bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accuracy of portion size estimation by canteen and school staff on school meals
Authors: Liz Martins M , Marques A R 
Published: October 2020

Abstract

Background
A correct estimation of food portions is essential for canteen and school staff involved on school meals, affecting children's nutritional status. Thus, it is essential evaluate food portions perception, aiming to improve benefits provided by school meals.

Methods
This study focused on 35 Portuguese public schools of the city of Porto, that daily offer 6500 lunches to children aged 3 to 10 years old. At each school, the food handler responsible for platting at canteen and a school staff member responsible for the daily supervising of school meals was included. In line service, a meal composed by protein component, side dish, vegetables, bread and fruit was randomly selected. Participants estimated food portion sizes in grams by observing portions of each meal component, posteriorly weighed using a digital scale. Estimation and real values were compared for both participants.

Results
A total of 175 meal components were evaluated by 70 observers. Canteen staff underestimated, on average, 36.9g of side dish (p = 0.010), 63.7g of fruit (p &lt; 0.001) and 16.2g of bread (p &lt; 0.001). School staff underestimated, on average, 42.1g of side dish (p = 0.043), 70.7g of fruit (p &lt; 0.001) and 24.1 of bread (p &lt; 0.001). Dish type influenced the portion estimation by school staff with regard to the side dish (p = 0.026), being visual estimate of composed dishes closer to real values compared to non-composed dishes. Canteen staff attend to in-situ kitchen better estimated the portions of fruit and bread.

Conclusions
Food portions of side dish, bread and fruit were underestimated, so it can be concluded that the visual perception of canteen and school staff on school lunch is not accurate. It is essential training to ensure adequate portions serving in school meals and promoting actions for school staff to avoid the encouragement of overconsumption by children. These actions could have a great public health impact either on nutritional status adequacy and on food waste reduction.

Key messages
Food portions estimation of canteen staff was closer to real portion compared with school staff. It is huge the difficulty in visually estimation of food portions on school meals.
Evaluation of the presence of antibiotics in milk samples sold in the region of Campinas - SP
Authors: Lenzi Caminada S M , de Souza Zocante A C , de Souza S J , de Souza Rodrigues V F , Palaria Joaquim I O , Caminada M L 
Published: October 2020

Abstract
Milk is considered one of the most complete sources of health nutrients and is quite susceptible to contamination by antimicrobial residues due to the indiscriminate use of veterinary drugs to treat dairy cattle, mainly in the treatment of mastitis in cows. Antibiotic residues are considered chemical contaminants, arising from the treatment of pathologies of the dairy herd without adequate control of the disposal period provided by each medication.
Milk may also contain residues of other substances from agricultural products and / or inputs and environmental residues, such as: antiparasitic agents, growth promoters, milking hygiene products, heavy metals and mycotoxins. The present study aimed to qualitatively evaluate the presence of antibiotics in raw milk samples, being 2 samples of bovine milk and one sample of goat milk.
The samples of raw, bovine and goat milk were purchased from local stores and were kept at approximately 5 ºC for 8 hours and subsequently frozen at - 6 ºC for conservation purposes.
The tests were carried out at the premises of Hexis Científica, Av. Antonieta Piva Barranqueiros, 385 - Distrito Industial - Jundiaí-SP, which provided training and use of the laboratory. Kit Charm QUAD-1, Test LF-BRPAC-100K, interpretation of the EZ System test (HX0066-00205) which detects the presence of Beta-lactams, Quimolones, Sulfa drugs, Tetraciclynes, Macrolides, Gentamicin, Aminoglycosides and Amphenicols, covering the drugs required in the National Contaminant Waste Plan-PNCRC.
According to the analyzes, the samples studied did not show residues of antibiotics, which demonstrates the responsibility of producers with current legislation and consumers.

