bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of outdoor air pollution on respiratory deseases in the District of Tunis
Authors: Lahchaichi A , Bellali H , Harizi C , Ben Alaya Bouafif N , Talmoudi K , Chahed M K 
Published: November 2019

Abstract

Background
Asthma and Chronic Obstructive Pulmonary Disease (COPD) are the two most common chronic obstructive pulmonary diseases worldwide. The objective of this study was to analyze the relation between the daily levels of air pollution indicators and the number of emergency department visits (EDV) for asthma and COPD exacerbation in the District of Tunis.

Methods
We conducted a retrospective ecological study. We collected daily morbidity data from the emergency register of Ariana Mami Hospital from 1 January 2007 to 31 December 2014. We investigated the association between daily EDV for asthma or COPD exacerbation and daily concentrations levels of air pollutants by simple Pearson correlation and by binomial negative regression using generalized linear models (GLM).

Results
For morbidity data, we recorded 19127 EDV for asthma (10771, 56.3%) and COPD exacerbation (8356, 43.7%) between 2007 and 2014. We observed a rising trend in the number of EDV for COPD since 2007 with winter seasonality. Regarding the profile of air pollution in the study region, we have exceeded the thresholds of all standards for PM10, exceeding the Canadian standard for O3. However, no threshold exceeded for NO2 and SO2. In the univariate analysis, there was a positive correlation between the daily number of EDV for asthma and COPD exacerbation and NO2 ambient concentration (r = 0.121, p &lt; 10-3) and O3 level (r = 0.066, P &lt; 10-3). Multivariate analysis showed a significant positive association between the daily number of EDV for asthma and COPD exacerbation and NO2 daily concentration (Adjusted OR = 1.033, CI = [1.011 - 1.055], P &lt; 10-3) with a delayed effect of 10 days for NO2 and 12 days for O3.

Conclusions
The exacerbation of asthma and COPD was correlated to the NO2 outdoor air concentration level, with an immediate and other delayed effect of 10 days, also with the 12-day lag from the elevation of O3.

Key messages
Ambient air pollution is a major risk factor for respiratory health. Reducing NO2 emissions could decrease morbidity and direct health care costs of respiratory diseases.
Do we practice what we preach? Assessing the food environment in Malta’s only state hospital
Authors: Cuschieri S , Cauchi D 
Published: November 2019

Abstract

Introduction
Food environments are likely to be key contributors to the development of diabetes and obesity. Hospitals should strive to create a model food environment that facilitates and promotes a healthy eating behaviour among visitors, patients and staff. The study objective was to evaluate foods and beverages available for purchase in vending machines at Malta’s only state hospital.

Methods
An observational study gathered data regarding location, type of food and beverage items available in the vending machines found within the public areas within the only state hospital in Malta. All items on sale were categorized into ’healthy’ and ’unhealthy’ food and beverage according to pre-defined criteria.

Results
There were 33 vending machines: sixteen offered beverage options, and the remainder contained food items, which displayed exclusively confectionary items. The beverage machines were identically stocked so that bottled water contributed 17%, diet soft drinks 33% and regular soft drinks 50% of overall beverage choices. Fresh vegetables or fruit were not available for sale (except for 1 beverage machine offering fresh squeezed orange juice) with most items on display classified as ‘unhealthy’.

Conclusions
Hospital food environments should complement health professionals’ efforts in promoting healthier lifestyles, however, the majority of foods and beverages available for purchase at Malta’s only state hospital through vending machines is unhealthy. Urgent action is required to rectify the current situation.

Key messages
Vending machines offered ’unhealthy’ choices to patients, relatives and staff. Hospital food environment should promote healthier food and beverage options.
Situations in which mothers experience difficulty stimulating healthy EBRB in school-aged children
Authors: Ruiter E L M , Fransen G A J , Molleman G R M , Hoeijmakers M J H M , van der Velden K , Engels R C M E 
Published: November 2019

Abstract

Background
Parental support is an important element in overweight prevention programs for children. The purpose of this study was to examine everyday life situations in which mothers encounter difficulties encouraging healthy energy balance-related behavior in their school-age children.

Methods
We formed four focus groups containing 6-9 participants each. The participants were mothers of Dutch, Turkish, or Moroccan descent with a child 8-13 years of age. All focus group sessions were recorded, transcribed, and coded. Content was analyzed conventionally using ATLAS.ti 6.

Results
Twenty-seven difficult everyday life situations were identified in 14 settings. The five most frequently reported situations were a daily struggle regarding eating vegetables, eating breakfast on time before going to school, eating candy and snacks between meals, and spending excessive time watching television and using the computer. A perceived loss of parental control, the inability to establish rules and the failure to consistently enforce those rules were the most commonly cited reasons for why the mothers experience these situations as being difficult.

