: AOR= 0.42, p &lt; 0.05). On the other hand, children whose mothers' educational level are higher (senior /vocational high school: AOR =1.42, p &lt; 0.1; college and above: AOR =1.81, p &lt; 0.01) and whose mothers emphasize academic achievement (AOR =1.77, p &lt; 0.1) are at greater risks than those without.
Discussions: The results point to the protective role of mother's higher level of education aspiration than the child, although mothers who emphasize academic achievement seem to increase children's depressive symptomatology. Future interventions that aim to promote mental health of adolescents and parents should take the value attributed to education, and the comparison between parental and children's self-aspirations into consideration.

Key messages
Mother and her child lower risks of being depressed when mother’s educational aspiration is higher than that of her child's. Child increases risks of being depressed when his/her mother emphasizes academic achievement.
Empowering seizures awareness: knowledge, attitudes and fears of school staff trained in rescue drugs
Authors: Pompili E , Bert F , Corradi A , Gualano M R , Venuti S , Siliquini R 
Published: October 2020

Abstract

Background
The administration of rescue medication at school concerns, in all Europe, students suffering from chronic pathologies for which it may be essential, on doctor's prescription, to take therapy during school hours. About 16% of the school's emergency calls are related to a seizure crisis. In this case, since the parents are absent, the first rescuer is necessarily the school staff, who should be properly trained because prolonged seizures can cause severe harm and even death.

Methods
Every year, the Local Health Unit “TO3”, in Northern Italy, provides training for school staff to administrate rescue medication at school. A questionnaire survey on knowledge, attitudes and fears towards seizures was conducted during the school year 2019/2020. The same questionnaire was administered to school staff trained for seizures at the end of the course, while the staff trained for other diseases such as diabetes, allergies and asthma completed it before the course.

Results
110 questionnaires have been completed. About 60% of the sample had been trained in seizure management at least once in their lifetime. The respondents had a mean age of 48.7±9.6 years and a mean job experience of 17.4±11.2 years. Most of them were females (83%). Median knowledge score (10 points max) in subjects with no seizures training was 6, while it was 8.5 in subjects with seizures training (p &lt; 0.001). The self-reported level of confidence in their own skills to administer rescue medication was high in 10.4% of subjects not trained for seizures and in 63.8% of those trained (p &lt; 0.001).

Conclusions
Results suggest that medical training for school staff boosts knowledge scores and levels of self-confidence relating to the administration of rescue medication. Moreover, after the training, the school staff changed attitude towards seizures, no longer considered as a problem, and became more aware, less fearful, and more inclined to act in case of need, making school a safer place for all students.

Key messages
School staff trained in the administration of rescue medication are fundamental to guarantee the right to education for students suffering from chronic pathologies such as seizures. Empowering seizures awareness in schools is very important to change the attitude of school staff no longer considering seizures as a problem, making school a safer place for all European students.
Self-monitoring improved child feeding among low educated slum mothers in Bangladesh, a pilot study
Authors: Jannat K , Rahman M , Agho K , Parvez S , Merom D 
Published: October 2020

Abstract

Issue
Child undernutrition in urban slums is the most serious but least addressed health problem in many LMICs including Bangladesh. Slum children are deprived of adequate feeding as advocated by WHO. Face-to-face contact to monitor adherence to child feeding recommendations is costly. We aimed to identify if a visual aid for self-monitoring, in the form of a pictorial calendar, could assist illiterate slum mothers to self-regulate their child feeding behaviours and increase adherence to recommended child feeding practices.
Description of the practice: A mixed method study was conducted (Randomised Controlled Trial + semi-structured qualitative interviews) over four weeks in a slum area of Dhaka city. Thirty-four mothers to child aged 6-23 months having &lt;5 years of education were recruited. Mothers randomized to intervention arm (n = 17) received an hour of complementary feeding education along with a pictorial calendar and color-coded stickers representing food groups. The control arm received the education session only. The primary outcome was Minimum Dietary Diversity (MDD: ≥4 food groups in past 24 hours); the Generalised Estimation Equations (GEE) with a log link and binomial family was used to test treatment by time interactions.

Results
The proportion of achieving MDD was more common (RR 1.2, 95%CI 0.8, 1.8) among mothers from intervention arm compared to control mothers. Intervention mothers were more likely to identify the appropriate food groups compared to control mothers. More than 80% of the mothers completed the calendar for all 28 days of study duration. During qualitative interviews, most mothers (4/5) stated that the pictorial calendar acted as a reminder for them.