Key messages
As for the public health issue, different types of risks are associated with the presence of antimicrobials in milk, such as microbiological, immunopathological and toxic-pharmacological. The carrying out of information actions, in the production chain, regarding the risks arising from the ingestion of food contaminated by antimicrobial agents is essential for consumer safety.
Multiple risk behaviour and socioeconomic status during the transition from adolescence to adulthood
Authors: Tinner L , Wright C , Heron J , Caldwell D , Campbell R , Hickman M 
Published: October 2020

Abstract

Background
Multiple risk behaviour (MRB) means the occurrence of two or more risk behaviours and is associated with a range of negative outcomes. What is unknown is whether MRB is associated with socioeconomic status (SES) in adulthood. This study aimed to examine the association between adolescent MRB and young adult SES and whether those who experienced early life socioeconomic disadvantage also faced greater negative impact of adolescent MRB.

Methods
Two prospective birth cohort studies; British Cohort Study 1970 (BCS70) and Avon Longitudinal Study of Parents and Children (ALSPAC), born in 1991-1992, were used. Logistic regression assessed the association between MRB and young adult SES. Three early life SES variables were examined for their moderating effect on the association using models with and without interaction parameters. Likelihood ratio tests ≤p=0.05 indicated evidence to support moderation. Multiple imputation was used to account for missing data.

Results
Adolescent MRB was negatively associated with young adult SES (university degree attainment) in BCS70 (OR 0.81, 95% CI: 0.76, 0.86) and ALSPAC (OR 0.85, 95% CI: 0.82, 0.88). There was a dose response, with each additional risk behaviour resulting in reduced odds of university degree attainment. In BCS70, maternal education (p = 0.03), parental occupation (p = 0.009) and household income (p = 0.03) moderated the effect of adolescent MRB on young adult SES. The effect of MRB on university degree attainment was stronger for those from poorer socioeconomic backgrounds. No evidence of moderation was found in ALSPAC.

Conclusions
Adolescence is a critical time to address MRB as behaviours established here may have effects in adulthood. Intervening on adolescent MRB may improve later SES and thus health outcomes later in life. Evidence for a moderation effect in the BCS70 but not ALSPAC suggests that measures should be investigated for their ability to capture the nuance of contemporary young adult SES.

Key messages
Intervening on adolescent multiple risk behaviour could improve socioeconomic life chances in young adulthood. Variables that capture the nuance of contemporary young adult socioeconomic status should be explored.
Share your rare with care: a patient corner for the European Reference Networks on Rare Disease
Authors: Rubba F , Montella E , Carannante I , Trummolo M C , Simeone A , Vozzella E A , Magri P , Iervolino A , Colao A , Triassi M 
Published: October 2020

Abstract

Background
The European Reference Network on Rare Disease (ERN) is focused on providing more equitable care across Europe and creates a network of both medical specialists and patient experts. One relevant objective of the activities planned into the ERNs is to address the economic dimensions of rare diseases in order to develop strategies to improve research and patients' access to orphan drugs (ODs) and highly specialized health technologies. The themes built in these preliminary years were directed toward guidelines and policies concerning reimbursement of ODs and direct provision by the healthcare system.

Methods
to proceed further in humanization of care we establish involvement of patients' associations in decision making and implementation of clinical practice guidelines. We built in Federico II University Hospital where 12 ERN were aligned a front office corner shared between patients association and hospital direction in order to face the patient difficulties along the pathway. The corner is open three times a week on the morning, with a dedicated phone number.

Results
Main issues regarded the understanding of the disease and the diagnosis (ie, lack of familiarity with the rare disease, disease heterogeneity, lack of established diagnostic criteria, misdiagnosis,) the development of effective treatments and the need for efficacy along the path way of care (ie, geographical limitations, disease coding systems, ethical and privacy issues). Fewer concerns were about the equity of access and other social pressures. Conclusions In general, in ERN context, few people declared to work in human and social issues, including research on patient's quality of life, patient's awareness, or methods for social support. Our findings demonstrated that Patients were positively affected from the corner initiative: this may ameliorate the use of infrastructures offering services, also that rarely known as national and international biobanking platforms, registries and networks.

