bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of different wastewater treatment plants in antibiotic resistance spreading
Authors: Bonetta S , Pignata C , Bonetta S a , Gasparro E , Lorenzi E , De Ceglia M , Gilli G , Carraro E 
Published: October 2020

Abstract
The global action plan on antimicrobial resistance reports the necessity to develop standards and guidance for the presence of antimicrobial agents in the environment, especially in wastewater, highlighting its possible role in the antibiotic resistance spreading. In addition, the New European One Health Action Plan against Antimicrobial Resistance underlines the need to support research into knowledge gaps on the release of resistant microorganisms into the environment and their dissemination. The aim of this study was to evaluate the presence of Antibiotic Resistance Bacteria (ARB) and Antibiotic Resistance Genes (ARG) in wastewater treatment plants (WWTPs). At this scope, untreated sewage and treated effluents of three different WWTPs (A, B and C) were sampled for one year. Sample dilutions were plated on R2Agar added/not-added with 4 different antibiotics (ampicillin 32mg/L; tetracycline 16 mg/L; chloramphenicol 32 mg/L; sulfamethoxazole 50,4 mg/L) to evaluate the percentage of antibiotic resistant bacteria and their WWTPs removal rate (%). DNA extraction on the filter used to concentrate the wastewater samples was performed to reveal the ARG presence; subsequently specific PCRs for ARG (blaTEM, tetA, sul II, sul III) were carried out. ARB were detected in all samples analysed. The highest antibiotic resistance percentage was revealed in the sewage (mean 21,7%±4,8) and effluent (mean 21,1%±3,0) of the three wastewater treatment plants for sulfamethoxazole. Moreover, sul II was the most present gene in the samples (81% of all samples, 89 % of sewages and 72% of effluents). The lower WWTPs removal was recovered in the plant B for the tetracycline (95, 7%). The results obtained underlines the need to monitor WWTP as critical hot spot for the antibiotic resistance spreading also considering the One Health approach. Furthermore, the results obtained could suggest interventions to reduce the spread of the antibiotic resistance in the integrated urban water cycle.

Key messages
The information obtained could provide usefulness information about the role of wastewater treatment plant in the antibiotic resistance spreading. The results could contribute to suggest the interventions targeted to reduce the antibiotic resistance phenomenon in the integrated urban water cycle.
E-cigarettes from the perspective of teenagers – results of focus studies
Authors: Pluta K , Balwicki Ł 
Published: October 2020

Abstract
Research shows that over 80% of smokers start their habit under the age of 18. A few years ago young people undertook risky behaviors related to nicotine initiation mainly by smoking cigarettes. Today, next to traditional tobacco products, electronic cigarettes are becoming more and more popular. Due to the prevalence of new forms of nicotine addiction, modification of anti-tobacco prevention programs is required. The purpose of the research was exploration - learning the opinions and attitudes of young people towards e-cigarettes.
The qualitative study was conducted using the FGI method (focus group interview). The meetings were modereted by specially trained psychologists. 48 students participated in the meetings of six focus groups, divided by gender and smoking status (smokers/non-smokers). The participants are young people aged 15-19, attending high schools in Warsaw, Kielce and Lublin. In conversations, young people emphasized the impact of e-cigarettes in smoking initiation - it usually occurs at the age of 12-14. E-cigarettes are perceived as cigarettes “for younger”, non-addictive, less serious, providing more entertainment. 'Cloud chasing' is particularly popular. They perform social functions - they are helpful in establishing relationships. Teenagers do not see the harmfulness of e-cigarettes.
Participants mentioned their advantages over traditional tobacco products - they can be smoked everywhere and do not leave an unpleasant smell. Some of the respondents admit to the simultaneous use of electronic and traditional cigarettes. Moreover, many parents allow children to smoke electronic cigarettes.
Vaping have become a natural way to relaxation and socialization for adolescents. E-cigarettes do not have such a negative connotation as traditional tobacco products. Young people do not see them as harmful, which is a challenge for effective preventive measures.

Key messages
Adolescents do not see e-cigarettes as harmful, which is a challenge for effective preventive measures. Vaping have become more and more popular - it's natural way to relaxation and socialization for young people.
Children with deficit in executive abilities have risk for emerging weakness in grammar understanding
Authors: Kiselev S 
Published: October 2020

Abstract

Background
Children with specific language impairment have difficulties producing and understanding language (Bishop, 1997). Specifically, these children have deficit in grammar understanding. The goal of this research was to examine the hypothesis that children at the age of 5-6 with deficit in executive abilities have a risk for emerging weakness in grammar understanding at the age of 8-9.