Conclusions
We identified five difficult everyday life situations related to healthy energy balance-related behavior. These five difficult situations were used as the input for developing a web-based parenting program designed to prevent children from becoming overweight. We reasoned that if we use these situations and the underlying reasons, many parents would recognize these situations and are willing to learn how to deal with them and complete the e-learning.

Key messages
The identified everyday-life-situations in which mothers experience difficulty stimulating healthy EBRBs in their children age 8-13 were used as input for our e-learning program to prevent overweight. Mothers who live in low-SES neighborhoods were easily willing to participate in focus groups and discuss EBRB-related topics.
Visual information on labels in commercial baby foods on Bulgarian market
Authors: Rangelova L , Partzova A 
Published: November 2019

Abstract

Background
Production and sale of commercial baby foods in Bulgaria has grown in the last years. The evidence suggests that inappropriate promotion and advertising of commercial complementary foods can affect unfavourably child nutrition. The World Health Assembly has urged all Member States to “end inappropriate promotion of foods for infants and young children”.

Methods
The survey is part of WHO Regional Office for Europe project: Commercial foods for infants and young children in the WHO European Region. The data was collected in November 2017 in two districts in Sofia, Bulgaria using the mobile questionnaire, developed by WHO. The presence on various types of visual information on the package was recorded for 771 products on the market.

Results
The results reviled that 94.4% of the labels of baby foods on the market in the capital of Bulgaria - Sofia, use the pictures of ingredients and 52.9% - the cartoon images. The use of images of infants and young children presented in 8.7 % of the products and 6.9% of them marketed as suitable for babies under six months old, in violation of the International Code of Marketing of Breastmilk Substitutes. 0.4 % of baby foods use images of mothers in the labels. The “other” visual information related to various claims including “quality”, “bio” (i.e. organic) and various other nutrition and health claims.

Conclusions
There is inappropriate promotion of commercial complementary foods on Bulgarian market.

Key messages
Special measures, including legislative to limit inappropriate practices for the advertising of foods for infants and young children, are needed. Raising the parents’ awareness of the criteria for selecting commercial complementary foods is necessary.
Food “from the Outside” and Correct Nutrition for Outpatients
Authors: Tur-Sinai A , Bisharat B , Zelber-Gagi S 
Published: November 2019

Abstract

Background
It is a common custom to visit patients in hospital. Visitors often bring along outside food products, including some that may not be recommended for the patient. Even so, neither the Ministry of Health nor the hospitals have explicit guidelines in place as to what people can and cannot bring their inpatient friends or kin. The study deals with three main questions: What are the patterns of spending on outside food products for inpatients? What are the types of food products brought for inpatients? How medical professionals view the matter?

Methods
This quantitative study uses three closed-structured-questionnaire surveys-among visitors, inpatients, and medical staff. Thematic analysis of the findings yields patterns of spending on outside food products for inpatients, the types of food products brought, awareness of the health implications of consuming these products, patterns of consumption among inpatients, and how medical professionals view the matter.

Results
There are five major findings: (a) Most expenditure on outside food for inpatients occurs in the first few days of hospitalization. (b) Most food brought to inpatients is not defined as healthy. (c) There is a gap between visitors’ awareness of the health implications of bringing food to inpatients and their actual conduct. (d) Most patients realize that the food brought to them is bad for their health but tend to eat it anyway. (e) Medical staff disapproves of bringing food to inpatients.

Conclusions
Information on the extent of bringing food to inpatients, and the types and nature of what is brought, sheds light on the question of food security among inpatients, with emphasis on the motive behind the (in)correct nutrition. Information about the attitudes of patients, visitors, and medical staff toward the need to continue bringing food sheds light on questions of equality and social justice in inpatient care.

Key messages
Healthcare services should be more aware of assuring inpatients’ right to correct nutrition in the senses of reducing inpatients’ exposure to externalities that may impede their convalescence. Healthcare services should be more mindful of the advantages of using the egalitarian nutrition system that hospitals operate for all patients.
Effect of lifestyle on blood pressure in Portuguese population under antihypertensive drugs
Authors: Salvador M R , Gonçalves S C , Romana G Q , Nunes B , Kislaya I , Dias C M , Rodrigues A P 
Published: November 2019

Abstract

Background
Hypertension is one of the main risk factors for disability and death from cardiovascular diseases. Current guidelines include initiatives to control blood pressure values in hypertensive patients that focus on lifestyle changes. The main objective of this study was to estimate the association between lifestyle and blood pressure in patients under antihypertensive drugs.