Key messages
Humanization of care issues and strategies are nowadays mandatory in rare diseases. Patients are positively affected from shared initiatives.
Health status and health behaviours of the Hungarian homeless caregivers
Authors: Nagy-Borsy E , Szeitl B , Kiss I , Rákosy Z s 
Published: October 2020

Abstract

Background
So far little attention has been given to the physical and mental health of homeless caregivers. Their health behavior can serve as role model for homeless people. For this reason, the aim of our study was to identify the health problems and health behavior of homeless caregivers.

Methods
We conducted a representative nationwide survey including 559 individuals to determine the homeless caregivers' health status and health behavior. The results were compared with the age and sex adjusted data of the European Health Interview Survey 2014 that was carried out in the general Hungarian adult population.

Results
The majority of participants (71%) gave positive ratings to their own health, they considered their health status significantly better compared to the general population (p = 0.002). Of them 34% had chronic disease compared to the 39% of the general population, 27% experienced limitation because of their health problems. Their mental status was worse than the general population, 40% had depression compared to the 23% of the reference. Majority of them (59%) were obese or overweight, those who lived in countryside were more likely to be obese or overweight than those who lived in the capital (p = 0.02). Only 41% of them consumed fruits and 26% of them consumed vegetables on a daily basis. These rates were significantly lower compared to the general population, p &lt; 0.008. Most of them (62%) were occasional drinker. The prevalence of current smokers (37%) were higher among them than in the general population (32%)

Conclusions
In conclusion, the homeless caregivers had worse mental health status than the general Hungarian population. They were also characterized by unhealthy lifestyle such as inadequate fruit and vegetable consumption and high rate of smoking. As caregivers serve as a role model for homeless people, supporting their health and health behavior might have strong effect on health of homeless people as well.

Key message
The survey’s findings indicate the health program for homeless caregivers would be worthwhile specially focusing on smoking cessation, healthy eating and mental health.
The determinants and consequences of forgoing healthcare
Authors: Petrovic D , Sandoval J L , Guessous I , Stringhini S 
Published: October 2020

Abstract

Background
Forgoing healthcare is associated with unfavorable health-related outcomes, a higher risk of hospitalization, and a decreased quality of life. Relatively to its neighboring countries, forgoing healthcare for economic reasons is high in Switzerland, primarily because of the high out of pocket expenditures that characterize the Swiss healthcare system. The purpose of this study was to investigate the determinants of forgoing healthcare, and to examine the long term health-related consequences of unmet medical needs.

Methods
We used data from “Bus Santé”, a cross-sectional study conducted in the city of Geneva (CH). Socioeconomic factors were self-reported by participants at baseline (N = 5032, 2007-2011), including income, education, receiving subsidies, and insurance deductibles (mandatory out of pocket expenditures). Forgoing healthcare for economic reasons was self-reported by study participants, including details about the frequency and the type of forgone care. Prospectively, a subset of participants came for a follow-up visit (2014-2015) in order to assess objective (glycemia, blood pressure, plasma lipids) and subjective health-outcomes (self-reported physical and mental health) resulting from forgone healthcare at baseline.

Results
At baseline, adverse socioeconomic circumstances (lower income, education, receiving subsidies, and high deductibles) were associated with a higher risk of forgoing healthcare (OR range 1.51-5.49, p &lt; 0.015). Four years later, participants who reported forgoing healthcare at baseline were at a higher risk of having lower HDL-cholesterol (β=-0.08 [-0.14;-0.03]), and adverse physical and mental self-reported health outcomes when compared to controls (p &lt; 0.017).

Conclusions
Forgoing healthcare is driven by adverse socioeconomic circumstances, subsequently leading to adverse lipid profiles and poor self-reported health outcomes. Unmet medical needs may constitute a pathway through which socioeconomic status affects health.