Methods
136 children at the age of 5-6 were assessed using 5 subtests from NEPSY (Tower, Auditory Attention and Response Set, Visual Attention, Statue, Design Fluency), which are designed to assess executive abilities in children. We have revealed 27 children with deficit in executive abilities. These children were included in the experimental group. The control group included 27 children with no deficit in executive abilities. In the framework of longitudinal research children at the age of 8-9 from both groups were assessed by Grammar Understanding Test from Luria's neuropsychological assessment technique.

Results
One-way ANOVA has revealed significant differences (p&lt;.05) between groups for scores in Grammar Understanding Test. Children from experimental group had low level of grammar understanding.

Conclusions
This research has shown that deficit in executive abilities can predict the delay in development of grammar understanding in children. These results provided insight into cognitive mechanisms in typically developing and the underlying nature of specific language impairments, helping to elucidate the nature of impaired mechanism in this disorder. It can be assumed that deficit in executive abilities is one of the risk factors for emerging weakness in grammar understanding in children.

Key messages
Deficit in executive abilities is one of the risk factors for emerging weakness in grammar understanding in children. There is relationship between grammar understanding and executive abilities in children.
Cost-effectiveness of an indicated preventive intervention for depression in adolescents
Authors: Ssegonja R , Sampaio F , Alaie I , Philipson A , Hagberg L , Murray K , Sarkadi A , Langenskiöld S , Jonsson U , Feldman I 
Published: October 2020

Abstract

Background
Adolescent depression has negative health and economic outcomes in the short- and long-term. Indicated preventive interventions, in particular group based cognitive behavioural therapy (GB-CBT), are effective in preventing depression in adolescents with subsyndromal depression. However, little is known about the cost-effectiveness of these interventions.

Methods
A Markov cohort model was used to conduct cost-effectiveness analyses comparing a GB-CBT indicated preventive intervention for depression, to a no-intervention option. Taking a time horizon of 5- and 10 years, incremental differences in societal costs and health benefits expressed as cases of depression prevented, and as quality adjusted life years (QALYs) gained were estimated. Through univariate and probabilistic sensitivity analyses, the robustness of the results was explored. Costs, presented in 2018 USD, and effects were discounted at a yearly rate of 3%.

Results
The base-case analysis showed that GB-CBT indicated preventive intervention incurred lower costs, prevented more cases of depression and generated higher QALYs compared to the no-intervention option for both time horizons. Offering the intervention was even a cost saving strategy and demonstrated a probability of being cost-effective of over 95%. In the sensitivity analyses, these results were robust to the modelling assumptions. Limitations: The study considered a homogeneous cohort and assumed a constant annual decay rate of the relative treatment effect.

Conclusions
GB-CBT indicated preventive interventions for depression in adolescence can generate good value for money compared to leaving adolescents with subsyndromal depression untreated.

Key messages
Indicated preventive interventions for depression are cost-saving and can generate substantial health benefits. Indicated preventive interventions can be adopted as cost-effective preventive strategies for depression.
Factors associated with depressive episode among first year University students in Serbia
Authors: Čanković S , Čanković D , Radić I , Rakić D , Ukropina S , Nićiforović Šurković O , Tomašević T , Tamaš T , Mijatović Jovanović V 
Published: October 2020

Abstract

Background
Some findings indicate that university students are at higher risk of depression despite being a socially advantaged population, showing that 15 to 25% of them develop some type of mental disorder during graduation, and depression is one of the most prevalent. The aim of this study was to investigate the prevalence of depressive symptoms and its association with gender, material status, social health, and behavioral factors among university students.

Methods
The research represents a cross-sectional study conducted at the University of Novi Sad, Serbia. The research involved 455 first-year students. The average age of participants was 19.3 years (72.1% girls and 27.9% boys). Patient Health Questionnaire (PHQ-9) was used to measure depressive symptoms (cut point for depressive episode ≥10). Additional questions were focused on self-assessed material status, social health, and behavioral factors (smoking and alcohol use). The binary logistic regression model was used to estimate the association between depression and observed independent variables.

Results
The prevalence of moderate to severe depressive episode among students was 18.0%, with no gender differences. Out of the total, 11.0% of students had suicidal thoughts or thoughts of hurting themselves. Multivariable logistic regression showed that self-assessed poor material status (OR = 2.04; 95%CI: 1.06-3.89), self-assessed poor social health (OR = 8.9; 95%CI:4.87-16.42) and smoking (OR = 2.18; 95%CI: 1.09-4.39) were significant predictors of depression among first-year university students.

Conclusions
High prevalence of depressive episode among university students call for the action for the promotion of mental health, particularly among those of lower socioeconomic status, and points out the importance of social health and social network in the prevention of mental disorders.