Methods
An analysis of the data of Portuguese Health Examination Survey (INSEF) was performed. Individuals who met INSEF inclusion criteria and who referred to be under antihypertensive drugs in the two weeks prior to the questionnaire were studied. Lifestyle variables (alcohol consumption, smoking, additional salt intake, fruit and vegetables consumption, practice of physical activity) were measured by questionnaire, and blood pressure values were obtained by physical examination. Associations between lifestyle factors and blood pressure, stratified by sex and adjusted to sociodemographic variables and to obesity, were estimated through a multiple linear regression model.

Results
Alcohol consumption (ß=6.31, p = 0.007) and smoking (ß=4.72, p = 0.018) were associated with systolic blood pressure in men. Additional salt intake, fruit and vegetable consumption, and practice of physical activity were not associated with blood pressure in men. In women, no association was observed for any behavioural variable.

Conclusions
These conclusions reinforce the need, also in the population under antihypertensive drugs, particularly in the male sex, to focus the fight against high systolic blood pressure in these two modifiable and preventable behaviours: smoking and alcoholic consumption.

Key messages
Alcohol consumption and smoking are the behavioral determinants associated with high systolic blood pressure values in men under antihypertensive drugs. These conclusions reinforce the need to focus the fight against high systolic blood pressure in the preventable and modifiable behavioural determinants.
Drinking water quality: results from the data analysis in Lombardy region
Authors: Rivolta S , Diurno G , Ammoni E , Castaldi S , Gramegna M 
Published: November 2019

Abstract

Background
Ensuring access to safe and quality drinking water is an essential aspect of public health, as well as a fundamental human right as an extension of the right to life affirmed by the Universal Declaration of Human Rights. Previously in Lombardy, the reporting of water sampling control activities was prepared only by the local health authorities (LHAs). Recently, however, the activation of a data centralization information system allows the monitoring of the whole regional territory and the elaboration of a periodic report.

Methods
The data relating to the analytical checks on drinking water in the Lombardy Region were extracted from the regional database for 2014, 2015 and 2016 and grouped by ’Chemical’, ’Microbiological’ and ’Indicators’ parameters.
The analysis focused on the number and analytical compliance of all the samples performed. All the results considered both the overall regional data and each LHA.

Results
From a quantitative point of view, the activity of entering the sampling data seems to progressively improve, remaining rather heterogeneous among the various LHAs.
From a qualitative point of view drinking water in Lombardy is to be considered good overall: both the chemical and microbiological non-compliant samples in Lombardy are lower than 10% for the years 2014 and 2015 and lower than 5% in 2016 thus indicating an apparently improving trend.

Conclusions
For a better evaluation of the numerical appropriateness of the controls carried out, an update of the registry system of the supply areas and a more uniform LHA programming is necessary.
For a better assessment of the quality of water destined for human consumption oriented to the conformity of parameters, it is necessary to adopt an analytical judgment system on individual parameters instead of on the entire sample. A further improvement will be the inclusion in the database of the data of the aqueduct managers included in the Water Safety Plans (WSPs).

Key messages
Water quality assessment and its control activity reporting is an essential aspect in public health prevention. It is essential to strive for continuous improvement in the data collection method to better monitor potential risks and to evaluate the best future safe water supply strategies.
Knowledge and Attitude towards the Gradual Reduction of Salt in Bread – an Online Survey
Authors: Costa A , Costa L , Santos J , Braz P , Santos M , Brazão R , Lopes I , Guerreiro A , Alves J , Caldas de Almeida T 
Published: November 2019

Abstract

Background
Bread is one of the main sources of salt intake in Portugal. Based on this evidence, a protocol signed between national Health Sector and the Associations of Industrial Bakeries, in 2017, established gradually decrease salt in bread until 2021. This measure also targets schools’ available bread, this should not exceed 1g salt, to end of 2018. A pilot Health Impact Assessment (HIA) aims to assess the potential impact on salt reduction in bread on the eating habits of children (6-18 years) and their families.

Methods
A questionnaire is being performed to assess the effect of this measure. The first version was designed by a panel of 11 experts (content validity), following the plain text principles. A external specialist revised it for facial validity. A pilot was tested. Thereafter, a REDCap online survey of “Knowledge and Attitude towards the Gradual Reduction of Salt in Bread” questionnaire was finalized. The target group is the parents or guardians of children and young persons, of School Clusters in the south of Portugal.