Key messages
Adverse socioeconomic circumstances lead to unmet medical needs, even in wealthy countries. Unmet medical needs lead to poor objective and subjective health-related outcomes.
Associations of education and income with alcohol use among Japanese pregnant women
Authors: Murakami K , Obara T , Ishikuro M , Ueno F , Noda A , Kuriyama S 
Published: October 2020

Abstract

Background
Alcohol use during pregnancy can lead to adverse health consequences for the fetus. Identification of pregnant women who are most likely to drink is essential for targeting interventions. However, evidence on associations of education and income with alcohol use during pregnancy is inconsistent.

Methods
We analyzed data from 11484 pregnant women who agreed to participate in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study in Japan from 2013 to 2017. Women were dichotomized as current drinker and non-drinker (past drinker, never drinker, constitutionally never drinker) during early pregnancy and during middle pregnancy, respectively. Multivariate logistic regression analyses were conducted to examine whether educational attainment or equivalent household income was associated with alcohol use, after adjusting for women's age, work status, smoking, income/education, and their partners' education.

Results
Prevalence of alcohol use during early and middle pregnancy was 21.1% and 6.5%, respectively. Higher education and higher income were significantly associated with an increased risk of alcohol use during early pregnancy; the odds ratio (OR) of ≥university education compared with ≤high school education was 1.54 (95% confidence interval [CI], 1.35-1.76), and the OR of ≥ 4 million compared with &lt;2 million Japanese yen was 1.39 (95% CI, 1.20-1.61). Education and income were not associated with alcohol use during middle pregnancy; the corresponding ORs were 1.08 (95% CI, 0.87-1.35) and 1.03 (95% CI, 0.82-1.29), respectively.

Conclusions
Associations of education and income with alcohol use were observed during early pregnancy, not during middle pregnancy. No amount of alcohol and no time to drink can be considered safe during pregnancy. More public health awareness is needed to prevent alcohol use during early pregnancy.

Key messages
Different strategies for preventing alcohol use are required during early pregnancy and during middle pregnancy. Interventions for alcohol use during early pregnancy should focus on women with higher education and/or higher income.
Personality traits and engagement in activities - predictors of life satisfaction for ageing persons
Authors: Reine I , Čama E 
Published: October 2020

Abstract

Background
The aim of the research was to find out, using primary SHARE (Survey of Health, Aging, and Retirement in Europe) data, how personality traits and involvement in activities predict life satisfaction. Two research questions were raised: (1) Is there a connection between personality traits, engagement in activities and satisfaction with life? (2) How do personality traits and involvement in activities predict life satisfaction? In total, 1479 respondents (36.8% (545) men, 63.2% (934) women) were selected from the Latvian sample, over 50 years old (M = 66,58, SD = 11,21), with permanent residence in the territory of Latvia. The results of the study showed that life satisfaction is predicted by personality traits such as neuroticism, conscientiousness, openness and agreeableness. On the other hand, the types of activities offered predict the impact on life satisfaction by engaging in volunteer/charity work.

Conclusions
there is a relationship between personality traits, engagement in activities and satisfaction with life. Personality traits such as neuroticism, conscientiousness, openness, and agreeableness can predict life satisfaction. Practical application of

Results
knowing the personality traits and engagement in activities, as predictive factors for life satisfaction for Latvians over 50 years, will probably indicate which personality traits and some of the offered activities will be taken by those who have not reached 50 years of age. The study was performed within the project/agreement No. 1.1.1.2/VIAA/3/19/540 'Challenges of ageing in the Baltic Sea region'.