Key messages
Students on the first year of University should be screened for depressive symptoms. It is important to educate students on how to create a strong support network and to implement intervention programs for improving mental health through fostering healthy lifestyles change.
Public Health Tracking to address the complexity of environmental health: The case of France
Authors: Medina S , Le Tertre A , Caserio-Schönemann C , Fouillet A , Leonardi G , Vardoulakis S 
Published: October 2020

Abstract
To address the complex relationship between environment and health, public-health professionals have recognized the benefits of building enduring interdisciplinary partnerships and of developing innovative Environmental and Public Health Tracking (EPHT) systems. In specific, EPHT can increase understanding of environmental health threats; improve comparability of risks between different areas of the world; enable transparency and trust among citizens and institutions; and inform preventive decision making. EPHT does so by sharing data and knowledge; and by identifying and supporting best practices.
In France, the concept of EPHT builds on the observation that our changing environment creates new risks that require both specific surveillance of the link between exposure and health indicators, and syndromic surveillance (SyS) of sentinel health indicators. A specific surveillance of air pollution and health has been informing French policies on air pollution for 23 years. France has also coordinated the European Apheis and Aphekom specific-surveillance projects. Using routine pollution and health data, these projects succeeded by being built on a Europe-wide collaborative network that facilitates decision-making on local and national levels.
In addition, since the 2003 heat wave France has developed syndromic surveillance for detecting the health impacts of new threats as diverse as environmental phenomena and emerging infectious diseases. France also coordinated the Triple-S project, which inventoried SyS activities in Europe; and produced guidelines for human and veterinary SyS in Member States and a proposal for a European SyS strategy. Examples of the complementarity between specific and SyS in environmental health in France include: heat and cold waves, air pollution, flooding, storms and industrial accidents. In today's world of open data, EPHT shows great promise for contributing to better informing decision makers and the population on environmental-health risks.

Key messages
Environmental and Public Health Tracking (EPHT) systems and enduring interdisciplinary partnerships provide an innovative way to address the complex relationship between environment and health. France has been in the forefront of applying innovative EPHT (Environmental and Public Health Tracking) by using complementary specific and syndromic (SyS) surveillance systems.
Stress is affected by a combination of work- and non-work-related stressors and social support
Authors: Larsen F B , Sørensen J B , Willert M V , Lasgaard M 
Published: October 2020

Abstract

Background
Work-related stress has received much attention. However, the relative importance of work- and non-work-related stressors on stress level has received less attention. The present study aims to determine the relative importance of work- and non-work-related stressors and social support on stress level at population level.

Methods
The study used data from the population-based health survey 'How are you?' in 2017 in Central Denmark Region (N = 32,417). Stress level was measured using the Perceived Stress Scale. Stressors were measured in nine domains including work situation and non-work related stressors. Furthermore, perceived social support was assessed. The study used dominance analyses based upon regression models with perceived stress as the dependent variable and stressors and social support as independent variables for describing the variance in stress level. Analyses were adjusted for gender, age, education and ethnic background.

Results
Work-related and non-work related stressors along with social support explained 43% of the variance in stress level. The three most important contributors to the explained variance in stress level were 'disease', 'social support' and 'work situation'. Stratified by labour marked status, stressors and social support explained 38% (in work) and 46% (outside the labour marked) of the variance in stress level. Most important independent variables were 'work situation', 'social support' and 'disease' (in work), and 'disease', 'work situation' and 'financial circumstances' (outside the labour marked).

Conclusions
Stress was affected by work- and non-work-related stressors and social support. At populations-level 'disease' was the most important stressor. However, among respondents in work 'work situation' was the most important stressor, whereas 'disease' was the most important stressor outside the labour marked.

Key messages
Stress level is affected by a combination of work- and non-work-related stressors and social support. As a consequence stress prevention should not focus solely on work-related stressors.
People‘s perceptions of Alzheimer‘s disease in Lithuania
Authors: Jurgilaitė M , Beržanskytė A 
Published: October 2020

Abstract

Background
The achievements in health sector resulted in longer lifespan which makes modern society to face aging problems. Alzheimer disease is one of the most obvious health problems becoming more prevalent in humanity's future. The aim of the study was to evaluate people's perceptions of Alzheimer disease in Lithuania.

Methods
The data were collected by self-administered questionnaire of 27 questions using online social media platform. 737 respondents gave the feedback in limited time of one-week period. Cronbach α of privity was found 0.62. The relative frequencies and prevalence ratios were compared in groups by different sociodemographic categories. Non-parametric tests were conducted to establish statistical significance which was set at p &lt; 0.05. Confidence intervals were used for prevalence statistics.