Lessons
An encouraging tendency towards better complementary feeding and better knowledge was seen among the intervention mothers compared to controls. Future research with a larger sample is needed to establish the significance of effect size.

Key messages
Pictorial calendar appeared to help sustain knowledge and improve feeding practices. Self-monitoring using a pictorial calendar could be a good visual aid for low-educated mothers from low socio-economic status.
Measurement of violation of maternal integrity in childbirth: review from a multilevel perspective
Authors: Batram-Zantvoort S , Miani C , Wandschneider L , Razum O 
Published: October 2020

Abstract

Background
Violation of maternal integrity (VMI) during childbirth is reported by women and observed by researchers globally. It has serious health consequences for the mother and the infant in the short and long-term. The terminology to capture VMI ranges from disrespect and abuse to mistreatment and obstetric violence. This variety of terms and concepts is reflected in a multitude of operationalisation and measurement strategies.

Methods
In a scoping review, we examined how VMI has been measured in quantitative studies. Using a theoretically informed framework differentiating between the macro, meso, and microlevel, we reflected on the dimensions of VMI included as items in measurement instruments and categorised them in the framework, aiming to highlight the dominantly chosen approaches to VMI as well as the still under-researched fields and perspectives on drivers, expressions and consequences of VMI.

Results
The majority of scales and surveys described in the studies concentrated on the interactional aspects of VMI, located on the microlevel (e.g. verbal abuse, neglect by care providers). Only a few studies dealt with meso-level factors potentially associated with VMI (e.g. staff shortage). Macro-level perspectives on health policies and legislation, gender equity or societal norms remained rare. Instruments used to measure VMI were very heterogeneous and therefore non-comparable with regard to the outcomes and prevalence of VMI.

Conclusions
There is a need to adopt a multilevel perspective to identify further expressions and effects of VMI. Furthermore, the role of macro-level, structural determinants should be investigated. Last, the use of compatible instruments is required to obtain comparable data on VMI nature and prevalence.

Key messages
Measurement instruments of VMI mainly cover interactional aspects of the phenomenon. The meso-, and macrolevel dimensions of VMI are under-researched. The heterogeneity of the instruments measuring VMI hinders comparison of the outcomes and their prevalence.
Assessing late presentation for female adolescents and young women with HIV in 2019, South Africa
Authors: Cassim N , Coetzee L M , Glencross D K 
Published: October 2020

Abstract

Background
South Africa has the biggest HIV epidemic in the world, with an estimated 7.1million people living with HIV in 2018. In 2016, women aged 15-24 contributed 37% of new infections. Poverty, low status, gender-based violence (GBV) and intergenerational relationships possibly contribute to this disparate HIV prevalence. The objective of this study was to describe very advanced HIV disease (CD4&lt; count &lt;100cells/µL) amongst 15-24 year old females by interrogating routine laboratory CD4 data.

Methods
Specimen level CD4 laboratory data of female patients aged 15-24 was extracted for the 2019 calendar year. Patients were categorized as adolescents (15-19) or young women (20-24), in age categories of (i) 15-16, (ii) 17-19, (iii) 20-21 and (iv) 22-24 years. Frequency tables were used to report test volumes and the percentage of samples with counts &lt;100 cells/µl.

Results
Amongst 259 088 CD4 outcomes extracted, 5.4% of samples had counts &lt;100 cells/µl, with 75.4% of samples from young women and 24.6% from adolescents. Most samples reported an age between 22-24 (52.2%), with the lowest proportion (5.8%) noted in 15-16 year olds. Median CD4 was 485 cells/µL, with medians of 490 and 470 cells/µl noted for young women and adolescents respectively. Review of the &lt;100 cells/µl group revealed a median of 43 cells/µL, with 38 and 46 cells/µL reported for young women and adolescents respectively. There was no significant association between the median CD4 and age category. Very advanced HIV disease by age categories of 15-16, 17-19, 20-21 and 22-24, comprised 7.0%, 5.6%, 5.0% and 5.3% respectively.

Conclusions
This study demonstrated unacceptable rates of very advanced HIV disease in female adolescents and young women, suggesting HIV seroconversion as teenagers or younger. Evidence-based specific health care interventions for these girls are urgently required, including tailoring social services and health facilities to secure the sexual health of girls and young women.

Key messages
Very advanced HIV disease presentation in female adolescents is unacceptably high. Young women and adolescents with late presentation.