Key messages
Personality traits and engagement in activities may predictit life satisfaction in older people. Volunteer work is one of the best predictors of satisfaction with life among older people.
Tobacco content in video on demand services in low- and middle-income countries
Authors: Fitzpatrick I , Byrne D , Cranwell J , Gilmore A 
Published: October 2020

Abstract

Background
There is clear evidence that exposure to tobacco is linked to smoking uptake. The economic and social burden of diseases associated with smoking is particularly high in low-and middle-income countries, where smoking uptake is high and exposure to tobacco use and branded content is widespread. Streamed content exhibits consistently higher levels of tobacco content than broadcast media and these levels have increased. The prevalence of smoking and tobacco content in video-on-demand (VOD) services is troubling given their popularity with youth audiences and the ease with which content can be accessed by children. This is because barriers to youth consumption that exist for film or broadcast media, including content gatekeepers, are absent.

Methods
The most popular VOD series from 10 low- and middle-income countries (Bangladesh, Brazil, China, India, Indonesia, Mexico, Pakistan, Philippines, Ukraine and Vietnam) were identified based on demand expressions and coded for individual depictions of tobacco. 18 series were analysed, representing a mix of international content in several languages. 111 episodes, totalling 81.4 hours of coded content, were analysed for tobacco depictions and characterisation of smoking characters.

Results
Tobacco content was prevalent and particularly prominent in non-English language series, where readily identifiable “stars” frequently partook in smoking. Cigarettes dominated tobacco imagery, with other forms (pipes and electronic nicotine delivery systems) rarely appearing. Notably, there were several incidents featuring well-known brands. Given that access to VOD services is difficult to moderate, youth audiences can easily access programming featuring high levels of tobacco use by identifiable characters, played by well-known actors. A lack of control regarding consumption of streamed content means that it is extremely important for content producers like Netflix and Amazon to ensure VOD content is suitable for youth audiences.

Key messages
Tobacco content in video-on demand services is increasing. Tobacco exposure is linked to smoking uptake.
Older men from global settings more vulnerable to clinical changes associated with food insecurity
Authors: Pirkle C , Peltzer N , Câmara S , Gomes J , Ylli A 
Published: October 2020

Abstract

Background
Studies of the food security status of older adults are rare outside of the United States, especially in low- and middle-income settings. Food insecurity may contribute to disease and disability. Using a diverse sample of older adults, we examine the association of food insecurity with clinical and self-reported measures that are related to disease and impairment.

Methods
Cross sectional analysis of 1482 older adults from Kingston and St. Hyacinthe (Canada), Tirana (Albania), Manizales (Colombia), and Natal (Brazil). Outcome measures were Body Mass Index (BMI), waist circumference, and self-reported unintentional weight loss. Food insecurity was assessed with the 9-item Latin American and Caribbean Household Food Security Scale. Covariates were age, sex, study site, and education. Statistical analyses included Student's T-test, Chi-square test, and linear regression.

Results
83% of participants were food secure; 12% experienced mild food insecurity and 5%, moderate/severe food insecurity. Among men, BMI and waist circumference varied significantly by food security status (p &lt; 0.05). Mean BMI among men with moderate/severe food insecurity was 25.5 compared to 27.0 for mild and 27.5 for no food insecurity. The pattern for waist circumference was similar (93.9cm for moderate/severe, 96.7cm for mild, and 98.9cm for no food insecurity). More food insecure men reported unintentional weight loss (13%) than food secure men (10%). This pattern was not observed among women. Statistical adjustment for study site, education, and age did not change the findings.

Conclusions
Significant differences in clinical indicators of disease were observed by food security status in men. At the extreme, low BMI and waist circumference are linked to increased risk of malnutrition, compromised immune function, and respiratory and digestive diseases. Differences in these measures by food security status emphasize the need for gender and age specific food security interventions.

Key messages
Food insecure men experience clinical indicators of disease significantly more than food insecure women. Successful food security interventions may require sex specific focus across global settings. Little research has been done on food insecurity in elderly outside of North America and study findings contribute to significant gap in sex specific research in this population across global settings.