Results
56.1% of the respondents had insufficient awareness about Alzheimer's disease (95% CI: 52.2; 59.3%). The level of awareness depended on the education and person's occupation in health area. However, 47.1% of health professionals didn't have sufficient awareness. Respondents had problem recognizing Alzheimer's symptoms and risk factors. 51.7% believed that Alzheimer's disease is stigmatized in the society. More women and people with higher education agreed with this statement (p &lt; 0.001). Alzheimer disease was ranked as third most intimidating disease. However just 37.9% knew it was fatal. 85% believed they could take care of the sick family member, but admitted the care should be done jointly by the family and the state (94.6%).

Conclusions
Awareness of Alzheimer disease is insufficient. People themselves have quite good perception of the disease, but think that there is stigma and little disdain in the society. Most of the respondents are ready to nurse their sick family members, however, they expect aid from the government. Nonetheless, respondents would prefer to be admitted to care institution if it would be their case.

Key messages
Age related diseases should become main problem to be solved in the future. One of them is Alzheimer’s disease, therefore the public health measurement should be taken now to prevent it. It is important to know people’s perception of the disease, before taking any preventive actions. It enables to see what areas need intervention and where can Public health measures help.
The ecopsychosocial provision for psychiatric environments
Authors: Chrysikou E 
Published: October 2020

Abstract
Environment affects quality of care. Yet there are very few evaluation methods to address such issues. The SCP model is a user-inclusive, multi-paramentric method for the planning, design and evaluation of psychiatric facilities. Its application to psychiatric wards indicated hiatus between top-down (designers, building commissioning authorities) vs bottom up (patients and staff) understanding of what constitutes a therapeutic environment. That generated the need to investigate the socio-spatial context of psychiatric wards. This research aimed to promote our understanding of psychiatric space in relation to social interaction. Two acute wards in the UK provided the locus. Each was evaluated using the SCP model institutional vs domestic checklist, open-ended interviews with 10 staff and 12 patients and auditing of the spaces. Then, a Space Syntax analysis using depthmap was employed to model social activity inside the wards. The SCP model analysis indicated that the wards, one of them new and purpose built and the other part of an old psychiatric campus soon to be replaced, demonstrated strong institutional features, even compared to previous samples using the same tools. The juxtaposition with space syntax demonstrated that areas mapped as integrated, i.e., socio-friendly, were areas where antisocial behaviours were observed. This could be interpreted by Goffman's theory on total institutions, as institutional spaces might be the context of reverse socio-spatial norms according to Hillier's social logic of space. Thus, institutional spaces could still house mental health provision. Integrated approaches for evaluating healthcare facilities for fit for purpose and social integration need to become part of a healthcare evaluation system. Healthcare provision should be evaluated for ecopsychosocially supportive environments.

Key messages
The project raised the question of the appropriateness of mental healthcare environments. The spaces for the treatment and care of psychiatric patients might not be fit for their social re-integration.
International medical student’s mental health: psychological distress and socio-cultural adaptation
Authors: Hachemi H , Dimitrijević M , Stojanović J , Cvjetković S 
Published: October 2020

Abstract

Background
The greater academic mobility and globalization have introduced a substantial number of foreign students to more universities. The lack of recent studies about their adaptation and signs of psychological distress arose an interest about this relevant issue. Recognizing the factors involved in the adaptation process are vital for international students, especially medical, as they are considered the future health-care workforce. Ensuring their well-being is essential for consumers safety, satisfaction and raising quality at lower costs. Thus, the aim of this research was to explore the predictors of psychological distress including socio-demographic variables and socio-cultural adaptation

Methods
A cross-sectional study was conducted at the University of Belgrade School of Medicine, where 124 (65 males and 59 females) international students from 32 countries were interviewed using a socio-demographic questionnaire and psychometric tools such as Revised Socio-cultural Adaptation Scale (SCAS-R) and Depression, Anxiety, Stress Scale (DASS-21). Statistical analysis included prevalence data and multiple linear regression.

Results
The prevalence of depression, anxiety and stress was found to be 39%, 55% and 41%, respectively. Maladaptation to a new environment by lack of participation in the community and focus on own interests were significant predictors of depression (β = −.39, p&lt; .01) and stress (β = −.36, p&lt; .05), while anxiety was associated with both female gender (β = −.30, p&lt;.05), self-centration and absence of community involvement (β = −.37, p&lt; .01).

Conclusions
There is a high prevalence of anxiety followed by stress and depression among international medical students. The results highlighted the importance of cultural adaptation for psychological distress. This shows a requirement for developing an adequate, accessible professional counselling and peer support services for foreign students that are necessary to achieve sustainable development goals.

Key messages
Encouraging researchers to further investigate the needs of international medical students. The development and implementation of health policies addressing student’s mental health.