Results
Final online survey totalizes 33 items, divided into four blocks: 1.Knowledge and General literacy data, 2.Domestic Consumption, 3.Scholar consumption and 4.Sociodemographic. An adult responsible for the child/young person should answer the survey. Access is possible through a REDCap link, using computers available in the School Cluster, or other manner suitable for the purpose.

Conclusions
This survey will contribute to the identification of modifiable behaviors related with salt intake. Such evidence may eventually provide the opportunity for new strategies in this area.

Key messages
Health Impact Assessment as a procedure to assess the effects of measures and policies on human health. Questionnaires are a rapid tool to access perceptions, attitudes and knowledge.
The psychometric properties of a short version of the General Self-Efficacy Scale: A Rasch analysis
Authors: Steigen A M S , Finbråten H S F , Kleppang A L K 
Published: November 2019

Abstract

Background
Self-efficacy is important in adolescence and is found to affect adolescents’ physical activity, risk-taking behaviour and health decisions. Self-efficacy describes a person’s belief in own coping abilities. Having good measures of self-efficacy may contribute to more valid knowledge about the potential role of self-efficacy as a health promoting factor in adolescents lives. Several scales measuring self-efficacy exists. One of these is the General Self-Efficacy Scale comprising 10-items. However, there exists several short versions of the scale. In a large cross-sectional study among adolescents in secondary schools in Norway, five of the items from the General Self-Efficacy Scale are used. The aim of this study is to examine the psychometric properties of this short version of the General Self-Efficacy Scale applying Rasch measurement theory.

Methods
This study is based on cross-sectional data from the Youth Data Survey. The data collection was carried out in lower and upper secondary schools in Norway during 2018. In total, 6646 adolescents responded to a web-based questionnaire. The data were analysed using the partial credit parameterization of the unidimensional Rasch model.

Results
Preliminary results indicated that the short version had acceptable reliability (person separation index: 0.78). However, the targeting could have been better (mean person location: 1.441). All items had ordered thresholds. One under-discriminating item and three over-discriminating items were identified. Three items displayed differential item functioning with regard to gender and one item displayed differential item functioning for school level.

Conclusions
Based on our preliminary findings this short version of the General Self-Efficacy Scale has the potential to measure self-efficacy among adolescents, but there are room for improvements. The scale has some shortcomings related to targeting and differential item functioning that needs to be further explored.

Key messages
The short version of the General Self-Efficacy Scale has the potential to measure self-efficacy in adolescents. The scale has some shortcomings that needs to be further judged.
Unexpected effect of smoking/drinking cessation among computed tomography lung screening consumers
Authors: Chen C-C , Wu W-C , Chan D-C 
Published: November 2019

Abstract

Background
Low-dose computed tomography (LDCT) screening is an innovated tool for lung cancer prevention. The findings of LDCT trials indicated that the screening could increase the motivation of smoking cessation for high-risk groups. However, none studies have investigated the associations between commercial LDCT lung screening and unhealthy behaviours among those customers.

Methods
We established a prospective observational study at a community hospital in Taiwan. In total, 1326 customers of the commercial LDCT lung screening without lung cancer history were recruited. At the day of screening, interviewers collected their baseline demographic information and smoking/drinking habits. Only 605 participants completed two follow-up surveys at the 3rd and 12th month. Screening findings were defined as ’normal’ if there were no nodules or only definitely benign nodules and as ’abnormal’ if any lung nodule or ground-glass opacity were found. We applied the generalised linear mixed model to estimate the effects of time and screening findings on daily smoking and weekly drinking.

Results
The rates of daily smoking (weekly drinking) decreased from 13.1% (15.5%), to 10.9% (12.9%) in the 3rd month, and 7.9% (12.4%) in the 12th month. The associations between abnormal screening findings and smoking (-0.25, 95% CI: -0.77,0.28) or drinking (0.13, 95% CI: -0.29, 0.56) cessation are not significant. The time effect on smoking cessation was persistent (-0.23 and -0.62 at the two periods, 95% CI: -0.39, -0.07 and -0.85. -.038), and the effect on stopping drinking was relatively small (-0.23 and -0.28 at the two periods, 95% CI: -0.43, -0.04 and -0.52, -0.04).
Conclusions Commercial LDCT screening would decrease the rates of smoking more than drinking among these consumers, and the abnormal finding was not further associated with cessations. It implies that commercial screenings may be beneficial for decreasing unhealthy behaviours as a teachable occasion.

Key messages
Commercial LDCT lung screening program may have benefits for decreasing smoking and even drinking behaviours among the non-specific high-risk population. It might be a good moment for health providers and practitioners to conduct cancer-related health education during commercial screening programs.